Life Expectancy and Healthy Life Expectancy of Adults in Oman: Does Women’s Longer Life Expectancy than Men Mean Success or Burden for Women?

Objectives: The objective of this study was to examine the life expectancy (LE) and healthy life expectancy (HLE) of Omani adults with age and gender differentials, focusing on whether the higher LE of women than men is a gain or burden for women. Method: Data for the study come from multiple sources such as the 2010 population census, the 2008 World Health Survey in Oman, and secondary data published in the Statistical Yearbook of Oman. The life table and the modified life table proposed by Sullivan were used for estimating the LE and HLE of adult people of age 20 and above, respectively. Results: LE in Oman reached 76 years for both sexes in recent times. However, since 2010 LE has been stalled in the vicinity of 76 years in Oman. Women had higher LE than men (79 years versus 74 years). In terms of HLE, men outweighed women in Oman. At the age of 20, the gap between male-female LE was found to be 4.7 years in favor of females, whereas the gap between male-female HLE was found to be 5.8 years in favor of males. Females spent a relatively long time in poor health status than males (20.8 years versus 10.8 years) and the proportion of life spent in poor health was greater for females than males (35.0% vs. 19.3%). This revealed the paradox of less mortality but higher morbidity among women, supporting the “Failure of Success” hypothesis. Conclusion: Appropriate health policy and strategy need to be taken to reduce the gender gap in LE and HLE in Oman.

Direct Healthy Life Expectancy Estimates from Life Tables with a Sullivan Extension: The case of Brazil 2003

The Healthy Life Expectancy (HLE) in Brazil 2003 was estimated by Romero et al (2005) by using the Sullivan method and data from the World Health Survey carried out in Brazil in 2003. Here we use a Direct method to estimate the Healthy Life Years Lost (HLYL) and then the HLE. This is done after the analytic derivation of a more general model of survival-mortality and the estimation of a parameter bx related to the HLYL is followed by the formulation of a computer program providing results similar to those of the World Health Organization for the Healthy Life Expectancy (HALE) and the corresponding HLYL estimates. This program is an extension of classical life table including more columns to estimate the cumulative mortality, the average mortality, the person life years lost, and finally the HLYL parameter bx. Even more, a further extension of the Excel program based on the Sullivan method provides estimates of the Healthy Life Expectancy at every year of the lifespan.

Prevalence of Depressive Disorders and Associated Factors among Adult Population of Dubai 2019

<b><i>Background:</i></b> Globally, depressive disorders are one of the leading causes of ill mental health and disability affecting about 1 in 4 people at some point in their lives. Population-level data on depressive disorders in the region are sparse yet essential for health sectors. This is the first population estimate for the prevalence of depressive disorders and associated factors in Dubai. <b><i>Objective:</i></b> The aim of this study was to estimate the prevalence of depressive disorders and the associated factors among adults aged ≥18 years in the Emirate of Dubai 2019. <b><i>Method:</i></b> This is a complex-design cross-sectional population survey targeting Dubai residents aged ≥18 years. This study was part of the Dubai Household Survey 2019 (DHHS-2019). The total number of participants was 2,244, with a response rate of 91.6%. The design was a 2-stage stratified cluster sample. Trained investigators conducted computer-assisted face-to-face interviews using the World Health Survey questionnaire and Patient Health Questionnaire (PHQ-9) screening. Analysis was design-based adjusting for weight, primary sampling unit, and stratum. <b><i>Results:</i></b> The overall prevalence of depressive disorders was 2.3% (95% confidence interval [CI]: 1.6%–3.4%). Screening revealed 1.9% (95% CI: 1.2%–2.9%) of participants were positive for depressive disorders, with no prior diagnosis constituting approximately 74% of the depressed. Factors associated with depression were adjusted using logistic regression and revealed significantly higher odds of depressive disorders among the following: unmarried (single, divorced, and widowed) comparing to married (odds ratio [OR]: 2.7, 95% CI: 1.2–6.3) and smokers than nonsmokers (OR: 3.3, 95% CI: 1.4–8.0). Employment was found to be a protective factor and reduced the odds of having depressive disorders by 80% comparing to unemployed (OR: 0.2, 95% CI: 0.1–0.7). Moreover, those suffering from health conditions had higher odds for having depressive disorders, such as chest pain (OR: 20.2, 95% CI: 5.5–74.8), history of tuberculosis (TB) (OR: 12.6, 95% CI: 2.1–76.8), and history of stroke (OR: 22.5, 95% CI: 6.8–74.2). <b><i>Conclusion:</i></b> The prevalence of depressive disorders was relatively low in Dubai compared to most countries. However, approximately 74% of individuals with depression were undiagnosed, indicating the need for screening programs. The odds of having depressive disorders were significantly higher among unmarried, unemployed, smokers, and those with a history of TB and stroke.

Association between diabetes and edentulism and their joint effects on health status in 40 low and middle-income countries

IntroductionPrevious studies on the diabetes–edentulism relationship have yielded conflicting results. Therefore, the goal of this study was to investigate the association between diabetes and edentulism, and their joint effects on health status in adults from 40 low and middle-income countries (LMICs).Research design and methodsData from the World Health Survey were used for this cross-sectional study (2002–2004). Forty countries (18 low-income and 22 middle-income countries) were included. Edentulism and diabetes were assessed using yes-no questions based on self-report. Health status was assessed in seven different domains (self-care, pain/discomfort, cognition, interpersonal activities, sleep/energy, affect, and perceived stress). The association between diabetes (exposure) and edentulism (outcome) was analyzed using multivariable logistic regression models, while their joint effects on health status were assessed using multivariable linear regression models.ResultsThere were 175 814 adults aged ≥18 years included in this study (mean (SD) age 38.4 (16.0) years; 49.3% men). Overall, the prevalence of edentulism was 6.0% and diabetes was 2.9%. There was a positive and significant association between diabetes and edentulism in the overall sample (OR=1.40, 95% CI 1.18 to 1.66), in low-income countries (OR=1.78, 95% CI 1.21 to 2.62) and in middle-income countries (OR=1.24, 95% CI 1.04 to 1.47). In addition, people with comorbid diabetes and edentulism had worse health status in the domains of cognition, sleep/energy, and perceived stress, compared with those with diabetes only.ConclusionsDiabetes was positively associated with edentulism in this sample of more than 175 000 individuals living in LMICs. Providing oral care to individuals with diabetes may potentially lead to a reduction in their risk of edentulism.

Has Iran achieved the goal of reducing the prevalence of households faced with catastrophic health expenditure to 1%? The results of a national study

Background Access to universal health coverage and reducing the prevalence of catastrophic health expenditure (CHE) to 1% are the commitments of the Islamic Republic of Iran. The aim of this study was to investigate the prevalence of households exposed to CHE. Methods This cross-sectional study was performed on 2000 households in five provinces of Iran in 2021. Data were collected through interviews using the World Health Survey questionnaire. Results Data from households whose health care costs were more than 40% of their capacity to pay were included in the group of households with CHE. Determinants of CHE were identified using multivariate regression analysis. 8.3% of households were exposed to CHE. The variables of being a female head of household, use of inpatient, outpatient, dental, and rehabilitation services, families with disabled members and low economic status of the households were significantly associated with increased odds of facing CHE. Conclusion In the final year of the sixth five-year development plan, Iran has not yet achieved its goal of "reducing the percentage of households exposed to CHE to 1%," and a high percentage of Iranian households still face CHE. Policymakers should pay attention to factors increasing the chance of facing CHE in designing interventions and this can help the goal of financial protection against health costs.

Social determinants of overweight and obesity in Paraguayan adults using quantile regression

Background: The World Health Organization (WHO) defines the double burden of malnutrition as the new face of malnutrition. This is a serious problem in Latin American countries, especially Paraguay, which has a high obesity rate. This study aimed to gather data to inform a national strategy for confronting the double-burden challenge in Paraguay by 1) identifying whether the body mass index (BMI) of study subjects differed significantly according to social determinants, and 2) assessing the factors affecting BMI and the extent of their impact according to BMI quantile levels. Design and Methods. Data were collected using a questionnaire adapted from the WHO World Health Survey. We collected 2,200 responses from September 16 to October 7, 2018. After excluding the questionnaires with missing data, we analyzed 1,994 respondents aged 17 years and older living in Limpio, Paraguay. The analyses included t-test and chi-squared test to identify significant differences and 10th quantile regression to assess associations. Results. Analyses showed significant differences in participants’ BMI levels based on age and diagnoses of diabetes or hypertension. In quantile regression analyses, age was significantly associated with BMI quantiles at all but one level. Educational attainment was significantly associated with the 10%–40% and 60%–70% quantiles of BMI. Conclusions. Age, education level, diabetes, and hypertension were significant predictors of obesity. Obesity programs that focus on people aged more than 60 years are required. In addition, targeted nutritional education may be a useful intervention.

The measurement of health inequalities: does status matter?

Approaches to measuring health inequalities are often problematic because they use methods that are inappropriate for categorical data. In this paper we focus on “pure” or univariate health inequality (rather than income-related or bivariate health inequality) and use a concept of individual status that allows a consistent treatment of such data. We take alternative versions of the status concept and apply methods for treating categorical data to examine self-assessed health inequality for the countries included in the World Health Survey. We also use regression analysis on the apparent determinants of these health inequality estimates. We show that the status concept that is used will affect health-inequality rankings across countries and the way health inequality is related to countries’ median health, income, demographics and governance.

Multimorbidity and Subjective Cognitive Complaints: Findings from 48 Low- and Middle-Income Countries of the World Health Survey 2002–2004

Background: Data on the association between multimorbidity and subjective cognitive complaints (SCC) are lacking from low- and middle-income countries (LMICs). Objective: To assess the association between multimorbidity and SCC among adults from 48 LMICs. Methods: Cross-sectional, community-based data were analyzed from the World Health Survey 2002–2004. Ten chronic conditions (angina, arthritis, asthma, chronic back pain, depression, diabetes, edentulism, hearing problems, tuberculosis, visual impairment) were assessed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Multivariable linear regression and mediation analyses were conducted to explore the associations. Results: A total of 224,842 individuals aged≥18 years [mean (SD) age 38.3 (16.0) years; 49.3% males] constituted the final sample. Compared to no chronic conditions, the mean SCC score was higher by 7.13 (95% CI = 6.57–7.69), 14.84 (95% CI = 13.91–15.77), 21.10 (95% CI = 19.49–22.70), 27.48 (95% CI = 25.20–29.76), and 33.99 (95% CI = 31.45–36.53) points for 1, 2, 3, 4, and≥5 chronic conditions. Estimates by sex and age groups (18–44, 45–64,≥65 years) were similar. Nearly 30% of the association between multimorbidity (i.e.,≥2 chronic conditions) and SCC was explained by psychological factors (i.e., perceived stress, sleep problems, anxiety symptoms). Conclusion: Multimorbidity is associated with SCC among adults in LMICs. Future studies should investigate whether addressing psychological factors in people with multimorbidity can improve cognitive function, and whether screening for SCC in individuals with multimorbidity can be a useful tool to identify individuals at particularly high risk for future cognitive decline.

Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.