Journal of health inequalities最新文献

{"title":"Nutritional habits and lifestyle of patients qualified for Roux-en-Y gastric bypass and sleeve gastrectomy bariatric surgery","authors":"Natalia Komorniak, M. Hoffmann, Bartosz Kowalewski, Krzysztof Kaseja, M. Szczuko","doi":"10.5114/jhi.2020.96973","DOIUrl":"https://doi.org/10.5114/jhi.2020.96973","url":null,"abstract":"Introduction: Obesity is a disease affecting an increasing number of people around the world. Studies show that the diet of obese patients is qualitatively poor, which is linked to many vitamin and mineral deficiencies in this group of patients. Aim of the study: To determine whether selected elements of patients’ lifestyle contributed to the occurrence of extreme obesity among them. Material and methods: The study involved 60 patients qualified for surgical treatment. A survey related to dietary habits was conducted and anthropometric measurements were taken. For the survey used in this study the questionnaire contained questions on: socio-economic situation, health condition, presence of diseases accompanying obesity, dietary habits and physical activity. All the results were statistically analysed using the STATISTICA 12 software. Results: As many as 75% of women and 80.5% of men qualified for the two types of surgeries led a sedentary lifestyle and did not engage in any physical activity. Majority of patients ate only 2-3 meals a day at irregular intervals and snacked between meals. Approximately 1/3 of patients did not eat breakfasts and 1/5 ate meals during the night. Women most often snacked under stress and men snacked as a habit in front of the TV/computer. Conclusions: Dietary habits and a sedentary lifestyle were the main contributors to the development of obesity, along with eating to reduce stress. A consultation with a psychologist would help patients to reduce excessive body weight. KeY wOrds: bariatric surgery, obesity, feeding behaviour, sedentary lifestyle, eating disorders. address fOr cOrrespOndence: Małgorzata Szczuko, Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 24 Broniewskiego St., 71-460 Szczecin, Poland, e-mail: malgorzata.szczuko@pum.edu.pl DOI: https://doi.org/10.5114/jhi.2020.96973 IntroductIon Throughout the last decades, obesity has gained a prominent place among other non-infectious chronic diseases as a serious health problem in many countries [1]. According to data from World Health Organization (WHO), in 2014 there were more than 1.9 billion overweight adults globally, including more than 600 million obese people. A study published in 2015 [2] showed that almost half of adult Europeans (47.6%) is overweight (54.5% of men and 40.8% of women), and 12.8% (14% of men and 11.5% of women) is obese. Paradoxically, despite the fact that obesity is a preventable disease, most people live in countries where excessive weight and obesity kill more people than malnutrition – it is the fifth cause of deaths in the world. Obesity is the most common pathological state leading to significant deterioration in the health of all social groups in developed countries [3]. Obesity is characterized by increased amount of fatty tissue due to hypertrophy and/or hyperplasia of adipocytes. In people with excessive body mass, the most","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"274 1-2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78462491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic disparities in parity and child mortality in Nigeria: a multiple indicator cluster survey","authors":"B. Ghose, S. Yaya","doi":"10.5114/jhi.2020.95826","DOIUrl":"https://doi.org/10.5114/jhi.2020.95826","url":null,"abstract":"Introduction: Women’s reproductive or fertility behaviour and overall maternal and child health outcomes are greatly influenced by various biological and psychosocial factors, which themselves seem to vary substantially among different ethnic backgrounds. This study was undertaken on a representative sample of Nigerian women to assess whether: 1) the ethnic disparities in fertility and child mortality rates are significant even after controlling for potential confounders, 2) women who experience higher child mortality have higher fertility rates. Methods: Cross-sectional data on 34,139 women aged between 15 and 49 years were extracted from a multiple indicator cluster survey conducted in 2017. The total number of children ever born and self-re-ported events of child health were used as outcome variables. Ethnic differences in parity and child mortality were analysed using multivariable regression techniques. Results: Significant ethnic variation was found across fertility and under-five mortality rates. These variations persisted even after adjusting for several potential risk factors. There was an inverse relationship between under-five mortality and fertility. The prevalence of having > 6 children was highest among women who reported > 2 child deaths. In the regression analysis, high-parity women were found to have experienced higher child mortalities. Conclusions: Significant ethnic differences exist in fertility and under-five mortality, which might be indicative of ethnic inequalities in health determinants and access to healthcare resources. The findings also support the view that women who experience child death are more likely to have higher fertilities than those who do not. Future studies should explore the underlying disparities in child mortality and fertility rates in Nigeria.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82225114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational inequalities in mortality due to alcoholic liver disease in Poland","authors":"M. Pikala, K. Janik-Koncewicz, W. Zatoński","doi":"10.5114/JHI.2020.103229","DOIUrl":"https://doi.org/10.5114/JHI.2020.103229","url":null,"abstract":"Introduction: Poland has been experiencing an epidemic of alcohol-attributable deaths in the last decades. There is a growing body of scientific evidence that educational level is linked to health behaviours and health status. The aim of the study was to analyse the impact of educational inequalities on mortality due to alcoholic liver disease (ALD) in Poland in 2002 and 2011. Material and methods: The analysis included deaths due to alcoholic liver disease which occurred in 2002 and 2011 and information on education among Poles, aged 20 and over. Data originated from records of death certificates obtained from the database of the Central Statistical Office in Poland and the censuses. Attained educational level have been reclassified according to the International Standard Classification of Education. To assess the educational inequalities rate ratio of mortality in the group with lowest education to mortality in the group with highest education was used. Results: The lowest risk of death due to ALD was in the group with higher education, and the highest risk was in the group with the lowest education in both men and women (i.e. standardised death rate per 100,000 = 0.26 in 2002 and 0.68 in 2011 in higher educated vs 1.40 and 6.23, respectively, in lower educated women). In men, the highest risk of death from ALD was observed in the group with the lowest education aged 45-64 years (20.22/100,000 in 2002, and 44.08/100,000 in 2011). The rate ratio between 2002 and 2011 increased only in women. Conclusions: Significant differences in deaths from alcoholic liver cirrhosis due to education have been observed in Polish adults. There is an urgent need to implement national alcohol control programs in Poland which would especially deal with alcohol consumption in the groups of population with lower education levels.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86515347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of psychoactive substances by young people reporting suicidal thoughts, plans, and attempts in the context of sociodemographic factors","authors":"Maciej Zygo, B. Pawłowska, E. Potembska, L. Kapka-Skrzypczak","doi":"10.5114/jhi.2020.95504","DOIUrl":"https://doi.org/10.5114/jhi.2020.95504","url":null,"abstract":"Aim of the study: To analyse the prevalence of psychoactive substance use by young people reporting suicidal thoughts, plans, and attempts, including sociodemographic factors. Material and methods: The study involved 5685 individuals aged 13 to 19 years. Seventy percent ( n = 3980) of them were girls and 30% ( n = 1705) were boys. They attended schools in the Lublin Province in Eastern Poland. Forty-six percent ( n = 2615) of those surveyed were city dwellers and 54% ( n = 3070) lived in rural areas. The mean age of the participants was 16.91 years and the median was 17 years. The participants were surveyed using a self-report questionnaire designed by the study authors. Results: Statistically significant relationships were found between the participants’ suicidal behaviours (thoughts, plans, and attempts) and their use of alcohol and drugs. Conclusions: Individuals who report suicidal thoughts, plans, and attempts are more likely to abuse alcohol and use drugs than those who do not report suicidal behaviours. Significantly more young people living in the city than in the countryside abuse alcohol and take drugs. Women who live in urban areas start drinking at a significantly lower age than their peers living in the countryside.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84145213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the prevalence and risk factors of pelvic floor disorders among women in rural Turkey","authors":"S. Kaplan, C. Turkler, M. Bülbül, P. Kırıcı","doi":"10.5114/JHI.2020.103230","DOIUrl":"https://doi.org/10.5114/JHI.2020.103230","url":null,"abstract":"Introduction: Pelvic floor disorders (PFD) are an important cause of urogynecological surgery affecting the quality of life seen in many women, such as pelvic organ prolapse (POP), stress urinary incontinence (SUI) and urge urinary incontinance (UUI). We aimed to determine prevalence and associated risk factors for SUI, UUI and POP in rural Turkey. Material and methods: PFD approved for screening in Turkey in terms of screening questions and PFD was made using data obtained from the database. The patients were divided into three groups: patients with POP, SUI, and UUI. Of the patients, 7163 (43.9%) were in the POP group, 6815 (41.8%) were in the SUI group, and 2349 (14.3%) were in the UUI group. The relationship between the frequency of symptoms commonly reported for SUI, UUI and POP and the relationship between demographic and pregnancy history information were compared. Results: The prevalence of SUI was 37.8% (95% CI: 37.3-38.2), 14.8% (95% CI: 14.3-15.3) for UUI and 43.8% (95% CI: 43.2-44.5) for POP. In the multivariate binary logistic regression analysis, the risk of PFD increased with age, an increase in the number of vaginal births, high BMI, macrosomia, early maternal age, previous abdominal/pelvic surgery history, and difficult delivery history. Conclusions: PFD are quite common among women in rural Turkey. However, risk factors are similar to risk factors in developed countries.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81501484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editors concerning the paper “The burden of avoidable disease from air pollution: implications for prevention”","authors":"Cezary Wojtyła","doi":"10.5114/JHI.2020.101722","DOIUrl":"https://doi.org/10.5114/JHI.2020.101722","url":null,"abstract":"In their recent paper entitled “The burden of avoidable disease from air pollution: implications for prevention”, Jonathan Samet and Meghan Buran discuss one of the most important, current problems of public health [1]. Air pollution is nowadays the greatest threat to the health of the population around the world. It is not without reason that the World Health Organization (WHO) defined air pollution as the single greatest environmental risk to health [2], at the same time specifying the problem as the “new tobacco” [3]. As the authors of the paper point out, both smoking and ambient air pollution make major contributions to disease burden. There are many similarities between air pollution and smoking, in terms of population exposure, the possibility of reducing adverse health effects through adequate control of its intake and emission, and the foreseeable resistance to legislative solutions from groups to which these branches of the economy bring income. Despite the benefits of introducing appropriate regulations of air pollution and tobacco smoking control, the costs required to develop these are incomparable. However, we should always remember the consequences of not introducing regulations, especially in the case of countries such as Poland, where high levels of PM2.5 are still observed. According to the WHO Ambient Air Pollution Database, over 30 of the 50 most polluted cities in Europe are located in Poland [4]. This situation contributes annually to about 23,500 premature deaths [1]. The scale is likely much larger. It should be remembered that the negative impact of air pollution on pregnancy and the development of a child in the following years of their life possibly lead to premature death in the future. The developing fetus is extremely sensitive to the harmful effects of air pollution and its compounds inhaled by a pregnant woman. These compounds are transferred through the pulmonary alveoli to the maternal circulation, reaching in effect the placenta and the fetal circulation [5]. The immature immunological system and liver of the fetus make the metabolism of these compounds and their elimination difficult. Exposure of a pregnant woman to compounds contained in polluted air may result in intrauterine growth restriction, preterm birth, low birthweight, development of congenital abnormalities, and unfavorable course of pregnancy or delivery [6, 7]. The fetal DNA repair mechanisms are also immature, which, with the simultaneous intense proliferation of cells, leads to changes in the genetic material and epigenetic changes that multiply during subsequent cell divisions, increasing the risk of chronic diseases and cancer in postnatal life, and may lead to premature death [7, 8]. Today’s air pollution could take its toll on human health for decades to come. Thus, the earlier appropriate control policies are taken to reduce it, the healthier society will be, not only today but also in the future.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76143782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nutritional assessment of children aged 1-3 years in the Greater Poland (Wielkopolska) region of Poland","authors":"Paulina Wojtyła-Buciora, L. Kapka-Skrzypczak, Z. Chęcińska-Maciejewska, K. Kozłowski, H. Krauss","doi":"10.5114/jhi.2020.96974","DOIUrl":"https://doi.org/10.5114/jhi.2020.96974","url":null,"abstract":"Introduction: Adequate nutrition is vital in infants and toddlers to ensure optimal development, both somatic and mental. Aim of the study: To assess nutrition in children aged 13-36 months (toddlers), living in the Greater Poland region (Wielkopolska), according to their nutritional status and current nutritional recommendations. The relationship between anthropometric parameters (body mass and height) with nutritional status was also investigated in regard to WHO standards. Material and methods: A questionnaire-based survey was conducted along with an assessment of the daily dietary intake. There were n = 520 toddler subjects, aged 13-36 months, of whom n = 322 were girls and n = 188 were boys. The study was based on the subjects’ present and previous nutritional behaviours in relation to current nutritional norms. Outcomes were also compared with centile charts prepared by the WHO. Data were statistically analysed using the SPSS-IBM software package, adopting p < 0.5 as being statistically significant. Results: Mothers breast fed their children in 78% of cases; however, such feeding was not exclusive in the first six months of life. Children were started on supplemented diets at various times during this period, at an average of 4.23 months. Overall, our study revealed poor dietary intake of milk, which is rich in unsaturated fatty acids and vitamin D. The dietary balance between vegetables and fruit was inappropriate. Furthermore, daily fluid intakes were quite markedly inadequate. Toddlers’ mainly drank either water or sweetened fizzy/sparkling drinks (soda-pop). According to the centile charts, 15% were underweight, 71% had normal BMIs, 5% were overweight, and 8% were obese. Conclusions: Promoting breast feeding should be treated as a public health priority because so few mothers exclusively do so in the first six months of their offspring’s life. Nutrition in toddlers aged 13-36 months often differs from the recommended standard models, and thus medical-dietetic advice should always be designed to track and remedy this situation. Toddlers’ diets therefore need to be modified whenever BMIs are abnormal so as to ensure that dietary intake has the required nutrient profiles necessary for adequate nutrition.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84402995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the article titled: “The burden of avoidable disease from air pollution: implications for prevention” by Jonathan Samet and Meghan Buran","authors":"T. Zatoński","doi":"10.5114/JHI.2020.103228","DOIUrl":"https://doi.org/10.5114/JHI.2020.103228","url":null,"abstract":"","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87458659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco taxation: A key tool for public health","authors":"J. Branston","doi":"10.5114/JHI.2019.87821","DOIUrl":"https://doi.org/10.5114/JHI.2019.87821","url":null,"abstract":"Tobacco taxes are widely regarded as one of the most effective tobacco control policies for improving the public health, which is why they are a key part of the World Health Organisation (WHO) Framework Convention for Tobacco Control (FCTC). Such taxes increase the cost of selling tobacco products, and the resulting higher retail prices provide a strong encouragement for smokers to quit their deadly habit. Tobacco taxes also provide a source of significant tax revenue, which can be used to fund other public health measures, amongst other things, and such revenues generally increase when tax rates are increased. However, recent studies have shown that the tobacco industry has adopted a range of strategies to minimise the impact of such taxes, but also that the nature of the tobacco taxes applied can help combat such actions. Tobacco taxes are most effective when they take the form of a lump sum paid per tobacco stick, rather than when they are taxed in proportion to the sales price, and the downside of proportion taxes can be partially offset by the use of appropriate Minimum Excise Taxes. Such an approach to taxation not only reduces the pricing spread of tobacco products in the market place but also the tax in relation to the harm caused. This is important as smokers need a strong signal to quit their deadly habit, or at least to switch to less risky products if they are unwilling or unable. Tobacco taxes also need to be regularly updated in order to address the problem that tobacco products become more affordable over time as consumer incomes increase. An announced government policy commitment to regular above-inflation increases in tobacco duty is therefore helpful, although tax changes are most effective when unexpected and relatively large. If taxes are not regularly increased, research shows that the industry cleverly adjusts its prices in order to both maintain tobacco use and also increase their profits. This effectively means that the industry is increasing their profits when this money could have gone to the government in the form of higher tax revenues. The tobacco industry often argues that tax increases will lead to large increases in illicit tobacco products that bypass tobacco taxation, but their own actions show that they do not believe this line. Recent experience in the UK also shows that tobacco taxes can be consistently increased significantly, whilst simultaneously driving down the rate of illicit tobacco use. The key is a comprehensive package of enforcement measures. The Polish government is strongly encourage to increase taxes from their relatively low level compared to leading tobacco control countries such as the UK, Ireland, and Australia. For example, according to the European Commission as of 1st March 2019, the taxation due on 1,000 cigarettes was only €99.45 in Poland, but €329.99 in the UK and €378.49 in Ireland. With so low levels of taxation Poland has some of the cheapest tobacco in Europe, with the Weighted Ave","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73699582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explanatory perspectives","authors":"J. Mackenbach","doi":"10.1093/oso/9780198831419.003.0003","DOIUrl":"https://doi.org/10.1093/oso/9780198831419.003.0003","url":null,"abstract":"Chapter 3 (‘Explanatory perspectives’) provides a digest of the vast amounts of explanatory research on health inequalities that has been conducted over the past three decades. It introduces recent methodological advances, such as the counterfactual approach to causality, quasi-experimental study designs, and mediation analysis. It reviews the scientific evidence that education, occupational class and income have a causal effect on health. It introduces life-course models, summarizes current understanding of the role of six groups of contributing factors (genetics, childhood environment, material living conditions, social and psychological factors, health-related behaviours, and health care), and describes the biological mechanisms of ‘embodiment’ of social inequality. It also discusses the merits of nine overarching theories of health inequalities: ‘social selection’, ‘diffusion of innovations’, ‘cultural capital’, ‘inverse equity’, ‘inverse care law’, ‘neo-materialism’, ‘psychosocial environment’, ‘fundamental causes’ and ‘political economy of health’.","PeriodicalId":93580,"journal":{"name":"Journal of health inequalities","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87430670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}