Quantification of disparities in the distribution of lifestyle and metabolic risk factors, prevalence of non-communicable diseases and related mortality: the Belgian Health Interview Surveys 1997–2018

ObjectivesComprehensively measure the trends in health disparities by sociodemographic strata in terms of exposure to lifestyle and metabolic risks, and prevalence and mortality of non-communicable diseases (NCDs) during the last 20 years in Belgium.DesignCross-sectional analysis of periodic national-representative health interview surveys and vital statistics.SettingPopulation-based study of adult residents in Belgium between 1997 and 2018.ParticipantsAdults aged 25–84 years and resident in Belgium in the years 1997 (7256 adults), 2001 (8665), 2004 (9054), 2008 (7343), 2013 (7704) and 2018 (8358).Main outcome measureAge-standardised prevalence rates of modifiable lifestyle risks (poor diet, smoking, excessive alcohol use and leisure-time physical inactivity), metabolic risks (high body mass index (BMI), blood pressure and cholesterol levels) and major NCDs (type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVDs), cancer, asthma and chronic obstructive pulmonary disease (COPD)), with their relative health disparities across strata by age, sex, region of residence, nationality, education and income level, and according to high versus low engagement in the four lifestyle risks, calculated from a survey-weighted age-adjusted logistic regression.ResultsGreater avoidable disparities were observed between extremes of education and income strata. The most marked disparities were found for exposure to lifestyle risks (except excessive alcohol use), prevalence of high BMI as well as T2DM, asthma and COPD, with disparities of daily smoking and COPD worsening over time. Still, NCD-specific mortality rates were significantly higher among men (except asthma), residents of Wallonia and Brussels (except cerebrovascular disease), and among the native Belgians (except T2DM and asthma). High engagement in lifestyle risks was generally observed for men, residents of the region Wallonia, and among lower education and income strata. This subgroup (20%) had a worse health profile as compared with those who had a low-risk lifestyle (25%), shown by prevalence ratios varying between 1.1 and 1.6 for metabolic risks, and between 1.8 and 3.7 for CVD, asthma and COPD.ConclusionsImproving population health, including promoting greater health equity, requires approaches to be tailored to high-risk groups with actions tackling driving root causes of disparities seen by social factors and unhealthy lifestyle.

Mobilising Information and Cancer Prevention: A Comparative Content Analysis of Online Cancer News (Preprint)

BACKGROUND Cancer is a severe health issue in Malaysia. Different media channels, especially digital media outlets play an essential role as a health educator to disseminate cancer health information, as well as persuade and mobilise cancer prevention in the community. However, little is known about the knowledge of mobilising information (calls to action) in online cancer news, especially from Asian media outlets. OBJECTIVE This study aimed at analysing cancer news articles that contain mobilising information and its news components on the selected Malaysian English and Chinese newspapers with online versions. METHODS The Star Online and Sin Chew Online were selected for analysis because the two newspaper websites enjoy the highest circulation and readership in the English-language and the Chinese-language streams respectively. Two bilingual coders searched the cancer news articles based on sampling keywords, after that read and coded each news article accordingly. Six coding variables were conceptualised from previous studies (i.e., cancer type, news type, news source, news focus, cancer risk factors and mobilising information), and a perfect consistency using Cohen’s Kappa was built between coders (k=.73-.97). Descriptive analysis was used to examine the frequency and percentage of each coding item; Chi-square test was applied to analyse the differences between two newspaper websites, and the associations between examined variables and the presence of mobilising information were examined through binary logistic regression. RESULTS Among 841 analysed news articles, 69.6% (585/841) presented mobilising information. News distributions were unbalanced throughout the year in both English and Chinese newspaper websites; some months occupied the peak (i.e., February and October), but cancer issues and mobilising information for cancer prevention received minimal attention in other months. The news articles from The Star Online and Sin Chew Online were significantly different in several news components, such as the present rates of mobilising information (x^2=9.25, p=.003), providing different types of mobilising information (Interactive MI: x^2=12.08, p=.001), interviewing different news sources (Government Agency: x^2=12.05, p=.001), concerning different news focus (Primary Cancer Prevention: x^2=10.98, p=.001), and mentioning different cancer risks (Lifestyle Risks: x^2=7.43, p=.007). Binary logistic regression results reported that online cancer news articles were more likely to provide mobilising information when interviewed NGOs, focused on topics related to primary cancer prevention, and highlighted lifestyle risks (OR: 2.77, 95% CI: 1.89-4.05; OR: 97.70, 95% CI: 46.97-203.24; OR: 186.28; 95% CI: 44.83-773.96; p=.001; respectively). CONCLUSIONS This study provided new understandings regarding mobilising information in cancer news coverage. It could wake and trigger the individuals’ pre-existing attitudes and intentions on cancer prevention. Thus, health professionals, health journalists, and health campaign designers should be concentrated on mobilising information when distributing health information to the community.

Clustering of Lifestyle Cardiovascular Risk Factors Among Healthy Government Servants in Kuala Terengganu: Who And What to Target

Cardiovascular disease is the leading cause of death and disability among men and women in nearly all nations, including Malaysia. Lifestyle cardiovascular risk factors such as dietary habits, physical inactivity and smoking are considered fundamental risk factors for cardiovascular disease. Previous studies showed that the clustering of cardiovascular risk factors significantly increase the risk of developing cardiovascular events. Surveillance of these key modifiable risk factors, including its clustering and study of factors associated is needed to monitor the magnitude of the problem and effects of our interventions. This study aimed to determine the prevalence and factors associated with clustering of lifestyle cardiovascular risk factors among government servants in Kuala Terengganu, Malaysia. This was a cross-sectional study conducted between June and September 2013 among 121 government servants, selected using simple random sampling from all servants asymptomatic of cardiovascular disease at a multi-department government center in the capital of Terengganu. A questionnaire, which consisted of socio-demographic data, International Physical Activity Questionnaire (IPAQ) and the dietary component of WHO STEPs, were used as the research tools. Clustering of lifestyle cardiovascular risk was defined as the presence of two or more of the lifestyle risk factors. Prevalence of clustering of lifestyle risks in this study was 57% (95% CI: 0.47, 0.67). Respondents with income less than RM3, 000 was significantly associated with clustering of lifestyle cardiovascular risks (p=0.032, OR 2.57, CI: 1.08, 6.07). This study provides evidence of clustering of lifestyle risks in the local asymptomatic healthy subjects. Therefore, comprehensive lifestyle interventions may be an effective strategy for controlling CVD risk factors, especially among those with low socioeconomic status where affordable interventions should be suggested. A more effective approach should be identified to promote affordable healthier diet and healthy lifestyle activities. Keywords: Clustering; Lifestyle; Cardiovascular Risk Factors; low socioeconomic status.

Ten years of deep neck space abscesses

BackgroundThe incidence of deep neck space abscesses, which can result in significant morbidity and mortality, is rising. The aetiology is thought to be dental. However, this study suggests a reduction in tonsillectomies may be associated with the rise.MethodIn a retrospective cohort study, patients were identified by a clinical code within one hospital over 10 years. Evidence of preceding infection source, management, lifestyle risks, comorbidities and demographics were extracted.ResultsFifty-two patients were included: 23 (44 per cent) had concurrent or recent tonsillitis; 11 (21 per cent) had poor dental hygiene; 22 (42 per cent) were smokers; and 9 (17 per cent) had diabetes. The incidence of deep neck space abscess cases increased from 1 in 2006, to 15 in 2015 (correlation value 0.9; p = 0.00019).ConclusionThe incidence of deep neck space abscess cases is increasing. Risk factors include tonsillitis, smoking and dental infection. This paper adds to the growing evidence that deep neck space abscesses are increasingly related to tonsillitis, and questions whether the threshold for tonsillectomy has been raised too high.