Socioeconomic Differences in Smoking and Cessation Across a Period of Rapid Economic Growth in an Upper-Middle-Income Country

2018 ◽  
Vol 21 (11) ◽  
pp. 1539-1546
Author(s):  
Jeevitha Mariapun ◽  
Noran N Hairi ◽  
Chiu-Wan Ng
Keyword(s):  
Smoking Prevalence ◽  
Peninsular Malaysia ◽  
Middle Income Country ◽  
Middle Income ◽  
Middle Income Countries ◽  
Socioeconomic Gradient ◽  
The Poor ◽  
Increasing Trend ◽  
Former Smokers ◽  
The Rich

Abstract Introduction Higher smoking rates and lower cessation rates among the poor compared to the rich are evident in high-income countries. In low and middle-income countries (LMICs), many of which are in the early stages of tackling the tobacco epidemic, more knowledge is required of the socioeconomic inequalities in smoking. This is especially the case for upper-middle-income countries, where smoking prevalence is highest. This study examines trends in the socioeconomic gradient in smoking and cessation among adults across a period of rapid economic development in Malaysia, an LMIC with an upper-middle-income economy. Methods The socioeconomic trends in smoking were analyzed using data from cross-sectional National Health and Morbidity Surveys for the years 1996, 2006, and 2011. Household per capita income was used as a measure of socioeconomic position. As a measure of inequality, the concentration index that quantified the degree of socioeconomic inequality in a health outcome was computed. Smoking was assessed in current and former smokers. The study population was examined by gender, region, and age group. Results This study found a trend of an increasingly higher smoking prevalence among the poor and higher cessation rates among the rich. With the exception of younger women in Peninsular Malaysia, the socioeconomic gradient in current smoking is concentrated among the poor. For former smokers, especially men, distributions across the years were mostly concentrated among the rich. Conclusion It is important to ensure that health policies, programs, and interventions consider the potential impact of the socioeconomic patterning in smoking on equity in health. Implications Findings on the socioeconomic gradient in smoking and cessation from Malaysia across a period of rapid economic development will contribute to addressing the paucity of knowledge on the socioeconomic gradient of smoking and cessation in other progressing LMICs. This study provides evidence from an upper-middle-income country, of an increasing trend of smoking among the poor and an increasing trend of cessation rates among the rich, particularly for men. We found opposing trends for younger adult women in the more developed, Peninsular Malaysia. More rich young women were found to have taken up smoking compared to socioeconomically less advantaged young women.

scholarly journals Socioeconomic inequalities in lifestyle risk factors across low- and middle-income countries

2021 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer
Keyword(s):  
Risk Factors ◽  
Alcohol Use ◽  
Tobacco Use ◽  
Socioeconomic Inequalities ◽  
Middle Income ◽  
Lifestyle Risk Factors ◽  
Middle Income Countries ◽  
The Poor ◽  
Harmful Alcohol ◽  
Lifestyle Risk

Abstract Background The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce their underlying risk factors, which are often linked to lifestyles. To effectively supplement nationwide policies with targeted interventions, it is important to know how these risk factors are distributed across socioeconomic segments of populations in LMICs. This study quantifies the prevalence and socioeconomic inequalities in lifestyle risk factors in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030. Methods Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with the different lifestyle risk factors. Results The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively − 0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off. The associations between the share of GDP spent on health and the socioeconomical distribution of lifestyle factors are multidirectional. Conclusions This study emphasizes the importance of lifestyle risk factors in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in lifestyle risk factors - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted to supplement nationwide policies.

Opioid use disorders national registries and opioids sales registries: A 10-year prevalence study from a middle-income country

2021 ◽  
Vol 17 (5) ◽  
pp. 383-388
Author(s):  
Daniela Yucumá, MD ◽  
Ana Beatriz Pizarro, RN ◽  
Diego Alberto Moreno, MD ◽  
Juan David Mosos, MD ◽  
Marian Rincón-Montaña, MD ◽  
...  
Keyword(s):  
Behavioral Disorders ◽  
Progressive Increase ◽  
National Registry ◽  
Middle Income Country ◽  
Opioid Use ◽  
Middle Income ◽  
Middle Income Countries ◽  
Icd 10 ◽  
Opioid Use Disorders ◽  
Mental And Behavioral Disorders

Objectives: (1) To estimate the prevalence, geographic distribution, and demographic characteristics of patients diagnosed with mental and behavioral disorders due to the use of opioids in Colombia, between 2009 and 2018. (2) To describe the opioid sales trends in Colombia over the last few years.Methods: We conducted an observational study analyzing information from Individual National Registry of Health Services and the Colombian official database for pharmaceuticals prices and quantities sold. The included ICD-10 codes were mental and behavioral disorders due to the use of opioids (F11) codes subdivisions.Results: 12,557 cases of mental and behavioral disorders due to opioid use were reported, with a rate of 3.0 per 100,000 inhabitants for the studied period. Men represented 74.2 percent, with a male:female ratio of 2.9:1. The highest prevalence was found between 20 and 24 years, in the northwest Colombian area. A progressive increase in the total number of opioid units sold during the study period was found, and the most frequently sold opioids were tramadol (55 percent) and codeine (20 percent).Conclusions: Recognition of opioid use disorders has increased in the last 10 years; it affects more males than females, mostly young adults, and is higher in certain affluent regions of Colombia. We found a progressive annual increase in the sales of opioids in the country, which could be related to the increase in the rate of registries. Studies that have analyzed opioid abuse in Latin America are limited, and further studies are needed to evaluate this situation in middle-income countries from the region.

Socioeconomic inequalities in unhealthy lifestyles in low- and middle-income countries

2020 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Socioeconomic Inequalities ◽  
Individual Characteristics ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
The Poor ◽  
Harmful Alcohol ◽  
Low And Middle Income

Abstract Background: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce unhealthy lifestyles. To effectively target these interventions, it is important to know how unhealthy lifestyles vary with socioeconomic characteristics. This study quantifies prevalence and socioeconomic inequalities in unhealthy lifestyles in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030.Methods: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with different unhealthy lifestyles.Results: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively -0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off.Conclusions: This study emphasizes the importance of unhealthy lifestyles in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in unhealthy lifestyles - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted.

Inequalities in smoking prevalence during pregnancy: Comparing results from 53 low and middle income countries

2015 ◽  
Author(s):  
Fernando C. Wehrmeister ◽  
María Clara Restrepo-Méndez ◽  
Giovanny V.A. França ◽  
Aluisio J.D. Barros ◽  
Cesar G. Victora
Keyword(s):  
Smoking Prevalence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Inequality and Fiscal Redistribution in Middle Income Countries: Brazil, Chile, Colombia, Indonesia, Mexico, Peru and South Africa

2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Nora Lustig
Keyword(s):  
South Africa ◽  
Fiscal Policy ◽  
Health Spending ◽  
Social Spending ◽  
Income Poverty ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Rich ◽  
Incidence Analysis ◽  
Consumption Taxes

AbstractThis paper examines the redistributive impact of fiscal policy for Brazil, Chile, Colombia, Indonesia, Mexico, Peru and South Africa using comparable fiscal incidence analysis with data from around 2010. The largest redistributive effect is in South Africa and the smallest in Indonesia. Success in fiscal redistribution is driven primarily by redistributive effort (share of social spending to GDP in each country) and the extent to which transfers/subsidies are targeted to the poor and direct taxes targeted to the rich. While fiscal policy always reduces inequality, this is not the case with poverty. When pensions are not considered a transfer, fiscal policy increases poverty in Brazil (over and above market income poverty) due to high consumption taxes on basic goods. Total spending on education is pro-poor except for Indonesia, where it is neutral in absolute terms. Health spending is pro-poor in Brazil, Chile and South Africa, roughly neutral in absolute terms in Mexico, and not pro-poor in Indonesia and Peru.

scholarly journals Nanomedicine for the poor: a lost cause or an idea whose time has yet to come?

Nanomedicine ◽  
2021 ◽  
Author(s):  
Vuk Uskoković
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Gdp Per Capita ◽  
Lost Cause ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Poor ◽  
Scientific Innovation ◽  
Per Capita ◽  
To Come

The most effective COVID-19 vaccines, to date, utilize nanotechnology to deliver immunostimulatory mRNA. However, their high cost equates to low affordability. Total nano-vaccine purchases per capita and their proportion within the total vaccine lots have increased directly with the GDP per capita of countries. While three out of four COVID-19 vaccines procured by wealthy countries by the end of 2020 were nano-vaccines, this amounted to only one in ten for middle-income countries and nil for the low-income countries. Meanwhile, economic gains of saving lives with nano-vaccines in USA translate to large costs in middle-/low-income countries. It is discussed how nanomedicine can contribute to shrinking this gap between rich and poor instead of becoming an exquisite technology for the privileged. Two basic routes are outlined: (1) the use of qualitative contextual analyses to endorse R&D that positively affects the sociocultural climate; (2) challenging the commercial, competitive realities wherein scientific innovation of the day operates.

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