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PubMed2006

Child poverty in rich countries, 2005, part I.

Protecting children from the sharpest edges of poverty during their years of growth and formation is both the mark of a civilized society and a means of addressing some of the evident problems that affect the quality of life in the economically developed nations. The proportion of children living in poverty has risen in a majority of the world's developed economies over the past decade. This report asks what is driving poverty rates upwards and why some OECD countries are doing a much better job than others in protecting children at risk.

Child↗

PubMed1987

The prevention of health risks in Cuba.

Cuba still has a double burden of health risks. It must contend with some risks to health that persist in underdeveloped rural areas, and it must also deal with the risk factors associated with modern, urban living conditions. The economic and social changes fostered in the postrevolutionary period have reduced the relative importance of the first set of factors, but the changes have also introduced or intensified a myriad of factors derived from their own successes. In this article, the risk factors of greatest concern in contemporary Cuba are described, and the strategies adopted to combat these risk factors, together with the ways in which such strategies are shaped by Cuba's social and economic development are discussed.

Chronic Disease↗

PubMed1998

Bed-ridden elderly in Japan: social progress and care for the elderly.

The demand for health care and social welfare services for the elderly has increased and in Japan, there is a need in the social system to improve the quality of life, especially for those who are disabled. This article directs attention to bed-ridden elderly persons from the standpoint of social problems attending economic development and population changes based on data from Japan, the United States, Sweden, and OECD countries. Compared to the United States, there are more bed-ridden elderly in Japan, and inadequate public resources for caring. Physicians, nurses, care workers, and rehabilitation specialists such as physiotherapist and occupational therapist per 1000 aged sixty-five or over are 89.5 in Japan while 237.4 in Sweden. Japan has the fewest such health and welfare personnel among developed countries. Even with increases in such personnel through the New Gold Plan, future increase in aged population would off-set the effect and the problem of providing care for the elderly remains.

Aged↗

PubMed2005

Shifting epidemiology of Flaviviridae.

The dengue, West Nile, Japanese encephalitis and yellow fever viruses are important mosquito-borne viruses whose epidemiology is shifting in response to changing societal factors, such as increasing commerce, urbanization of rural areas, and population growth. All four viruses are expanding geographically, as exemplified by the emergence of West Nile virus in the Americas and Japanese encephalitis virus in Australasia. The large, recent global outbreaks of severe neurological disease caused by West Nile virus, the increasing frequency of dengue hemorrhagic fever outbreaks in the Americas, and the emergence of yellow fever virus vaccination-associated viscerotropic disease, are new clinical epidemiologic trends. These worrisome epidemiologic trends will probably continue in coming decades, as a reversal of their societal and biological drivers is not in sight. Nevertheless, the substantial reductions in Japanese encephalitis virus incidence resulting from vaccination programs and economic development in some Asian countries provide some encouragement within this overall guarded outlook.

Animals↗

PubMed1997

Prevalence of diabetes and its risk factors in China, 1994. National Diabetes Prevention and Control Cooperative Group.

OBJECTIVE: To determine the prevalence of diabetes and impaired glucose tolerance (IGT) and its risk factors in the Chinese population. RESEARCH DESIGN AND METHODS: This study was a population-based cross-sectional study of 224,251 residents aged 25-64 years in 19 provinces and areas, including cities and rural areas of the north, south, east, and middle part of China. RESULTS: Using the 1985 World Health Organization criteria, the prevalence of diabetes and IGT was 2.5 and 3.2%, respectively, in 213,515 subjects aged 25-64 years. Two thirds (70.3%) of the cases had newly recognized diabetes. The prevalence of diabetes in China is about three times higher than it was 10 years ago. On average, subjects with diabetes are older, have higher personal annual incomes, and more often have a family history of diabetes. They also have higher mean BMI, waist-to-hip ratio (WHR), systolic blood pressure, diastolic blood pressure, and a greater prevalence of hypertension. They perform less physical activity and have less education than people with normal oral glucose tolerance test results. Multiple logistic stepwise regression analysis shows that age, BMI (or WHR), family history of diabetes, hypertension, less physical activity, and higher annual income are independent risk factors of NIDDM, and that low education is also an independent risk factor of NIDDM in people with higher personal annual income. CONCLUSIONS: The prevalence of diabetes in China is increasing with economic development and changes from traditional to modernized lifestyle, especially where people had lower level of education and socioeconomic development. Therefore, Chinese people should attempt to retain certain features of their traditional lifestyle (physical activity, healthy food, moderate body weight). Increased knowledge of risk factors for diabetes may help to prevent a further rapid increase in the prevalence of diabetes in China.

Adult↗

PubMed2000

Islam and suicide.

Suicide and homicide rates of a sample of 72 nations were associated with a cluster of social variables related to economic development but not with a cluster related to the proportion of Islamic adherents.

Humans↗

PubMed2006

Trend and disease burden of bacillary dysentery in China (1991-2000).

OBJECTIVE: We aimed to determine the burden of bacillary dysentery in China, its cross-regional variations, trends in morbidity and mortality, the causative bacterial species and antimicrobial resistance patterns. METHODS: We extracted and integrated governmental statistics and relevant medical literature published from 1991 to 2000. Data were also collected from one general hospital each for the six provinces and Jin-an district, Shanghai, representative of six geographical regions and a modern city. FINDINGS: In 2000, 0.8-1.7 million episodes of bacillary dysentery occurred of which 0.5 to 0.7 million were treated at health-care facilities and 0.15-0.20 million patients were hospitalized. The highest morbidity and mortality rates were among the youngest and oldest age groups. Bacillary dysentery peaked during the summer months. The major causative species was Shigella flexneri (86%) and the predominant S. flexneri serotype was 2a (80%). About 74-80% of Shigella isolates remained susceptible to fluorinated quinolones. CONCLUSION: We conclude that while morbidity and mortality due to bacillary dysentery has decreased considerably in China in the past decade due to increasing access to affordable health care and antibiotics, a considerable burden exists among the youngest and oldest age groups and in regions with low economic development. We suggest that while a vaccine would be effective for short- and medium-term control of bacillary dysentery, improved water supply, sanitation, and hygiene are likely to be required for long-term control.

Adolescent↗

PubMed1997

A study of complaints of fatigue by workers employed in Vietnamese factories with newly imported technology.

The aim was to study the actual situation of subjective fatigue among the Vietnamese workers in factories with newly imported technology. A cross-sectional study concerning working conditions and the fatigue complaints of 389 workers who are employed in 10 Vietnamese factories with newly imported technology, was conducted from August to September 1994. About 60% of the workers were satisfied with their current working conditions. Regarding occupational risks at the workplace, heat, dust and noise were identified as the three most dangerous risks. About 46% of the workers complained about the incompatibility of the machines and equipment they were using, which are too large for Vietnamese workers. One third of all workers felt that the work pace is too rapid. Seventeen percent of the workers considered their working conditions monotonous. Finally, among 150 female workers under 40 years old, 45 workers (30.0%) complained of irregularity of menstruation. Generally these problems were more common among workers in textile factories. The prevalence rate of subjective fatigue complaints was significantly increased after work in all 30 items. The fatigue level were substantially high among workers in textile factories. Female workers in this sector had a high prevalence rate of irregularity of menstruation. There were many problems observed in the Vietnamese factories with newly imported technology. Special consideration is required to improve the working conditions of female workers in the textile industry. Both the Vietnamese government and donor countries have to give special attention to the transfer of worker-friendly technology to Vietnam, in order to achieve sound economic development.

Adult↗

PubMed1980

Study of arrests and convictions in a methadone maintenance program.

The study of arrests and convictions carried out by Teledyne Economic Development Co.'s Narcotic Abuse Treatment Program included a total sample of 1,200 program participants. During the period of the study, between July 1975 and March 1977, 1,200 program participants were included in this study of which 480 were arrested and 122 convicted of various crimes. In part, the purpose of this study was to see if there were any significant relationships between various variables and arrest and conviction rate. It was found that no significant relationships existed.

California↗

PubMed1985

A cross-national perspective on the evolution of alcohol prohibition.

Despite alcohol being the earliest and most widely known of mood-altering substances, there have always been attempts to restrict and control its use. National prohibition of alcohol represents the most ambitious attempt to provide a legal framework for such restrictions. The present paper, following a comparative-historical approach, looks at the course of alcohol prohibition policies in two countries with differing ethnic backgrounds, religious orientations, and stages of economic development: the United States and India. Tracing the historical forces which shaped the prohibition policies in both the countries and their apparent lack of success, the paper identifies some common elements. Among the more important, though with situational variations, are the high degree of moralistic and patriotic fervor associated with prohibition efforts, the projection of guilts and fears of the proponents onto alcohol use, and aspects of culture conflict and opposing group interests. Dysfunctions introduced into the control system by socioeconomic changes resulted in prohibition being either abandoned or altered substantially in both countries.

Alcohol Drinking↗

PubMed1994

Beverage alcohol spending in Singapore: an empirical update.

Data on Singapore suggest strongly that consumer spending on imported and locally produced beverage alcohol was on the rise from 1986 through 1991 just as it had been from 1978 through 1986. Although not alarming in contrast to countries such as South Korea, the rise could signal an emerging problem with both public health and economic growth implications. In terms of economic growth, Singapore's continued economic success and its future plans require a highly skilled labor force, but skilled local workers are in very short supply. Continued rises in spending on beverage alcohol could pose a potential constraint to labor availability and therefore continued material progress. On the public health side, a rise in spending on beverage alcohol could lead to illness and accidents that cause chronic absenteeism, decrease on-the-job productivity, and lead to the permanent loss of valuable workers through alcohol-related motor car and other fatal accidents. A minimalist intervention strategy featuring education and rehabilitation might therefore be a reasonable policy option for government to consider pursuing, both on economic development and public health grounds.

Alcoholic Beverages↗

PubMed1999

Seroepidemiology of schistosomiasis in Puerto Rico: evidence for vanishing endemicity.

The current study summarizes our findings of anti-schistosome egg antibody by the circumoval precipitin test for two different populations in Puerto Rico. One group, exclusively males more than 40 years of age and from all municipalities on the island, was from the Veterans Administration Hospital for the period 1988-1997. The second group resided southeast of San Juan, around the municipality of Caguas and adjacent municipalities east of Caguas, was of both sexes and mostly until 1997 of undetermined ages for the period 1993-1997. Results reveal a yearly decrease in testing requests from the Veterans Administration Hospital from 148 in 1988 and 1989 with 16% positive to three in 1996 through 1998 with none positive. This decrease in testing requests was because of a decrease of suspicion of schistosomiasis in this group. The other patient population from the Caguas region showed a gradual but continuous decrease in seropositive individuals from 21% in 1993 to 12% in 1996, with precipitous decrease to 5% in 1997 and only 1% in 1998. Moreover, there were four patients from which at least two serum samples were obtained one or two years apart and tested. In each instance the more recently obtained sample had lower antibody reactions than the first as reflected in lower percentages of positive egg reactors. The fact that they were treated with praziquantel after the first testing also suggests that the infected population was being eliminated through chemotherapy. These combined results suggest the elimination of infections with Schistosoma mansoni in the traditionally high prevalence regions east of San Juan in the absence of any proactive control efforts in Puerto Rico. Because of the rapid urbanizing of Puerto Rico, the one identifiable control effort is economic development and well being.

Adult↗

PubMedDate not supplied

The ears of the hippopotamus: manifestations, determinants, and estimates of the malaria burden.

Malarious patients experience asymptomatic parasitemia; acute febrile illness (with cerebral damage, anemia, respiratory distress, hypoglycemia); chronic debilitation (anemia, malnutrition, nervous system-related sequelae); and complications of pregnancy (anemia, low birth weight, increased infant mortality). These manifestations in patients, communities, and countries reflect intrinsic (human, parasite, mosquito) and extrinsic (environmental, social, behavioral, political, and economic conditions as well as disease-control efforts) determinants. At a minimum, between 700,000 and 2.7 million persons die yearly from malaria, over 75% of them African children. Between 400 and 900 million acute febrile episodes occur yearly in African children under 5 yr of age living in endemic areas. Although about half of these children are parasitemic, all merit consideration of malaria-specific therapy, which is becoming more problematic because of parasite resistance to drugs. These numbers will more than double over the next 20 yr without effective control. Fewer than 20% of these febrile episodes and deaths come to the attention of any formal health system. The relatively few ill patients who have any contact with the health services represent the "ears of the hippopotamus." Greatly intensified research activities and control of the intolerable burden of malaria are mandatory if economic development is to accelerate in Africa. In particular, support should be targeted to understanding and preventing malaria-induced anemia, hypoglycemia, effects on pregnancy, and neurologic and developmental impairment. To decrease and stop transmission of this intolerable scourge, there is an urgent need for malaria vaccines, newer drugs, and better vector control methods as well as the ability to improve current technologies and use them more efficiently.

Africa↗

PubMed2001

Evaluation of health-related programmes in Africa: a vision for 2020.

BACKGROUND: Whereas systematic evaluation practice is over five decades old in economically developed continents (DCs), that culture has not yet taken root in Africa. OBJECTIVE(S): To provide an overview of the current situation of health-related evaluation in the African Region; to envision an appropriate evaluation framework for the next two decades; and to provide overviews of what formative (FE) and summative (SE) evaluations are and how they could be conducted. DESIGN: Descriptive study. SETTING: Health policies and plans evaluation in the WHO African Region. SUBJECTS OR PARTICIPANTS: WHO Country Representatives for 25 African Countries. INTERVENTIONS: Non-intervention descriptive study. MAIN OUTCOME MEASURES: Availability and quality of long-term health plan (LTHP), health policy (HP), strategic plan (SP), operational plan (OP), and an evaluation culture. RESULTS: The study found that: 88%, 8%, 36%, 28% and 48% of the countries in the Region do not have LTHP, HP, SP, OP and evaluation culture. A conceptual evaluation framework, tools for formative and summative evaluations are proposed. CONCLUSION: It is envisioned that all partners for health development in Africa will cooperate with individual countries to develop (or strengthen) LTHPs, HPs, SPs, and Ministries of Health OPs (national, provincial and district level); and to make complementary investments in building technical and administrative capacity for evaluating implementation of District Operational Plans (DOPs).

Africa↗

PubMed1992

Leprosy in French Polynesia. Epidemiological trends between 1946 and 1987.

The analysis of computerized data (OMSLEP system) on patients from French Polynesia followed since 1940 has shown a decrease in the mean annual detection rates for leprosy, all forms combined, from 24.73 per 100,000 inhabitants in 1946 to 8.1 per 100,000 in 1987 (y = -0.49 x + 45.83; p < 0.05). In fact, the decrease was significant (y = -1.18 x + 83.54; p < 0.05) during the first half of the study period (1946-66), but not during the second half (1967-87). Similarly, a significant decrease in all of the specific mean annual detection rates (according to the form of leprosy and to the sex and age of patients), in the proportion of multibacillary patients among the total of newly detected cases, and in the proportion of all patients with disabilities at the onset of leprosy was observed only during the first half of the study period (1946-66). Nevertheless, when comparing age-specific cumulative detection rates, calculated by 10-year age groups over the period 1946-66, to those of the period 1967-87, an ageing of the leprosy population was noted. Finally, the decrease of mean annual detection rates was greater in the smaller populations of remote islands than in the population of Tahiti, the main island, where 70% of the total population were living during the study period. This decline was shown to correspond to an effective improvement of the leprosy situation which could be attributed, among other factors (such as economic development and systematic BCG vaccination), to the implementation of a control programme for leprosy in 1950. The introduction in 1982 of multidrug therapy for all patients suffering active leprosy has raised the hope of a subsequent decline of leprosy in French Polynesia in the near future.

Adolescent↗

PubMed1983

Community-based health care: contradictions and challenges.

Social contradictions, including uneven economic development and the private-public duality, make community-based provision of health care difficult. The unrestricted expansion of private medical centers has been criticized from several perspectives including inadequate coordination of services, high costs, and negative effects on urban housing and living conditions. Corporate and professional control over health policy, monopolization, and public subsidization foster expansion of private institutions. While private facilities enlarge, public health-care institutions deteriorate, close, or shift to private management. Many clients eligible for care at public hospitals do not receive adequate attention in the private sector. Despite their achievements, community clinics have problems that threaten their survival. The financial insecurity of community clinics is an inherent feature of the private-public duality that affects the entire health-care system. Community clinics and public hospitals offer a potential for broader organizing and empowerment.

California↗

PubMed1998

Pneumoconiosis problem among the Vietnamese coal mine workers.

In this report, the authors present the pneumoconiosis problem among Vietnamese coal mine workers. As coal is one of the most important products for export, its production has been intensified recently. With the strong incentive for rapid economic development, health problems of miners tend to take second place. As shown in the present report, miners' working conditions are very bad, and health protection measures are not sufficiently implemented. It is apparent that official statistics underestimate the actual situation because of the inadequacy of the reporting system. Because the financial barrier to establishing a sufficient reporting system for pneumoconiosis is enormous, an epidemiologic study is the most effective way to assess the actual situation. It is also useful to conduct epidemiologic studies as part of an international collaborative project, in order to transfer necessary knowledge and epidemiologic skills from the developed countries to Vietnam.

Coal Mining↗

PubMed2000

Occupational exposure, environmental pollution and chronic respiratory symptoms in Vietnam.

Since the introduction of the market economy in 1986, Vietnam has been in the process of rapid economic development. However, the current state of affairs in the industries is very profit-oriented and due consideration is not given to the occupational health services and environmental health. In order to investigate the relationship among occupational exposure to dust/chemicals (toxic gases/fume), environmental pollution and chronic respiratory symptoms in Vietnam, the questionnaire standardized by the American Thoracic Society was applied to 1,562 subjects living in the Quang Ninh area and its surroundings, North Vietnam. Chronic respiratory symptoms such as cough, phlegm, wheezing and breathlessness appeared from the questionnaire. According to the results of multiple logistic regression analyses, among current non-smokers, the odds ratios of chronic respiratory symptoms with a history of occupational exposure to dust, living in polluted district and age were over unity. Especially for cough, significantly higher odds ratios were observed among those with the history of occupational exposure to dust: 2.248 (95% confidential interval: 1.642-3.077). Among current smokers, the odds ratios of chronic respiratory symptoms with the history of occupational exposure to dust were over unity. These results indicate that the history of occupational exposure to dust, living in polluted area and age cause non-smokers to have chronic respiratory symptoms, and also that the history of occupational exposure to dust affect the current smokers.

Adult↗