Self-reported Non-communicable Diseases Research Articles

Socioeconomic inequalities in noncommunicable diseases in Portugal: an analysis of three decades

Abstract Background Least favored people experience poorer health than those with higher socioeconomic (SE) status. These inequalities are mainly due to disparities in noncommunicable diseases (NCD). Over the last decades, Portugal experienced important SE challenges, including the recession, making it fundamental to assess how health inequalities have been affected. Hence, this study aimed to examine the evolution of SE inequalities in the prevalence of NCD in Portugal in the last 32 years. Methods We used data from all the six National Health Interview Surveys (1987, 1995, 1999, 2005, 2014, and 2019). Considering the main causes of morbimortality and data availability, we selected seven self-reported NCD: diabetes, hypertension, stroke, acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), asthma, and depression. We estimated the relative (RII) and absolute (SII) indexes of inequalities using education and income as proxies for SE status, adjusted for sex and age, for each NCD and survey. Results Regarding education, RII decreased until 2005 but increased since 2005 for diabetes (RII87=4.4; RII05=2.0; RII19=2.6) and hypertension (RII87=1.8; RII05=1.3; RII19=1.8). For asthma, RII oscillated until 2005 but increased since then (RII05=0.9; RII19=1.9). Although data for the remaining diseases are only available since 2005, an upward trend in educational RII is noticeable in stroke (RII05= 2.1; RII19=4.3), AMI (RII05=0.9; RII19=3.4), COPD (RII05=1.4; RII19=2.2), and depression (RII05=0.9; RII19=2.1). The results for SII and using income as SE indicator followed similar trends. Conclusions This study found persisting inequalities in NCD, with an increasing trend after 2005. These findings are of concern since they emphasize the persistence of health inequalities and the vulnerability of the most deprived groups to economic crisis. Health and social policies are crucial to attenuate these inequalities, especially considering the announced financial crisis. Key messages • In Portugal, socioeconomic inequalities in noncommunicable diseases have been increasing since 2005. • It is crucial to tackle inequalities in health, especially considering the predicted economic crisis and the vulnerability of the most deprived groups to such events.

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.

Prevalence of self-reported noncommunicable diseases in grassroot-level health worker of Petlad taluka: A cross-sectional study

ABSTRACT Context: Noncommunicable diseases (NCDs) kill 41 million people each year globally. The financial burden of NCDs, including lifelong and expensive treatment with loss of income, forces many people into poverty. Healthcare workers (HCWs) are an essential group of the workforce in building a healthier society. They must choose a healthy lifestyle to have better health for themselves. Aim: To estimate the prevalence of self-reported NCDs in grassroot-level HCWs of Petlad taluka along with the study of various healthcare and lifestyle practices among them Methods and Material: In this cross-sectional study, grassroot-level HCWs of Petlad taluka of Anand district were given a self-administered questionnaire, which included their demographic details, their current health status, and health practices followed by them Statistical Analysis: The data collected were entered in Microsoft Excel-2019 and analysed by SPSS version 15. Descriptive analysis and univariate analysis were performed. Results: NCDs’ prevalence was 10.2%. Hypertension and diabetes were the commonest. Nearly 50% HCWs have their body mass index in a normal range. The majority of them were aware of healthy diet practices and exercise. Conclusions: Our study reported a lower prevalence of NCDs than other studies (50%). Dietary practices appear to be healthy, but a significant proportion of them are overweight. The majority of them prefer to consult at a government hospital. Healthy behaviour and practices should be encouraged and maintained in HCWs.

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.

Association between non-communicable diseases and physical activity level in older adults visiting primary health care centers in Jizan, Saudi Arabia.

To examine the association between the number of non-communicable diseases (NCDs) and physical activity (PA) in older adults visiting primary healthcare centers (PHCCs) in Jizan, Saudi Arabia. This cross-sectional study was carried out on men and women aged ≥60 who visited PHCCs, Jizan City between June and September 2021. Eleven self-reported NCDs were identified and summed to produce a single score, and PA scores were calculated based on the self-reported PA Scale for the Elderly (PASE). Multiple linear regression models were used to examine the association between the number of NCDs and PA in the included population. In total, 94 participants were included in this study. Of these, 62 were men, and 32 were women. The mean age was 67.29±6.58 years, and the mean PASE score was 53.67±29.72. A significant negative association was found between the number of NCDs and PA, even after a fully adjusted analysis. This study found a significant inverse association between the number of NCDs and PA in older adults. In addition, age was associated with lower PA, even among older adults. PA should be recommended to older adults to prevent or reduce the number of NCDs. Future research should focus on examining cause-and-effect associations at a national level.

Socioeconomic and Medical Vulnerabilities Among Syrian Refugees with Non-communicable Diseases Attending Médecins Sans Frontières Services in Irbid, Jordan

Non-communicable diseases (NCDs) are high-prevalence health problems among Syrian refugees. In 2014, Médecins Sans Frontières (MSF) identified unmet NCD care needs and began providing free-of-charge services for Syrian refugees in Irbid, Jordan. This study aimed to describe current socioeconomic and medical vulnerabilities among MSF Irbid Syrian refugee patients and their households and raise awareness of their ongoing health needs that must be addressed. A cross-sectional survey among Syrian refugees attending MSF NCD services in Irbid Governorate, Jordan was conducted by telephone interviews in January 2021 to query sociodemographic characteristics, economic situation, self-reported NCD prevalence, and Ministry of Health (MoH) policy awareness. Descriptive analysis of indicators included proportions or means presented with 95% confidence intervals. The survey included 350 patient-participants in 350 households and 2157 household members. Mean age was 28.3 years. Only 13.5% of household members had paid or self-employed work; 44% of households had no working members. Mean monthly income was 258.3 JOD (95%CI: 243.5–273.1) per household. Mean expenditures were 320.0 JOD (95%CI: 305.1–334.9). Debt was reported by 93% of households. NCD prevalence among adults was 42% (95%CI: 40–45). Hypertension was most prevalent (31.1%, 95%CI: 28.7–33.7), followed by diabetes (21.8%, 95%CI: 19.7–24.1) and cardiovascular diseases (14.4%, 95%CI: 12.6–16.4). Only 23% of interviewees were aware of subsidized MoH rates for NCD care. Twenty-nine percent stated they will not seek MoH care, mainly due to the unaffordable price. Our findings highlight increased vulnerability among MSF Irbid Syrian refugee NCD patients and their households, including: an older population; a high percentage of unemployment and reliance on cash assistance; higher proportion of households in debt and a high number of households having to resort to extreme coping mechanisms when facing a health emergency; and a higher proportion of people with multiple comorbid NCDs and physical disability. Their awareness of subsidised MoH care was low. MoH care is expected to be unaffordable for many. These people are at increased risk of morbidity and mortality. It is vital that health actors providing care for Syrian refugees take action to reduce their risk, including implementing financial support mechanisms and free healthcare.

The Mediating Role of Healthy Lifestyle Behaviours on the Association between Perceived Stress and Self-Rated Health in People with Non-Communicable Disease.

Perceived stress can affect people’s lifestyle behaviours and self-rated health. A balanced, healthy lifestyle can alleviate experiences of stress. For clinicians to use evidence-based and theory-based knowledge in health dialogues with people with non-communicable diseases, and in order to develop more effective behavioural counselling, more knowledge is needed. Hence, this study aimed to examine the mediating role of sedentary behaviour, daily physical activity, physical exercise, and dietary habits on the association between perceived stress and self-rated health in people with or without one to four self-reported non-communicable diseases (myocardial infarction, stroke, hypertension, diabetes). The study used a cross-sectional design. Responses from in total 10,583 individuals were collected in 2016 and 2019 by a self-report questionnaire. A series of simple and multiple regression analyses were conducted to examine the mediating effects of healthy lifestyle behaviours on the association between perceived stress and self-rated health. The results show that the investigated healthy lifestyle behaviours partly mediated the association between perceived stress and self-rated health in people with no diagnosis, and in people with one or two diagnoses. It can be concluded that healthy lifestyle behaviours could probably be targeted in relation to the number of noncommunicable diseases that the individuals have.

Relationships between non-communicable disease, social isolation and frailty in community dwelling adults in later life: findings from the Hertfordshire Cohort Study

BackgroundSocial relationships play a fundamental role in individuals’ lives and health, and social isolation is prevalent among older people. Chronic non-communicable diseases (NCDs) and frailty are also common in older adults.AimsTo examine the association between number of NCDs and social isolation in a cohort of community-dwelling older adults in the UK, and to consider whether any potential association is mediated by frailty.MethodsNCDs were self-reported by 176 older community-dwelling UK adults via questionnaire. Social isolation was assessed using the six-item Lubben Social Network Scale. Frailty was assessed by the Fried phenotype of physical frailty.ResultsThe median (IQR) age of participants in this study was 83.1 (81.5–85.5) years for men and 83.8 (81.5–85.9) years for women. The proportion of socially isolated individuals was 19% in men and 20% in women. More women (18%) than men (13%) were identified as frail. The number of NCDs was associated with higher odds of being isolated in women (unadjusted odds ratio per additional NCD: 1.65, 95% CI 1.08, 2.52, p = 0.021), but not in men, and the association remained robust to adjustment, even when accounting for frailty (OR 1.85, 95% CI 1.06, 3.22, p = 0.031).DiscussionNumber of self-reported NCDs was associated with higher odds of social isolation in women but not in men, and the association remained after considering frailty status.ConclusionsOur observations may be considered by healthcare professionals caring for community-dwelling older adults with multiple NCDs, where enquiring about social isolation as part of a comprehensive assessment may be important.

Association between contact with a general practitioner and depressive symptoms during the COVID-19 pandemic and lockdown: a large community-based study in Hangzhou, China

ObjectivesTo determine the association of general practitioner (GP) contact with depressive symptoms during the COVID-19 pandemic and lockdown in China.DesignIn April 2020, a follow-up survey was conducted on the basis...

Seasonal and socio-demographic patterns of self-reporting major disease groups in north-west Burkina Faso: an analysis of the Nouna Health and Demographic Surveillance System (HDSS) data

BackgroundSub-Saharan Africa (SSA) is facing a rapid growth of non-communicable diseases (NCDs), while communicable diseases still prevail. For rural SSA, evidence for this development is scarce. We aimed at quantifying self-reported major disease groups according to season, and determining the associations with socio-economic factors in rural Burkina Faso.MethodsThis study used data of 4192 adults (age range: 18–101 years; male: 49.0%) from the Nouna Health and Demographic Surveillance System (HDSS) in north-west Burkina Faso, rainy season of 2010 and dry season of 2011. We assessed the proportions and their 95% confidence intervals (CIs) of self-reported major disease groups as defined by the World Health Organization. For their associations with socio-economic factors, odds ratios (OR), 95% CIs and p-values were calculated by logistic regression.ResultsThe surveys were completed by 3949 adults in 2010 (mean age: 37.5 ± 14.9 years, male: 48.8%) and by 4039 adults in 2011 (mean age: 37.3 ± 16.2 years, male: 49.1%). The proportions of self-reported communicable diseases were 20.7% (95% CI: 19.4–21.9%) in the rainy season and 11.0% (10.0–11.9%; McNemar’s p < 0.0001) in the dry season. Self-reported NCDs amounted to 5.3% (4.6–6.0%) and 4.5% (3.8–5.1%; p = 0.08), respectively. In each year, less than 1% reported injuries (p = 0.57). Few individuals reported an overlap of communicable diseases and NCDs: 1.4% in 2010 and 0.6% in 2011. In the multiple-adjusted models, formal education (vs. lack of education) showed the strongest association with self-reporting of communicable diseases in both seasons. For NCD-reporting, non-manual occupation (vs. manual) was positively associated, only in the rainy season.ConclusionsSelf-reporting of communicable diseases is subject to seasonal variation in this population in north-west Burkina Faso. The exact reasons for the low overall self-reporting of NCDs and injuries, apart from a low socio-demographic position, require further investigation.

Association between non-communicable diseases and satisfaction with healthcare and self-rated health: experiences from post-conflict communities

Introduction/Objective. Estimating the prevalence of non-communicable diseases (NCD), multimorbidities, and their association with self-rated health as well as satisfaction with healthcare. Methods. This cross-sectional study was conducted among ethnic Serb communities at Kosovo and Metohija during 2015?2016. Data of socio-demographic and lifestyle characteristics, self-rated health status and satisfaction with healthcare was obtained through a survey which included 1067 adults, 535 of whom reported presence of NCD. Multinomial regression was performed to analysis factors associated with self-rated health and self-rated satisfaction with the healthcare. Results. Presence of one NCD was reported by 50.1% respondents, whereas 23.1% of the respondents reported multimorbidity. While self-reported NCD presence was negatively associated with self-rated health (p = 0.001?0.016), no association between NCDs and satisfaction with healthcare was observed (p = 0.178?0.974). Being single (p = 0.011?0.017), lower educational level (p = 0.031?0.047), regular breakfast (p = 0.032), frequent vegetable intake (p = 0.009?0.029), no alcohol use (p = 0.010), shorter waiting time (p = 0.001?0.004) and sufficient finance for dental care (p = 0.021) were factors statistically significantly correlated with greater satisfaction with the healthcare. Conclusion. Presence of NCD was negatively associated with self-rated health status, while shorter waiting time and adequate finances were associated with higher level of satisfaction with the healthcare. The results of our study could be of the importance for policy makers in creating the more effective healthcare service in unstable political and security situations.

Does health insurance impact health service utilization among older adults in urban China? A nationwide cross-sectional study

BackgroundChina’s rapidly aging population has led to many challenges related to the health care delivery and financing. Since 2007, the Urban Residents Basic Medical Insurance (URBMI) program has provided financial protection for older adults living in urban areas not already covered by other health insurance schemes. We conducted a national level assessment on this population’s health needs and health service utilization.MethodsRecords for 9646 individuals over the age of 60 were extracted for analysis from two National Health Service Surveys conducted in 2008 and 2013. Multiple regression models were used to examine associations between socioeconomic factors, health needs and health service utilization while controlling for demographic characteristics and survey year.ResultsSelf-reported illness, especially non-communicable diseases (NCDs) increased significantly between 2008 and 2013 regardless of insurance enrollment, age group or income level. In 2013, over 75% of individuals reported at least one NCD. Outpatient services decreased for the uninsured but increased for those with insurance. Middle- and high-income groups with insurance experienced a higher increase in outpatient visits and hospital admissions than the low-income group. Forgone hospital admissions (defined as an admission indicated by a doctor but which was declined or not followed through by the patient) decreased. However, over 20% of individuals had to forgo necessary hospital admissions, and 40% of these cases were due to financial barriers. Outpatient visits and hospital admissions increased between 2008 and 2013, and insured individuals utilized more services than those without insurance.ConclusionAfter the implementation of URBMI, health service utilization increased and forgone hospital admissions decreased, indicating the program helped to improve access to health services. However, there was still a marked difference in utilization among different income groups, with the high-income group experiencing the greatest increase. This factor calls for further attention to be given to issues related to equity. Prevalence of self-reported NCDs greatly increased among the study population between 2008 and 2013, suggesting that health insurance programs need to ensure they cover sufficient support for the treatment and prevention of NCDs.

Self-reported non-communicable diseases and associated socio-demographic status among ethnic minority populations in Vietnam, 2019.

The aim of this study was to report the prevalence of self-reported non-communicable diseases among ethnic minority populations in Vietnam and related factors. A total of 5033 individuals aged 15 years and older who belonged to ethnic minority populations from 12 provinces in Vietnam completed a household survey. The overall prevalence of self-reported non-communicable diseases was 12.4% (95% CI: 11.5%–13.4%). Cardiovascular diseases were the most prevalent, followed by diabetes. Ethnicity was shown to have an independently significant correlation to having any non-communicable diseases. Older people, near-poor and non-poor people had significantly higher odds of having non-communicable diseases as compared to younger and poor people.

Health profile of adult special immigrant visa holders arriving from Iraq and Afghanistan to the United States, 2009-2017: A cross-sectional analysis.

BackgroundBetween 2,000 and 19,000 Special Immigrant Visa (SIV) holders (SIVH) from Iraq and Afghanistan resettle in the United States annually. Despite the increase in SIV admissions to the US over recent years, little is known about the health conditions in SIV populations. We assessed the burden of select communicable and noncommunicable diseases (NCDs) in SIV adults to guide recommendations to clinicians in the US.Methods and findingsWe analyzed overseas medical exam data in Centers for Disease Control and Prevention’s (CDC) Electronic Disease Notification system (EDN) for 19,167 SIV Iraqi and Afghan adults who resettled to the US from April 2009 through December 2017 in this cross-sectional analysis. We describe demographic characteristics, tuberculosis screening results, self-reported NCDs, and risk factors for NCDs (such as obesity and tobacco use). In our data set, most SIVH were male (Iraqi: 59.7%; Afghan: 54.7%) and aged 18–44 (Iraqi: 86.3%; Afghan: 95.6%). About 2.3% of Afghan SIVH and 1.1% of Iraqi SIVH had a tuberculosis condition. About 0.3% of all SIVH reported having chronic hepatitis. Among all SIVH, 56.5% were overweight or had obesity, 2.4% reported hypertension, 1.1% reported diabetes, and 19.4% reported current or previous tobacco use. Iraqi SIVH were 3.7 times more likely to have obesity (95% CI: 3.4–4.0), 2.5 times more likely to report diabetes (95% CI: 1.7–3.5), and 2.5 times more likely to be current or former smokers (95% CI: 2.3–2.7) than Afghan SIVH. Limitations include the inability to obtain all SIVH records, self-reported medical history of NCDs, and the underdiagnosis of NCDs such as hypertension and diabetes because formal laboratory testing for NCDs is not used during overseas medical exams.ConclusionIn this analysis, we found that 56.5% of all SIVH were overweight or had obesity, 2.4% reported hypertension, 1.1% reported diabetes, and 19.4% reported current or previous tobacco use. In general, Iraqi SIVH were more likely to have obesity, diabetes, and be current or former smokers than Afghan SIVH. State public health agencies and clinicians doing domestic screening examinations of SIVH should consider screening for obesity—as per the CDC’s Guidelines for the US Domestic Medical Examination for Newly Arriving Refugees—and smoking and, if appropriate, referral to weight management and smoking cessation services. US clinicians can consider screening for other NCDs at the domestic screening examination. Future studies can explore the health profile of SIV populations, including the prevalence of mental health conditions, after integration into the US.

Socio-economic-related health inequality in non-communicable diseases among older people in Viet Nam

AbstractThis study contributes to a growing literature body of studies aimed at explaining socio-economic-related health inequality in non-communicable diseases (NCDs), with a focus on older people who are commonly affected by socio-economic gradient in later life. It identifies factors associated with self-reported NCDs and examines socio-economic-related health inequality in self-reported NCDs between rural and urban Vietnamese older people. This cross-sectional study utilised data from the Viet Nam Ageing Survey. A sample of 2,682 older people aged 60 and over (urban = 703, rural = 1,979) was analysed. Concentration indices were computed to measure socio-economic inequalities in self-reported NCDs. Concentration index decomposition analysis was performed to determine the relative contributions of the determinants to explaining those inequalities. Significant socio-economic inequalities in self-reported NCDs favouring the rich were found, in which the degree of inequality was more pronounced in urban areas than in their rural counterparts. Household wealth and social health insurance were the main drivers contributing to increased socio-economic inequalities in self-reported NCDs in urban and rural areas, respectively. Among disadvantaged groups, older people living alone, with lowest wealth and with social health insurance had highest probability of reporting at least one NCD for both areas. Public policies aimed at narrowing wealth gaps and expanding and improving principle roles of social health insurance should prioritise the most disadvantaged groups in order to achieve health equality.

Gender disparities in the burden of non-communicable diseases in India: Evidence from the cross-sectional study

IntroductionThe present study aims to determine the socio-economic inequalities in the self-reported Non-Communicable Diseases (NCDs) considering the gender perspective in India. MethodsThe study utilizes a cross-sectional study data from India, based on the public repository of Demographic and Health Surveys, 2015–16. The survey utilized multi-stage sampling procedure. The total of 699,686 women and 103,525 men age 15–49 years were analyzed in the study. Descriptive statistics and binary logistic regression has been used to understand the interplay between socio-cultural factors associated with at least one self-reported non-communicable disease in India. Additionally, poor-rich-ratio and concentration Index has been utilized for analyzing the socio-economic inequalities in the burden of non-communicable diseases in the country. ResultsThe findings from the study suggest that, the overall prevalence of reporting at least one non-communicable disease was found to be higher amongst the women as compared to men. The results shows that the odds of reporting NCDs was higher among individuals (both men and women), who belong to the age bracket of 35 years and above, and are widowed/divorced/separated, residing in urban areas, belonging to affluent class, living in the Southern part of the country, consuming alcohol, smoking, and chewing tobacco. ConclusionsThe evidence generated by the study helps us to comprehend the socio-economic, demographic and behavioral predictors associated with the prevalence of self-reported non-communicable diseases in India, with an inclination towards the respondents belonging to the richest wealth quintile.

Subjective health and quality of life among elderly people living with chronic multimorbidity and difficulty in activities of daily living in rural South Africa.

Background: South Africa has been experiencing a growing proportion of elderly population with rapid increases in the burden of non-communicable diseases (NCDs) characteristic of population aging. Rural areas in South Africa represent a far smaller fraction of the population, however, share a relatively higher burden of NCDs. In the current literature, there is limited evidence on rural studies in the context of chronic diseases and activities of daily living (ADLs) among the elderly population (60 years and above) in South Africa.Purpose: In this regard, we undertook the present study with the objective of examining the demographic, behavioral, and socioeconomic predictors of subjective health, depression, and quality of life among elderly men and women living in the rural areas (n=2,627).Methods: Data for this study were collected from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI). Main explanatory variables were self-reported NCDs and difficulties in ADLs. The predictors of subjective health, depression, and quality of life were assessed using multivariable regression methods.Results: We found that the proportion of participants who reported good health, not having depression, and good quality of life was respectively 44.7%, 81.3%, and 63%. Women in the oldest age group (80+ years) were significantly less likely to report good health (OR=0.577, 95% CI=0.420, 0.793) and quality of life (OR=0.709, 95% CI=0.539, 0.933) compared with those in the youngest group. Having more than one chronic condition and ADL difficulties significantly lowered the odds of good health, having no depression, and quality of life among men and women.Conclusion: The present findings suggest the involvement of sociodemographic factors in health and quality of life outcomes among elderly South Africans, and call for enhanced efforts to address these health limiting conditions such as ADLs and chronic multimorbidity.

Dental service utilisation among adults in a European developing country: findings from a national health survey

The objective was to estimate the frequency of visits to a dentist and to assess the impact of determinants on dental care utilisation among adults in the Republic of Srpska (RS), Bosnia and Herzegovina. We conducted a cross-sectional study using data from the 2010 National Health Survey performed in the RS. A total of 4,128 adults (≥18years) were interviewed in their homes. Multivariate logistic regression was used to assess the relationship between demographic characteristics, socio-economic characteristics, health behaviours, self-rated health, self-reported noncommunicable diseases (NCDs) and dental care utilisation. Only 20% of all respondents reported a visit to a dentist in the year preceding the interview. Younger respondents (OR=0.97), women (OR=1.30-1.39), urban dwellers (OR=1.41-1.61), those who were employed (OR=1.20) and those who self-reported NCDs (OR=1.32-1.33) more frequently utilised dental services. The opposite was true for those in the low wealth index group (OR=0.79), persons with a low (OR=0.31) and middle (OR=0.48) level of education and people who self-rated their health as average (OR=0.76-0.80). The present study revealed a low frequency of visits to a dentist, especially for preventive oral health care. It also confirmed demographic, socio-economic and health-related differences in dental-care utilisation in RS. To minimise those differences, systemic approaches aimed at increasing access to dental care could be an important step. Oral health-promotion policies need to be adopted in the RS.

Prison primary care and non-communicable diseases: a data-linkage survey of prevalence and associated risk factors.

BackgroundThe size and mean age of the prison population has increased rapidly in recent years. Prisoners are a vulnerable group who, compared with the general population, experience poorer health outcomes. However, there is a dearth of research quantifying the prevalence of non-communicable diseases (NCDs) among prisoner populations.AimTo explore both the prevalence of NCDs and their risk factors.Design & settingA cross-sectional survey was undertaken that was compared with clinical records in two male prisons in the north of England.MethodSelf-report surveys were completed by 199 prisoners to assess sociodemographic characteristics, general health, NCD prevalence, and risk factor prevalence. Data were checked against that retrieved from prison clinical records.ResultsIt was found that 46% reported at least one NCD and 26% reported at least one physical health NCD. The most common self-reported NCD was 'anxiety and depression' (34%), followed by 'respiratory disease' (17%), and 'hypertension' (10%). Having a physical health NCD was independently associated with increasing age or drug dependence.The level of agreement between clinical records and self-report ranged from 'fair' for alcohol dependence (kappa 0.38; P<0.001) to 'very good' for diabetes (kappa 0.86; P<0.001).ConclusionCompared with mainstream populations and despite high prevalence of risk factors for NCDs physical illness NCDs, with the exception of respiratory disease, are less common. However, poor mental health is more common. These differences are possibly owing to the younger average age of prison populations, since prevalence of risk factors was reported as high.Secondary data analysis of clinical records is a more methodologically robust way of monitoring trends in prisoner population disease prevalence.

Use of artificial sweeteners in Brazil: a household survey approach

The objective was to estimate the prevalence of artificial sweetener use by the adult Brazilian population and users' characteristics. Analysis of data from the Brazilian National Survey on Access, Utilization, and Promotion of Rational Use of Medicines (PNAUM, 2014), a nationwide population-based survey. The target outcome was self-reported use of sweeteners by Brazilians 20 years and older. The independent variables were sex, age, major geographic region of Brazil, schooling in complete years, and economic status according to the Brazilian Economic Classification Criterion of the Brazilian Association of Research Companies (ABEP). The health condition indicators were: self-reported noncommunicable diseases (NCDs), number of NCDs, and body mass index (BMI). Prevalence of sweetener use in the Brazilian adult population was 13.4% (95%CI: 12.5-14.3), and it was higher in females and in persons 60 years or older, in the Northeast and Southeast, among individuals from economic classes A and B, and among obese individuals. Persons with chronic diseases (especially diabetes) showed the highest prevalence of use of sweeteners, and their use increased with the number of reported comorbidities. Prevalence of use of artificial sweeteners was 13.4% and was associated with sociodemographic and health characteristics.