METHODS: The socioeconomic trends in smoking were analyzed using data from cross-sectional National Health and Morbidity Surveys for the years 1996, 2006, and 2011. Household per capita income was used as a measure of socioeconomic position. As a measure of inequality, the concentration index that quantified the degree of socioeconomic inequality in a health outcome was computed. Smoking was assessed in current and former smokers. The study population was examined by gender, region, and age group.
RESULTS: This study found a trend of an increasingly higher smoking prevalence among the poor and higher cessation rates among the rich. With the exception of younger women in Peninsular Malaysia, the socioeconomic gradient in current smoking is concentrated among the poor. For former smokers, especially men, distributions across the years were mostly concentrated among the rich.
CONCLUSION: It is important to ensure that health policies, programs, and interventions consider the potential impact of the socioeconomic patterning in smoking on equity in health.
IMPLICATIONS: Findings on the socioeconomic gradient in smoking and cessation from Malaysia across a period of rapid economic development will contribute to addressing the paucity of knowledge on the socioeconomic gradient of smoking and cessation in other progressing LMICs. This study provides evidence from an upper-middle-income country, of an increasing trend of smoking among the poor and an increasing trend of cessation rates among the rich, particularly for men. We found opposing trends for younger adult women in the more developed, Peninsular Malaysia. More rich young women were found to have taken up smoking compared to socioeconomically less advantaged young women.
METHOD: Using a fixed effects panel regression analysis from 67 countries spanning over a period of five decades (1960-2013), the present study sought to explore the impact of per capita gross domestic product (per capita GDP) on the DPI ratio and the underlying factors responsible for the relationship.
RESULTS: Our result suggests that per capita GDP followed a reverse U-shaped relationship with DPI. Moreover, the relative improvements in higher mobility roads as compared to improvements in higher accessibility roads, motorcycle ownership to passenger car ownership ratio, percentage of population living in an urban area, infant mortality rate, and the percentage of population below 15 years of age and above 64 years of age contributed to this relationship. Practical Applications: This implies that, at lower level of economic growth where road deaths exceed road injuries, countries should implement low-cost measures to combat road deaths cases. Such measures include mandating wearing of quality helmets and daytime running headlights for motorcycles. On the other hand, at higher level of economic growth where road injuries surpass road deaths, countries are encouraged to devote more resources to improving medical technology and services to treat road injury victims, mandating seatbelt use, as well as enhancing and promoting public transportation service.