scholarly journals Protecting the vulnerable during COVID-19: Treating and preventing chronic disease disparities

2020 ◽  
Vol 4 ◽  
pp. 125
Author(s):  
Linda M. Mobula ◽  
David J. Heller ◽  
Yvonne Commodore-Mensah ◽  
Vanessa Walker Harris ◽  
Lisa A. Cooper
Keyword(s):  
Vulnerable Populations ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Socioeconomic Groups ◽  
Policy Interventions ◽  
Vulnerable Patients ◽  
Increased Risk ◽  
Care Models ◽  
Key Policy ◽  
Poor Outcomes

The coronavirus disease 2019 (COVID-19) pandemic has exacerbated health disparities across ethnic and socioeconomic groups. Non-communicable diseases (NCDs) - such as hypertension, diabetes, and obstructive lung diseases – are key drivers of this widening gap, because they disproportionately afflict vulnerable populations. Vulnerable populations with non-communicable diseases, in turn, are disproportionately affected by COVID-19 itself – but also at increased risk of poor outcomes from those underlying conditions. Proven strategies for NCD control must be adapted to help vulnerable patients react to these dual threats. We detail six key policy interventions – task shifting, workforce protection, telehealth and mobile services, insurance restructuring and increased funding for NCDs, prescription policies for NCDs and community partnerships - to bridge this care gap. Long-term integration of these care models post-COVID-19 may prevent care shocks during future pandemics, bolstering emerging universal primary care models.

scholarly journals The Implementation of Childhood Obesity Related Policy Interventions in Malaysia—A Non Communicable Diseases Scorecard Project

2021 ◽  
Vol 18 (11) ◽  
pp. 5950
Author(s):  
Wilfred Kok Hoe Mok ◽  
Noran Naqiah Hairi ◽  
Caryn Mei Hsien Chan ◽  
Feisul Idzwan Mustapha ◽  
Thamil Arasu Saminathan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Childhood Obesity ◽  
Communicable Diseases ◽  
Overweight And Obesity ◽  
Current Status ◽  
Non Communicable Diseases ◽  
Modified Delphi ◽  
Policy Interventions ◽  
Non Governmental Organizations ◽  
The Government

(1) Background: The prevalence of overweight and obesity among children has increased tremendously in the ASEAN region, including Malaysia. In Malaysia, the National Strategic Plan for Non-Communicable Diseases (2015–2025) provides the overall framework for its response to the non-communicable diseases (NCD) epidemic. Preventing childhood obesity is one of the key strategies for early intervention to prevent NCDs. The objective of this research is to examine the current status of policy interventions in addressing childhood obesity in Malaysia. (2) Methods: A panel of 22 stakeholders and experts from Malaysia, representing the government, industry, academia and non-governmental organizations, were sampled using a modified Delphi technique. Data were collected using a modified NCD scorecard under four domains (governance, risk factors, surveillance and research and health systems response). A heat map was used to measure the success of the four realms of the NCD scorecard. For each domain of the NCD scorecard, the final score was grouped in quintiles. (3) Results: A total of 22 participants responded, comprising of eight (36.4%) males and 14 (63.4%) females. All the domains measured in implementing policies related to childhood obesity were of low progress. Nine governance indicators were reported as 22.5% (low progress), four in the risk factors domain, and two in the surveillance. This shows that timely and accurate monitoring, participatory review and evaluation, and effective remedies are necessary for a country’s surveillance system. (4) Conclusion: Although Malaysia has published several key strategic documents relating to childhood obesity and implemented numerous policy interventions, we have identified several gaps that must be addressed to leverage the whole-of-government and whole-of-society approach in addressing childhood obesity in the country.

scholarly journals Relationship between childhood obesity and dietary behavior in selected school-going children from Dhaka city, Bangladesh

2020 ◽  
Vol 7 (7) ◽  
pp. 2469
Author(s):  
Mohammad Rahanur Alam ◽  
Mohammad Asadul Habib ◽  
A. K. Obidul Huq ◽  
Sumaiya Mamun ◽  
Sompa Reza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fast Food ◽  
Primary Schools ◽  
Significant Risk ◽  
Dietary Behavior ◽  
Communicable Diseases ◽  
Overweight And Obesity ◽  
Dhaka City ◽  
Non Communicable Diseases ◽  
Increased Risk

Background: The prevalence of non-communicable diseases is rising in Dhaka City, Bangladesh. Obesity is one of the significant risk factors for many non-communicable diseases. This research aimed to investigate the current prevalence of overweight and obesity among children in selected schools in Dhaka City through anthropometric evaluation, as well as to assess the correlation of various environmental determinants such as physical activity, dietary behavior, lifestyle habits, are associated with increased risk of obesity in children.Methods: This school-based cross-sectional study was conducted among 106 participants (50 male and 56 female participants) aged 6-14 years selected by convenience sampling from four randomly selected primary schools of different regions of Dhaka city. A pre-tested questionnaire was used to collect data.Results: The prevalence of overweight and obesity among school-going children 24.5%, 68% respectively. Factors associated with being obese included type of game (χ2=34.036; p=0.001), total playtime (χ2=17.788; p=0.000), TV and computer watch time (χ2=27.321; p=0.007), spend money to buy fast food (χ2=26.451; p=0.002), eating days fast food in a week (χ2=24.825; p=0.003), type of tiffin (χ2=19.757; p=0.072).Conclusions: Less playtime, longer watching TV and computer, and eating more fast food are major risk factors for overweight and obesity among school-going children in Dhaka city. Interventions are needed to increase awareness of child overweight weight and obesity risk factors to decrease the prevalence of overweight and obesity.

scholarly journals Estimation of Salt Consumption from 24-hour Urine Collection in a Nepalese Population (P18-084-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Dinesh Neupane ◽  
Megan Henry ◽  
Di Zhao ◽  
Per Kallestrup ◽  
Bhagawan Koirala ◽  
...  
Keyword(s):  
Salt Intake ◽  
Daily Intake ◽  
Communicable Diseases ◽  
Processed Foods ◽  
Urine Collection ◽  
Community Based Interventions ◽  
Community Based ◽  
Dietary Counseling ◽  
Non Communicable Diseases ◽  
Increased Risk

Abstract Objectives High salt (sodium chloride) intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. Current consumption of salt in Nepal is unknown. The objective of this study was to estimate average salt intake in a Nepalese population from 24-hr urine collection in a population-based survey. Methods Participants (n = 499) were recruited from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) cohort in the peri-urban area of Pokhara municipality from July to December 2018. The modified version of STEPS survey of non-communicable diseases (NCD) risk factors was administered. Salt intake was estimated from a single 24-hr urine collection. Multivariate linear regression was used to estimate differences in salt intake (g) associated with a variety of factors including demographics, lifestyle, health care, and health literacy. Results Mean (SD) age was 50.0 (9.7) years; mean salt intake was 13.0 (4.8) g/person/d. Male gender, younger age, and higher body mass index were significantly associated with higher salt intake (Table). Although 55% of respondents thought that they consumed just the right amount of salt, 96% were consuming more than the WHO-recommended level of less than 5 g/d. Almost half of the respondents reported that they consumed processed food containing high amounts of salt. In multivariate analyses, systolic blood pressure was 0.4 mmHg (95% CI: 0.05, 0.7) higher per 1-gram increase in salt intake. Conclusions Daily intake of salt in this Napalese population was over twice the WHO recommended upper limit, indicating a substantial need to reduce salt across the entire population. Community-based interventions for behavior modification through health education and dietary counseling may be effective in this population where salt is added during cooking. Still, interventions targeting the marketing, availability, and labeling of processed foods is also important, as intake of processed foods was also commonplace in Nepal. Funding Sources PHI through financial support from Centers for Disease Control and Prevention (CDC), USA; Jayanti Memorial Trust (JMT), Nepal; Nepal Development Society (NEDS), Nepal. Supporting Tables, Images and/or Graphs

scholarly journals A study on prevalence of risk factors for non-communicable diseases among allopathic doctors of Vijayawada city, Andhra Pradesh

2019 ◽  
Vol 6 (8) ◽  
pp. 3508
Author(s):  
Kiran Prakash K. ◽  
Venkata Suresh Anga
Keyword(s):  
Risk Factors ◽  
Fruits And Vegetables ◽  
Dietary Habits ◽  
Communicable Diseases ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Life Styles ◽  
Premature Deaths ◽  
Increased Risk

Background: Chronic non-communicable diseases (CNCDs) are the leading cause of death in the world. Accounting for around 60% of all deaths and 44% of premature deaths worldwide. The objective of the study was to assess the prevalence of risk factors for non-communicable diseases among allopathic doctors in Vijayawada.Methods: A cross-sectional survey was conducted on allopathic practicing doctors who were working in the various Hospitals, clinics, Nursing Homes within the corporation limits of Vijayawada city.Results: Out of the 720 study subjects, 498 doctors (69.2%) were males and 222 doctors (30.8%) were females. majority of the doctors 515 (71.5%) were with educational qualification of master degrees (MS/MD/MDS). Doctors in clinical specialty are more 565 (78.5%) compared with non-clinical 133 (18.4%) and dental 22 (3.1%). With regarding working sector, nearly one third of doctors were working in private sector 532 (73.9%).Conclusions: Because of more exposure to unhealthy life styles like smoking, alcohol, unhealthy dietary habits like high intake of salt, inadequate use of fruits and vegetables, oil fries and by leading a sedentary life and high risk factors like overweight/obesity, hypertension and diabetes a large number of the doctor’s population were at increased risk for chronic non-communicable diseases. 

scholarly journals Non-communicable Diseases among Refugee Claimants in Greek Refugee Camps: Are Their Health-care Needs Met?

2019 ◽  
Vol 32 (Special_Issue_1) ◽  
pp. i36-i51 ◽  
Author(s):  
Signe Smith Jervelund ◽  
Oda Nordheim ◽  
Theoni Stathopoulou ◽  
Terje Andreas Eikemo
Keyword(s):  
Health Care ◽  
Multiple Logistic Regression Analysis ◽  
Communicable Diseases ◽  
Refugee Camps ◽  
Care Needs ◽  
Non Communicable Diseases ◽  
Medical Needs ◽  
Increased Risk ◽  
Refugee Claimants ◽  
Unmet Medical Needs

Abstract Little is known about the prevalence of non-communicable diseases (NCDs) among newly arrived refugees in Europe and whether their medical needs are met. To elucidate the prevalence of NCDs and unmet medical needs in the different migration phases, we used survey data on 267 adult asylum seekers at Greek refugee camps in 2016. Using multiple logistic regression analysis, we estimated determinants for unmet medical needs in Greece. The most prevalent reported NCDs in Greece were: back or neck pain (26.6 per cent) and severe headache (24.7 per cent). The prevalence of most NCDs in the migration phases followed a U- or J-shaped pattern: decreased during migration and increased after migration to Greece; thus, new cases of NCDs after arrival in Greece made up the vast majority of all cases. Accordingly, the refugee claimants were worse off further in the migration process. Unmet medical-care needs were reported by 41.3 per cent with one NCD after arrival in Greece. Compared with young adults, adults aged 51+ years were in increased risk of reporting unmet medical needs in Greece (odds ratio = 7.59; p = 0.015). This knowledge is important for health-care systems in receiving countries to plan for improved access to health-care services for refugees with NCDs.

scholarly journals Socioeconomic status and prevalence of chronic non-communicable diseases in Chinese women: a structural equation modelling approach

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014402 ◽  
Author(s):  
Hui Yin ◽  
Qunhong Wu ◽  
Yu Cui ◽  
Yanhua Hao ◽  
Chaojie Liu ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Structural Equation Modelling ◽  
Structural Equation ◽  
Chinese Women ◽  
Communicable Diseases ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Non Communicable Diseases ◽  
Equation Modelling ◽  
Increased Risk

ObjectiveTo investigate the role of socioeconomic status (SES) in chronic non-communicable diseases (NCDs) and offer theoretical evidence for the prevention and control of NCDs.DesignCross-sectional survey and structural equation modelling.SettingNationwide, China.ParticipantsFemale participants in the 2008 National Health Services Survey in China who were 15 years and older.ResultsSES factors were associated with the increased risk of NCDs in Chinese women. Education was identified as the most important factor with a protective role (factor loading=−0.115) for NCDs. Income mainly affected NCDs directly, whereas occupation mainly affected NCDs indirectly. The effects of SES on NCDs were more significant than that of smoking. Medical insurance, smoking and self-reported health played a mediating role in the correlations between those SES factors and NCDs.ConclusionsIn China, socioeconomic disparities associated with the prevalence of NCDs exist among women. Educational and social interventions are needed to mitigate their negative consequences on health outcomes in Chinese women.

scholarly journals Effect of maternal diet on the epigenome: implications for human metabolic disease

2011 ◽  
Vol 70 (1) ◽  
pp. 64-72 ◽  
Author(s):  
Karen A. Lillycrop
Keyword(s):  
Metabolic Disease ◽  
Epigenetic Regulation ◽  
Disease Risk ◽  
Maternal Diet ◽  
Later Life ◽  
Communicable Diseases ◽  
Non Communicable Diseases ◽  
Increased Risk ◽  
Postnatal Environment ◽  
Nutritional Environment

The rapid increase in the incidence of chronic non-communicable diseases over the past two decades cannot be explained solely by genetic and adult lifestyle factors. There is now considerable evidence that the fetal and early postnatal environment also strongly influences the risk of developing such diseases in later life. Human studies have shown that low birth weight is associated with an increased risk of CVD, type II diabetes, obesity and hypertension, although recent studies have shown that over-nutrition in early life can also increase susceptibility to future metabolic disease. These findings have been replicated in a variety of animal models, which have shown that both maternal under- and over-nutrition can induce persistent changes in gene expression and metabolism within the offspring. The mechanism by which the maternal nutritional environment induces such changes is beginning to be understood and involves the altered epigenetic regulation of specific genes. The demonstration of a role for altered epigenetic regulation of genes in the developmental induction of chronic diseases raises the possibility that nutritional or pharmaceutical interventions may be used to modify long-term cardio-metabolic disease risk and combat this rapid rise in chronic non-communicable diseases.

scholarly journals Sustainability of a school-based health intervention for prevention of non-communicable diseases in marginalised communities: protocol for a mixed-methods cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e047296
Author(s):  
Patricia Arnaiz ◽  
Larissa Adams ◽  
Ivan Müller ◽  
Markus Gerber ◽  
Cheryl Walter ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
Controlled Trial ◽  
Communicable Diseases ◽  
Lifestyle Changes ◽  
Effective Prevention ◽  
Non Communicable Diseases ◽  
School Based ◽  
Increased Risk

IntroductionThe prevalence of chronic, lifestyle-related diseases is increasing among adults and children from low-income and middle-income countries. Despite the effectiveness of community-based interventions to address this situation, the benefits thereof may disappear in the long term, due to a lack of maintenance, especially among disadvantaged and high-risk populations. The KaziBantu randomised controlled trial conducted in 2019 consisted of two school-based health interventions, KaziKidz and KaziHealth. This study will evaluate the long-term effectiveness and sustainability of these interventions in promoting positive lifestyle changes among children and educators in disadvantaged schools in Nelson Mandela Bay, South Africa, in the context of the COVID-19 pandemic.Methods and analysisThis study has an observational, longitudinal, mixed-methods design. It will follow up educators and children from the KaziBantu study. All 160 educators enrolled in KaziHealth will be invited to participate, while the study will focus on 361 KaziKidz children (aged 10–16 years) identified as having an increased risk for non-communicable diseases. Data collection will take place 1.5 and 2 years postintervention and includes quantitative and qualitative methods, such as anthropometric measurements, clinical assessments, questionnaires, interviews and focus group discussions. Analyses will encompass: prevalence of health parameters; descriptive frequencies of self-reported health behaviours and quality of life; the longitudinal association of these; extent of implementation; personal experiences with the programmes and an impact analysis based on the Reach, Efficacy, Adoption, Implementation, Maintenance framework.DiscussionIn settings where resources are scarce, sustainable and effective prevention programmes are needed. The purpose of this protocol is to outline the design of a study to evaluate KaziKidz and KaziHealth under real-world conditions in terms of effectiveness, being long-lasting and becoming institutionalised. We hypothesise that a mixed-methods approach will increase understanding of the interventions’ capacity to lead to sustainable favourable health outcomes amid challenging environments, thereby generating evidence for policy.Trial registration numberISRCTN15648510

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