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PubMed2005

The coexistence of child undernutrition and maternal overweight: prevalence, hypotheses, and programme and policy implications.

The purpose of this paper is to document the prevalence of the phenomenon of the coexistence of a stunted child and an overweight mother (SCOWT) in the same household in low- and middle-income countries. We also explore whether this phenomenon is associated with a country's level of economic development and urbanization and highlight policy directions for public nutrition. Data from 36 Demographic and Health Surveys (DHS) were used (23 in Africa, 8 in Latin America, and 5 in Asia). Stunting was defined as height-for-age < -2 SD of the reference population and maternal overweight as a body mass index (BMI) of > 25 kg m(-2). World Bank and United Nations figures were used for gross national product per capita (an indicator of economic development) and for level of urbanization respectively. Descriptive statistics were derived, and multivariate linear regression analysis was used to model the association between economic development, urbanization and the prevalence of SCOWT. The prevalence of SCOWT is generally below 10%, except in four countries, of which three are in Latin America. Among our sample of countries, SCOWT is generally more prevalent in Latin America than in Africa, and is near or below 5% in all five countries of Asia. Contrary to our expectations, SCOWT is not necessarily more prevalent in urban than rural areas. We also find that when economic development is controlled for, SCOWT is associated with urbanization only in Latin America. In Africa and Asia, SCOWT is associated with economic development, but not urbanization. The concrete recognition of the SCOWT phenomenon is an important step to delineating more effective and integrated strategies to address problems of over- and undernutrition and dietary quality within countries, regions and households. This gives special importance to designing programmes and policies that will address the food and nutrition needs of each individual, rather than assuming that those needs are addressed by targeting programmes or policies to the household as a whole.

Adult↗
PubMed1975

Population growth-a menace to what?

Originally, many of the initiators of the World Population Conference, which took place in Bucharest in 1974, had hoped that the Conference would imply a final breakthrough for the view that family planning measures should be given top priority in all less-developed countries. In fact, however, the Plan of Action passed by the Conference contains very little relating to population and family planning. Instead, the document is dominated by wordy phrases about the necessity of attaining social and economic development in those countries. Will the insight that family planning programs work efficiently only if they are an integral part of programs for the social and economic development of a country lead to such programs being realized? There is every reason to doubt that the plan of Action will have any such effect. The reasons for the underdevelopment of Third World countries cannot be removed through such United Nations resolutions. In the People's Republic of China, family planning is widely accepted, especially in the towns, and now also among the rural population. Limiting the number of children is considered part of China's development effort. China is a less-developed country that is in the process of rapid social and economic development. The issue at stake in other Third World countries is how to achieve a similar development. As soon as this goal is achieved, family planning efforts are meaningful and have a chance of success. The experience of China demonstrates that even there it took time before the efforts succeeded. There are many Third World countries that could, without much difficulty, support a population considerably larger than the present one. But there are no doubt also a number of countries where the population is already so large that a continued population increase would be harmful. The need to achieve rapid development becomes increasingly urgent, not in the least to make it possible to attain a reduced population growth. The sad truth is that so little development takes place in those countries. Without social and economic development, the present rapid population increase will continue in those countries where there is already an overly dense population.

China↗
PubMed2005

Pressure ulcers: guideline development and economic modelling.

AIM: This paper presents the development process for clinical guidelines on the use of pressure-relieving devices (beds, mattresses and overlays), with emphasis on incorporating economic evidence. BACKGROUND: Previous UK guidelines on the use of pressure-relieving devices to prevent pressure ulcers have not considered whether any recommendations made are cost effective. The routine inclusion of cost effectiveness evidence in guidelines is a recent policy development, and there has been little research into its potential role in the guideline process. METHODS: We systematically reviewed the literature to assess both the clinical and cost effectiveness of pressure-relieving devices for prevention of pressure ulcers. Where there was sufficient evidence on the comparative clinical effectiveness between alternative devices, economic modelling was undertaken to assess comparative cost effectiveness. A guideline development group (comprising both clinicians and patient representatives) reviewed all the available evidence to formulate clinical practice guidelines and recommendations for further research. RESULTS: Studies showed that caring for people vulnerable to developing pressure ulcers on high-specification foam mattresses compared with standard hospital mattresses significantly reduced their risk of developing a pressure ulcer. Cost effectiveness modelling indicated that, because of savings accruing through treating fewer pressure ulcers, high-specification foam mattresses are likely to cost less overall and are more effective. The resulting clinical practice guideline was uncompromising on the use of high-specification foam mattresses as the minimum provision in patients vulnerable to pressure ulcers. Significant weaknesses were identified in both the quality and availability of evidence for most of the other pressure relieving devices considered. CONCLUSIONS: Cost effectiveness assessment was an integral part of the guideline development process. It clarified the shortcomings of some of the clinical effectiveness evidence and helped in formulating pragmatic clinical practice recommendations.

Bedding and Linens↗
PubMed2004

Obesity and inequities in health in the developing world.

OBJECTIVE: To update the social distribution of women's obesity in the developing world and, in particular, to identify the specific level of economic development at which, if any, women's obesity in the developing world starts to fuel inequities in health. DESIGN: Multilevel logistic regression analyses applied to anthropometric and socioeconomic data collected by nationally representative cross-sectional surveys conducted from 1992 to 2000 in 37 developing countries within a wide range of world regions and stages of economic development (gross national product (GNP) from 190 to 4440 US dollars per capita). SUBJECTS: : In total, 148 579 nonpregnant women aged 20-49 y. MEASUREMENTS: Body mass index to assess obesity status; quartiles of years of education to assess woman's socioeconomic status (SES), and GNP per capita to assess country's stage of economic development. RESULTS: Belonging to the lower SES group confers strong protection against obesity in low-income economies, but it is a systematic risk factor for the disease in upper-middle income developing economies. A multilevel logistic model-including an interaction term between the country's GNP and each woman's SES-indicates that obesity starts to fuel health inequities in the developing world when the GNP reaches a value of about 2500 US dollars per capita. CONCLUSIONS: For most upper-middle income economies and part of the lower-middle income economies, obesity among adult women is already a relevant booster of health inequities and, in the absence of concerted national public actions to prevent obesity, economic growth will greatly expand the list of developing countries where this situation occurs.

Adult↗
PubMed2006

Nutritional solutions to major health problems of preschool children: how to optimise growth and development.

Despite major economic development in the last few decades, childhood nutrition remains a great challenge for the human species. A combination of undernutrition, overnutrition, and poor dietary quality affect to a variable extent all of the world's populations, and are often combined in the same areas and even in the same families. Malnutrition is part of the life of many individuals since conception and is transmitted by 1 generation to the next. Countries with lower income per capita and poor socioeconomic strata are mainly affected and, in turn, malnutrition hampers their development. The eradication of child malnutrition is crucial in the fight against poverty. This article examines whether this goal will be achieved within the time frame the United Nations has set.

Africa↗
PubMed2006

The Northwest Forest Plan as a model for broad-scale ecosystem management: a social perspective.

I evaluated the Northwest Forest Plan as a model for ecosystem management to achieve social and economic goals in communities located around federal forests in the US. Pacific Northwest. My assessment is based on the results of socioeconomic monitoring conducted to evaluate progress in achieving the plan's goals during its first 10 years. The assessment criteria I used related to economic development and social justice. The Northwest Forest Plan incorporated economic development and social justice goals in its design. Socioeconomic monitoring results indicate that plan implementation to achieve those goals met with mixed success, however I hypothesize there are two important reasons the plan's socioeconomic goals were not fully met: some of the key assumptions underlying the implementation strategies were flawed and agency institutional capacity to achieve the goals was limited. To improve broad-scale ecosystem management in the future, decision makers should ensure that natural-resource management policies are socially acceptable; land-management agencies have the institutional capacity to achieve their management goals; and social and economic management goals (and the strategies for implementing them) are based on accurate assumptions about the relations between the resources being managed and well-being in local communities. One of the difficulties of incorporating economic development and social justice goals in conservation initiatives is finding ways to link conservation behavior and development activities. From a social perspective, the Northwest Forest Plan as a model for ecosystem management is perhaps most valuable in its attempt to link the biophysical and socioeconomic goals of forest management by creating high-quality jobs for residents of forest communities in forest stewardship and ecosystem management work, thereby contributing to conservation.

Conservation of Natural Resources↗
PubMed2000

[Man, health, development and economics].

In the next few years the key topics of the health debate in Latin America and the Caribbean will centre on the relationship between health, development and economics. The author suggests that there is a more important issue at the heart of this question, that is whether man should be the central element of any health and social system and the order of priority this consideration should be given with regards to development strategy and economic planning.

Caribbean Region↗
PubMed2003

Applying a nutribusiness approach to increase animal source food consumption in local communities.

Animal source foods (ASF) in the diets of schoolchildren are beneficial for supporting optimal physical and cognitive development. Nevertheless, behavioral change and economic development are needed to increase and sustain adequate meat product consumption by schoolchildren in developing countries. A NutriBusiness enterprise may be one way for local communities to promote economic development while increasing the availability of meat for children. This work evaluates the feasibility of a NutriBusiness enterprise involving the production of rabbits and the manufacture of solar dried snack food. Some rabbits would be kept for home use, whereas others would be used in the manufacture of a rabbit-sweet potato dried snack food that could be fed to children or sold for income. The NutriBusiness enterprise would be composed of participants from the community contributing to a cooperative effort for setting up a manufacturing facility and organizing production, manufacturing and marketing functions. A unit operation for rabbit-sweet potato Chiparoos, based on full-capacity operation of a single solar drier would involve up to 110 shareholder families, each producing 240 rabbits/y with 120 used at home and 120 sold for Chiparoos manufacture. Participation in the enterprise would increase the availability to children of iron, zinc and vitamin B-12, and other nutrients, and provide approximately 350 dollars/y additional income for the family.

Animals↗
PubMed1996

The economic determinants of Greek return migration to the islands of the East Aegean.

"The purpose of this article is to investigate the economic determinants of Greek return migration to the islands of the East Aegean, a region comprising hundreds of islands of different size in four administrative departments....[It] examines the sensitivity of return migration flows to changes in economic variables which influence decisions to return....The purpose...is to investigate the effect on return migration not only of economic development in the host country (push factors) but also of economic development in the islands of the East Aegean (pull factors), given their isolation from the mainland and their different economic structures." (SUMMARY IN SPA AND FRE)

Behavior↗
PubMed1986

Capitalism, socialism, and the physical quality of life.

This study compared capitalist and socialist countries in measures of the physical quality of life (PQL), taking into account the level of economic development. The World Bank was the principal source of statistical data, which pertained to 123 countries and approximately 97 percent of the world's population. PQL variables included indicators of health, health services, demographic conditions, and nutrition (infant mortality rate, child death rate, life expectancy, crude death rate, crude birth rate, population per physician, population per nursing person, and daily per capita calorie supply); measures of education (adult literacy rate, enrollment in secondary education, and enrollment in higher education); and a composite PQL index. All PQL measures improved as economic development increased. In 30 of 36 comparisons between countries at similar levels of economic development, socialist countries showed more favorable PQL outcomes (p less than .05 by two-tailed t-test). This work with the World Bank's raw data included cross-tabulations, analysis of variance, and regression techniques, which all confirmed the same conclusions. The data indicated that the socialist countries generally have achieved better PQL outcomes than the capitalist countries at equivalent levels of economic development.

Adult↗
PubMed2004

[Relationship between tuberculosis prevalence and socio-economic factors in China].

OBJECTIVE: In order to figure out how and to what degree the social and economic development and control strategy influencing the epidemics of tuberculosis and to provide reference for tuberculosis prevention and control in China. METHODS: Based on the data from the nationwide random surveys on tuberculosis in 1979, 1984/1985, 1990 and 2000 and the indexes on social and economic development of China, correlation coefficient was used to analyze the relationship of three factors including (1) the change of epidemic situation of tuberculosis from 1979 to 2000; (2) the level of social and economic development; (3) the implementation of Health V Project. RESULTS: The prevalence rate of smear positive tuberculosis was significantly correlated to per capita net income of rural population, consumption level of city population, per capita GDP, density of population, and proportion of rural population. Among which the correlation with per capita net in come of rural population, consumption level of city population, per capita GDP, or density of population showed negative, correlation but the proportion of rural population showed positive. The range of GDP increase was similar in both areas with or without the implementation of Health V Project from 1990 to 2000 (77.2% and 77.8%). However, the ranges of the decline of prevalence rate were quite different (44.4% and 12.3%) in the two areas. In the western part of China, the range of GDP increase was similar in the areas with or without the implementation of Health V Project. However, the prevalence rate declined in the area that implementing the project but increased in other areas without the project. CONCLUSION: The level of social and economic development had influenced the prevalence rate of tuberculosis, but the implementation of tuberculosis control project played an important role in the reduction of tuberculosis prevalence rate from 1979 to 2000 in China.

China↗
PubMed2005

GIS-based quantification of future nutrient loads into Lake Peipsi/Chudskoe using qualitative regional development scenarios.

This study aims at the quantification of possible future nutrient loads into Lake Peipsi/Chudskoe under different economic development scenarios. This drainage basin is on the borders of Russia, Estonia and Latvia. The sudden disintegration of the Soviet Union in 1991 caused a collapse of agricultural economy, and consequently, a substantial decrease of diffuse and point-source nutrient emissions. For the future, uncertainties about economic development and the priorities that will be set for this region make it difficult to assess the consequences for river water quality and nutrient loads into the lake. We applied five integrated scenarios of future development of this transboundary region for the next twelve to fifteen years. Each scenario consists of a qualitative story line, which was translated into quantitative changes in the input variables for a geographical information system based nutrient transport model. This model calculates nutrient emissions, as well as transport and retention and the resulting nutrient loads into the lake. The model results show that the effects of the different development scenarios on nutrient loads are relatively limited over a time span of about 15 years. In general, a further reduction of nutrient loads is expected, except for a fast economic development scenario.

Estonia↗
PubMed1997

Regionalization, economic restructuring and labour migration in Singapore.

"This paper documents the impact of economic development on changes in employment and labour migration in Singapore. High export-led growth and the relaxation of immigration policies in the late 1960s enabled employment of substantial numbers of unskilled foreign labour in manufacturing, construction and domestic service sectors....Economic development in the 1990s, characterized by the regionalization drive which relocates relatively resource-intensive operations of Singapore-based companies overseas, has led to increased retrenchments and a moderation of demand for foreign workers. The upgrading of remaining production operations in Singapore is expected to increase demand for workers with higher skill levels. Emigration of highly educated and skilled professionals from Singapore became a national concern in the late 1980s. However, with regionalization, the new challenge in the 1990s has become one of encouraging Singaporeans to temporarily take up overseas positions." (SUMMARY IN FRE AND SPA)

Asia↗
PubMed1998

Trends in childhood cancer mortality as indicators of the quality of medical care in the developed world.

BACKGROUND: Mortality from childhood cancer in general and childhood leukemia in particular has sharply declined in economically developed countries over the last 30 years, whereas the incidence of these diseases has remained essentially unaltered. Therefore, childhood malignancies can be used as tracers of accessibility to and effectiveness of medical care. The objective of this study was to compare the reduction of mortality from childhood cancer in general, and childhood leukemia in particular, in four economically developed areas of the world, to assess accessibility to and effectiveness of technologically advanced medical care. METHODS: The authors used data from the World Health Organization to compare the evolution over time of gender specific, age-adjusted mortality from childhood cancer in general and childhood leukemia in particular in the childhood (birth to age 14 years) populations of North America, western Europe, Japan, and Australia and New Zealand during the period 1960-1993. They assessed the evolution over time and the cumulative percentage representing the decline in mortality from childhood cancer and childhood leukemia in the four aforementioned areas of the world. RESULTS: The decline in mortality from both the disease entities considered and for both genders has been more pronounced in North America than in other economically developed areas of the world. CONCLUSIONS: When disease control depends on technologically advanced medical care, as in the case of cancer, the North American population is benefited by earlier and effective introduction of new therapeutic approaches. This conclusion does not apply to other childhood diseases, the incidence of which is higher among low-income groups and control of which depends on prevention rather than treatment.

Adolescent↗
PubMed2004

Evaluation of coastal zone sustainability: an integrated approach applied in Shanghai Municipality and Chong Ming Island.

A systems approach has been applied to the examination of sustainable development in the coastal zone. This complex system is envisaged as comprising three sub-systems: environment and resources, economic development and society. A sustainability indicator system based on these three sub-systems has been set up to evaluate the nature of development in the coastal zone. The administrative regions of the Municipality of Shanghai and Chong Ming Island (in the Yangtze Estuary) have been selected as two coastal zones in which to demonstrate the feasibility and effectiveness of the approach. The approach indicated that the development process in Shanghai is one of weak sustainability with relatively rapid social and economic development at the cost of environment and resource degradation. In contrast, social and economic development in Chong Ming County has been limited to protect the regional environment and resources indicating a more sustainable approach to development.

Algorithms↗