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Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study

ACTION Study Group

Eur J Cancer, 2017 03;74:26-37.
PMID: 28335885 DOI: 10.1016/j.ejca.2016.12.014

BACKGROUND: Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC).

METHODS: The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs ≥ 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes.

RESULTS: The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4·9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages.

CONCLUSION: The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor.

Matched MeSH terms: Income
Fulltext Uptake and determinants of private health insurance enrollment in a country with heavily subsidised public healthcare: A cross-sectional survey in East Coast Malaysia

Abd Khalim MA, Sukeri S

PLoS One, 2023;18(1):e0278404.
PMID: 36649258 DOI: 10.1371/journal.pone.0278404

Malaysia's subsidised public healthcare system is heavily reliant on government funding. Increasing the uptake of private health insurance (PHI) would alleviate the financial burden on public healthcare facilities caused by high patient loads. The study aimed to determine the uptake of PHI and its associated factors among the East Coast Malaysian populations. A cross-sectional online survey was conducted between February and June 2021. Proportionate stratified sampling was applied to select 1138 participants, and logistic regression was performed to determine the factors associated with PHI uptake. The proportion of the study samples that purchased PHI was 54.3%. Enrolment of private health insurance was associated with working in the public sector (aOR: 6.06, 95% CI: 2.65, 13.88) and private sector (aOR: 6.27, 95% CI: 2.65, 14.85), being self-employed (aOR: 9.23, 95% CI: (3.59, 23.70), being in the middle 40% household income percentile (aOR: 2.74, 95% CI: 1.95, 3.85) and top 20% household income percentile (aOR: 4.42, 95% CI: 2.87, 6.80), and living in urban areas (aOR: 1.31, 95% CI: 1.01, 1.70). Even in the presence of subsidised public healthcare, the high proportion of PHI uptake reflects a demand for private health insurance. The study suggests that PHI should be promoted among those who are employed or self-employed, the middle- and high-income groups, and urban residents. The findings may be beneficial for the government and insurance companies to improve strategies to enhance PHI uptake among these population.

Matched MeSH terms: Income*
Fulltext Dietary Intake among Adolescents in a Middle-Income Country: An Outcome from the Malaysian Health and Adolescents Longitudinal Research Team Study (the MyHeARTs Study)

Abdul Majid H, Ramli L, Ying SP, Su TT, Jalaludin MY, Abdul Mohsein NA

PLoS One, 2016;11(5):e0155447.
PMID: 27187889 DOI: 10.1371/journal.pone.0155447

Optimal nutrition is essential for healthy growth during adolescence. This study aims to investigate the baseline nutritional intake of Malaysian adolescents by gender, body mass index, and places of residence, both urban and rural. A cohort study was conducted consisting of 794 adolescents (aged 13-years) attending 15 public secondary schools from the Central (Kuala Lumpur and Selangor) and Northern (Perak) Regions of Peninsular Malaysia. Qualified dietitians conducted a 7-day historical assessment of habitual food intakes. Facilitated by flipcharts and household measurement tools, detailed information on portion sizes and meal contents were recorded. Nutritionist Pro™ Diet Analysis software was also used to analyze the dietary records.The mean age of the adolescents was 12.86 ± 0.33 y; the mean energy intake was 1659.0 ± 329.6 kcal/d. Males had significantly (P < .001) higher energy intake than females (1774.0 ± 369.8 vs 1595.2 ± 320.6 kcal/d); adolescents in rural schools consumed more energy and cholesterol (P < .001) compared to adolescents in urban schools (1706.1 ± 377.7 kcal/d and 244.1 ± 100.2 mg/d, respectively). Obese adolescents in rural schools consumed more energy and sugar (1987.6 ± 374.0 kcal/d and 48.9 ± 23.0 g/d) (p-value <0.001).The dietary intake of normal weight versus obese adolescents differs by the location of their school. Thus, the implementation of a structured and tailored intervention is recommended to help minimize this nutritional inequality.

Matched MeSH terms: Income*
Dental care access among individuals with Down syndrome: a Malaysian scenario

Abdul Rahim FS, Mohamed AM, Marizan Nor M, Saub R

Acta Odontol Scand, 2014 Nov;72(8):999-1004.
PMID: 25029211 DOI: 10.3109/00016357.2014.936036

The purpose of this cross-sectional study was to assess the legal representatives' perceptions on dental care access of individuals with Down syndrome (DS) compared to their non-DS siblings in Peninsular Malaysia.

Matched MeSH terms: Income
Applying the Transtheoretical Model to evaluate the effect of a call-recall program in enhancing Pap smear practice: a cluster randomized trial

Abdullah F, Su TT

Prev Med, 2013;57 Suppl:S83-6.
PMID: 23415623 DOI: 10.1016/j.ypmed.2013.02.001

The objective of this study was to evaluate the effect of a call-recall approach in enhancing Pap smear practice by changes of motivation stage among non-compliant women.

Matched MeSH terms: Income/statistics & numerical data
Job satisfaction and perceived future roles of Malaysian dental therapists: findings from a national survey

Abu Bakar A, Mohd Nor NA, Ab-Murat N, Jaafar N

Int J Dent Hyg, 2015 Aug;13(3):199-205.
PMID: 25040653 DOI: 10.1111/idh.12095

OBJECTIVE: To assess Malaysian dental therapists' perceptions of their job satisfaction and future roles.
METHODS: A nationwide postal survey involving all Malaysian dental therapists who met the inclusion criteria (n = 1726).
RESULTS: The response rate was 76.8%. All respondents were females; mean age 35.4 years (SD = 8.4). Majority were married (85.5%) and more than one-half had a working experience of <10 years (56.1%). Majority worked in community dental service (94.3%) and in urban areas (61.7%). Overall, they were highly satisfied with most aspects of their career. However, they were least satisfied with administrative workload (58.1%), career advancement opportunities (51.9%) and remuneration package; specifically income (45.2%), allowances (45.2%) and non-commensurate between pay and performance (44.0%). Majority perceived their role as very important in routine clinical tasks such as examination and diagnosis, preventive treatment, extraction of deciduous teeth and oral health promotion. However, fewer than one-half consider complex treatment such as placement of preformed crowns on deciduous teeth (37.1%) and extraction of permanent teeth (37.2%) as very important tasks.
CONCLUSION: Majority expressed high career satisfaction with most aspects of their employment but expressed low satisfaction in remuneration, lack of career advancement opportunities and administrative tasks. We conclude that most Malaysian dental therapists have positive perceptions of their current roles but do not favour wider expansion of their roles. These findings imply that there was a need to develop a more attractive career pathway for therapists to ensure sustainability of effective primary oral healthcare delivery system for Malaysia's children.

Matched MeSH terms: Income
The impact of democracy and income on CO2 emissions in MINT countries: evidence from quantile regression model

Agbede EA, Bani Y, Naseem NAM, Azman-Saini WNW

Environ Sci Pollut Res Int, 2023 Apr;30(18):52762-52783.
PMID: 36847946 DOI: 10.1007/s11356-023-25805-z

This study analyses the relationship between democracy and environmental pollution in the MINT countries using a panel data spanning 1971-2016. It also investigates the interactive effect of income and democracy on CO2 emissions. We used various estimation techniques for the analysis, ranging from the quantile regression, OLS-fixed effect and GLS-random effect regressions with Driscoll-Kraay standard errors to control for cross-sectional dependence while a panel threshold regression is used for robustness check. The results showed existence of long-run relationship between CO2 emissions and the explanatory variables. The quantile regression results for interaction model indicate that economic growth, democracy and trade openness promote environmental pollution via their positive effects on CO2 emissions. Primary energy however reduces pollution across the lower and middle quantiles but enhances it in higher quantiles. The interaction effect is negative and statistically significant across all quantiles. This implies that democracy has a significant role in moderating the impact of income on CO2 emission in the MINT countries. It thus follows that if the MINT countries radically strengthen democracy and enhance income, it would be possible for them to achieve greater economic development and reduce CO2. In addition, a single threshold model is used to identify the asymmetry in response to CO2 emissions at lower and upper levels of democratic regimes. The results showed that once the degree of democracy is above the threshold level, an increase in income would reduce CO2 emissions but once it is below the threshold level, the effect of income becomes insignificant. Based on these results, the MINT countries need to strengthen democracy, enhance income level and relax trade barriers.

Matched MeSH terms: Income
Fulltext Factors affecting risk tolerance among small-scale seasonal commodity farmers and strategies for its improvement

Agussabti A, Romano R, Rahmaddiansyah R, Isa RM

Heliyon, 2020 Dec;6(12):e05847.
PMID: 33426340 DOI: 10.1016/j.heliyon.2020.e05847

In developing countries, farming businesses are dominated by small-scale farmers with limited resources. Such farmers are subjected to high risks, influencing the success rate of their agricultural endeavors. This study, conducted in Aceh Province, Indonesia, measured the risk tolerance among six groups of farmers with businesses based on the following seasonal commodities: paddy, corn, soy, chili, potato, and tomato. A total of 360 respondents were surveyed and 54 key respondents interviewed. A Likert scale was used to assess the risk tolerance levels of the farmers, and ordinal regression analysis to analyze the factors influencing risk tolerance. Paddy, chili, and potato farmers had a relatively high tolerance to farming risks, whereas corn and tomato farmers showed a moderate tolerance. Soy farmers were classified into the low risk tolerance category. Ordinal analysis indicated that the risk tolerance of farmers in each commodity group was influenced by specific factors. Overall, it was found that the farmers' attitudes to risk tolerance were significantly affected by the following factors: experience, education, farming income, capital, land status, and land size. An intervention strategy including improvements in the curriculum, actors, network, scope of clusters, and technology are among the strategies required to positively improve farmers' perceptions and increase their tolerance to farming risks.

Matched MeSH terms: Income
Fulltext Economic impact of a vaccine preventable disease: a scoping review on tuberculosis

Aidalina Mahmud, Azimatun Noor Aizuddin

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):254-261.
MyJurnal

Using pulmonary tuberculosis (pTB) as an example of a vaccine-preventable disease (VPD), we aimed to gather evidence on the economic impact of treating a case or managing an outbreak of a VPD. A scoping review was con- ducted. Online databases (MEDLINE and Google Scholar) were used to collate published studies from the year 2015 to 2019 on the management cost of one case or an outbreak of pTB. Keywords used were cost, treatment, outbreak, pulmonary tuberculosis, tuberculosis, economic, economic evaluation. A total of 29 studies were analysed. The costs of pTB treatment for individual patient were higher in high-income countries compared to middle-income and low-income countries. A case of pTB can result in household catastrophic health expenditure; while an outbreak can overwhelm the health system’s capacity, and disrupts the economy of a country. Therefore, accessibility of vaccines especially in low-income countries must be ensured. Also, vaccine-hesitant individuals must reconsider their stance on vaccination.

Matched MeSH terms: Income
Quality of life of multiethnic adolescents living with a parent with cancer

Ainuddin HA, Loh SY, Low WY, Sapihis M, Roslani AC

Asian Pac J Cancer Prev, 2012;13(12):6289-94.
PMID: 23464447

BACKGROUND: Research evidence suggests a debilitating impact of the diagnosis of cancer on the quality of life of the afflicted individuals, their spouses and their families. However, relatively few studies have been carried out on the impact on the QOL of adolescents living with parents diagnosed with cancer. This paper presents a sub- analysis on the impact of parental cancer (colorectal, breast and lung) on adolescents.
MATERIALS AND METHODS: This is a cross-sectional study on adolescents aged 13-18 years old. Upon ethical clearance obtained from UMMC Medical Ethics Committee, patients with colorectal, breast or lung cancer and their adolescent children were recruited from the Clinical Oncology Unit of University of Malaya Medical Centre. Respondents who gave consent completed a demographic questionnaire and the Pediatric Quality of Life Inventory, via the post, email, home visit or meetings at the clinics.
RESULTS: 95 adolescents from 50 families responded, giving a response rate of 88 percent. The adolescent's mean age was 16 years (ranging between 13-18 years). Adolescents with parental cancer had the lowest mean score in emotional functioning (p<0.05). Male adolescents had significantly higher quality of life overall and in physical functioning compared to female adolescents. Adolescents with a father with cancer had better school functioning compared to adolescents whose mothers had cancer. Families with household income of RM 5000 and above have significantly better quality of life compared to families with lower household income.
CONCLUSIONS: Adolescent sons and daughters of parents with a cancer diagnosis show lowered QOL, particularly with reference to emotional functioning and school performance. Addressing the needs of this young group has been slow and warrants special attention. Revisiting the risk and resilience factors of adolescents might also inform tailored programs to address the needs of this neglected adolescent population.

Matched MeSH terms: Income
Ability to Pay for Future National Health Financing Scheme among Malaysian Households

Aizuddin AN, Aljunid SM

Ann Glob Health, 2017 11 21;83(3-4):654-660.
PMID: 29221542 DOI: 10.1016/j.aogh.2017.10.002

BACKGROUND: Malaysia is no exception to the challenging health care financing phenomenon of globalization.
OBJECTIVES: The objective of the present study was to assess the ability to pay among Malaysian households as preparation for a future national health financing scheme.
METHODS: This was a cross-sectional study involving representative samples of 774 households in Peninsular Malaysia.
FINDINGS: A majority of households were found to have the ability to pay for their health care. Household expenditure on health care per month was between MYR1 and MYR2000 with a mean (standard deviation [SD]) of 73.54 (142.66), or in a percentage of per-month income between 0.05% and 50% with mean (SD) 2.74 (5.20). The final analysis indicated that ability to pay was significantly higher among younger and higher-income households.
CONCLUSIONS: Sociodemographic and socioeconomic statuses are important eligibility factors to be considered in planning the proposed national health care financing scheme to shield the needed group from catastrophic health expenditures.

Matched MeSH terms: Income*
Fulltext Ability and willingness to pay for health care and contribute to national healthcare financing scheme among farmers in Selangor

Aizuddin, A.N., Hoda, R., Rizal, A.M., Yon, R., Al Junid, S.M.

Malaysian Journal of Community Health, 2011;17(1):56-63.
MyJurnal

Introduction: In view of high healthcare expenditure, Malaysia also faces problems in healthcare financing. The policy option is to establish a national health financing scheme. However, it is a problem to develop mechanisms to cover social insurance package to more than one third of the population working in informal sector such as farmers. Therefore, there is an urgent need to assess the ability and willingness of the farming community. The main objective was to study the ability and willingness in the farming community to contribute to national healthcare financing scheme.

Methodology: This a cross sectional study involved 400 farmers in Selangor. A total of 92.3% farmers were able to pay for the healthcare.

Results: Willingness to contribute to The national healthcare financing scheme were RM2.00 per month.

Conclusion: The education level influenced the ability to pay while the educational level and per capita income influenced willingness to pay.

Matched MeSH terms: Income
Electrolyte profile of Malaysian mothers' milk

Alaudeen S, Muslim N, Faridah K, Azman A, Arshat H

Malays J Reprod Health, 1988 Dec;6(2):102-7.
PMID: 12342169

PIP: The influence of socioeconomic status (ethnicity, income and parity) on electrolyte composition (sodium and potassium) in human milk is little known. We have thus quantitatively analyzed approximately 700 samples of milk (1-90 days postpartum) obtained from healthy Malaysian mothers' (Malay, Chinese and Indians) of full term infants. Results show that the mean concentration (mmol/l) of sodium is highest (48.2+or-1.7, Mean+or-SEM) in the Malaysian mothers' colostrum and this value decreased by 30% in their transitional milk and remained constant throughout subsequent days of lactation (mature milk). Ethnically, it is found that the level of sodium in colostrum of Malay and Chinese mothers were similar while the Indian mothers' colostrum showed apparently higher value (52.7+or-3.4 mmol/l) that is statistically insignificant. The transitional milk of all 3 ethnic groups studied exhibited similar levels of sodium. On subsequent days of lactation (mature milk) the Malay mothers exhibited lowest concentration (25.9+or-2.6 mmol/l) of sodium that is significantly (P0.05) different from that of Chinese and Indian mothers. Income and parity do not significantly affect the sodium level in Malaysian mothers' milk during all stages of lactation studied. The level of potassium, however did not change significantly with days of lactation. Like sodium, potassium too was not influenced by income and parity. (Author's).

Matched MeSH terms: Income*
Fulltext Association between household food insecurity and nutritional outcomes among children in Northeastern of Peninsular Malaysia

Ali Naser I, Jalil R, Wan Muda WM, Wan Nik WS, Mohd Shariff Z, Abdullah MR

Nutr Res Pract, 2014 Jun;8(3):304-11.
PMID: 24944776 DOI: 10.4162/nrp.2014.8.3.304

BACKGROUND/OBJECTIVES: The purpose of the study was to investigate the relationship between household food insecurity and nutritional status of children in low-income households. A cross sectional study involved a survey of households (n = 223) receiving the financial assistance.
SUBJECTS/METHODS: Eligible mothers that fulfilled the inclusion criteria such as non-pregnant, non-lactating mothers, aged 18 to 55 years with their youngest children aged 2 to 12 years, were purposively selected. The Radimer/Cornell hunger and food-insecurity instrument was administered and children's height and weight were measured.
RESULTS: About 16.1% of the households were food secure, while 83.9% experienced some kind of food insecurity. Out of food insecure category, 29.6% households were food insecure, 19.3% women were individual food insecure and 35.0% fell into the child hunger category. Education of the mother (P = 0.047), household size (P = 0.024), number of children (P = 0.024), number of children going to school (P = 0.048), total monthly income (P < 0.001), income per capital (P < 0.001), number of household members contributing to the income (P = 0.018) and food expenditure (P = 0.006) were significant risk factors for household food insecurity. The prevalence of underweight, stunting and wasting in children were 61.0%, 61.4% and 30.6% respectively. Based on multinomial logistic regression, children in food-insecure households were 2.15 times more likely to be underweight and three times to be stunted than children in the food-secure households.
CONCLUSIONS: The findings suggest that household food insecurity is associated with the nutritional status of the children in the rural area of Northeastern Peninsular Malaysia.
KEYWORDS: Northeastern Peninsular Malaysia; child hunger; household food insecurity; nutritional status

Matched MeSH terms: Income
Trade-environment nexus in OIC countries: fresh insights from environmental Kuznets curve using GHG emissions and ecological footprint

Ali S, Yusop Z, Kaliappan SR, Chin L

Environ Sci Pollut Res Int, 2021 Jan;28(4):4531-4548.
PMID: 32944853 DOI: 10.1007/s11356-020-10845-6

Being closely correlated with income and economic growth, trade openness impacts the environmental quality through different means. The study analyzes the robustness of the environmental Kuznets curve (EKC) hypothesis in OIC countries by examining the extent to which trade openness influence environmental quality through different environmental indicators for the period 1991 to 2018. A new methodology dynamic common correlated effects (DCCE) is applied to resolve the issue of cross-sectional dependence (CSD). We have used greenhouse gas (GHG) emissions, carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) along with ecological footprint as indicators of environmental quality. Results of DCCE estimation identify a negative association of trade openness with CO2, N2O, and CH4, while the positive relationship with the ecological footprint in overall OIC countries and higher income OIC countries. On the other hand, trade openness has a positive association with all environmental indicators in lower income OIC countries. Our findings confirm that inverted-U-shaped EKC exists in all groups of OIC countries when CO2, CH4, and ecological footprint are used as environmental indicators. However, a U-shaped EKC exists in overall OIC countries and lower income OIC countries when N2O is used. Eventually, it is recommended that if OIC countries continue trade openness policies and energy sector reforms and maintain sustainable use of biocapacity; then, they will be able to combat environmental issues with the increase in income.

Matched MeSH terms: Income
Fulltext The impact of casemix reimbursement on hospital revenue in Indonesia

Aljunid, Syed Mohamed, Amrizal Muhammad Nur, Irwan Saputra

Jurnal Sains Kesihatan Malaysia, 2020;18(2):1-8.
MyJurnal

The objective of this study is to examine the impact of the casemix reimbursement on the hospital revenue at three selected hospitals (Type B, C and D) reimbursed using 602 groups from 14,749 cases. The results of the study showed that the hospitals received 32.4% higher income when reimbursed with Indonesia Case Bases Groups (INA-CBG) as compared to fee-for-service. Type D hospitals is the biggest gainer with 81.0% increased in income followed by Type B hospital that obtained 34.7% higher revenue. In conclusion, the use of INA-CBG as a prospective payment method has benefitted the hospitals by the increase in the revenues. It is hope that additional resources gained in this programme will allow the hospitals to provide optimum care to the population. It is recommended that the JKA management will use the INA-CBG casemix data to monitor the performance of the hospitals to ensure that quality and efficiency of the services provided to the population is continuously maintained.

Matched MeSH terms: Income
Fulltext The moderation role of board independence change in the relationship between board characteristics, related party transactions, and financial performance

Almaqtari FA, Farhan NHS, Al-Hattami HM, Elsheikh T

PLoS One, 2022;17(12):e0279159.
PMID: 36520881 DOI: 10.1371/journal.pone.0279159

The present study examines the moderation effect of board independence change on the relationship between board characteristics, related party transactions and financial performance of Indian listed banks over 10 years from 2010 to 2019. While board size, independence, diligence, and remuneration were taken to represent board characteristics, all key personnel and subsidiaries' transactions were considered measures for related party transactions. On the other hand, the financial performance of banks was measured by two accounting-based measures (return on assets and profit after tax) and two market-based measures (earning per share and Tobin Q). The results revealed that board independence change has a significant negative effect on financial performance. Further, the results indicated that board independence change moderates positively and significantly the relationship between related party transactions and financial performance. The findings also showed that board independence change had a moderating effect that significantly and negatively weakens board size and effectiveness, negatively influencing banks' profitability. Unlike other studies, this study uniquely uses board independence change as a moderator between board characteristics, related party transactions, and several measures of banks' financial performance. The limited research highlighting this issue, where Indian banks have encountered several challenges in the last few years, has motivated the present study to bridge the existing gaps in the strand literature. Therefore, this research opens useful insights and has beneficial implications for policymakers, bankers, financial analysts, and academicians.

Matched MeSH terms: Income
The effect of health programs on breastfeeding and child mortality in Peninsular Malaysia

Anderson KH

Res Popul Econ, 1984;5:87-112.
PMID: 12266419
Matched MeSH terms: Income
Fulltext Income and obesity in an urban poor community: a cross-sectional study

Andoy-Galvan JA, Lugova H, Patil SS, Wong YH, Baloch GM, Suleiman A, et al.

F1000Res, 2020;9:160.
PMID: 32399203 DOI: 10.12688/f1000research.22236.1

Background: Recent studies have shown that higher income is associated with a higher risk for subsequent obesity in low- and middle-income countries, while in high-income countries there is a reversal of the association - higher-income individuals have a lower risk of obesity. The concept of being able to afford to overeat is no longer a predictor of obesity in developed countries. In Malaysia, a trend has been observed that the prevalence of obesity increases with an increase in income among the low-income (B40) group. This trend, however, was not further investigated. Therefore, this study was performed to investigate the association of income and other sociodemographic factors with obesity among residents within the B40 income group in an urban community. Methods: This cross-sectional study used a systematic sampling technique to recruit participants residing in a Program Perumahan Rakyat (PPR), Kuala Lumpur, Malaysia. The sociodemographic characteristics were investigated through face-to-face interviews. Weight and height were measured, and body mass index (BMI) was calculated and coded as underweight, normal, overweight and obese according to the cut-off points for the Asian population. A chi-squared test was used to compare the prevalence of obesity in this study with the national prevalence. A generalized linear model was introduced to identify BMI predictors. Results: Among the 341 participants, 25 (7.3%) were underweight, 94 (27.6%) had normal weight, 87 (25.5%) were overweight, and 135 (39.6%) were obese. The proportion of obese adults (45.8%) was significantly higher than the national prevalence of 30.6% (p<0.001). Among all the tested variables, only income was significantly associated with BMI (p=0.046). Conclusion: The proportion of obesity in this urban poor community was higher compared with the national average. BMI increased as the average monthly household income decreased.

Matched MeSH terms: Income*
Inequalities in Consumption Expenditure on Pharmaceuticals: Evidence from Malaysia

Ang WC, Cheah YK

Int J Soc Determinants Health Health Serv, 2023 Oct;53(4):528-538.
PMID: 37081820 DOI: 10.1177/27551938231170831

Pharmaceuticals play an important role in health improvements. This study is the first of its kind to examine the influences of household heads' sociodemographic characteristics and household profiles on pharmaceuticals expenditure among households of different income levels. The country of interest is a fast-growing developing country. Data from the Malaysian Household Expenditure Surveys 2014 and 2016 were used in the pooled cross-sectional analyses. Double-hurdle models were used to analyze consumption and amount decisions of pharmaceuticals. Analyses stratified by income were conducted. Results showed that households headed by younger adults (<60 years), males, less educated individuals, Bumiputera, and divorced/widowed adults were less likely to consume and spent less on pharmaceuticals compared with households headed by older adults (≥60 years), females, more educated individuals, non-Bumiputera, and single adults. These differentials varied across income groups. In conclusion, household heads' age, gender, educational levels, ethnicity, marital status, and household profiles are important determining factors of expenditure on pharmaceuticals among low-, middle- and high-income households.

Matched MeSH terms: Income*

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