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Changing NAFLD Epidemiology in China

Lee HW, Wong VW

Hepatology, 2019 Jul 12.
PMID: 31298746 DOI: 10.1002/hep.30848

In Factfulness, the late Dr. Hans Rosling illustrated how most people grossly underestimated education, income, life expectancy, and vaccination rates in low-income countries.(1) It is natural human psychology to have fixed images about the developing world. Nonetheless, the world is changing. According to the latest World Bank figures, 184 of 218 (84%) countries or regions are now classified as middle-income or high-income economies.(2) Many countries previously labeled as developing countries (such as Armenia, Colombia, Malaysia, and Serbia) are now classified as upper-middle-income economies. Although many problems remain and deserve our attention, Dr. Rosling emphasized that it is equally important to recognize that there is progress and many policies do work. Otherwise, we risk dismissing useful strategies and impeding their implementation. This article is protected by copyright. All rights reserved.

Matched MeSH terms: Income
Chronic illness and sustainable careers: How individuals with multiple sclerosis negotiate work transitions in a middle-income country

Vijayasingham L, Jogulu U, Allotey P

Soc Sci Med, 2020 01;245:112699.
PMID: 31785425 DOI: 10.1016/j.socscimed.2019.112699

Reports of work change and transitions are common amongst individuals with chronic illnesses such as multiple sclerosis (MS). However, there is little research on the lived experience of these work transitions. The scarcity of this research is particularly evident within low-and-middle-income countries, where protection laws and resources such as anti-discrimination laws and reasonable work modifications may not exist or be well enforced. In this paper, we explore how and why individuals with MS seek and achieve work transitions in the structural context of Malaysia. We interviewed ten working individuals with MS (July-december 2015) using a joint hermeneutic phenomenology and constructivist grounded theory approach. Using a broad conceptual lens of 'sustainable careers', we examine their careers as a series of experiences, decisions, and events, paying attention to the influences of context, time, their personal levels of agency and sense of meaning. Participants described work transitions as early as within the first year of diagnosis, that were prompted by voluntary, involuntary and semi-voluntary reasons. Key aspects of the process of seeking new roles included an exploration of alternative roles and paths, and then acquiring, trialing/adapting and remaining engaged in their new roles. Participants identified the perception and experience of 'being unemployable', based on how their diagnosis and short-term symptoms were responded to by employers. Nevertheless, participants used various strategies and career resources to obtain and maintain meaningful work roles. However, success in obtaining or maintaining new roles were not equally achieved. This research draws attention to the cumulative economic disadvantage of a chronic illness diagnosis, even at milder and episodic stages. Furthermore, it reiterates the need for cohesive structural protection in low-and-middle-income countries to facilitate a more equal ability to remain economically resilient and capable of engaging in meaningful long-term careers when living with a chronic illness.

Matched MeSH terms: Income
Clinical Burden of Invasive Pneumococcal Disease in Selected Developing Countries

Maimaiti N, Ahmed Z, Md Isa Z, Ghazi HF, Aljunid S

Value Health Reg Issues, 2013 09 13;2(2):259-263.
PMID: 29702874 DOI: 10.1016/j.vhri.2013.07.003

OBJECTIVE: To measure the clinical burden of invasive pneumococcal disease (IPD) in selected developing countries.
METHODS: This is an extensive literature review of published articles on IPD in selected developing countries from East Asia, South Asia, Middle East, sub-Saharan Africa, and Latin America. We reviewed all the articles retrieved from the knowledge bases that were published between the years 2000 and 2010.
RESULTS: After applying the inclusion, exclusion, and quality criteria, the comprehensive review of the literature yielded 10 articles with data for pneumococcal meningitis, septicemia/bacteremia, and pneumonia. These selected articles were from 10 developing countries from five different regions. Out of the 10 selected articles, 8 have a detailed discussion on IPD, one of them has s detailed discussion on bacteremia and meningitis, and another one has discussed pneumococcal bacteremia. Out of these 10 articles, only 5 articles discussed the case-fatality ratio (CFR). In our article review, the incidence of IPD ranged from less than 5/100,000 to 416/100,000 population and the CFR ranged from 12.2% to 80% in the developing countries.
CONCLUSIONS: The review demonstrated that the clinical burden of IPD was high in the developing countries. The incidence of IPD and CFR varies from region to region and from country to country. The IPD burden was highest in sub-Saharan African countries followed by South Asian countries. The CFR was low in high-income countries than in low-income countries.

Matched MeSH terms: Income
Clustering of cardiovascular risk factors in a middle-income country: a call for urgency

Selvarajah S, Haniff J, Kaur G, Hiong TG, Cheong KC, Lim CM, et al.

Eur J Prev Cardiol, 2013 Apr;20(2):368-75.
PMID: 22345688 DOI: 10.1177/2047487312437327

BACKGROUND: This study aimed to estimate the prevalence of cardiovascular risk factors and its clustering. The findings are to help shape the Malaysian future healthcare planning for cardiovascular disease prevention and management.
METHODS: Data from a nationally representative cross-sectional survey was used. The survey was conducted via a face-to-face interview using a standardised questionnaire. A total of 37,906 eligible participants aged 18 years and older was identified, of whom 34,505 (91%) participated. Focus was on hypertension, hyperglycaemia (diabetes and impaired fasting glucose), hypercholesterolaemia and central obesity.
RESULTS: Overall, 63% (95% confidence limits 62, 65%) of the participants had at least one cardiovascular risk factor, 33% (32, 35%) had two or more and 14% (12, 15%) had three risk factors or more. The prevalence of hypertension, hyperglycaemia, hypercholesterolaemia and central obesity were 38%, 15%, 24% and 37%, respectively. Women were more likely to have a higher number of cardiovascular risk factors for most age groups; adjusted odds ratios ranging from 1.1 (0.91, 1.32) to 1.26 (1.12, 1.43) for the presence of one risk factor and 1.07 (0.91, 1.32) to 2.00 (1.78, 2.25) for two or more risk factors.
CONCLUSIONS: Cardiovascular risk-factor clustering provides a clear impression of the true burden of cardiovascular disease risk in the population. Women displayed higher prevalence and a younger age shift in clustering was seen. These findings signal the presence of a cardiovascular epidemic in an upcoming middle-income country and provide evidence that drastic measures have to be taken to safeguard the health of the nation.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Income/statistics & numerical data*
Fulltext Collecting Forest Resources as Livelihood Strategies in Kampung Tambirat, Sarawak

NURUL NADZATUL FARAH MOHD KHAIRI

Trends in Undergraduate Research, 2018;1(1):0-0.
MyJurnal

A livelihood is a means of making a living, securing necessities of life such as water, shelter medicine and clothing. For communities dependent on forest resources for livelihoods, sustainability of forests are important. In Kampung Tambirat this study aims to find the income generated from forest resources particularly Nypah palm forests, the measures of conservation, challenges and type of assistance required so that the villagers engagement in the activities will flourish in the future and benefit the younger generations. It is found that there are no conservation measures for Nypah forests and seasonal floods further increases the difficulty for the villagers to sustain their livelihood activities.

Matched MeSH terms: Income
Community acceptance and willingness-to-pay for a hypothetical Zika vaccine: A cross-sectional study in Indonesia

Harapan H, Mudatsir M, Yufika A, Nawawi Y, Wahyuniati N, Anwar S, et al.

Vaccine, 2019 03 07;37(11):1398-1406.
PMID: 30739794 DOI: 10.1016/j.vaccine.2019.01.062

BACKGROUND: Understanding people's perceptions of the economic benefits of a potential Zika vaccine (ZV) is critical to accelerating its introduction into either public sector programs or private market. The aim of this study was to assess the acceptance and willingness-to-pay (WTP) for a hypothetical ZV and the associated explanatory variables in Indonesia.
METHODS: We conducted a health facility-based cross-sectional study in Aceh and West Sumatra province from 1 February to 13 June 2018. Patients who visited outpatient departments, have had children or were expecting their first child, were approached and interviewed to collect information on acceptance, WTP, demographic and socio-economic variables and attitudes towards childhood vaccines. Associations of explanatory variables influencing acceptance and WTP were assessed using logistic regression and linear regression analysis, respectively.
RESULTS: In total, 956 respondents were included in the final analysis of acceptance, of whom 338 (35.3%) expressed their WTP. We found that 757 (79.1%) of the respondents were likely to be vaccinated and to recommend their partner to be vaccinated. Higher educational attainment, having a job, having heard about Zika and a good attitude towards childhood vaccination were associated with ZV acceptance in the univariate analyses. In the multivariate analysis, attitude towards childhood vaccination was the strongest predictor for ZV vaccination. We found the geometric mean and median of WTP was US$ 13.1 (95% CI: 11.37-15.09) and US$ 7.0 (95% CI: 4.47-10.98), respectively. In the final model, having heard about Zika, having a job, and higher income were associated with a higher WTP.
CONCLUSION: Although the acceptance rate of the ZV is relatively high in Indonesia, less than 40% of respondents are willing to pay, underscoring the need for a low-cost, high-quality vaccine and public sector subsidies for Zika vaccinations in the country.

Matched MeSH terms: Income/statistics & numerical data
Comparative growth of Malay, Chinese and Indian school children in Malaysia

Chen ST

Southeast Asian J. Trop. Med. Public Health, 1976 Sep;7(3):443-51.
PMID: 1030848

The weights and heights of 3,312 Malaysian primary school boys and girls, aged 6 to 11 years, belonging to various ethnic groups in Malaysia were measured. On the whole, the Chinese children were taller and heavier than the Malay and the Indian children who were the least heavy among the three ethnic groups. Economically the Indians were the poorest among the three ethnic groups and they also had the largest family size. When the household incomes were taken into consideration it was found that the growth achievement of the higher income children was better than that of the poorer children, irrespective of their ethnic groups. It is interesting to note that, although the Indian children as a whole, were the least heavy of the three ethnic groups, yet the growth achievement of the higher income Indian children was similar to that of the higher income Chinese children. The differences in growth achievement of the various ethnic groups are probably due to environmental differences, rather than genetic differences. It seems likely that Malaysian children of different ethnic groups (Malay, Chinese and Indian) can attain similar statures if environmental conditions are similar.

Matched MeSH terms: Income
Fulltext Conditional multiple logistic regression can confirm the relationship between hypertension and income groups in a matched case-control study

Norsa'adah B, Naing L

Med J Malaysia, 2006 Aug;61(3):383-5.
PMID: 17240599
Matched MeSH terms: Income*
Fulltext Connectedness among Urban Parks from the Users' Perspective: A Systematic Literature Review

Li J, Md Dali M, Nordin NA

Int J Environ Res Public Health, 2023 Feb 18;20(4).
PMID: 36834348 DOI: 10.3390/ijerph20043652

Although many benefits of urban green space networks have been consistently demonstrated, most of the discussion on space connectivity has concentrated on ecological aspects, such as patch-corridor-matrix connectivity. There are limited systematic studies that have investigated the connectedness between urban parks and people. This study aimed to explore the connectedness among urban parks from the users' perspective by using a systematic literature review. By following the PRISMA protocol and analyzing 54 studies from Scopus and Web of Science between 2017 and 2022, we proposed the concepts of physical connectedness and perceived connectedness. The "physical connectedness" contained the dimensions of road attributes and park attributes, as well as six categories including physical accessibility, street connectivity, the street environment, spatial scale, facilities and amenities, and natural elements. The "perceived connectedness" mainly referred to people's perception of the physical environment. The four categories were perceived accessibility, perceived safety, aesthetics, and Kaplan's perceptual model. Finally, in terms of individual attributes, the impact of sociodemographic factors (age, gender, income, education, and occupation) and the motivation for activity on park connectedness were also taken into account. On the basis of our findings, this study suggested that park connectedness should not only focus on physical connectedness but also perceived connectedness.

Matched MeSH terms: Income
Consumption Expenditure on Processed Meat and Its Correlates: An Ethnic Comparison

Cheah YK, Appannah G, Abdul Adzis A

Nutr Cancer, 2023;75(2):498-509.
PMID: 36111368 DOI: 10.1080/01635581.2022.2123534

Background: The objective of the present study is to investigate the influences of sociodemographic and household factors on consumption expenditure on processed meat among households in Malaysia.Methods: Data were extracted from the Malaysian Household Expenditure Survey (HES) 2016. Lognormal hurdle models were utilized to assess the likelihood of consuming processed meat and the amount consumed. The independent variables consisted of household heads' age, educational level, gender, marital status, employment status, ethnicity, as well as household income, household region and household locality.Results: Bumiputera households with younger heads were more likely to consume processed meat and spent more than households with older heads. Chinese and Indian households in a higher income group had a higher likelihood of consuming and spending on processed meat than those in a lower income group. The probability of consuming processed meat and the amount consumed were positively associated with being from East Malaysia and urban areas.Conclusions: There are distinguished roles of sociodemographic and household factors across ethnic groups in consumption expenditure on processed meat. Policy makers should take account of age, income, education, household region and household locality factors when formulating intervention measures.

Matched MeSH terms: Income*
Fulltext Contrasting Associations Between Diabetes and Cardiovascular Mortality Rates in Low-, Middle-, and High-Income Countries: Cohort Study Data From 143,567 Individuals in 21 Countries in the PURE Study

Anjana RM, Mohan V, Rangarajan S, Gerstein HC, Venkatesan U, Sheridan P, et al.

Diabetes Care, 2020 12;43(12):3094-3101.
PMID: 33060076 DOI: 10.2337/dc20-0886

OBJECTIVE: We aimed to compare cardiovascular (CV) events, all-cause mortality, and CV mortality rates among adults with and without diabetes in countries with differing levels of income.
RESEARCH DESIGN AND METHODS: The Prospective Urban Rural Epidemiology (PURE) study enrolled 143,567 adults aged 35-70 years from 4 high-income countries (HIC), 12 middle-income countries (MIC), and 5 low-income countries (LIC). The mean follow-up was 9.0 ± 3.0 years.
RESULTS: Among those with diabetes, CVD rates (LIC 10.3, MIC 9.2, HIC 8.3 per 1,000 person-years, P < 0.001), all-cause mortality (LIC 13.8, MIC 7.2, HIC 4.2 per 1,000 person-years, P < 0.001), and CV mortality (LIC 5.7, MIC 2.2, HIC 1.0 per 1,000 person-years, P < 0.001) were considerably higher in LIC compared with MIC and HIC. Within LIC, mortality was higher in those in the lowest tertile of wealth index (low 14.7%, middle 10.8%, and high 6.5%). In contrast to HIC and MIC, the increased CV mortality in those with diabetes in LIC remained unchanged even after adjustment for behavioral risk factors and treatments (hazard ratio [95% CI] 1.89 [1.58-2.27] to 1.78 [1.36-2.34]).
CONCLUSIONS: CVD rates, all-cause mortality, and CV mortality were markedly higher among those with diabetes in LIC compared with MIC and HIC with mortality risk remaining unchanged even after adjustment for risk factors and treatments. There is an urgent need to improve access to care to those with diabetes in LIC to reduce the excess mortality rates, particularly among those in the poorer strata of society.

Matched MeSH terms: Income/statistics & numerical data
Fulltext Contribution of women's fisheries substantial, but overlooked, in Timor-Leste

Tilley A, Burgos A, Duarte A, Dos Reis Lopes J, Eriksson H, Mills D

Ambio, 2021 Jan;50(1):113-124.
PMID: 32385810 DOI: 10.1007/s13280-020-01335-7

A greater understanding of gendered roles in fisheries is necessary to value the often-hidden roles that women play in fisheries and households. We examine women's contributions to household food and income using focus group discussions, market surveys, and landings data in six communities in Timor-Leste. Women were actively fishing more days per month than men. Gleaning was the most frequent activity and 100% of trips returned with catch for food and/or income. Mollusc and crab catches were common and exploitation appeared targeted on a dynamic reappraisal of changing food values and changing estimates of group needs. With as many as 80% of households in coastal areas involved in fishing, and at least 50% of women fishing, this highlights the current lack of women's engagement as a critical gap in fisheries management approaches. The current androcentric dialogue limits social-ecological understanding of these systems and the potential for their effective stewardship.

Matched MeSH terms: Income
Fulltext Correlates of physical activity level among hemodialysis patients in Selangor, Malaysia

Wong SW, Chan YM, Lim TS

Malays J Nutr, 2011 Dec;17(3):277-86.
PMID: 22655450 MyJurnal

There is mounting evidence demonstrating the importance of adequate physical activity to promote better well-being among hemodialysis patients. Available data pertaining to the levels of physical activity and its determinants among hemodialysis patients is, however, scarce in Malaysia. The objectives of this study are hence to determine the levels of physical activity and it associated factors among hemodialysis patients.

Matched MeSH terms: Income
Fulltext Correlation Analysis between Residents' Income Satisfaction and Mental Health Based on Big Data

Wang Y, Li H, Teo BS, Jaharadak AA

Occup Ther Int, 2022;2022:8199824.
PMID: 36032183 DOI: 10.1155/2022/8199824

This paper presents an in-depth study and analysis of the correlation between satisfaction with rural residents' income and mental health well-being in the context of industrial structure upgrading. Most of the studies on residents' subjective well-being from the perspective of relative income or income inequality have started from the happiness of rural residents and the satisfaction of rural residents' life, and few scholars have focused on the psychological health of rural residents. Subjective well-being is significantly related to external and internal goals in desire. Life satisfaction is significantly and positively correlated with external and internal goals, as well as the six dimensions of desire, except for social identity; positive emotions are significantly and positively correlated with internal goals; negative emotions are only negatively correlated with self-acceptance, and there is a significant positive correlation between income level and desire. In vertical income, there is also a process of judging whether the expected income is achieved. If the expected income growth level is achieved, the income satisfaction will increase. Desire mediates the effect of income level on subjective well-being. Income level influences subjective well-being through internal goals; income level influences life satisfaction and positive emotions through external goals. The relationship between income inequality and mental health is influenced by the characteristics of the population, with women and middle-aged people being the most negatively affected. This relationship is also influenced by income level, with the effect of income inequality on mental health showing a negative effect in the lower and middle-income groups but a positive effect in the higher income groups. Income inequality affects residents' mental health through the mediating effects of a sense of social justice, life stress, and trust in government. Inequality in household wealth can exacerbate the negative effects of income inequality on mental health.

Matched MeSH terms: Income
Fulltext Cost volume profit analysis for full paying patient services in Malaysia: A study protocol

Mohd Fadzil M, Wan Puteh SE, Aizuddin AN, Ahmed Z, Muhamad NA, Harith AA

PLoS One, 2023;18(11):e0294623.
PMID: 37988370 DOI: 10.1371/journal.pone.0294623

Dual practice within public hospitals, characterised by the concurrent provision of public and private healthcare services within public hospitals, has become a widespread phenomenon. With the participation of selected public hospitals, dual practice within public hospitals, also known as Full Paying Patient services, was an initiative the Ministry of Health Malaysia took in 2007 to retain senior specialist physicians in Malaysia. The revenue generated from the Full Paying Patient services aims to provide an avenue for public sector specialists to supplement their incomes while alleviating the Government's burden of subsidising healthcare for financially capable individuals. However, the effectiveness of Full Paying Patient services in recouping service delivery costs and yielding a profit is still uncertain after 16 years of implementation. This study is designed to evaluate the impact of Full Paying Patient inpatient services volume, revenue, and cost on profit versus loss at selected hospitals from 2017 to 2020. From the perspective of healthcare providers, we plan to perform a cost volume profit analysis. This analysis enables us to determine the break-even point, at which total revenues match total costs, along with no-loss and no-profit thresholds for Full Paying Patient services. This study has the potential to provide insights into how variations in service volume, cost, and pricing impact healthcare providers' profitability. It also offers critical financial information regarding the volume of services required to reach the break-even point. A comprehensive understanding of service volume, cost and pricing is imperative for making informed decisions to fulfil the objectives and ensure the sustainability of the FPP services.

Matched MeSH terms: Income
Cost-Effectiveness Analysis of Non-Statin Lipid-Modifying Agents for Secondary Cardiovascular Disease Prevention Among Statin-Treated Patients in Thailand

Kongpakwattana K, Ademi Z, Chaiyasothi T, Nathisuwan S, Zomer E, Liew D, et al.

Pharmacoeconomics, 2019 Oct;37(10):1277-1286.
PMID: 31243736 DOI: 10.1007/s40273-019-00820-6

BACKGROUND: Using non-statin lipid-modifying agents in combination with statin therapy provides additional benefits for cardiovascular disease (CVD) risk reduction, but their value for money has only been evaluated in high-income countries (HICs). Furthermore, studies mainly derive effectiveness data from a single trial or older meta-analyses.
OBJECTIVES: Our study used data from the most recent network meta-analysis (NMA) and local parameters to assess the cost effectiveness of non-statin agents in statin-treated patients with a history of CVD.
METHODS: A published Markov model was adopted to investigate lifetime outcomes: (1) number of recurrent CVD events prevented, (2) quality-adjusted life-years (QALYs) gained, (3) costs and (4) incremental cost-effectiveness ratios (ICERs) of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) and ezetimibe added to statin therapy. Event rates and effectiveness inputs were obtained from the NMA. Cost and utility data were gathered from published studies conducted in Thailand. A series of sensitivity analyses were performed.
RESULTS: Patients receiving PCSK9i and ezetimibe experienced fewer recurrent CVD events (number needed to treat [NNT] 17 and 30) and more QALYs (0.168 and 0.096 QALYs gained per person). However, under the societal perspective and at current acquisition costs in 2018, ICERs of both agents were $US1,223,995 and 27,361 per QALY gained, respectively. Based on threshold analyses, the costs need to be reduced by 97 and 85%, respectively, for PCSK9i and ezetimibe to be cost-effective.
CONCLUSIONS: Despite the proven effectiveness of PCSK9i and ezetimibe, the costs of these agents need to reduce to a much greater extent than in HICs to be cost-effective in Thailand.

Matched MeSH terms: Income
Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand

Tosanguan J, Chaiyakunapruk N

Addiction, 2016 Feb;111(2):340-50.
PMID: 26360507 DOI: 10.1111/add.13166

AIMS: Clinical smoking cessation interventions have been found typically to be highly cost-effective in many high-income countries. There is a need to extend this to low- and middle-income countries and undertake comparative analyses. This study aimed to estimate the incremental cost-effectiveness ratio of a range of clinical smoking cessation interventions available in Thailand.
METHODS: Using a Markov model, cost-effectiveness, in terms of cost per quality-adjusted life years (QALY) gained, from a range of interventions was estimated from a societal perspective for males and females aged 40 years who smoke at least 10 cigarettes per day. Interventions considered were: counselling in hospital, phone counselling (Quitline) and counselling plus nicotine gum, nicotine patch, bupropion, nortriptyline or varenicline. An annual discounting rate of 3% was used. Probabilistic sensitivity analyses were conducted and a cost-effectiveness acceptability curve (CEAC) plotted. Comparisons between interventions were conducted involving application of a 'decision rule' process.
RESULTS: Counselling with varenicline and counselling with nortriptyline were found to be cost-effective. Hospital counselling only, nicotine patch and bupropion were dominated by Quitline, nortriptyline and varenicline, respectively, according to the decision rule. When compared with unassisted cessation, probabilistic sensitivity analysis revealed that all interventions have very high probabilities (95%) of being cost-saving except for nicotine replacement therapy (NRT) patch (74%).
CONCLUSION: In middle-income countries such as Thailand, nortriptyline and varenicline appear to provide cost-effective clinical options for supporting smokers to quit.

Matched MeSH terms: Income
Demand for quality vegetables in Malaysia

Tey, Y.S., Mad Nasir, S., Zainalabidin, M., Jinap, S., Abdul Gariff, R.

International Food Research Journal, 2009;16(3):313-327.
MyJurnal

The objective of this study is to investigate the demand for quality vegetables in Malaysia. This study estimates quality elasticities from the difference between expenditure and quantity elasticities in order to show the demand for quality vegetables in Malaysia. By using the Household Expenditure Survey 2004/2005, expenditure and quantity Engel equations are estimated via two stage least square. The positive estimated quality elasticities (except root and tuberous vegetable) show that Malaysian consumers tend to increase their demand for quality vegetables in response to their incomes rise. To be more specific, urban consumers are expected to demand more of higher quality vegetables (except root and tuberous vegetable) than rural consumers.

Matched MeSH terms: Income
Demographic and fertility characteristics of 4 squatter settlements

Yusof K, Zulkifli SN

Malays J Reprod Health, 1985;3(1):31-45.
PMID: 12268887
Matched MeSH terms: Income
Fulltext Demographic and socioeconomic inequalities in oral healthcare utilisation in Malaysia: evidence from a national survey

Tan YR, Tan EH, Jawahir S, Mohd Hanafiah AN, Mohd Yunos MH

BMC Oral Health, 2021 01 19;21(1):34.
PMID: 33468125 DOI: 10.1186/s12903-020-01388-w

BACKGROUND: Throughout the years, oral healthcare utilisation in Malaysia has been low despite various efforts by the Ministry of Health Malaysia for improvement. This study aimed to determine the prevalence of oral healthcare utilisation and identify factors associated with oral healthcare utilisation among adults in Malaysia.
METHODS: Secondary data analysis of adults aged 18 years and over from the National Health and Morbidity Survey 2019 was conducted in this study. Characteristics of respondents and those who utilised oral healthcare were described using complex sample descriptive statistics. Logistic regression analysis was performed to examine the association between the dependent and independent variables. Dependent variable was oral healthcare utilisation in the last 12 months. Independent variables were demographic and socioeconomic factors (predisposing, enabling and need characteristics) based on Andersen's Behavioural Model.
RESULTS: A total of 11,308 respondents, estimated to represent 21.7 million adults aged 18 years and over in Malaysia were included in the analysis. Prevalence of oral healthcare utilisation in the last 12 months was 13.2%. Demographic factors of sex, age, marital status, and socioeconomic factors of education level and occupation as well as health belief such as medical check-up were significantly related to oral healthcare utilisation. Enabling factor of household income quintile had significant association with oral healthcare utilisation. Inequalities were observed; females (OR = 1.57, 95% CI = 1.25, 1.96), younger adults (OR = 1.64, 95% CI = 1.15, 2.33), those who were married (OR = 1.65, 95% CI = 1.23, 2.22), those with higher education (OR = 2.21, 95% CI = 1.23, 3.99), those who had medical check-up in the last 12 months (OR = 1.86, 95% CI = 1.53, 2.25) and those with higher income (OR = 1.43, 95% CI = 1.04, 1.96) were more likely to utilise oral healthcare.
CONCLUSION: Understanding factors associated with utilisation of oral healthcare could help in formulating effective interventions to improve oral healthcare utilisation. Demographic and socioeconomic factors are strong determinants of oral healthcare utilisation in Malaysia. Appropriate interventions to strengthen the existing programmes aimed to promote regular and timely oral health check-ups are needed to improve oral healthcare utilisation.

Matched MeSH terms: Income*

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