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PubMed1993

Demographic variables in fetal and child mortality: Hmong in Thailand.

Conventional theories would not predict the 60% decline of infant mortality which has occurred among the Hmong population of Thailand, from 123/1000 in the mid-1960s to 48 in the mid-1980s. The Hmong population in northern Thailand has sustained high fertility and low use of modern health services. Most Hmong live in relatively remote rural villages and earn their living by self-employed farming. They have low levels of education, especially for women. They live in multi-generational patrilineal-patrilocal extended family households. Women's status is low. These characteristics contrast strongly with the majority ethnic Thai population, among whom a comparable mortality decline has been accompanied by widespread use of family planning, rapidly declining fertility, widespread use of modern health facilities, rapidly increasing levels of education for both sexes, rapid economic development, and a predominance of nuclear-based family households. Distributions of Hmong pregnancies by birth order and maternal age have remained relatively constant while fetal and young child death rates have declined for each level of parity and all maternal ages in recent cohorts. As predicted by conventional theories, infant mortality rates are highest among higher order births and for births to mothers of the highest ages, however there is relatively little effect on risk of infant mortality of first order pregnancies, or births to very young (10-14 year old) women. Fetal and infant mortality have declined steadily in recent cohorts at each parity level and all maternal ages. Modern medical care and decline in a surplus of female deaths associated with low status of women might explain the declines in fetal and child deaths regardless of parity or maternal age. Use of modern medical care for delivery is recent and accounts for less than 10% of all recent Hmong births, but survival rates are not consistently or significantly higher for children born with a modern birth attendant. Sex-specific mortality rates calculated from reproductive histories show no surplus of female deaths in the past, but females have benefitted more from recent mortality declines than males. Ethnographic evidence suggests that Hmong have customs which act to protect the health of mother and child ('chicken soup theory'), and that they are predisposed to accept innovations (including use of modern medicine) which they see as beneficial. This may allow them to respond especially quickly to small opportunities for improving their children's survival, as compared with other ethnic groups.

Birth Order↗
PubMed1994

Comparability of telephone and household breast cancer screening surveys with differing response rates.

We compared telephone and household surveys as methods for obtaining information about breast cancer screening. The study population was comprised of women age 40 years or older who were permanent residents of two large areas of Florida. We contacted women using random digit dialing for the telephone survey. We used a stratified multistage design for the household survey. Response rates were 49% (telephone) and 77% (household). Distributions of most screening (mammography, clinical examination, and breast self-examination) and demographic variables were comparable for the two surveys; income was higher in the telephone survey. Both surveys underestimated the proportion of older women, based on 1990 Census data.

Adult↗
PubMed2000

How is household vulnerability gendered? Female-headed households in the collectives of Suleimaniyah, Iraqi Kurdistan.

This research tries to reach an understanding of the well-being of female-headed household members through a comparison to male-headed household members in the collectives of the Suleimaniyah governorate in Iraqi Kurdistan. Research was undertaken in five collectives in Suleimaniyah during the summer of 1998. The research contributes to the current gender and development debates which are concerned with improving the understanding of the specific gendered forms of disadvantage faced by female-headed households rather than assuming the universal poverty of this group. An understanding of well-being is approached through a broad conceptualisation of vulnerability in preference to a narrow poverty definition. That the findings of this research are complex attests to the multi-dimensional and mutually constitutive gendered experiences of vulnerability. The definitive conclusion to emerge from this research is a refuting of the rhetoric-fuelled stereotype that households headed by women are at a disadvantage in all the dimensions of vulnerability in comparison to households headed by men. The research also establishes the methodological necessity of examining intra-household distributive mechanisms that determine individuals' well-being.

Developing Countries↗
PubMedDate not supplied

The effects of different levels of air pollution on atopy and symptoms of allergic rhinitis.

We evaluated the prevalence of symptoms of allergic rhinitis and atopy among two groups living in areas with different pollution levels. The study was conducted among high school students living in Bayrampaşa (polluted by SO2 and TSP) and Beykoz (unpolluted, residential area) in Istanbul (n = 386). Each subject filled out a standardized self-administered questionnaire. Atopic status was evaluated by skin-prick testing using eight different allergens. Also, anterior active rhinomanometry was performed to evaluate the symptoms objectively. Significantly higher prevalence rates for symptoms of allergic rhinitis were found in Bayrampaşa (22.8%) compared to Beykoz (6%). However, no significant difference was found for atopic status among the two groups. When we evaluated the atopic status of subjects with symptoms of allergic rhinitis between the two areas, the prevalence of atopic students was found to be relatively higher in the unpolluted area (BZ). This difference was not statistically significant. Within the atopic population, subjects complaining of symptoms of allergic rhinitis were significantly more frequent in the polluted area (BP), suggesting that air pollution causes an increase in symptoms of allergic rhinitis in the atopic population, but this is not significantly higher than the increase in symptoms of allergic rhinitis of the total study group. Our results suggest that pollutants exert irritant effects on mucous membranes of the population in general rather than aggrevating symptoms in predisposed individuals. Smoking was more frequent in the unpolluted area. Exposure to parental smoking in childhood and heating systems in houses were evenly distributed. Household crowding was lower in Beykoz. Rhinomanometric measurements among the two groups did not show significant difference. Multiple logistic regression models estimating the role of each risk factor independently showed significant odds ratio associated with residence in Bayrampaşa for symptoms of allergic rhinitis (OR = 4.6, 95% CI = 9.0-2.3). In conclusion, this study suggests that outdoor pollution has adverse effects on the symptoms of allergic rhinitis, while it has no effect on the prevalence of atopy in Istanbul in the 1990s.

Adolescent↗
PubMed1992

Bird antigen persistence in the home environment after removal of the bird.

Hypersensitivity pneumonitis (HP) secondary to bird exposure is treated with glucocorticosteroids and avoidance. Despite therapy, symptoms may persist for a prolonged time. Just as cat antigen, Fel d 1, may persist for greater than 20 weeks after cat removal, there may be persistent bird antigen to explain prolonged symptoms in bird HP. It was the intent of this study to determine household distribution and persistence of bird antigen after removal of the bird from the patient's home. The homes of patients with birds were followed serially after bird removal with multiple samples collected using a hand-held vacuum cleaner. Bird antigen levels were determined by an inhibition enzyme-linked immunoassay. In five homes the antigen declined gradually despite extensive environmental control measures, with high levels still detectable at 18 months in one home. This data suggests that high levels of bird antigen can be detected for prolonged periods of time after bird removal and environmental cleanup. The antigen may account for the persistence of disease in some patients with HP. In severe HP, the preferred therapy may be temporary relocation of the patient away from the room in which the bird was housed, in addition to corticosteroids, until the patient's environment is demonstrated to be relatively bird antigen-free.

Air Pollution↗
PubMed1981

The parasites obtained and bacteria isolated from house rats (Rattus rattus Linnaeus, 1758) caught in human habitations in Ibadan, Nigeria.

A total of 169 house rats were killed in different households distributed within five localities of Ibadan. A wide range of parasites were encountered. The flea, Ceratophylus fasciatus was the commonest ectoparasite found. Trichostrongylus columbriformis eggs were the commonest nematode and Hymenolepis diminuta the only cestode. Escherichia coli was the commonest bacterium found. The incidence of helminthiasis, especially H. diminuta, was generally high among rats trapped in the villages and the indigenous areas of the city. One hundred and twenty eight (128) of the rats possessed Trypanosoma lewisi infection, seventy one (71) had Anaplasma marginale while fifty seven (57) had Babesia microti infection. The public health importance of some of the parasites found is discussed.

Animals↗
PubMed1995

Waterborne cryptosporidiosis associated with a borehole supply.

From 1 April to 31 May 1993, 64 cases of cryptosporidiosis were diagnosed within one district health authority. Forty were classified as primary cases, 35 of whom were clustered in an area supplied by a discrete public water supply that supplied the majority of homes in a large town. Most of the water in this supply is abstracted from boreholes and some is filtered before distribution. Households that received mains water from this supply were 15 times more likely to be affected than households nearby that received water from other sources. A case control study demonstrated a dose response relationship between consumption of water obtained from the town supply and risk of illness. Very low concentrations of cryptosporidial oocysts were detected in the water supply on four occasions several weeks after the outbreak. Environmental investigation failed to reveal a likely mechanism for contamination of the water supply.

Adolescent↗
PubMedDate not supplied

Differences in household characteristics by income distribution in Pakistan.

The authors examine household characteristics by income distribution in Pakistan using data from the 1979 Population, Labour Force and Migration (PLM) Survey. Tabular data, organized by measures of income and expenditure, are presented on average household size, dependency ratios, average number of children and average number of adults, proportion of female household members, labor force participation rates for various ages, and occupational status of heads of households. The authors conclude that "the findings for Pakistan generally are in consonance with those for other Third World countries and confirm that certain characteristics are associated with poverty." Comments by Karol J. Krotki are also included (pp. 668-9).

Adolescent↗
PubMed1996

Gender difference in cereal intake: possible impacts of social group affiliation and season.

Food may not be equitably distributed within the household. The distribution depends on some factors, one of which is availability of food. The generalised proposition of gender bias against women in the distribution of food in South Asia has been examined here in three culturally contrasting population groups in two seasons, viz. lean and peak. The result shows that in all the three groups, in all household membership categories, the intake of cereal is higher than the recommended intake, but the male-female differences in net intakes are higher in peak season than in lean season.

Adolescent↗
PubMed2005

[Household food availability in Brazil: distribution and trends (1974-2003)].

OBJECTIVE: Data from household food budget surveys were examined in order to describe the regional and socio-economic distribution of household food availability in Brazil in 2002-2003 and trends from 1974 to 2003. METHODS: The study uses data from the "Pesquisa de Orçamento Familiar 2002-2003" budget survey conducted by the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística) from July 2002 to June 2003, including a national sample of 48,470 households. In each household, during seven consecutive days, all monetary and non-monetary expenses with food and beverages for family consumption were registered. Crude weights of purchased foods were transformed into calories and nutrients with the use of food composition tables. RESULTS: Adequate protein content and a high proportion of animal protein were found in all regions and income strata. These were the most important positive aspects identified in the household food availability in Brazil. On the other hand, all regions and socio-economic strata showed excess calories from sugar and little availability of fruits and vegetables. An excessive proportion of calories came from total and saturated fat in the more economically developed regions and in the urban milieu, as well as among higher-income families. Time-trends in metropolitan areas indicated a decline in the consumption of basic, traditional foods, such as rice and beans; notable increases (up to 400%) in the consumption of processed food items, such as cookies and soft drinks; maintenance of the excessive consumption of sugar; and a continuous increase in total fat and saturated fat content in the diet. CONCLUSIONS: Patterns and trends regarding household food availability in Brazil are consistent with the increasing participation of chronic non-communicable diseases in morbidity and mortality and with the continuous increase in the prevalence of obesity.

Brazil↗
PubMedDate not supplied

Economic abuse and intra-household inequities in food security.

Food insecurity affected over 2.3 million Canadians in 2004. To date, the food security literature has not considered the potential impact of economic abuse on food security, but there are three ways in which these two important public health issues may be related: 1) victims of economic abuse are at risk of food insecurity when they are denied access to adequate financial resources; 2) the conditions that give rise to food insecurity may also precipitate intimate partner violence in all its forms; 3) women who leave economically abusive intimate heterosexual relationships are more likely to live in poverty and thus are at risk of food insecurity. This paper presents a case of one woman who, during a qualitative research interview, spontaneously reported economic abuse and heterosexual interpersonal violence. The economic abuse suffered by this participant appears to have affected her food security and that of her children, while her husband's was apparently unaffected. There is an urgent need to better understand the nature of intra-household food distribution in food-insecure households and the impact of economic abuse on its victims' food security. Such an understanding may lead to improved food security measurement tools and social policies to reduce food insecurity.

Battered Women↗
PubMed1998

Household health expenditures in Nepal: implications for health care financing reform.

His Majesty's Government of Nepal has embarked on an ambitious social welfare programme of increasing the accessibility of primary education and health care services in rural communities. The implications on the financing of health care services are substantial, as the number of health posts has increased twelve-fold from 1992 to 1996, from 200 to 2597. To strengthen health care financing, government policy-makers are considering a number of financing strategies that are likely to have a substantial impact on household health care expenditures. However, more needs to be known about the role of households in the current structure of the health economy before the government designs and implements policies that affect household welfare. This paper uses the Nepal Living Standards Survey, a rich, nationally-representative sample of households from 1996, to investigate level and distribution of household out-of-pocket health expenditures. Utilization and expenditures for different types of providers are presented by urban/rural status and by socioeconomic status. In addition, the sources of health sector funds are analyzed by contrasting household out-of-pocket expenditures with expenditures by the government and donors. The results indicate that households spend about 5.5% of total household expenditures on health care and that households account for 74% of the total level of funds used to finance the health economy. In addition, rural households are found to spend more on health care than urban households, after controlling for income status. Distributing health care expenditures by type of care utilized indicates that the wealthy, as well as the poor, rely heavily on services provided by the public sector. The results of this analysis are used to discuss the feasibility of implementing alternative health care financing policies.

Developing Countries↗
PubMedDate not supplied

[An application of the Gompertz function to the analysis and projection of households by size class].

A technique for representing the distribution of households by size class using the Gompertz function is introduced. "By extension, it may also be used to disaggregate, by size class, an available projection of the total number of households. The technique does not consider directly the dynamic aspects of the family life cycle, however, it has a methodological advantage: it makes use of information usually available in most census publications." The technique is illustrated using international data and data from the Brazilian censuses of 1960, 1970, and 1980. "Finally, the function is used to disaggregate, by size class, a recent projection of households for Brazil. The analyses show that, in fact, the Gompertz function is a consistent model to disaggregate the total number of households by size class. The methods may be useful as a base to develop models to estimate future housing needs according to the size of the dwellings." (SUMMARY IN ENG)

Americas↗
PubMedDate not supplied

Income distribution in rural Sagar.

"The study makes an attempt to identify the pattern of household income distribution in rural areas, based on the socio-economic surveys in Sagar district [in India]." Factors affecting family income include "occupational structure, distance from nearby urban centers and general accessibility.... The rural settlements under urban influence or with proper accessibility have a greater percentage of high-income families. The major source of income for over a third of the rural families of the district is agricultural labour, while another third earns its living by other agricultural work and the rest are either petty businessmen or are engaged in services."

Asia↗
PubMedDate not supplied

Distributions of long-term household exposure of different population groups to nitrogen dioxide.

Exposure distributions to nitrogen dioxide in living rooms during the summer and winter were calculated for four groups of Zagreb inhabitants (high school students, university students, employed, and retired persons) using Duan's Cartesianization method. Households were classified into three categories according to fuel used for cooking and heating--electricity (or no gas use), propane-butane, and natural gas. The results showed a seasonally dependent contribution to exposure in households from outdoor sources through ventilation, while type of fuel used for heating and cooking, representing indoor pollution sources, had a predominant influence on exposure levels. Exposure distribution functions could be represented by lognormal, or summation by proportion of lognormal and normal distributions. A comparison of the results and the proposed exposure guideline value suggests that either the guideline value is too large, or a nitrogen dioxide exposure problem exists only in a small percentage of homes and is caused by the high rate of air exchange between the kitchen and living room.

Air Pollution, Indoor↗
PubMed1991

Opening the box: intrahousehold food allocation in rural Nepal.

The study examined intrahousehold food behavior in six villages in a rural hill area of mid-Western Nepal. Qualitative and quantitative methodologies taken from both anthropology and nutritional sciences were used to collect data on food belief systems, household allocation of food resources, and the effect of these features on diet and anthropometric status in a sample of 767 individuals in 115 households. Background data were also collected on socioeconomic status and demographic variables such as education levels, occupation, and migration patterns. The core methodological approach used direct structured observations of meals to examine how food is distributed within households. The results document a variety of mechanisms by which some individuals are favored over others through household food distribution, including serving order, serving method, refusing to serve foods, channeling foods and substituting low status foods for high status foods. No differences were observed in mechanisms of food distribution or nutrient intake between male and female children, contrary to evidence in the literature suggesting that male children will be favored. On the other hand, adult women were less likely to meet their nutrient requirements for energy, beta-carotene, riboflavin, and vitamin C than men of the same age. Women's late position in household serving order, channeling of special foods to males and children, and lower total intake of food accounts for these findings.

Adolescent↗
PubMed1990

[[A re-examination of Raffles's statistics on the population of Java in the early nineteenth century]].

The author analyzes the accuracy of the population data published by Sir Thomas Raffles concerning early nineteenth-century Java, Indonesia. Specific topics considered include "a. errors in computation, b. distribution of household size by sub-district, c. distribution of sex-ratio by sub-district, d. variation of age-structure by sub-district, [and] e. problems of Chinese population. Special attention was given to the consistency of the definition of categories and the distribution patterns of the reported figures." (SUMMARY IN ENG)

Age Distribution↗
PubMed1996

A problem in household composition.

"Distinction made between household-persons and household-markers [the person who identifies the family or household as a unit] is formalized in the notion of nested populations. This leads to an extension of the Leslie model into a formulation of growth for both population and households. The extended model involves the matrix presentation of household composition where ratios of household-persons who are age 0, per household-marker, function as surrogate values for fertility rates. The extended model describes change over time in the distribution of population by age, and in the distribution of households by age of household-marker, or household-head. The model involves the inversion of a nonnegative matrix, and is feasible only if it yields, projected over time, nonnegative entries in vectors representing distribution of population by age, and distribution of household-heads by age. Conditions for the feasibility of the extended model are discussed, and a sufficient condition for feasibility over a single interval is identified." (SUMMARY IN FRE)

Age Distribution↗