scholarly journals Developing indicators of age-friendly neighbourhood environments for urban and rural communities across 20 low-, middle-, and high-income countries

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Emily J. Rugel ◽  
Clara K. Chow ◽  
Daniel J. Corsi ◽  
Perry Hystad ◽  
Sumathy Rangarajan ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Disease Risk ◽  
High Income ◽  
Community Level ◽  
Assessment Tools ◽  
World Health ◽  
Mixed Data ◽  
Local Context ◽  
Traffic Lights

Abstract Background By 2050, the global population of adults 60 + will reach 2.1 billion, surging fastest in low- and middle-income countries (LMIC). In response, the World Health Organization (WHO) has developed indicators of age-friendly urban environments, but these criteria have been challenging to apply in rural areas and LMIC. This study fills this gap by adapting the WHO indicators to such settings and assessing variation in their availability by community-level urbanness and country-level income. Methods We used data from the Prospective Urban and Rural Epidemiology (PURE) study’s environmental-assessment tools, which integrated systematic social observation and ecometrics to reliably capture community-level environmental features associated with cardiovascular-disease risk factors. The results of a scoping review guided selection of 18 individual indicators across six distinct domains, with data available for 496 communities in 20 countries, including 382 communities (77%) in LMIC. Finally, we used both factor analysis of mixed data (FAMD) and multitrait-multimethod (MTMM) approaches to describe relationships between indicators and domains, as well as detailing the extent to which these relationships held true within groups defined by urbanness and income. Results Together, the results of the FAMD and MTMM approaches indicated substantial variation in the relationship of individual indicators to each other and to broader domains, arguing against the development of an overall score and extending prior evidence demonstrating the need to adapt the WHO framework to the local context. Communities in high-income countries generally ranked higher across the set of indicators, but regular connections to neighbouring towns via bus (95%) and train access (76%) were most common in low-income countries. The greatest amount of variation by urbanness was seen in the number of streetscape-greenery elements (33 such elements in rural areas vs. 55 in urban), presence of traffic lights (18% vs. 67%), and home-internet availability (25% vs. 54%). Conclusions This study indicates the extent to which environmental supports for healthy ageing may be less readily available to older adults residing in rural areas and LMIC and augments calls to tailor WHO’s existing indicators to a broader range of communities in order to achieve a critical aspect of distributional equity in an ageing world.

scholarly journals Prevalence and access to care for cardiovascular risk factors in older people in Sierra Leone: a cross-sectional survey

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038520
Author(s):  
Maria Lisa Odland ◽  
Tahir Bockarie ◽  
Haja Wurie ◽  
Rashid Ansumana ◽  
Joseph Lamin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Access To Care ◽  
Sierra Leone ◽  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Health System Strengthening ◽  
Low Income Countries

IntroductionPrevalence of cardiovascular disease risk factors (CVDRFs) is increasing, especially in low-income countries. In Sierra Leone, there is limited empirical data on the prevalence of CVDRFs, and there are no previous studies on the access to care for these conditions.MethodsThis study in rural and urban Sierra Leone collected demographic, anthropometric measurements and clinical data from randomly sampled individuals over 40 years old using a household survey. We describe the prevalence of the following risk factors: diabetes, hypertension, dyslipidaemia, overweight or obesity, smoking and having at least one of these risk factors. Cascades of care were constructed for diabetes and hypertension using % of the population with the disease who had previously been tested (‘screened’), knew of their condition (‘diagnosed’), were on treatment (‘treated’) or were controlled to target (‘controlled’). Multivariable regression was used to test associations between prevalence of CVDRFs and progress through the cascade for hypertension with demographic and socioeconomic variables. In those with recognised disease who did not seek care, reasons for not accessing care were recorded.ResultsOf 2071 people, 49.6% (95% CI 49.3% to 50.0%) of the population had hypertension, 3.5% (3.4% to 3.6%) had diabetes, 6.7% (6.5% to 7.0%) had dyslipidaemia, 25.6% (25.4% to 25.9%) smoked and 26.5% (26.3% to 26.8%) were overweight/obese; a total of 77.1% (76.6% to 77.5%) had at least one CVDRF. People in urban areas were more likely to have diabetes and be overweight than those living in rural areas. Moreover, being female, more educated or wealthier increased the risk of having all CVDRFs except for smoking. There is a substantial loss of patients at each step of the care cascade for both diabetes and hypertension, with less than 10% of the total population with the conditions being screened, diagnosed, treated and controlled. The most common reasons for not seeking care were lack of knowledge and cost.ConclusionsIn Sierra Leone, CVDRFs are prevalent and access to care is low. Health system strengthening with a focus on increased access to quality care for CVDRFs is urgently needed.

Safe Arrivals: Responding to the Local Context in a Training Program for Birth Attendants in Cambodia

2014 ◽  
Vol 4 (2) ◽  
pp. 77-85
Author(s):  
Lois V. McKellar ◽  
Kevin Taylor
Keyword(s):  
Rural Areas ◽  
Cultural Context ◽  
Cultural Practices ◽  
Skilled Birth Attendant ◽  
World Health ◽  
Local Context ◽  
Birth Attendants ◽  
Quality Assurance Process ◽  
Health Organization ◽  
Assurance Process

The World Health Organization (WHO) recommends that every woman should have a skilled birth attendant (SBA) attend her birth; however, until this ideal is met, traditional birth attendants (TBA) continue to provide care to women, particularly in rural areas of countries such as Cambodia. The lack of congruence between an ideal and reality has caused difficulty for policy makers and governments. In 2007, The 2h Project, an Australian-based, nongovernment organization in partnership with a local Cambodian organization, “Smile of World,” commenced the “Safe Arrivals” project, providing annual training for SBAs and TBAs in the rural provinces of Cambodia. Following implementation of this project, feedback was collected through a questionnaire undertaken by interviews with participants. This was part of a quality assurance process to further develop training in line with WHO recommendations and to consider the cultural context and respond to local knowledge. Over a 2-year period, 240 birth attendants were interviewed regarding their role and practice. Specifically, through the responses to the questionnaires, several cultural practices were identified that have informed training focus and resource development. More broadly, it was evident that TBAs remain a valuable resource for women, acknowledging their social and cultural role in childbirth.

scholarly journals ANALISIS KONSUMSI PANGAN TINGKAT RUMAH TANGGA DI PROPINSI LAMPUNG

Agro Ekonomi ◽  
2006 ◽  
Vol 13 (2) ◽  
Author(s):  
Meliyanah Meliyanah ◽  
Suhatmini Hardyastuti ◽  
Djuwari Djuwari
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Urban Areas ◽  
Household Consumption ◽  
Income Level ◽  
High Income ◽  
Middle Income ◽  
Household Level ◽  
Rural And Urban Areas ◽  
Rural And Urban

This research diamed to: 1) knowing the selft-price elasticity, cross-price elasticity and income elasticity of consumption per food item on household level according to location and income level; and 2) knowing the reation between level of income and food consumption on household level according to location and income level.This research used data from SUSENAS of Lmapung Province in 2002 with number of sample of 2091 household, which being differed between rural and urban areas based on low, middle, and high level of income. The data analysis used tobit model and sensored regression.The result showed that: 1) the demand of rice and beeh for household consumption in every level of income in rural and urban areas were inelastic; 2) Coen only been consumed by low income level household in rural areas and the demand was inelastic; 3) the demand of cassava for household consumption on low income level in urban area was elastic, While in middle income level, high income level and every level of income in rural area, cassava demand was inelastic. Cassava was considered as inferior goods; 4) The demand of fish for household consumption an every level of income in rural and urban areas was elastic. Household in rural area on every level of income and in urban areas on middle and high income level consider fish as a main necessity. While on low income level  household in urban areas, it was considered as classy/exclusive good; 5) the demand of chicken; for household in rural areas on middle and high income level was inelastic. When in rural low income level and urban middle and high income level, was inelastic chicken meat was considend as classy/exclusive good the rural low income level household; 6) egg demand for household consumption in rural areas on every level of income was inelastic, while in urban area it was elastic for every level income; 7) the rural and urban household on every level of income considered rice as the stpale food; 8) Household in rural and urban areas on middle and high level of income considered beef as main necessity; 9) On household with middle income level in rural areas, egg was considere as inferior good; while an low income level in urban areas, egg was considere as expensive good.

scholarly journals Using smartphone-based virtual patients to assess the quality of primary healthcare in rural China: protocol for a prospective multicentre study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020943 ◽  
Author(s):  
Jing Liao ◽  
Yaolong Chen ◽  
Yiyuan Cai ◽  
Nan Zhan ◽  
Sean Sylvia ◽  
...  
Keyword(s):  
Quality Assessment ◽  
Low Income ◽  
Rural Areas ◽  
Assessment Tool ◽  
Low Cost ◽  
Care Quality ◽  
Assessment Tools ◽  
Face Validity ◽  
Virtual Patients ◽  
Health Centres

IntroductionValid and low-cost quality assessment tools examining care quality are not readily available. The unannounced standardised patient (USP), the gold standard for assessing quality, is costly to implement while the validity of clinical vignettes, as a low-cost alternative, has been challenged. Computerised virtual patients (VPs) create high-fidelity and interactive simulations of doctor-patient encounters which can be easily implemented via smartphone at low marginal cost. Our study aims to develop and validate smartphone-based VP as a quality assessment tool for primary care, compared with USP.Methods and analysisThe study will be implemented in primary health centres (PHCs) in rural areas of seven Chinese provinces, and physicians practicing at township health centres and village clinics will be our study population. The development of VPs involves three steps: (1) identifying 10 VP cases that can best represent rural PHCs’ work, (2) designing each case by a case-specific development team and (3) developing corresponding quality scoring criteria. After being externally reviewed for content validity, these VP cases will be implemented on a smartphone-based platform and will be tested for feasibility and face validity. This smartphone-based VP tool will then be validated for its criterion validity against USP and its reliability (ie, internal consistency and stability), with 1260 VP/USP-clinician encounters across the seven study provinces for all 10 VP cases.Ethics and disseminationSun Yat-sen University: No. 2017-007. Study findings will be published and tools developed will be freely available to low-income and middle-income countries for research purposes.

scholarly journals Association between commensality with depression and suicidal ideation of Korean adults: the sixth and seventh Korean National Health and Nutrition Examination Survey, 2013, 2015, 2017

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Yoon Hee Son ◽  
Sarah Soyeon Oh ◽  
Sung-In Jang ◽  
Eun-Cheol Park ◽  
So-Hee Park
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
National Health ◽  
Low Income ◽  
Subgroup Analysis ◽  
Rural Areas ◽  
High Income ◽  
Korean Adults ◽  
Income Groups ◽  
The City

Abstract Objectives This study investigated whether commensality (eating a meal with others) is associated with mental health (depression, suicidal ideation) in Korean adults over 19 years old. Methods Our study employed data from the sixth and seventh Korea National Health and Nutritional Examination Surveys (KNHANES) for 2013, 2015, and 2017. The study population consisted of 14,125 Korean adults (5854 men and 8271 women). In this cross-sectional study, data were analyzed with the Rao-Scott chi-square test and multiple logistic regression to evaluate the association between commensality(0[includes skipping meals] to 3 times eating meals together) and both depression and suicidal ideation using select questions from the Mental Health Survey. By setting socioeconomic factors, health conditions, and behavioral factors as confounders, we conducted a subgroup analysis to reveal the effect on depression and suicidal ideation commensality. Results Commensality was significantly associated with depression and suicidal ideation (p < 0.05). In both sexes, people who ate fewer meals together had poorer mental health. In a subgroup analysis, we revealed greater odds of developing depression in men when living in rural areas and belonging to low-income groups. In contrast, greater odds of suicidal ideation in men who ate alone when living in the city and belonging to high-income groups. On the other hand, Women in every region had greater odds of being depressed if they ate alone. And greater odds of suicidal ideation in women who ate alone when living in the city and belonging to medium-high income groups. Conclusions Our analysis confirmed that Korean adults with lower chance of commensality had greater risk of developing depression and suicidal ideation. And it could be affected by individuals’ various backgrounds including socioeconomic status. As a result, to help people with depression and prevent a suicidal attempt, this study will be baseline research for social workers, educators and also policy developers to be aware of the importance of eating together.

scholarly journals Living standards shape individual attitudes on genetically modified food around the world

2021 ◽  
Author(s):  
Sebastian Levi
Keyword(s):  
Public Opinion ◽  
Low Income ◽  
Rural Areas ◽  
Agricultural Biotechnology ◽  
Genetically Modified ◽  
Genetically Modified Crops ◽  
High Income ◽  
Low Income Countries ◽  
Living Standard ◽  
Genetically Modified Food

Agricultural biotechnology can help to sustainably intensify food production, but negative public opinion hinders the deployment of genetically modified crops and livestock. Previous research shows negative consumer attitudes in the Global North to be primarily driven by limited trust and religiosity, but public opinion in the Global South remains largely unexplored. Here, analyzing individual attitudes across 142 countries with a random forest model, I show that people in low-income countries are significantly more positive towards genetically modified food than those living in high-income countries. Globally, individual attitudes are primarily determined by living standard, agricultural output, and prevalence of undernourishment. Country income levels also moderate how demographic characteristics predict attitudes on bioengineered food. Highly educated urban men are most optimistic about agricultural biotechnology in high-income countries, while women, individuals living in rural areas, and those with little education are the most hopeful demographic in low-income countries. These results indicate that individual views are largely determined by the societal benefits expected from agricultural biotechnology and suggest that the conditions for further deregulation of genetically modified food are most favorable in low-income countries.

The Welfare Effects of Carbon Tax on Chinese Households: A Study Based on the 2013 Chip Survey Data

2021 ◽  
pp. 2050019
Author(s):  
LI Xuehui ◽  
LI Zhi ◽  
WANG Zhengxin
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Household Income ◽  
Urban Areas ◽  
Carbon Tax ◽  
Rural Households ◽  
High Income ◽  
Cyclic Utilization ◽  
Urban Rural ◽  
Low Income Households

Based on the micro-data from the 2013 Chinese Household Income Project (CHIP) Survey, the authors use a Quadratic Almost Ideal Demand System (QUAIDS) model to simulate and measure the impacts on the welfare of urban and rural households with different incomes after a carbon tax at 50[Formula: see text]RMB/ton was levied in China. The results show that the collection of carbon tax will increase households’ consumer spending to varying degrees. In urban areas, the carbon tax exerts the greatest impact on low-income households, followed by high-income households; while in rural areas, it has the most significant effects on high-income households and the least on low-income households. On the whole, carbon tax’s impact on urban households is greater than that on rural households. To a certain extent, it can help the household income inequality change for the better and narrow the urban–rural income gap. Since the carbon tax does not act on the distribution of Chinese household income in a simply regressive or progressive way, the authors believe that China should implement supporting policies such as tax subsidies or tax refund as supplements to carbon taxation in an effort to establish a mechanism for cyclic utilization of carbon tax revenue.

Pattern of Digital Divide and Convergence in Access to ICT Facilities among the Indian States

2018 ◽  
Vol 10 (1-2) ◽  
pp. 37-51
Author(s):  
Tanushree Agarwal ◽  
Prasant Kumar Panda
Keyword(s):  
Digital Divide ◽  
Mobile Phones ◽  
Low Income ◽  
Rural Areas ◽  
Secondary Data ◽  
Principal Component ◽  
High Income ◽  
Indian States ◽  
Internet Users ◽  
Economic Developments

Information and communication technology (ICT) such as Internet, mobile phones, computers and related network interfaces facilitate promotion of economic growth by improving the allocation and productivity of labour and capital, and also by promoting trade and competition in market. But these regional developments led by ICT technologies are not realised if there is a digital divide. In India, uneven digital developments may lead to uneven economic developments. Unless ICT developments grow faster in low-income states, they cannot catch up with high-income states, economically. In this context, this article aims to analyse the changing pattern of the digital divide and empirically examines the convergence in access to ICT facilities across the Indian states. The secondary data for 15 major states of India is used for the time period 2008–17 by considering three ICT variables, namely, telephone users, mobile phone users and Internet users per 100 populations. Principal component analysis (PCA) is used to construct ICT access index. With PCA scores, the Indian states are ranked at two data points and convergence is verified by using sigma and beta convergence techniques. Findings suggest that there is an uneven access to ICT facilities across the Indian states. In the last decade, the low-income states are growing on a better pace than the high-income states in providing access to facilities such as telephone and mobile phones. However, there is evidence of the divergence in the use of Internet facilities. So the governments’ attention in improving these facilities in the low-income states, particularly in rural areas and lagging districts, is important. Special policies and schemes need to be devised to promote the access of Internet services in the lagging states.

scholarly journals Psychiatry in paradise – the Solomon Islands

2011 ◽  
Vol 8 (2) ◽  
pp. 38-40
Author(s):  
Ashok N. Singh ◽  
Paul Orotaloa
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Solomon Islands ◽  
National Language ◽  
World Health ◽  
Low Income Country ◽  
South Pacific Ocean ◽  
The People ◽  
Health Organization ◽  
Sea Area

The Solomon Islands is situated in the South Pacific Ocean and is a low-income country. It comprises nearly 1000 islands with a total land area of 304 000 km2 spread over a sea area of about 1 500 000 km2, making communications, travel and service delivery difficult and creating inequities in access. The population of the Solomon Islands was estimated to be just over 580 000 in 2008, and is young, with 42% aged under 15 years (Solomon Islands Ministry of Health, 2006). The majority of the people are Melanesian (93%) and 98% of the population belong to a Christian church. The population is, though, extremely diverse, with 91 indigenous languages and dialects being spoken, in addition to the Solomon Islands pijin (the most common language) and English (the official national language). Over 83% of the population live in rural areas, where subsistence agriculture, fishing and food gathering are the main sources of income. There is no substantial tourist industry. The gross domestic product (GDP) is US$1.5 billion and annual per capita income is approximately US$2800 (International Monetary Fund, 2009). Total expenditure on health represented 5.6% of GDP but only 1% of the total health budget is allocated to mental health (World Health Organization, 2005).

Social status and dietary habits of the population (PURE study)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Tsygankova ◽  
G.V Artamonova ◽  
O.L Barbarash
Keyword(s):  
Marital Status ◽  
Low Income ◽  
Rural Areas ◽  
Urban Population ◽  
Dietary Habits ◽  
Income Level ◽  
High Income ◽  
Animal Origin ◽  
Funding Source ◽  
Effective Prevention

Abstract Introduction Recent data indicate that the population diet quality is related to its socio-economic status. Identification of dietary characteristics depending on the population status will help to determine effective prevention strategies diet-related diseases. Objective To assess the population dietary pattern depending on their income level, education and marital status. Methods A total of 1,600 people aged 35–70 years were examined in accordance with the program of Prospective Urban Rural Epidemiology (PURE) study. All participants were interviewed to determine the level of education, income, marital status and dependents. Diet was assessed using the Food Frequency Questionnaire. During data processing, products with similar characteristics were grouped into categories. To calculate the consumption frequency of particular group of products, following points were assigned: never, less than once a month – 1 point; 1–3 times a month – 2; once a week – 3; 2–4 times a week – 4; 5–6 times a week – 5; once a day – 6; 2–3 times a day – 7; 4–5 times a day – 8; more than 6 times a day – 9 points. Statistical processing was carried out using a software package Statistica 6.0. Results Women were more likely to eat fruits (27.37±8.50 points, p=0.000), vegetables (95.56±22.01 points, p=0.000) and cereals (16.02±4.08, p=0,000) than men. The consumption of the above mentioned products increased with age. In comparison with rural population, urban population were more likely to eat fruits in season (27.0±8.66 and 25.8±7.99 points respectively, p=0.028) and nuts (2.25±1.37 and 1.98±1.30 points, p=0.000). University-educated responders compared to less educated respondents more often used the following product groups: grain/cereals (16.15±4.06 and 15.22±4.20 points, p=0.000), nuts (2.40±1.40 and 2.04±1.31 points, p=0.000). High-income respondents compared with low-income subjects were more likely to eat fruits in season (27.75±8.55 and 26.26±8.41 points, p=0.001), vegetables out of season (76.83±18.57 and 74.99±18.49 points, p=0.047), products of animal origin (47.23±10.35 and 45.56±9.99 points, p=0.005). High-income respondents preferred sweets less than respondents with a low-income level. In contrast to single respondents, people living with a family were more like to consume fruits in season (27.00±8.43 and 26.01±8.53, p=0.038), heat-treated vegetables (32.08±8.40 and 30.73±8.55, p=0.001), animal products (47.51±9.84 and 43.06±10.00 points, p=0.000), soups (17.13±4.55 and 16.17±4.61 points, p=0.000), potatoes (25.49±5.33 and 24.20±6.04 points, p=0.000) and bakery products (40.93±7.09 and 39.93±8.04, p=0.008). Conclusion The urban population with a high level of income, educated at university and having a family, as well as women and older age group responders, more often ate fruits and vegetables, cereals, nuts than respondents living in rural areas with a low level of income and education or without family. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Pfizer initiative reserch grant

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