Infant mortality and family welfare: policy implications for Indonesia.
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STUDY OBJECTIVE: To examine the effect of family welfare index (FWI) and maternal education on the probability of infant death. DESIGN: A population based multistage stratified clustered survey. SETTING: Women of reproductive age in Indonesia between 1983-1997. DATA SOURCES: The 1997 Indonesian Demographic and Health Survey. MAIN RESULTS: Infant mortality was associated with FWI and maternal education. Relative to families of high FWI, the risk of infant death was almost twice among families of low FWI (aOR=1.7, 95%CI=0.9 to 3.3), and three times for families of medium FWI (aOR=3.3,95%CI=1.7 to 6.5). Also, the risk of infant death was threefold higher (aOR=3.4, 95% CI=1.6 to 7.1) among mothers who had fewer than seven years of formal education compared with mothers with more than seven years of education. Fertility related indicators such as young maternal age, absence from contraception, birth intervals, and prenatal care, seem to exert significant effect on the increased probability of infant death. CONCLUSIONS: The increased probability of infant mortality attributable to family income inequality and low maternal education seems to work through pathways of material deprivation and chronic psychological stress that affect a person's health damaging behaviours. The policies that are likely to significantly reduce the family's socioeconomic inequality in infant mortality are implicated. (+info)
Assessing health impact assessment: multidisciplinary and international perspectives.
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Health impact assessment (HIA) seeks to expand evaluation of policy and programmes in all sectors, both private and public, to include their impact on population health. While the idea that the public's health is affected by a broad array of social and economic policies is not new and dates back well over two centuries, what is new is the notion-increasingly adopted by major health institutions, such as the World Health Organisation (WHO) and the United Kingdom National Health Services (NHS)-that health should be an explicit consideration when evaluating all public policies. In this article, it is argued that while HIA has the potential to enhance recognition of societal determinants of health and of intersectoral responsibility for health, its pitfalls warrant critical attention. Greater clarity is required regarding criteria for initiating, conducting, and completing HIA, including rules pertaining to decision making, enforcement, compliance, plus paying for their conduct. Critical debate over the promise, process, and pitfalls of HIA needs to be informed by multiple disciplines and perspectives from diverse people and regions of the world. (+info)
Prevalence of blood-borne viral hepatitis in different communities in Yemen.
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It is generally believed that hepatitis B (HBV) and C (HCV) viruses are highly prevalent in the Republic of Yemen. This study investigated the prevalence of HBV and HCV markers in 494 blood donors from Aden, 493 blood donors from Sana'a, 97 residents from an African ethnic minority in Sana'a and 99 residents of Soqotra Island. There were significant differences in the prevalence of HBV carriage (HBsAg: 6.7, 15, 19.6 and 26.3% respectively; P < 0.001); past HBV infection (anti-HBc: 17.4, 18.5, 30.9 and 59.6% respectively; P < 0.001); susceptibility to HBV (absence of HBV markers: 73.3, 61.9, 38.1 and 9.1% respectively; P < 0.001), infectivity of HBV carriers (HBV DNA: 51.5, 33.8, 52.6 and 65.4% respectively; P = 0.028) and HCV antibodies (RIBA confirmed or indeterminate: 0.6, 0.2, 5.2 and 5.1% respectively; P < 0.001). A significant difference in HBV carrier rate and a borderline significant difference in the prevalence of natural infection was observed between males and females in the African community (P = 0.02 and 0.06 respectively). In contrast, in Soqotra Island, there was no significant sex difference in HBV carrier rate but susceptibility was significantly more prevalent in males (P = 0.03). This study illustrates that significant difference in prevalence and epidemiology exists among different communities within the same country, reflecting political, geographical and social differences. Control strategies should take these differences into account. (+info)
Mortality in the slave and white populations of Natchitoches Parish, Louisiana, 1850.
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A review of mortality from the 1850 census mortality schedules of Natchitoches Parish, Louisiana has provided a snapshot of the health conditions of African-American slaves. The cause of death was abstracted from the mortality schedule and categorized according to the ninth revision of the Manual of the International Classification of Diseases. Children under the age of 9 accounted for 44% of the total mortality. Sixty-four percent of all deaths recorded occurred in the slave population. Sixty-two percent of the slave deaths occurred in the male population. Leading causes of death were helminthiasis, whooping cough, fever, cholera, and pneumonia. Reports of mortality due to Cachexia Africana (dirt eating) among slaves are discussed. (+info)
FAILED PSYCHIATRIC CLINIC APPOINTMENTS. RELATIONSHIP TO SOCIAL CLASS.
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A study was made to determine what factors might be related to failure of patients to keep appointments at a county hospital psychiatric clinic. The hypothesis that the lowest status groups would have the poorest appointment records was substantiated in that they had the highest proportion of broken appointments without notification. Contrary to expectations, however, the highest status groups had poorer records than those in the central status groups-the skilled or semi-skilled workers and those with high school education. Marital status was also found to be related to appointment status, with divorced and separated persons displaying the greatest likelihood of breaking appointments without notifying the clinic. (+info)
PEPTIC ULCER IN SOUTH-WEST SCOTLAND.
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A survey is made of the incidence of peptic ulcer in a predominantly rural population in south-west Scotland. (+info)
THE GEOGRAPHIC PATHOLOGY OF CORONARY ATHEROSCLEROSIS.
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The purpose of these studies was to find large groups with significantly less coronary atherosclerosis than New Yorkers and to investigate the possible reasons for these differences. Direct comparison of hearts and measurements of coronary artery wall thickness, autopsy series, and clinical diagnoses of outpatients and hospital admissions revealed that the amount of coronary atherosclerosis and the number of myocardial infarcts is significantly less in East and West Africans compared to New Yorkers matched for age and sex. The factors producing these differences are apparently operative in childhood. East Africans were found to have a shorter blood clot-lysis time, fewer venous (and arterial) thromboemboli and lower serum lipid levels, with a lower relative percentage of serum linoleates, than age-matched New Yorkers. (+info)
HEPATITIS IN A HOUSING DEVELOPMENT: THE DETECTION OF SUBCLINICAL INFECTION.
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To detect the extent of subclinical infection during an outbreak of infectious hepatitis in a low-cost, high-density housing development, serum glutamic oxaloacetic transaminase (SGOT) levels were measured in 390 of the 1650 residents.Elevated SGOT values were found in 17.4% of those tested. Abnormal levels were more common in young children, occurring in 24.7% of those under 5 years of age and in 24.1% of those from 5 to 9 years of age.It was concluded that subclinical infection was widespread in the development, children under 10 years of age forming the principal reservoir. The concentration of many small children with poor personal hygiene favoured the spread of the infection.More extensive play areas and other facilities appropriate for large families, improved hygiene, dispersal of high-density housing units, and widespread use of gamma globulin in the event of an out-break are suggested as control measures. (+info)