Age and Social Disparities in the Use of Telemedicine During the COVID-19 Pandemic in Japan: Cross-sectional Study (Preprint)

BACKGROUND The use of telemedicine outpatient visits has increased dramatically during the COVID-19 pandemic in many countries. Although disparities in access to telemedicine by age and socioeconomic status (SES) have been well-documented, evidence is limited as to how these disparities changed during the COVID-19 pandemic. Moreover, the equity of patient access to telemedicine has been scarcely reported in Japan, despite the huge potential for telemedicine expansion. OBJECTIVE We aimed to investigate changes due to age and SES disparities in telemedicine use during the COVID-19 pandemic in Japan. METHODS Using data from a large internet survey conducted between August 25 and September 30, 2020, in Japan, we examined the associations of participant age and SES (educational attainment, urbanicity of residence, and income level) with their telemedicine use in the following two time periods during the pandemic: April 2020 and August-September 2020. RESULTS Of the 24,526 participants aged 18 to 79 years (50.8% [n=12,446] women), the proportion of individuals who reported using telemedicine increased from 2.0% (n=497) in April 2020 to 4.7% (n=1159) in August-September 2020. After adjusting for potential confounders, younger individuals were more likely to use telemedicine than older individuals in April 2020. Although this pattern persisted in August-September 2020, we also observed a substantial increase in telemedicine use among individuals aged 70 to 79 years (adjusted rates, 0.2% in April 2020 vs 3.8% in August-September 2020; P<.001 after multiple comparisons). We found disparities in telemedicine use by SES in August-September 2020 that did not exist in April 2020. In August-September 2020, individuals with a university degree were more likely to use telemedicine than those with a high school diploma or less (adjusted rates, 6.6% vs 3.5%; P<.001). Individuals living in urban areas exhibited higher rates of telemedicine use than those living in rural areas only in August-September 2020 (adjusted rates, 5.2% vs 3.8%; P<.001). Disparities in telemedicine use by income level were not observed in either time period. CONCLUSIONS In general, younger individuals increased their use of telemedicine compared to older individuals during the pandemic, although individuals in their 70s also increased their use of telemedicine. Disparities in telemedicine use by educational attainment and urbanicity of residence widened during the COVID-19 pandemic.

Download Full-text

Examining the Dietary Diversity of Children in Niger

Nutrients ◽

10.3390/nu13092961 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2961

Author(s):

Nafissatou Cisse Egbuonye ◽

Ariun Ishdorj ◽

E.L.J. McKyer ◽

Rahma Mkuu

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Dietary Diversity ◽

Descriptive Analysis ◽

Age Groups ◽

Wealth Index ◽

Cross Sectional Study ◽

Health Concern ◽

Cross Sectional ◽

Child Factors

Malnutrition is a major public health concern in Niger. The stunting rate in children in Niger is over 50%, one of the highest in the world. The purpose of this cross-sectional study was to examine children’s dietary diversity (CDD) and the maternal factors that impact CDD. A total of 1265 mother–child pairs were analyzed. Descriptive analysis was conducted to present maternal and child characteristics. To compare the mean scores of CDD in relation to the region, an independent sample t-test was conducted. A one-way ANOVA test was conducted to evaluate the CDD score by different age groups. A linear regression model was estimated to identify household, maternal and child factors that affect the CDD score. Our results indicate that most of the participants of our survey resided in rural areas and the majority (80.7%) of the mothers had no education. Factors such as region, children’s age, woman’s empowerment, vitamin A intake and wealth index were significant predictors of CDD (p < 0.05). The children residing in rural areas were more likely to have lower CDD scores (p < 0.05) than the children in urban areas, therefore becoming more susceptible to malnutrition.

Download Full-text

Prevalence and Correlates of Secondhand Smoking Exposure Among Pregnant and Postnatal Chinese Women

10.21203/rs.3.rs-96643/v1 ◽

2020 ◽

Author(s):

YUAN YANG ◽

Meng Zhang ◽

Haixin Bo ◽

Dongying Zhang ◽

Liangkun Ma ◽

...

Keyword(s):

Rural Areas ◽

Secondhand Smoke ◽

Urban Areas ◽

Chinese Women ◽

Cross Sectional Study ◽

Postnatal Period ◽

Cross Sectional ◽

Secondhand Smoking ◽

Smoking Exposure ◽

Postnatal Women

Abstract BackgroundInhalation of secondhand smoke during pregnancy and postnatal period is detrimental to developing infants and increases risk for health problems throughout the lifespan. This study examined the prevalence of exposure to secondhand smoke, its correlates, and its association with QOL among pregnant and postnatal Chinese women.MethodsThis multicenter, cross-sectional study was conducted between February and October 2019 in China. Participants were pregnant and postnatal women. We assessed associations of frequency and location of secondhand smoking with sample characteristics as well as depression and quality of life based on EPDS and WHOQOL-BREF, respectively.ResultsA total of 992 women participated in the study, of whom, 211 (21.3%, 95%CI=18.7-23.8%) had been exposed to secondhand smoking. Secondhand smoking was most common in public areas (56.4%), and residential homes (20.5%), while workplaces had the lowest rate of secondhand smoking (13.7%). Women with physical comorbidities were more likely to report secondhand smoking exposure, while younger women, women living in urban areas, and those with college or higher education level were less likely to report exposure to secondhand smoking.ConclusionThe prevalence of exposure to secondhand smoking is becoming lower among pregnant and postnatal women in China compared to findings reported in previous studies. Due to the detrimental impact of secondhand smoking on physical health, legal legislation should be promptly enforced to establish smoke-free environments in both public and private urban/rural areas for protection of pregnant and postnatal women, especially those who are physically vulnerable and less educated.

Download Full-text

The Quality of Life of Coronavirus Disease Survivors Living in Rural and Urban Area of Riau Province, Indonesia

Infectious Disease Reports ◽

10.3390/idr14010005 ◽

2022 ◽

Vol 14 (1) ◽

pp. 33-42

Author(s):

Suyanto Suyanto ◽

Shashi Kandel ◽

Rahmat Azhari Kemal ◽

Arfianti Arfianti

Keyword(s):

Quality Of Life ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

The Status ◽

Rural And Urban Area

This study assesses the status of health-related quality of life (HRQOL) among coronavirus survivors living in rural and urban districts in Riau province, Indonesia. The cross-sectional study was conducted among 468 and 285 Coronavirus disease (COVID-19) survivors living in rural and urban areas, respectively in August 2021. The St. George Respiratory Questionnaire (SGRQ) was used to measure the HRQOL of COVID-19 survivors. A higher total score domain corresponds to worse quality of life status. Quantile regression with the respect to 50th percentile found a significant association for the factors living in rural areas, being female, having comorbidities, and being hospitalized during treatment, with total score of 4.77, 2.43, 7.22, and 21.27 higher than in their contra parts, respectively. Moreover, having received full vaccination had the score 3.96 in total score. The HRQOL of COVID-19 survivors living in rural areas was significantly lower than in urban areas. Factors such as living in rural areas, female sex, having comorbidities, and history of symptomatic COVID-19 infection were identified as significant predictors for lower quality of life. Meanwhile, having full vaccination is a significant predictor for a better quality of life. The results of this study can provide the targeted recommendations for improvement of HRQOL of COVID-19 survivors.

Download Full-text

Nutritional status of Tunisian adolescents: associated gender, environmental and socio-economic factors

Public Health Nutrition ◽

10.1017/s1368980008002693 ◽

2008 ◽

Vol 11 (12) ◽

pp. 1306-1317 ◽

Cited By ~ 44

Author(s):

Hajer Aounallah-Skhiri ◽

Habiba Ben Romdhane ◽

Pierre Traissac ◽

Sabrina Eymard-Duvernay ◽

Francis Delpeuch ◽

...

Keyword(s):

Nutritional Status ◽

Abdominal Obesity ◽

Rural Areas ◽

Urban Areas ◽

Eating Habits ◽

Public Health Problem ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Cultural Tradition ◽

Cross Sectional

AbstractObjectiveTo assess the nutritional status of Tunisian adolescents and associated factors.DesignA cross-sectional study based on a national stratified random cluster sample.Subjects and methodsIn all, 1295 boys and 1577 girls aged 15–19 years, of whom 28·4 % had already left school. Socio-economic characteristics of the parents, anthropometric measurements, food behaviours and physical activity of the adolescents were recorded during home visits.ResultsPrevalence of underweight, overweight and obesity (WHO/National Center for Health Statistics reference) were, respectively, 8·1 %, 17·4 % and 4·1 % among boys and 1·3 %, 20·7 % and 4·4 % among girls; abdominal obesity was highly prevalent among both sexes. Prevalence of overweight differed by region (from 11·5 % to 22·2 %) and was higher in urban v. rural areas for males (21·7 % v. 10·4 %) but not for females (21·7 % v. 19·2 %). These differences were partially mediated by socio-economic and lifestyle factors for males. For females, influence of cultural factors is hypothesised. In rural areas, overweight was more prevalent among boys of higher economic level households, having a working mother or a sedentary lifestyle; for girls, prevalence increased with the level of education of the mother. In urban areas, prevalence of overweight was related to eating habits: it was higher for boys with irregular snacking habits and for girls skipping daily meals. Urban girls having left school were also more overweight.ConclusionOverweight and abdominal obesity in late adolescence have become a true public health problem in Tunisia with the combined effects of cultural tradition for girls in rural areas, and of rapid economic development for boys and girls in cities.

Download Full-text

Diabetes Burden in Urban and Rural Senegalese Populations: A Cross-Sectional Study in 2012

International Journal of Endocrinology ◽

10.1155/2015/163641 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

S. M. Seck ◽

D. G. Dia ◽

D. Doupa ◽

A. Diop-Dia ◽

I. Thiam ◽

...

Keyword(s):

Risk Factors ◽

Abdominal Obesity ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Biological Data ◽

Cross Sectional ◽

Family History Of Diabetes ◽

Rural And Urban Areas ◽

History Of

Diabetes represents a challenging global health issue in the 21st century. Data from sub-Saharan African populations are scarce and are usually restricted to urban settings. The objective of this study was to compare prevalence and risk factors of diabetes in rural and urban areas in Senegal.Methods.In a community-based survey between January and May 2012, we included 1027 adults aged≥18 years living in northern Senegal. Sociodemographic, clinical, and biological data were collected during household visits. Multivariate logistic regression was performed to identify factors associated with diabetes.Results.Mean age of participants was48.0±16.9years and 65.7% were female. Participants from urban area represented 55.7%. The age-standardized prevalence of diabetes was 7.6% (6.0% in men versus 9.0% in women). Prevalence of diabetes was higher in urban areas (8.1%) compared to rural areas (4.6%). Disease awareness rate was 43%. After multivariate analysis, age (OR = 1.63,p=0.001), familial history of diabetes (OR = 1.42,p=0.001), and abdominal obesity (OR = 1.17,p=0.05) were associated with diabetes.Conclusion.Diabetes is frequent in urban and rural areas in Senegal. Awareness rate is very low among populations. Age, family history of diabetes, and abdominal obesity are the main risk factors identified.

Download Full-text

Status and disparities of diabetes among urban and rural residents aged 40 years and older: insight from a population-based study in northeast China, 2017–2019

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-213755 ◽

2021 ◽

pp. jech-2020-213755

Author(s):

Liying Xing ◽

Yuanmeng Tian ◽

Li Jing ◽

Min Lin ◽

Zhi Du ◽

...

Keyword(s):

Risk Factors ◽

Rural Areas ◽

Urban Areas ◽

Northeast China ◽

Population Based ◽

Cross Sectional Study ◽

Haemoglobin A1c ◽

Rural Residents ◽

Cross Sectional ◽

High Prevalence

ObjectivesTo evaluate the up-to-date epidemiology of diabetes in northeast China.MethodsThe cross-sectional study was conducted between September 2017 and March 2019 using a multistage, stratified and cluster random sampling method. 18 796 participants (28.9% urban and 71.1% rural) aged ≥40 years were enrolled. Diabetes and pre-diabetes were diagnosed according to the history, fasting plasma glucose (FPG) and glycosylated haemoglobin A1c (HbA1c) levels.ResultsThe prevalence of diabetes was 17.1%, higher in urban than in rural residents (20.2% vs 15.8%, p<0.001). Meanwhile, the prevalence of pre-diabetes was 44.3%, higher in rural than in urban areas (49.4% vs 31.8%, p<0.001). The overall FPG and HbA1c were 6.10±1.94 mmol/L and 5.59%±1.08%. The FPG level was higher in rural area than in urban areas (6.15±1.83 mmol/L vs 5.97±2.18 mmol/L, p<0.001). Among participants with diabetes, 47.5% were aware of their diabetes condition; 39.5% were taking antidiabetic medications and 36.8% of people had their diabetes controlled. The awareness and treatment rates in rural areas were lower than those in urban areas (47.3% vs 57.5%, 34.4% vs 49.5%, p<0.001). Patients with diabetic, especially those in rural areas, tended to have multiple risk factors including hypertension (71.7%), overweight or obesity (69.6%) and dyslipidaemia (52.8%).ConclusionA considerable burden of diabetes was observed in northeast China, with high percentage of untreated diabetes, high prevalence of pre-diabetes, high overall FPG level and multiple uncontrolled risk factors in patients with diabetics. Therefore, region-specific strategies on prevention and management of diabetes should be emphasised.

Download Full-text

Prevalence of Soil Transmitted Helminthes (STH) Infection among Children Aged 2-17 Years in Urban and Rural Areas of Dhaka District in Bangladesh

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v5i2.16933 ◽

2013 ◽

Vol 5 (2) ◽

pp. 16-22 ◽

Cited By ~ 5

Author(s):

Sultana Shahana Banu ◽

Be-Nazir Ahmed ◽

Shamim Jubayer ◽

Sultana Gulshana Banu ◽

Khorsed Ara ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Strongyloides Stercoralis ◽

Cross Sectional Study ◽

Single Infection ◽

Double Infection ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Urban Study

A multi-staged cross sectional study was conducted among children aged 2 -17 years to assess the level of soil transmitted helminthes (ST H) infections and its relation to socio-demographic characteristics among them. Two thousand children were randomly selected from two rural and four different communities of urban areas of Dhaka district since November 2009 to June 2010. Four different communities classified as higher, medium, poorer and slum/ low socio-economic groups from urban areas were selected on the basis of their place of residence with different socio-economic status. Urban study subjects were again sub grouped into upper (higher and medium socio-economic) and lower (poorer and slum/low socio-economic) classes. Stool specimens of the respondents were collected and tested at the Parasitology department of I E DCR , using the Kato-katz faecal technique for identification of helminthes eggs following their morphology (A. lumbricoides, Ttrichiura, and A. duodenale), and larval stage (S. stercoralis). About 32.15% study population harbored at least one of the four helminthes species. Baseline prevalence of infections and mean parasite loads for Ascaris lumbricoides were 40.61% and 600.80 e/g, for Trichuris trichiura 30.42% and 206.11e/g, and for A. duodenale 6.80% and 78.75 e/g. Three children (0.49%) were positive for Strongyloides stercoralis. Single infection of 78.32 % and double infection of 21.68 % were recorded. Single infection of A. lumbricoides (40.61%) and T trichiura (30.42%) and double infection of A. lumbricoides - T trichiura (18.61%) were more prevalent. T he prevalence of ST H infection was 25.47 % and 38.68 % for rural and urban areas respectively (P<.001). Among urban study subjects, the distribution of ST H infection was 0.0 % in the higher (living in higher socioeconomic areas) (only 3 samples could be collected), 26.75 % in medium (living in medium socio-economic areas), 45.95 % in poorer and 50.54 % in slum/low socio-economic groups. Significantly higher number of ST H infection was observed among lower than that in upper socio-economic classes (P <.001). These results suggest that ST H infections remain a serious health problem among children in Bangladesh and need appropriate prevention and control measures.DOI: http://dx.doi.org/10.3329/bjmm.v5i2.16933 Bangladesh J Med Microbiol 2011; 05 (02): 16-22

Download Full-text

Decomposing inequality in catastrophic health expenditure for self-reported hypertension household in Urban Shaanxi, China from 2008 to 2013: two waves’ cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-023033 ◽

2019 ◽

Vol 9 (5) ◽

pp. e023033 ◽

Cited By ~ 4

Author(s):

Yafei Si ◽

Zhongliang Zhou ◽

Min Su ◽

Xiao Wang ◽

Xin Lan ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Health Expenditure ◽

Economic Status ◽

Cross Sectional Study ◽

Catastrophic Health Expenditure ◽

Urban China ◽

Shaanxi Province ◽

Vulnerable Groups ◽

Cross Sectional

ObjectiveDespite the latest wave of China’s healthcare reform initiated in 2009 has achieved unprecedented progress in rural areas, little is known for specific vulnerable groups’ catastrophic health expenditure (CHE) in urban China. This study aims to estimate the trend of incidence, intensity and inequality of CHE in hypertension households (households with one or more than one hypertension patient) in urban Shaanxi, China from 2008 to 2013.MethodsBased on the fourth and the fifth National Health Service Surveys of Shaanxi, we identified 460 and 1289 households with hypertension in 2008 and 2013, respectively for our analysis. We classified hypertension households into two groups: simplex households (with hypertension only) and mixed households (with hypertension plus other non-communicable diseases). CHE would be identified if out-of-pocket healthcare expenditure was equal to or higher than 40% of a household’s capacity to pay. Concentration index and its decomposition based on Probit regressions were employed to measure the income-related inequality of CHE.ResultsWe find that CHE occurred in 11.2% of the simplex households and 22.1% of the mixed households in 2008, and the 21.5% of the simplex households and the 46.9% of mixed households incurred CHE in 2013. Furthermore, there were strong pro-poor inequalities in CHE in the simplex households (−0.279 and −0.283) and mixed households (−0.362 and −0.262) both in 2008 and 2013. The majority of observed inequalities in CHE could be associated with household economic status, household head’s health status and having elderly members.ConclusionWe find a sharp increase of CHE occurrence and the sustained strong pro-poor inequalities for simplex and mixed households in urban Shaanxi Province of China from 2008 to 2013. Our study suggests that more concerns are needed for the vulnerable groups such as hypertension households in urban areas of China.

Download Full-text

Patterns of Risky Sexual Behaviors and Associated Factors among Youths and Adolescents in Vietnam

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17061903 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1903 ◽

Cited By ~ 2

Author(s):

Ha Ngoc Do ◽

Diep Ngoc Nguyen ◽

Hoa Quynh Thi Nguyen ◽

Anh Tuan Nguyen ◽

Hiep Duy Nguyen ◽

...

Keyword(s):

Substance Use ◽

Unintended Pregnancy ◽

Sexual Behaviors ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Unprotected Sex ◽

Risky Sexual Behaviors ◽

Cross Sectional ◽

Attitudes And Practices

Youths and adolescents are vulnerable to HIV/STIs from unprotected sex. Promotion of young population’s awareness about risky sexual behaviors is essential to develop contextualized interventions. A cross-sectional study was conducted in five Vietnamese provinces to document current attitudes and practices regarding sexual behaviors among youths. The information on sociodemographic characteristics, substance use, and sexual behaviors was collected via self-reported questionnaires. The factors associated with risky sexual behaviors were identified by the multivariate logistic regression. Among the 1200 participants, 73.5% reported having sex in their lifetime, and 48.1% used condoms at their latest sexual intercourse. Participants in urban areas were more likely not to intend to use condoms and had a higher unintended pregnancy rate than in rural areas. Older age was positively associated with not wanting to use and not using condoms. Substance-using participants were more likely to not use condoms. The participants taking alcohol or other stimulants before sex had a higher likelihood of unintended pregnancy. Respondents’ attitudes and practices regarding sexual behaviors were associated with gender and employment. This study indicated that young population’s awareness in Vietnam is high, however, risky sexual behaviors also remain common. Sex-related educational programs about the consequences of substance use, multiple sex partners, and unprotected sex should be developed.

Download Full-text

Prevalence and associated risk factor of hypertension among individuals of age 18-59 years in South-eastern Nepal: A cross-sectional study

Nepalese Heart Journal ◽

10.3126/njh.v16i1.23894 ◽

2019 ◽

Vol 16 (1) ◽

pp. 19-26 ◽

Cited By ~ 2

Author(s):

Prajjwal Pyakurel ◽

Deepak Kumar Yadav ◽

Jeevan Thapa ◽

Nishant Thakur ◽

Pramita Sharma ◽

...

Keyword(s):

Risk Factors ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Anthropometric Measurement ◽

Sectional Study ◽

Cross Sectional ◽

South Eastern ◽

Associated Risk Factors

Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition. Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension. Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension. Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes.

Download Full-text