Past research indicates that socioeconomic status (SES) accounts for differences in sensitivity across ethnic groups. However, comparatively little work has been conducted in Asia, with none examining whether ethnicity moderates the relation between SES and sensitivity. We assessed parenting behavior in 293 Singaporean citizen mothers of 6-month olds (153 Chinese, 108 Malay, 32 Indian) via the Maternal Behavioral Q-Sort for video interactions. When entered into the same model, SES (F(1,288) = 17.777, p
Knee pain is often underreported, underestimated and undertreated. This study was conducted to estimate the prevalence, burden and further identify socioeconomic factors influencing ethnic differences in knee pain and symptoms of OA among older adults aged 55 years and over in Greater Kuala Lumpur (the capital city of Malaysia). The sample for the Malaysian Elders Longitudinal Research (MELoR) was selected using stratified random sampling, by age and ethnicity from the electoral rolls of three parliamentary constituencies. Information on knee pain was available in 1226 participants, mean age (SD) 68.96 (1.57) years (409 Malay, 416 Chinese, 401 Indian). The crude and weighted prevalence of knee pain and self-reported knee OA symptoms were 33.3% and 30.8% respectively. There were significant ethnic differences in knee pain (crude prevalence: Malays 44.6%, Chinese 23.5% and Indians 31.9%, p<0.001). The presence of two or more non-communicable diseases (NCD) attenuated the increased risk of knee pain among the ethnic Indians compared to the ethnic Chinese. The prevalence of knee pain remained significantly higher among the ethnic Malays after adjustment for confounders. While the prevalence of knee pain in our older population appears similar to that reported in other published studies in Asia, the higher prevalence among the ethnic Malays has not previously been reported. Further research to determine potential genetic susceptibility to knee pain among the ethnic Malays is recommended.
INTRODUCTION: Tobacco smoking is a leading cause of premature death and disability, and over 80% of the world's smokers live in low- or middle-income countries. The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries.
METHODS: We used data, from the World Health Survey in 48 low-income and middle-income countries, to explore the impact of demographic and socioeconomic factors on the current smoking status of respondents. The data from these surveys provided information on 213,807 respondents aged 18 years or above that were divided into 4 pooled datasets according to their sex and country income group. The overall proportion of current smokers, as well as the proportion by each relevant demographic and socioeconomic determinant, was calculated within each of the pooled datasets, and multivariable logistic regression was used to assess the association between current smoking and these determinants.
RESULTS: The odds of smoking were not equal in all demographic or socioeconomic groups. Some factors were fairly stable across the four datasets studied: for example, individuals were more likely to smoke if they had little or no education, regardless of if they were male or female, or lived in a low or a middle income country. Nevertheless, other factors, notably age and wealth, showed a differential effect on smoking by sex or country income level. While women in the low-income country group were twice as likely to smoke if they were in the lowest wealth quintile compared with the highest, the association was absent in the middle-income country group.
CONCLUSION: Information on how smoking is distributed among low- or middle-income countries will allow policy makers to tailor future policies, and target the most vulnerable populations.
Study name: World Health Survey (Malaysia is a study site)
Cardiovascular disease (CVD) leads to high morbidity and mortality rate worldwide. Therefore, it is important to determine the risk of CVD across the sociodemographic factors to strategize preventive measures. The current study consisted of 53,122 adults between the ages of 35 and 65 years from The Malaysian Cohort project during recruitment phase from year 2006 to year 2012. Sociodemographic profile and physical activity level were assessed via self-reported questionnaire, whereas relevant CVD-related biomarkers and biophysical variables were measured to determine the Framingham Risk Score (FRS). The main outcome was the 10-year risk of CVD via FRS calculated based on lipid profile and body mass index (BMI) associated formulae. The BMI-based formula yielded a higher estimation of 10-year CVD risk than the lipid profile-based formula in the study for both males (median = 13.2% and 12.7%, respectively) and females (median = 4.3% and 4.2%, respectively). The subgroup with the highest risk for 10-year CVD events (based on both FRS formulae) was the Malay males who have lower education level and low physical activity level. Future strategies for the reduction of CVD risk should focus on screening via BMI-based FRS in this at-risk subpopulation to increase the cost-effectiveness of the prevention initiatives.
Study name: The Malaysian Cohort (TMC) project
Quality of life (QOL) is a proxy of health and social well-being. Hence, it is vital to assess QOL as it informs the strategies of policymakers to enhance the living conditions in communities. Rural areas in emerging economies are underserved in terms of modern facilities and technologies, which impact QOL. To address this, this study investigated whether income played a role in the QOL of rural residents within emerging economies using a large survey of Malaysian adults above 18 years old. The study extracted data from a sample of 18,607 respondents of a health and demographic surveillance system survey. A generalized linear model was used to estimate the impact of three income groups, the bottom 40%, middle 40% and top 20%, on perceived QOL, controlling for sociodemographic, chronic disease co-morbidities and mental health status. Results of the study showed a statistically significant association between income and the physical, psychological, social and environmental QOL domains. Using the bottom 40% as a reference category, the middle 40% and top 20% income groups showed a significant and positive association across the four domains of QOL. Hence, intervention programs are necessary to escalate the income levels of rural communities, especially the bottom 40%, to uplift perceived QOL among rural residents.
Acute diarrhoea is a major health problem in many parts of the world, contributing to about 1.8 million deaths globally. The objectives of the study were to assess the incidence, determinants, and severity of acute diarrhoea in the population. A nation-wide cross-sectional survey involving about 57,000 respondents was conducted via face-to-face interview among eligible respondents of all ages. An acute diarrhoeal episode was defined as having three or more episodes of loose stools in any 24-hour period within the past four weeks before the interview. The severity was measured by duration of acute diarrhoea and associated symptoms. The variables tested as determinants were age, sex, ethnicity, the highest educational level, total monthly household income, and locality. Univariate, bivariate and multivariate procedures meant for complex study design were used in the analyses. The four-week incidence of acute diarrhoea was 5% [95% confidence interval (CI) 4.8-5.2]. The incidence of acute diarrhoea among the estimated population was the highest among young adults aged 20-29 years, Other Bumiputras (the pre-dominant ethnic group in East Malaysia), those with tertiary-level of education, those earning a monthly household income of less than RM 400, and rural dwellers. Only age, ethnicity, the highest level of education attained, and locality were significantly associated with acute diarrhoea in bivariate analysis. In multivariate analysis, these four variables were found to be the determinants of acute diarrhoea. Sex and monthly household income were excluded from the model. The mean duration of acute diarrhoea was 2.0 days (standard deviation 1.3). Forty-six percent of the respondents reported stomach cramps as an associated symptom. The findings revealed that acute diarrhoea is still a major public-health concern in Malaysia and grossly under-notified. There is a need for intensification of public-health intervention efforts to reduce the incidence of acute diarrhoea while improving surveillance and notification of the disease.
This study was carried out to investigate the effect of economic globalization on economic growth in OIC countries. Furthermore, the study examined the effect of complementary policies on the growth effect of globalization. It also investigated whether the growth effect of globalization depends on the income level of countries. Utilizing the generalized method of moments (GMM) estimator within the framework of a dynamic panel data approach, we provide evidence which suggests that economic globalization has statistically significant impact on economic growth in OIC countries. The results indicate that this positive effect is increased in the countries with better-educated workers and well-developed financial systems. Our finding shows that the effect of economic globalization also depends on the country's level of income. High and middle-income countries benefit from globalization whereas low-income countries do not gain from it. In fact, the countries should receive the appropriate income level to be benefited from globalization. Economic globalization not only directly promotes growth but also indirectly does so via complementary reforms.
The population of the world reached seven billion in 2012. Pakistan's population stands at more than 180 million, is growing rapidly, and has the highest unmet need for family planning (FP) in isolated rural areas. The low usage of contraception in the rural areas of Pakistan correlates with the level of isolation, poverty, illiteracy, and to a large extent, religious misinterpretations/misconceptions. Almost 25% of couples who desired FP services were not receiving them for a variety of reasons of which religion could be one, especially in the rural remote areas where the media is still not reaching and influencing mind-sets. In this scenario, the role of social marketing in bringing about attitudinal and behavioural change among users in underserved areas and gatekeepers and opinion makers in society must not be neglected. The work in promoting FP, contraception and birth spacing requires authentic evidence from similar sociocultural contexts and this endeavour of compiling case studies from various Islamic countries on their FP initiatives is a good step. Governments around the world, including many in the Islamic world, support FP programmes to enable individuals and couples to choose the number and timing of their children.
Physical inactivity is the fourth leading risk factor for global mortality. Regular moderate-intensity physical activity has significant benefits for health. To determine the socioeconomic predictors of physical inactivity among elderly Malaysian population. A nationwide community-based survey was conducted among 4831 respondents aged ≥60 years with a face-to-face questionnaire. The prevalence of physical inactivity among the elderly was 88.0%, highest in respondents aged older than 80 years (95.4%), females (90.1%), other Bumiputra (92.2%), earning household income less than RM1000 (87.9%), and residing in urban locality (88.4%). In the multivariate model, the predictors of physical inactivity were only sex, ethnicity, locality, and age group (adjusted odds ratio = 1.3-3.6). The predictors of physical inactivity can identify the risk factors to develop policies that will reduce the public health burden of noncommunicable diseases.
The ACTION (Asean CosTs In ONcology) Study will be one of the largest observational studies of the burden of cancer ever conducted in Asia. The study will involve 10,000 newly diagnosed patients with cancer and will be carried out across eight low- and middle income countries within the ASEAN region (Indonesia, Thailand, Malaysia, Cambodia, Myanmar, Viet Nam, Laos and the Philippines). Patients will be interviewed three times over 12 months to assess their health, use of health care services, out of pocket costs related to their illness, social and quality of life issues. The project is a collaboration between the George Institute for Global Health, the ASEAN Foundation and Roche. The aim of the study is to assess the health and socioeconomic impact of cancer on patients in ASEAN communities, and the factors that may impact on these outcomes.
Environmental factors play a very important role in the child development process, especially in a situation like that of Iraq. Thirteen years of economic sanctions followed by the 2003 war and 8 years of unstable security have affected the daily life of Iraqi families and children. The objective of this study was to assess the associations between living environment domains and child intelligence quotient (IQ) score.
Quality of life after acute coronary heart disease amongst patients is important outcome factor in deliberations of patient's care. The main aim of the study was to examine the quality of life amongst acute CHD patients.
Co-management is now established as a mainstream approach to small-scale fisheries management across the developing world. A comprehensive review of 204 potential cases reveals a lack of impact assessments of fisheries co-management. This study reports on a meta-analysis of the impact of fisheries co-management in developing countries in 90 sites across 29 case-studies. The top five most frequently measured process indicators are participation, influence, rule compliance, control over resources, and conflict. The top five most frequently measured outcome indicators are access to resources, resource well-being, fishery yield, household well-being, and household income. To deal with the diversity of the 52 indicators measured and the different ways these data are collected and analysed, we apply a coding system to capture change over time. The results of the meta-analysis suggest that, overall fisheries co-management delivers benefits to end-users through improvements in key process and outcome indicators. However, the dataset as a whole is constituted primarily of data from the Philippines. When we exclude this body of work, few generalisations can be made about the impact of fisheries co-management. The lack of comparative data suitable for impact assessment and the difficulties in comparing data and generalising across countries and regions reiterates calls in other fields for more systematic approaches to understanding and evaluating governance frameworks.
Aflatoxins are one of the major risk factors in the multi-factorial etiology of human hepatocellular carcinoma. Therefore, the information on aflatoxins exposure is very important in the intervention planning in order to reduce the dietary intake of aflatoxins, especially among the children. This study investigated the relationship between aflatoxin B(1) (AFB(1)) lysine adduct levers in serum and socio-demographic factors and dietary intake of aflatoxins from nuts and nut products in Penang, Malaysia. A cross-sectional field study was conducted in five districts of Penang. A survey on socio-demographic characteristics was administered to 364 healthy adults from the three main ethnic groups (Malay, Chinese and Indian). A total of 170 blood samples were successfully collected and tested for the level of AFB(1)-lysine adduct. 97% of the samples contained AFB(1)-lysine adduct above the detection limit of 0.4 pg/mg albumin and ranged from 0.20 to 23.16 pg/mg albumin (mean±standard deviation=7.67±4.54 pg/mg albumin; median=7.12 pg/mg albumin). There was no significant association between AFB(1)-lysine adduct levels with gender, district, education level, household number and occupation when these socio-demographic characteristics were examined according to high or low levels of AFB(1)-lysine. However, participants in the age group of 31-50 years were 3.08 times more likely to have high AFB(1) levels compared to those aged between 18 and 30 years (P=0.026). Significant difference (P=0.000) was found among different ethnic groups. Chinese and Indian participants were 3.05 and 2.35 times more likely to have high AFB(1) levels than Malay. The result of AFB(1)-lysine adduct suggested that Penang adult population is likely to be exposed to AFB(1) but at a level of less than that needed to cause direct acute illness or death.
To determine the depth and sources of knowledge about osteoporosis (OP) among the public in Malaysia. A self-administered questionnaire was distributed to attendees of health-related public forums. A total of 87.1% of the attendees had heard of OP. Of these, 89.5% were concerned about getting OP. Significantly more women than men (P = .015), those with more than 10 years of schooling (P < .001), and those earning more than $US285 per month (P = .022) had heard of OP. Knowledge of OP risk factors was good: 97.1% identified low calcium intake, 87.8% lack of exercise, 80.0% family history of OP, and 75.8% postmenopausal status. A total of 38.7% of the attendees thought that OP was more serious than cancer and 35.1% more serious than heart disease; 55.7% obtained information about OP from newspapers and 46.4% from magazines. In this self-selected population, women, the better educated, and those earning higher incomes were more aware of OP. Knowledge of OP was obtained mainly from printed materials.