scholarly journals Inequality in physical activity, global trends by income inequality and gender in adults

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Chastin SFM ◽  
J. Van Cauwenberg ◽  
L. Maenhout ◽  
G. Cardon ◽  
E. V. Lambert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Income Inequality ◽  
Physical Inactivity ◽  
World Health ◽  
Middle Income ◽  
Physical Activity Guidelines ◽  
Middle Income Countries ◽  
Country Level ◽  
The World

Abstract Background Physical inactivity is a global pandemic associated with a high burden of disease and premature mortality. There is also a trend in growing economic inequalities which impacts population health. There is no global analysis of the relationship between income inequality and population levels of physical inactivity. Methods Two thousand sixteen World Health Organisation’s country level data about compliance with the 2010 global physical activity guidelines were analysed against country level income interquantile ratio data obtained from the World Bank, OECD and World Income Inequality Database. The analysis was stratified by country income (Low, Middle and High) according to the World Bank classification and gender. Multiple regression was used to quantify the association between physical activity and income inequality. Models were adjusted for GDP and percentage of GDP spent on health care for each country and out of pocket health care spent. Results Significantly higher levels of inactivity and a wider gap between the percentage of women and men meeting global physical activity guidelines were found in countries with higher income inequality in high and middle income countries irrespective of a country wealth and spend on health care. For example, in higher income countries, for each point increase in the interquantile ratio data, levels of inactivity in women were 3.73% (CI 0.89 6.57) higher, levels of inactivity in men were 2.04% (CI 0.08 4.15) higher and the gap in inactivity levels between women and men was 1.50% larger (CI 0.16 2.83). Similar relationships were found in middle income countries with lower effect sizes. These relationships were, however, not demonstrated in the low-income countries. Conclusions Economic inequalities, particularly in high- and middle- income countries might contribute to physical inactivity and might be an important factor to consider and address in order to combat the global inactivity pandemic and to achieve the World Health Organisation target for inactivity reduction.

scholarly journals Feasibility Study of the World Health Organization Health Care Facility-Based Antimicrobial Stewardship Toolkit for Low- and Middle-Income Countries

Antibiotics ◽  
2020 ◽  
Vol 9 (9) ◽  
pp. 556
Author(s):  
Gina Maki ◽  
Ingrid Smith ◽  
Sarah Paulin ◽  
Linda Kaljee ◽  
Watipaso Kasambara ◽  
...  
Keyword(s):  
Health Care ◽  
World Health Organization ◽  
Feasibility Study ◽  
Care Facility ◽  
Health Care Facility ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Health Organization

Antimicrobial stewardship (AMS) has emerged as a systematic approach to optimize antimicrobial use and reduce antimicrobial resistance. To support the implementation of AMS programs, the World Health Organization developed a draft toolkit for health care facility AMS programs in low- and middle-income countries. A feasibility study was conducted in Bhutan, the Federated States of Micronesia, Malawi, and Nepal to obtain local input on toolkit content and implementation of AMS programs. This descriptive qualitative study included semi-structured interviews with national- and facility-level stakeholders. Respondents identified AMS as a priority and perceived the draft toolkit as a much-needed document to further AMS program implementation. Facilitators for implementing AMS included strong national and facility leadership and clinical staff engagement. Barriers included lack of human and financial resources, inadequate regulations for prescription antibiotic sales, and insufficient AMS training. Action items for AMS implementation included improved laboratory surveillance, establishment of a stepwise approach for implementation, and mechanisms for reporting and feedback. Recommendations to improve the AMS toolkit’s content included additional guidance on defining the responsibilities of the committees and how to prioritize AMS programming based on local context. The AMS toolkit was perceived to be an important asset as countries and health care facilities move forward to implement AMS programs.

scholarly journals Adolescents’ physical activity: cross-national comparisons of levels, distributions and disparities across 52 countries

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
David Bann ◽  
Shaun Scholes ◽  
Meg Fluharty ◽  
Nikki Shure
Keyword(s):  
Physical Activity ◽  
Income Inequality ◽  
Time Allocation ◽  
Socioeconomic Disparities ◽  
Activity Levels ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Low Middle Income Countries ◽  
Cross National

Abstract Background Despite global concerns regarding physical inactivity, limited cross-national evidence exists to compare adolescents’ physical activity participation. We analysed data from 52 high- and low-middle income countries, with activity undertaken inside and outside of school in 2015. We investigated gender and socioeconomic disparities, and additionally examined correlations with country-level indices of physical education (PE) curriculum time allocation, wealth, and income inequality. Methods We compared adolescents’ reported activity levels inside and outside of school using nationally representative cross-sectional data from 52 high- and low-middle income countries (N = 347,935)—the Programme for International Student Assessment (PISA) in 2015. Students reported average attendance (days/week) in PE classes, and the days/week engaged in moderate activity (MPA) and vigorous activity (VPA) outside of school. We also compared gender and socioeconomic disparities, and additionally examined correlations with purported determinants—country-level estimates of PE curriculum time allocation, wealth, and income inequality. Results Average activity levels differed substantially both between and within regions, with potentially important differences in distributions identified—such as a bimodal distribution in the U.S. and Canada in PE. Males were more active than females, as were those from households with higher rather than lower household wealth; these disparities were modest for PE, but higher for moderate and vigorous activity outside school—there was strong evidence for heterogeneity in the magnitude of these disparities (e.g., I2 > 95% for gender differences across all countries). PE class attendance was positively correlated with PE curriculum time allocation (rho = 0.36); activity outcomes were inconsistently associated with country-level wealth and income inequality. Conclusions Our findings reveal extensive cross-country differences in adolescents’ physical activity; in turn, these highlight policy areas that could ultimately improve global adolescent health, such as the incorporation of minimum country-level PE classes, and the targeting of gender and socioeconomic disparities in activity conducted outside of school. Our findings also highlight the utility of educational databases such as PISA for use in global population health research.

Incidence of Insufficient Physical Activity Among Adults and Its Relationship with the Human Development Index: A Global Study

2020 ◽  
Vol 22 (7) ◽  
Author(s):  
Victoria Momenabadi ◽  
Elham Goodarzi ◽  
Maryam Seraji ◽  
Ahmad Naghibzadeh-Tahami ◽  
Reza Beiranvand ◽  
...  
Keyword(s):  
Physical Activity ◽  
Human Development ◽  
Human Development Index ◽  
Physical Inactivity ◽  
Middle Income ◽  
Non Communicable Diseases ◽  
Development Index ◽  
Middle Income Countries ◽  
The World ◽  
Insufficient Physical Activity

Background: Insufficient physical activity, particularly in low- and middle-income countries, plays an important role in the spread of non-communicable diseases. Objectives: The purpose of this study is to investigate the incidence of insufficient physical activity and its relationship with the human development index (HDI) in the world. Methods: This is an ecological study, and the study data, including the human development index and the incidence of insufficient physical activity, were extracted from the World Bank’s database. The descriptive analysis included mean and standard deviation. The inferential analysis consisted of two-way correlation and ANOVA at a significance level of less than 0.05. The analyses were performed using Stata-14 software. Results: The highest incidence of insufficient physical activity in both sexes (39.26 [37.42, 40.95]) was found in the Americas, especially in high-income regions. There was a significant positive correlation between the incidence of insufficient physical inactivity and HDI in the world (r = 0.446, P < 0.0001). This correlation was also significant in Asia and Africa (P < 0.05). The results showed a positive correlation between components of HDI (i.e., gross national income per 1000 capita, mean years of schooling, life expectancy at birth, and expected years of schooling) and insufficient activity (P < 0.0001). The results of ANOVA also exhibited a significant relationship between the mean prevalence of physical inactivity and the level of development (P < 0.0001). Conclusions: Given the significant correlation between the incidence of insufficient physical inactivity and HDI, understanding this correlation and its components, especially in low- and middle-income countries can alleviate the impact of physical inactivity epidemics in the future, thereby contributing to the effective global prevention of non-communicable diseases.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

scholarly journals Spatial Externalities of Income Inequality on Security in Latin America

Mathematics ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 245
Author(s):  
Pablo Ponce ◽  
José Álvarez-García ◽  
Mary Cumbicus ◽  
María de la Cruz del Río-Rama
Keyword(s):  
Income Inequality ◽  
Latin American ◽  
Spatial Dependence ◽  
Generalized Least Squares ◽  
Homicide Rate ◽  
World Health ◽  
Control Variables ◽  
Spatial Error ◽  
Middle Income ◽  
Middle Income Countries

The aim of this research is to analyse the effect of income inequality on the homicide rate. The study is carried out in 18 Latin American countries for the period 2005–2018. The methodology used is the Generalized Least Squares (GLS) model and the data were obtained from World Development Indicators, the World Health Organization and the Inter-American Development Bank. Thus, the dependent variable is the homicide rate and the independent variable is income inequality. In addition, some control variables are included, such as: poverty, urban population rate, unemployment, schooling rate, spending on security and GDP per capita, which improve the consistency of the model. The results obtained through GLS model determine that inequality has a negative and significant effect on the homicide rate for high-income countries (HIC) and lower-middle-income countries (LMIC), whereas it is positive and significant for upper-middle-income countries (UMIC). On the other hand, the control variables show different results by group of countries. In the case of unemployment, it is not significant in any group of countries. Negative spatial dependence was found regarding spatial models such as: the spatial lag (SAR) and spatial error (SEM) method. In the spatial Durbin model (SDM), positive spatial dependence between the variables was corroborated. However, spatial auto-regressive moving average (SARMA) identified no spatial dependence. Under these results it is proposed: to improve productivity, education and improve the efficiency of security-oriented resources.

Meeting Physical Activity Guidelines by Walking in Older Adults from Three-Middle Income Countries

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
C Davis ◽  
T Sentell ◽  
C Pirkle ◽  
J Fernandes de Souza Barbosa ◽  
C Curcio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Middle Income ◽  
Physical Activity Guidelines ◽  
Middle Income Countries

scholarly journals Simple and adaptable R implementation of WHO/ISH cardiovascular risk charts for all epidemiological subregions of the world

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2522 ◽  
Author(s):  
Dylan Collins ◽  
Joseph Lee ◽  
Niklas Bobrovitz ◽  
Constantinos Koshiaris ◽  
Alison Ward ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Communicable Disease ◽  
World Health Organisation ◽  
World Health ◽  
Cvd Risk ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Risk Charts ◽  
Free Open Source

The World Health Organisation and International Society of Hypertension (WHO/ISH) cardiovascular disease (CVD) risk assessment charts have been implemented in many low- and middle-income countries as part of the WHO Package of Essential Non-Communicable Disease (PEN) Interventions for Primary Health Care in Low-Resource settings. Evaluation of the WHO/ISH cardiovascular risk charts and their use is a key priority and since they only exist in paper or PDF formats, we developed a simple R implementation of the charts for all epidemiological subregions of the world. The main strengths of this implementation are that it is built in a free, open-source, coding language with simple syntax, can be modified by the user, and can be used with a standard computer.

scholarly journals The potential of low-intensity and online interventions for depression in low- and middle-income countries

2016 ◽  
Vol 3 ◽  
Author(s):  
C. L. H. Bockting ◽  
A. D. Williams ◽  
K. Carswell ◽  
A. E. Grech
Keyword(s):  
Mental Health ◽  
World Health ◽  
Online Interventions ◽  
Treatment Protocols ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Intensity ◽  
The World ◽  
Health Gap ◽  
Low And Middle Income

The World Health Organization (WHO) reports that low- and middle-income countries (LMICs) are confronted with a serious ‘mental health gap’, indicating an enormous disparity between the number of individuals in need of mental health care and the availability of professionals to provide such care (WHO in 2010). Traditional forms of mental health services (i.e. face-to-face, individualised assessments and interventions) are therefore not feasible. We propose three strategies for addressing this mental health gap: delivery of evidence-based, low-intensity interventions by non-specialists, the use of transdiagnostic treatment protocols, and strategic deployment of technology to facilitate access and uptake. We urge researchers from all over the world to conduct feasibility studies and randomised controlled studies on the effect of low-intensity interventions and technology supported (e.g. online) interventions in LMICs, preferably using an active control condition as comparison, to ensure we disseminate effective treatments in LMICs.

Meeting Physical Activity Guidelines by Walking in Older Adults from Three-Middle Income Countries

2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
C Davis ◽  
T Sentell ◽  
C Pirkle ◽  
J Fernandes de Souza Barbosa ◽  
C Curcio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Middle Income ◽  
Physical Activity Guidelines ◽  
Middle Income Countries

scholarly journals The active living gender’s gap challenge: 2013–2017 Eurobarometers physical inactivity data show constant higher prevalence in women with no progress towards global reduction goals

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
X. Mayo ◽  
G. Liguori ◽  
E. Iglesias-Soler ◽  
R. J. Copeland ◽  
I. Clavel San Emeterio ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Inactivity ◽  
International Physical Activity Questionnaire ◽  
World Health ◽  
Activity Levels ◽  
The World ◽  
Health Organization ◽  
Global Reduction ◽  
Activity Questionnaire ◽  
The Eu

Abstract Background The World Health Organization (WHO) considers physical inactivity (PIA) as a critical noncommunicable factor for disease and mortality, affecting more women than men. In 2013, the WHO set a 10% reduction of the PIA prevalence, with the goal to be reached by 2025. Changes in the 2013–2017 period of physical inactivity prevalence in the 28 European Union (EU) countries were evaluated to track the progress in achieving WHO 2025 target. Methods In 2013 and 2017 EU Special Eurobarometers, the physical activity levels reported by the International Physical Activity Questionnaire of 53,607 adults were analyzed. Data were considered as a whole sample and country-by-country. A χ2 test was used to analyze the physical inactivity prevalence (%) between countries, analyzing women and men together and separately. Additionally, PIA prevalence was analyzed between years (2013–2017) for the overall EU sample and within-country using a Z-Score for two population proportions. Results The PIA prevalence increased between 2013 and 2017 for the overall EU sample (p <  0.001), and for women (p = 0.04) and men (p < 0.001) separately. Data showed a higher PIA prevalence in women versus men during both years (p <  0.001). When separately considering changes in PIA by gender, only Belgium’s women and Luxembourg’s men showed a reduction in PIA prevalence. Increases in PIA prevalence over time were observed in women from Austria, Croatia, Germany, Lithuania, Malta, Portugal, Romania, and Slovakia and in men from Bulgaria, Croatia, Czechia, Germany, Italy, Lithuania, Portugal, Romania, Slovakia, and Spain. Conclusions PIA prevalence showed an overall increase across the EU and for both women and men between 2013 and 2017, with higher rates of PIA reported for women versus men during both years. PIA prevalence was reduced in only Belgium’s women and Luxembourg’s men. Our data indicate a limited gender-sensible approach while tacking PIA prevalence with no progress reaching global voluntary reductions of PIA for 2025.

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