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Ji X, Wu C, Chen M, Wu L, Li T, Miao Z, Lv Y, Ding H. Analysis of risk factors related to extremely and very preterm birth: a retrospective study. BMC Pregnancy Childbirth 2022; 22:818. [PMID: 36335328 PMCID: PMC9636775 DOI: 10.1186/s12884-022-05119-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/10/2022] [Indexed: 11/08/2022] Open
Abstract
Background: Preterm birth is one of the main causes of perinatal morbidity and mortality and imposes a heavy burden on families and society. The aim of this study was to identify risk factors and analyze birth conditions and complications of newborns born at < 32 gestational weeks for extremely preterm (EP) and very preterm (VP) birth in the clinic to further extend the gestational period. Methods: We performed a retrospective cohort study and collected data from 1598 pregnant women and 1660 premature newborns (excluding 229 premature babies who died due to severe illness and abandonment) admitted to the Obstetrics and Gynecology Hospital Affiliated with Nanjing Medical University in China from 2016 to 2020. We compared women’s and newborns’ characteristics by t-tests and Chi-square tests for continuous and categorical variables, respectively. Multivariable logistic regression was performed to estimate the effects of risk factors on EP and VP birth. Results: We identified 3 independent risk factors for EP birth: cervical incompetency (P < 0.001); multiple pregnancy (P < 0.01), primipara (P < 0.001). Additionally, we identified 4 independent risk factors for VP birth: gestational diabetes mellitus (GDM) (P < 0.05), preterm premature rupture of membrane (PPROM) (P < 0.01), fetal intrauterine distress (P < 0.001), and hypertensive disorder complicating pregnancy (HDCP) (P < 0.001). In addition, pairwise comparisons revealed statistically significant differences in the incidence rates of neonatal pneumonia, bronchopulmonary dysplasia (BPD) and sepsis between the 28–28 + 6 and 29–29 + 6 weeks of gestation groups (P < 0.05). Compared with 28–28 + 6 weeks of gestation, neonatal complications were significantly more common at < 26 weeks of gestation (P < 0.05). The incidence rates of neonatal intracranial hemorrhage(NICH), patent ductus arteriosus(PDA), patent foramen ovale(PFO), pneumonia, BPD and sepsis were significantly higher in the 26–26 + 6 and 27–27 + 6 gestational weeks than in the 28–28 + 6 gestational weeks (P < 0.05). Conclusion: PPROM, is the most common risk factor for EP and VP birth, and cervical insufficiency, multiple pregnancy, and primipara are independent risk factors for EP birth. Therefore, during pregnancy, attention should be devoted to the risk factors for PPROM, and reproductive tract infection should be actively prevented to reduce the occurrence of PPROM. Identifying the risk factors for cervical insufficiency, actively intervening before pregnancy, and cervical cervix ligation may be considered to reduce the occurrence of EP labor. For iatrogenic preterm birth, the advantages and disadvantages should be carefully weighed, and the gestational period should be extended beyond 28 weeks to enhance the safety of the mother and child and to improve the outcomes of preterm birth. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05119-7.
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Ma R, Zou L. Stillbirth trends by maternal sociodemographic characteristics among a large internal migrant population in Shenzhen, China, over a 10-year period: a retrospective study. BMC Public Health 2022; 22:325. [PMID: 35172785 PMCID: PMC8848954 DOI: 10.1186/s12889-022-12734-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 01/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cities such as Shenzhen in southern China have large immigrant populations, and the reproductive health issues of pregnant women in these populations have not received sufficient attention. Stillbirth seriously threatens their health and is becoming a social issue worthy of attention. We conducted this study to estimate the trend in stillbirths at 28 or more gestational weeks and the related sociodemographic characteristics of pregnant women among a large internal migrant population in South China. METHODS A stillbirth is defined as a baby born with no signs of life after a given threshold, and are restricted to births of 28 weeks of gestation or longer, with a birth weight of at least 1000 g for international comparison. A population-based retrospective cohort of all births from January 2010 to December 2019 in Baoan, Shenzhen, was conducted using the Shenzhen Birth Registry Database. The overall stillbirth rate and year-specific stillbirth rate were calculated as the number of foetal deaths ≥28 gestational weeks or a birth weight ≥ 1000 g divided by the number of births over the last decade or in each year, respectively. The associations between the risk of stillbirth and maternal sociodemographic status were assessed using logistic regression. Spearman's rank correlation was calculated to evaluate the correlation between the economic status of the maternal birthplace and the stillbirth. RESULTS An overall stillbirth rate of 4.5 per 1000 births was estimated in a total of 492,184 births in our final analysis. Migrant women accounted for 87% of the total population but had a higher stillbirth rate (4.8 per 1000 births) than the permanent population (2.8 per 1000 births). The stillbirth rate varied by region of maternal birthplace, from 4.1 per 1000 births in women from East China to 5.7 per 1000 births in women from West China. The GDP per capita of the maternal birthplace was strongly correlated with the stillbirth rate. CONCLUSIONS Large disparities in the stillbirth rate exist between migrant and permanent populations and among regions of maternal birthplace in China. Strategies targeting migrant women based on their maternal birthplace are needed to further reduce the burden of stillbirth.
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Affiliation(s)
- Rui Ma
- Institute of Women's and Children's Health Care, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Lingyun Zou
- Institute of Women's and Children's Health Care, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China.
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Abstract
Migrant workers show an increase in the incidence of serious, psychotic, anxiety, and post-traumatic disorders due to a series of socio-environmental variables, such as loss of social status, discrimination, and separations from the family. The purpose is to elaborate a systematic review and highlight the prevailing psychological pathologies of these workers and categories most at risk. Our research included articles published from 2009 to 2019 on the major databases (Pub Med, Cochrane Library, and Scopus) using a combination of some keywords. The online search indicated 1.228 references. Using inclusion and exclusion criteria, we analyzed 127 articles, in particular 12 reviews and 115 original articles. Principal emerging disorders from the research are depressive syndrome (poor concentration at work, feeling down, or anger and somatization), anxiety, alcohol or substance abuse, and poor sleep quality. This causes low life conditions, which is also due to marginalization from the social context and strenuous work; in fact, migrant workers may suffer verbal or physical abuse, and they are often employed in dangerous, unhealthy jobs. It is therefore essential to increase the role of occupational medicine and promote wellbeing for this vulnerable job category.
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Hou B, Nazroo J, Banks J, Marshall A. Migration Status and Smoking Behaviors in Later-Life in China-Evidence From the China Health and Retirement Longitudinal Study (CHARLS). Front Public Health 2018; 6:346. [PMID: 30533409 PMCID: PMC6266545 DOI: 10.3389/fpubh.2018.00346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 11/07/2018] [Indexed: 11/13/2022] Open
Abstract
Background: China is the biggest consumer of tobacco in the world, with a high prevalence of smoking especially among men. Along with the rapid demographic change in China, the burden of diseases attributable to health behaviors, particularly smoking is steadily increasing. So, smoking has become a major risk factor for mortality in China. Smoking behaviors may be related to migration processes, as a result of both who migrates and post-migration experiences related to socioeconomic position, stress and acculturation. Existing studies that have examined smoking and migration in China have, however, only focused on temporary rural-to-urban migrants and focused on relatively younger migrants. This paper examines the association between smoking behaviors and a comprehensive assessment of migration status in later-life in China. Methods: Using the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative dataset, this paper studies smoking behaviors of rural-to-urban migrants, urban-to-urban migrants, rural return migrants, and urban return migrants. We compare them with corresponding non-migrant groups in both rural and urban locations in China. Using a model that controls for demographic factors, early-life circumstances, socioeconomic factors, and factors related to migration, we examine both the decision to start smoking and the decision to quit smoking. In addition, we also address pre-migration selection in our analyses. Results: The results show rural-to-urban migrants are no more likely to start smoking compared with rural non-migrants, but they are more likely to quit smoking. While urban-to-urban migrants are more likely to start smoking compared with urban non-migrants, this effect is explained by the factors we include in the full model. Urban-to-urban migrants are, however, less likely to quit smoking. Moreover, both rural return migrants and urban return migrants seem to be more likely to start smoking and less likely to quit smoking compared with non-migrant groups. Conclusion: There are strong associations between migration status and later-life smoking behaviors in China; these associations vary greatly according to different migration status and point to populations and factors that public health activities should focus on.
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Affiliation(s)
- Bo Hou
- National School of Development, Peking University, Beijing, China
| | - James Nazroo
- Sociology, School of Social Sciences, The University of Manchester, Manchester, United Kingdom.,Manchester Institute for Collaborative Research on Ageing, School of Social Sciences, The University of Manchester, Manchester, United Kingdom.,Cathie Marsh Institute for Social Research, School of Social Sciences, The University of Manchester, Manchester, United Kingdom
| | - James Banks
- Economics, School of Social Sciences, The University of Manchester, Manchester, United Kingdom.,The Institute for Fiscal Studies, London, United Kingdom
| | - Alan Marshall
- School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom
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Zheng Y, Ji Y, Dong H, Chang C. The prevalence of smoking, second-hand smoke exposure, and knowledge of the health hazards of smoking among internal migrants in 12 provinces in China: a cross-sectional analysis. BMC Public Health 2018; 18:655. [PMID: 29793454 PMCID: PMC5968586 DOI: 10.1186/s12889-018-5549-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 05/07/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Previous studies have provided inconsistent findings on smoking among migrants, and very limited data exist on their second-hand smoke exposure. This study aims to investigate internal migrants' smoking prevalence, second-hand smoke exposure among non-smokers, and knowledge of the health hazards of smoking in 12 major migrant provinces in China in 2013. METHODS Data from the 2013 Migrant Dynamics Monitoring Survey in China published by the National Commission of Health and Family Planning was used in this study. Descriptive analysis, Chi-square analysis, and sex-stratified multivariate logistic regression analysis were used to explore the determinants of current smoking and second-hand smoke exposure. RESULTS Among 7200 migrants, 34.1% (55% male, 4% female) were current smokers. For males, factors associated with current smoking were education year (aOR = 0.95, 95% CI: 0.93-0.98), duration of stay (aOR = 1.01, 95% CI: 1.00-1.03) and occupation (aOR = 1.25, 95% CI: 1.03-1.53). For females, household registration status (aOR = 1.70, 95% CI: 1.04-2.80) was the most important factor associated with current smoking. Sixty five percent of non-smokers were exposed to second-hand smoke. Factors associated with exposure to second-hand smoke were duration of stay (aOR = 1.01, 95% CI: 1.00-1.02), divorced/widowed marital status (aOR = 0.48, 95% CI: 0.25-0.91), occupation (aOR = 1.29, 95% CI: 1.05-1.58) and the nature of employer (aOR = 0.77, 95% CI: 0.60-0.97). About 95% of participants were aware that lung cancer is one of the hazards of smoking. Non-current smokers had a better knowledge of fertility reduction and accelerated aging as hazards of smoking than current smokers (p < 0.01). Knowledge of the impact of smoking on cardiovascular diseases was relatively low compared with knowledge of other smoking-related hazards (26.1-44.3%). CONCLUSIONS Current smoking and exposure to second-hand smoke among internal migrants in China is high. Socio-demographic characteristics and migration status were strongly associated with current smoking and second-hand smoke exposure. We recommend specifically targeted tobacco control interventions to help to address these risk factors, such as focusing on divorced/widowed women.
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Affiliation(s)
- Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
- Department of Personnel, Beijing University of Chinese Medicine, Beijing, 100029 People’s Republic of China
| | - Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
| | - Hongbo Dong
- Graduate School, Peking Union Medical College, Beijing, 100730 People’s Republic of China
| | - Chun Chang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191 People’s Republic of China
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Li C, Liang Z, Bloom MS, Wang Q, Shen X, Zhang H, Wang S, Chen W, Lin Y, Zhao Q, Huang C. Temporal trends of preterm birth in Shenzhen, China: a retrospective study. Reprod Health 2018. [PMID: 29534760 PMCID: PMC5851155 DOI: 10.1186/s12978-018-0477-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Preterm birth is the leading cause of child mortality under 5 years of age. Temporal trends in preterm birth rates are highly heterogeneous among countries and little information exists for China. To address this data gap, we investigated annual changes in preterm birth incidence rate and explored potential determinants of these changes in Shenzhen, China. METHODS A total of 1.4 million live births, during 2003-2012, were included from the Shenzhen birth registry. Negative-binominal regression models were used to estimate the annual percent changes in incidence. To identify the potential determinants behind temporal trends, we estimated the contribution of each changing risk factor to changes in rate by calculating the difference in population-attributable risk fraction. RESULTS Annual preterm birth incidence rates increased by 0.94% (95% CI 0.30%, 1.58%) overall, 3.60% (95% CI 2.73%, 4.48%) for medically induced, and 3.13% (95% CI 1.01%, 5.31%) for preterm premature rupture of membranes, but decreased by 2.34% (95% CI 1.62%, 3.06%) for spontaneous preterm labor. Higher maternal educational attainment (0.20 rate increase), lower proportion of inadequate prenatal care (0.15 rate reduction), more multipara (0.08 rate reduction), decreased proportion of preeclampsia or eclampsia (0.05 rate reduction), and larger proportion of young and older pregnant women (0.04 rate increase) were significant contributors to the overall change over time. Contributions of changing risk factors were different between preterm birth subtypes. CONCLUSIONS Preterm birth rate in Shenzhen, China increased overall during 2003-2012, although trends varied across three preterm birth subtypes. The rising rates were associated with changes in maternal education and age.
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Affiliation(s)
- Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China.,Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China.,Department of Biostatistics and Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China
| | - Zhijiang Liang
- Department of Public Health, Guangdong Women and Children Hospital, 521, 523 Xing Nan Street, Guangzhou, 511442, China
| | - Michael S Bloom
- Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, USA
| | - Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China.,Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China
| | - Xiaoting Shen
- Center for Reproductive Medicine, The First Affiliated Hospital of Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China
| | - Huanhuan Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China.,Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China
| | - Suhan Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China.,Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China
| | - Weiqing Chen
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China
| | - Yan Lin
- Department of Children Health Care, Shenzhen Women and Children Hospital, Shenzhen, China
| | - Qingguo Zhao
- Department of Public Health, Guangdong Women and Children Hospital, 521, 523 Xing Nan Street, Guangzhou, 511442, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China. .,Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road #2, Guangzhou, 510080, China.
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Chai W, Zou G, Shi J, Chen W, Gong X, Wei X, Ling L. Evaluation of the effectiveness of a WHO-5A model based comprehensive tobacco control program among migrant workers in Guangdong, China: a pilot study. BMC Public Health 2018; 18:296. [PMID: 29486753 PMCID: PMC6389256 DOI: 10.1186/s12889-018-5182-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As a vulnerable population in China, migrant workers have a higher smoking rate than the general population. This study aims to assess the effectiveness of a WHO-5A based comprehensive tobacco control program in workplaces aggregated with migrants. METHODS Using a controlled before and after design, four purposely selected manufacturing factories were assigned to either intervention or control groups. Participants in the intervention arm received adapted 5A group counseling regularly supported by social-media and traditional health education approaches. The primary outcome was the change of smoking rate based on salivary cotinine concentration at three-month follow-up as compared to the control arm. Secondary outcomes were changes in smoking-related knowledge and attitudes assessed using questionnaires. Difference-in-differences approach (DID) and generalized estimating equations (GEE) models were used to conduct the effectiveness analysis. RESULTS 149 and 166 workers were enrolled in the intervention and control arm respectively. The multiple imputed and adjusted GEE models demonstrated that, compared to those in the control arm, participants in the intervention arm had nearly 2.4 times odds of improving smoking-related knowledge (OR = 2.40, 95% CI = 1.32-4.36, P = 0.02) and three times the odds of improving smoking-related attitude (OR = 3.07, 95% CI = 1.28-7.41, P = 0.03). However, no significant difference was found regarding the change of smoking rate between the two arms (P > 0.05). The regression analysis showed that attendance at the 5A group counseling sections was an important determinant of stopping smoking or improving smoking-related knowledge and attitudes in the intervention group. CONCLUSIONS This WHO-5A comprehensive intervention was effective in improving migrant workers' knowledge of smoking and anti-smoking attitudes. A large-scale, long-term trial is recommended to determine the effectiveness of this intervention. TRIAL REGISTRATION ChiCTR-OPC-17011637 at Chinese Clinical Trial Registry. Retrospectively registered on 12th June 2017.
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Affiliation(s)
- Wenxin Chai
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Guanyang Zou
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China.,Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Jingrong Shi
- Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wen Chen
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiao Gong
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiaolin Wei
- Division of Clinical Public Health and Institute for Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Li Ling
- Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China. .,Sun Yat-sen Center for Migrant Health Policy, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Li H, Yan X, Deng X, Yang L, Zhao S, Zou J, Luo Y, Cao S. Magnitude of and gender differences in cardiovascular risk profiles among community residents in Shenzhen, China. Public Health 2017; 147:59-65. [PMID: 28404497 DOI: 10.1016/j.puhe.2017.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 02/06/2017] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Understanding the prevalence of cardiovascular disease (CVD) risk factors has an impact on the public policy for initiating CVD prevention. This study aimed to examine the prevalence of current smoking, overweight/obesity, hypertension, diabetes mellitus (DM), and dyslipidemia among Shenzhen residents and to investigate gender differences in CVD risk profiles to identify the subgroups at higher risk. STUDY DESIGN A large cross-sectional study was conducted between April and May 2015. METHODS Using multistage cluster random sampling methods, a total of 1784 residents finished the face-toface interview survey. Physical examinations and blood tests were performed by qualified professionals. RESULTS The prevalence of current smoking, overweight/obesity, hypertension, DM, and dyslipidemia were 21.8%, 40.6%, 17.6%, 4.8%, and 35.7%, respectively. Clustering of two or more or three or more of CVD risk factors was noted in 35.7% and 14.1% of participants. The prevalence of current smoking (45.0% vs 1.1%, P < 0.001), overweight/obesity (48.5% vs 33.4%, P < 0.001), hypertension (19.7% vs 15.7%, P < 0.05), and dyslipidemia (46.5% vs 20.5%, P < 0.001) was found higher among male than among female participants. CONCLUSIONS This study adds to the evidence suggesting high prevalence rates of CVD risk factors and composite measures among Shenzhen residents. The higher level of CVD risk factors in male than in female residents is suggested. Effective population-based intervention programs such as smoking cessation, early detection, management, and treatment of hypertension, DM, and dyslipidemia should be initiated and enhanced especially among the males.
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Affiliation(s)
- H Li
- School of Medicine, Shenzhen University, Shenzhen, China.
| | - X Yan
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China.
| | - X Deng
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China
| | - L Yang
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China
| | - S Zhao
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China
| | - J Zou
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China
| | - Y Luo
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China
| | - S Cao
- Longhua District Center for Chronic Disease Prevention and Control, Shenzhen, China
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Prevalence of Tobacco Smoking and Determinants of Success in Quitting Smoking among Patients with Chronic Diseases: A Cross-Sectional Study in Rural Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020167. [PMID: 28208782 PMCID: PMC5334721 DOI: 10.3390/ijerph14020167] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 02/06/2017] [Indexed: 02/07/2023]
Abstract
Tobacco use is one of the behavioral risk factors for chronic diseases. The aim of the study was to investigate smoking prevalence in chronically ill residents and their smoking behavior in western rural China, to identify factors associated with success in quitting smoking, and to provide appropriate intervention strategies for tobacco control. Cross-sectional survey data from patients with chronic diseases from rural western China were analyzed. Among the 906 chronically ill patients, the current smoking prevalence was 26.2%. About 64.3% of smokers with chronic diseases attempted to quit smoking, 21.0% of which successfully quitted. The odds ratio (OR) of smokers with only one chronic disease to quit smoking successfully was higher than that of those who have other diseases (OR = 2.037, 95% confidence interval (CI) = 1.060-3.912; p < 0.05). The smokers who were always restricted to smoking in public places were more likely to quit smoking successfully than those who were free to smoke (OR = 2.188, 95% CI = 1.116-4.291; p < 0.05). This study suggests that health literacy, comorbidity of diseases, and psychological counseling should be considered when developing targeted tobacco prevention strategies. Strengthening tobacco control measures in public places such as rural medical institutions will be effective.
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Taype-Rondan A, Bernabe-Ortiz A, Alvarado GF, Gilman RH, Smeeth L, Miranda JJ. Smoking and heavy drinking patterns in rural, urban and rural-to-urban migrants: the PERU MIGRANT Study. BMC Public Health 2017; 17:165. [PMID: 28158997 PMCID: PMC5291966 DOI: 10.1186/s12889-017-4080-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 01/27/2017] [Indexed: 12/25/2022] Open
Abstract
Background Previous studies have found mixed results about cigarette and alcohol consumption patterns among rural-to-urban migrants. Moreover, there are limited longitudinal data about consumption patterns in this population. As such, this study aimed to compare the smoking and heavy drinking prevalence among rural, urban, and rural-to-urban migrants in Peru, as well as the smoking and heavy drinking incidence in a 5-year follow-up. Methods We analyzed the PERU MIGRANT Study data from rural, urban, and rural-to-urban migrant populations in Peru. The baseline study was carried out in 2006–2007 and follow-up was performed five years later. For the baseline data analysis, the prevalence of lifetime smoking, current smokers, and heavy drinking was compared by population group using prevalence ratios (PR) and 95% confidence intervals (95% CI). For the longitudinal analysis, the incidence of smoking and heavy drinking was compared by population group with risk ratios (RR) and 95% CI. Poisson regression with robust variance was used to calculate both PRs and RRs. Results We analyzed data from 988 participants: 200 rural dwellers, 589 migrants, and 199 urban dwellers. Compared with migrants, lifetime smoking prevalence was higher in the urban group (PR = 2.29, 95% CI = 1.64–3.20), but lower in the rural group (PR = 0.55, 95% CI = 0.31–0.99). Compared with migrants, the urban group had a higher current smoking prevalence (PR = 2.29, 95% CI = 1.26–4.16), and a higher smoking incidence (RR = 2.75, 95% CI = 1.03–7.34). Current smoking prevalence and smoking incidence showed no significant difference between rural and migrant groups. The prevalence and incidence of heavy drinking was similar across the three population groups. Conclusions Our results show a trend in lifetime smoking prevalence (urban > migrant > rural), while smoking incidence was similar between migrant and rural groups, but higher in the urban group. In addition, our results suggest that different definitions of smoking status could lead to different smoking rates and potentially different measures of association. The prevalence and incidence of heavy drinking were similar between the three population groups. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4080-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alvaro Taype-Rondan
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, Lima, 18, Peru.
| | - Antonio Bernabe-Ortiz
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, Lima, 18, Peru.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Germán F Alvarado
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Robert H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Liam Smeeth
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Armendáriz 497, Miraflores, Lima, 18, Peru.,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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Guan M. Measuring the effects of socioeconomic factors on mental health among migrants in urban China: a multiple indicators multiple causes model. Int J Ment Health Syst 2017; 11:10. [PMID: 28070220 PMCID: PMC5217273 DOI: 10.1186/s13033-016-0118-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 12/29/2016] [Indexed: 11/10/2022] Open
Abstract
Objectives Since 1978, rural–urban migrants mainly contribute Chinese urbanization. The purpose of this paper is to examine the effects of socioeconomic factors on mental health of them. Their mental health was measured by 12-item general health questionnaire (GHQ-12). Methods The study sample comprised 5925 migrants obtained from the 2009 rural-to-urban migrants survey (RUMiC). The relationships among the instruments were assessed by the correlation analysis. The one-factor (overall items), two-factor (positive vs. negative items), and model conducted by principal component analysis were tested in the confirmatory factor analysis (CFA). On the basis of three CFA models, the three multiple indicators multiple causes (MIMIC) models with age, gender, marriage, ethnicity, and employment were constructed to investigate the concurrent associations between socioeconomic factors and GHQ-12. Results Of the sample, only 1.94% were of ethnic origin and mean age was 31.63 (SD = ±10.43) years. The one-factor, two-factor, and three-factor structure (i.e. semi-positive/negative/independent usefulness) had good model fits in the CFA analysis and gave order (i.e. 2 factor>3 factor>1 factor), which suggests that the three models can be used to assess psychological symptoms of migrants in urban China. All MIMIC models had acceptable fit and gave order (i.e. one-dimensional model>two-dimensional model>three-dimensional model). Conclusions There were weak associations of socioeconomic factors with mental health among migrants in urban China. Policy discussion suggested that improvement of socioeconomic status of rural–urban migrants and mental health systems in urban China should be highlighted and strengthened. Electronic supplementary material The online version of this article (doi:10.1186/s13033-016-0118-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ming Guan
- Family Issues Center at Xuchang University, School of Business, Xuchang University, Road Bayi 88, Xuchang, Henan China
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12
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Chung VCH, Wong SYS, Wang HHX, Wong MCS, Wei X, Wang J, Liu S, Ho RST, Yu ELM, Griffiths SM. Use of Traditional and Complementary Medicine as Self-Care Strategies in Community Health Centers: Cross-Sectional Study in Urban Pearl River Delta Region of China. Medicine (Baltimore) 2016; 95:e3761. [PMID: 27281074 PMCID: PMC4907652 DOI: 10.1097/md.0000000000003761] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/22/2016] [Accepted: 04/02/2016] [Indexed: 01/10/2023] Open
Abstract
In China, Community Health Centers (CHCs) are major providers of primary care services, but their potential in empowering patients' self-management capacity has not been assessed. This study aims to describe self-care practice patterns amongst CHC attendees in urban China.In this cross-sectional quantitative study, 3360 CHC patients from 6 cities within the Pearl Delta Region were sampled using multistage cluster sampling.Thirty-seven per cent had used with over-the-counter Chinese herbal medicines (OTC CHMs) in the past year and majority of respondents found OTC CHMs effective. OTC CHMs were more popular amongst those who needed to pay out of pocket for CHC services. Less than 10% used vitamins and minerals, and those with a lower socioeconomic background have a higher propensity to consume. Although doubts on their usefulness are expressed, their use by the vulnerable population may reflect barriers to access to conventional health care, cultural affinity, or a defense against negative consequences of illnesses. About 25% performed physical exercise, but the prevalence is lower amongst women and older people. Taiji seems to be an alternative for these populations with promising effectiveness, but overall only 6% of CHC attendees participated.These results suggest that CHCs should start initiatives in fostering appropriate use of OTC CHM, vitamins, and minerals. Engaging community pharmacists in guiding safe and effective use of OTC CHM amongst the uninsured is essential given their low accessibility to CHC services. Prescription of Taiji instead of physical exercises to women and older people could be more culturally appropriate, and the possibility of including this as part of the CHC services worth further exploration.
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Affiliation(s)
- Vincent C H Chung
- From the JC School of Public Health and Primary Care (VCHC, SYSW, MCSW, XW, SL, RSTH, ELMY, SMG); Hong Kong Institute of Integrative Medicine (VCHC, SYSW), The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR; School of Public Health (HHXW), Sun Yat-Sen University; School of Public Health (JW), Guangzhou Medical University, Guangzhou, Guangdong Province, China; and Institute of Global Health Innovation (SMG), Imperial College London, London, UK
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Ji Y, Liu S, Zhao X, Jiang Y, Zeng Q, Chang C. Smoking and Its Determinants in Chinese Internal Migrants: Nationally Representative Cross-Sectional Data Analyses. Nicotine Tob Res 2016; 18:1719-26. [DOI: 10.1093/ntr/ntw101] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 04/03/2016] [Indexed: 11/14/2022]
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Prevalence and Associated Factors of Secondhand Smoke Exposure among Internal Chinese Migrant Women of Reproductive Age: Evidence from China's Labor-Force Dynamic Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:371. [PMID: 27043604 PMCID: PMC4847033 DOI: 10.3390/ijerph13040371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/06/2016] [Accepted: 03/23/2016] [Indexed: 11/17/2022]
Abstract
Secondhand smoke (SHS) is a major risk factor for poor health outcomes among women in China, where proportionately few women smoke. This is especially the case as it pertains to women’s reproductive health, specifically migrant women who are exposed to SHS more than the population at large. There are several factors which may increase migrant women’s risk of SHS exposure. This paper aims to investigate the prevalence and associated factors of SHS exposure among internal Chinese migrant women of reproductive age. The data used were derived from the 2014 Chinese Labor Dynamic Survey, a national representative panel survey. The age-adjusted rate of SHS exposure of women of reproductive age with migration experience was of 43.46% (95% CI: 40.73%–46.40%), higher than those without migration experience (35.28% (95% CI: 33.66%–36.97%)). Multivariate analysis showed that participants with a marital status of “Widowed” had statistically lower exposure rates, while those with a status of “Cohabitation” had statistically higher exposure. Those with an undergraduate degree or above had statistically lower SHS exposure. Those with increasing levels of social support, and those who currently smoke or drink alcohol, had statistically higher SHS exposure. Participants’ different work-places had an effect on their SHS exposure, with outdoor workers statistically more exposed. Our findings suggest that urgent tobacco control measures should be taken to reduce smoking prevalence and SHS exposure. Specific attention should be paid to protecting migrant women of reproductive age from SHS.
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Abstract
BACKGROUND This study describes the prevalence of depression symptoms and its impact on health-seeking behaviour among Chinese migrant workers in a sample of 1,533 Shenzhen residents. METHODS A cross-sectional questionnaire survey was administered in Shenzhen with a random sample of 859 registered and 674 non-registered residents. The 20-item Centre for Epidemiologic Studies-Depression Scale (CES-D) scale was used to measure depression symptoms. Multivariate regression analysis was applied to assess healthcare services utilisation. RESULTS Non-registered residents were more likely to have clinically significant depressive symptoms (CES-D score ≥ 16) (odds ratio (OR) = 1.81; confidence interval (CI) = 1.18, 2.76). Despite this, depressed non-registered residents had no significant difference in health-seeking behaviour when compared to those without depression (OR = 2.86; CI = 0.98, 8.32), while in contrast, depressed registered residents had a positive and stronger association with healthcare services utilisation and/or self-medication (OR = 3.34; CI = 1.28, 8.71). CONCLUSION The findings suggest higher prevalence of depression but less utilisation of healthcare services or self-medication among migrant residents. That migrants with depression lack access to healthcare suggests healthcare inequality. Psychological disorders require careful management and treatment; the mismatch in their health needs and access to care may contribute to the Inverse-care law.
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Affiliation(s)
- Kelvin K F Lam
- School of Public Health, Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janice M Johnston
- School of Public Health, Faculty of Medicine, The University of Hong Kong, Hong Kong
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Oyebode O, Pape UJ, Laverty AA, Lee JT, Bhan N, Millett C. Rural, urban and migrant differences in non-communicable disease risk-factors in middle income countries: a cross-sectional study of WHO-SAGE data. PLoS One 2015; 10:e0122747. [PMID: 25849356 PMCID: PMC4388413 DOI: 10.1371/journal.pone.0122747] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 02/13/2015] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Understanding how urbanisation and rural-urban migration influence risk-factors for non-communicable disease (NCD) is crucial for developing effective preventative strategies globally. This study compares NCD risk-factor prevalence in urban, rural and migrant populations in China, Ghana, India, Mexico, Russia and South Africa. METHODS Study participants were 39,436 adults within the WHO Study on global AGEing and adult health (SAGE), surveyed 2007-2010. Risk ratios (RR) for each risk-factor were calculated using logistic regression in country-specific and all country pooled analyses, adjusted for age, sex and survey design. Fully adjusted models included income quintile, marital status and education. RESULTS Regular alcohol consumption was lower in migrant and urban groups than in rural groups (pooled RR and 95%CI: 0.47 (0.31-0.68); 0.58, (0.46-0.72), respectively). Occupational physical activity was lower (0.86 (0.72-0.98); 0.76 (0.65-0.85)) while active travel and recreational physical activity were higher (pooled RRs for urban groups; 1.05 (1.00-1.09), 2.36 (1.95-2.83), respectively; for migrant groups: 1.07 (1.0 -1.12), 1.71 (1.11-2.53), respectively). Overweight, raised waist circumference and diagnosed diabetes were higher in urban groups (1.19 (1.04-1.35), 1.24 (1.07-1.42), 1.69 (1.15-2.47), respectively). Exceptions to these trends exist: obesity indicators were higher in rural Russia; active travel was lower in urban groups in Ghana and India; and in South Africa, urban groups had the highest alcohol consumption. CONCLUSION Migrants and urban dwellers had similar NCD risk-factor profiles. These were not consistently worse than those seen in rural dwellers. The variable impact of urbanisation on NCD risk must be considered in the design and evaluation of strategies to reduce the growing burden of NCDs globally.
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Affiliation(s)
- Oyinlola Oyebode
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, St Dunstand’s Road, London, United Kingdom
- * E-mail:
| | - Utz J. Pape
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, St Dunstand’s Road, London, United Kingdom
| | - Anthony A. Laverty
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, St Dunstand’s Road, London, United Kingdom
| | - John T. Lee
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, St Dunstand’s Road, London, United Kingdom
| | - Nandita Bhan
- Public Health Foundation of India, New Delhi, India
| | - Christopher Millett
- Department of Primary Care and Public Health, Imperial College, Reynolds Building, St Dunstand’s Road, London, United Kingdom
- Public Health Foundation of India, New Delhi, India
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Liu Y, Song H, Wang T, Wang T, Yang H, Gong J, Shen Y, Dai W, Zhou J, Zhu S, Pan Z. Determinants of tobacco smoking among rural-to-urban migrant workers: a cross-sectional survey in Shanghai. BMC Public Health 2015; 15:131. [PMID: 25886500 PMCID: PMC4334770 DOI: 10.1186/s12889-015-1361-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 01/06/2015] [Indexed: 11/15/2022] Open
Abstract
Background Although there are several studies to investigate the smoking behaviors among rural-to-urban Chinese migrants, no study has focused individually on this population in Shanghai. This study was performed to estimate the prevalence and identify the determinants of tobacco smoking among rural-to-urban migrants in Shanghai. Methods In this cross-sectional study, multi-stage quota sampling was used to select 5,856 rural-to-urban migrants aged 18 years or older from seven districts in Shanghai between July and October 2012. A structured questionnaire was administered to assess smoking knowledge, attitude, behavior and demographic characteristics. Mental health was assessed by the self-reported SCL-90. Multiple logistic regression analysis was used to determine the risk factors of smoking behavior. Results A total of 5,380 of the 5,856 migrants enrolled completed the questionnaire, among whom 45.0% of male and 2.0% of female participants reported current smoking. Multivariate analysis revealed current smoking in female migrants to be significantly associated with working at construction (OR, 8.08; 95% CI, 1.80-36.28), hotels/restaurants (OR, 5.06; 95% CI, 1.68-15.27), entertainment sector (OR, 6.79; 95% CI, 2.51-18.42), with monthly income > 3500 yuan (OR, 2.69; 95% CI, 1.21-5.98), number of migratory cities of 2 (OR, 2.39; 95% CI, 1.23-4.65), and SCL-90 total score > 160 (OR, 2.03; 95% CI, 1.03-3.98), while the male migrants working at construction (OR, 1.30; 95% CI, 1.04-1.62), entertainment sector (OR, 1.86; 95% CI, 1.36-2.56), being divorced/widowed (OR, 2.20; 95% CI, 1.02-4.74), with duration of migration of 4 or more than 4 years (OR, 1.42; 95% CI, 1.06-1.91), number of migratory cities of 3 or more than 3 (OR, 1.42; 95% CI, 1.13-1.80), and SCL-90 total score > 160 (OR,1.39; 95% CI, 1.07-1.79) showed an excess smoking prevalence. Conclusion Migration lifestyle and mental status were associated with current smoking behaviors. The identifications of risk factors for current smoking may help to target health promotion interventions.
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Affiliation(s)
- Yao Liu
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Huijiang Song
- Department of General Practice, Sanlin Community Health Service Center, 375 Sanlin Road, Shanghai, 200124, China.
| | - Tianying Wang
- Department of General Practice, Sanlin Community Health Service Center, 375 Sanlin Road, Shanghai, 200124, China.
| | - Tianhao Wang
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Hua Yang
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Jian Gong
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Yao Shen
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Wei Dai
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Jing Zhou
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Shanzhu Zhu
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
| | - Zhigang Pan
- Department of General Practice, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, 20032, China.
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Mou J, Griffiths SM, Fong HF, Dawes MG. Defining migration and its health impact in China. Public Health 2014; 129:1326-34. [PMID: 25515044 DOI: 10.1016/j.puhe.2014.01.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 01/09/2014] [Accepted: 01/16/2014] [Indexed: 12/13/2022]
Abstract
The scale and rapid expansion of urbanization resulting from socio-economic transformation in China at the beginning of the 21st century has accelerated rural-urban migration. Public health concerns from this increasing internal population mobility are now receiving attention from researchers. The health problems from internal migration pose particular demands on healthcare systems and relate to its demographic characteristics, with many younger and older people being left behind in the rural countryside. A review of literature, census, policy reports, government documents and media was undertaken to look at the classification system and health characteristics of China's internal migrants. It suggests that public health bears the consequences of political and economic decisions made elsewhere in society.
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Affiliation(s)
- J Mou
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Canada.
| | - S M Griffiths
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
| | - H F Fong
- Center for Global Public Health, University of California, Berkeley, USA
| | - M G Dawes
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Canada
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Sanadhya S, Nagarajappa R, Sharda AJ, Asawa K, Tak M, Batra M, Daryani H. The oral health status and the treatment needs of salt workers at sambhar lake, jaipur, India. J Clin Diagn Res 2013; 7:1782-6. [PMID: 24086913 DOI: 10.7860/jcdr/2013/5887.3275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 05/13/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Salt workers are exposed to the adversities of environmental conditions such as direct sunlight, salt dust and contact with brine, which have an impact on the health of workers. Since oral health is an integral part of the general health, we planned to determine its effect on the oral cavity. OBJECTIVES To assess the oral health status and the treatment needs among the workers of Sambhar Salts Limited at Sambhar Lake, Jaipur, India. MATERIAL AND METHODS A cross sectional, descriptive survey was conducted among 979 subjects (509 males; 470 females) who were aged between 19-68 years, who were the workers of Sambhar Salts Limited, Sambhar Lake, Jaipur, India. An interview on the demographic profile followed a clinical examination for recording the oral health status, based on the World Health Organization guidelines. The Chi-square test, t-test, One way Analysis of Variance and a Stepwise multiple linear regression analysis were used for the statistical analysis. RESULTS Females had a significantly greater prevalence of dental fluorosis (71.7%) and periodontal disease (96.4%) as compared to males (p= 0.001). The mean number of healthy sextants (0.71 ± 0.09) and the mean DMFT (5.19 ± 4.11) were also significantly higher in females as compared to those in males (p=0.001). One surface filling (78.2%), followed by pulp care and restoration (76.1%) were the most prevalent treatment needs. The gender and oral hygiene practices for dental caries and periodontal disease were respectively identified as the best predictors. CONCLUSION Considerable percentages of salt workers have demonstrated a higher prevalence of oral diseases. Higher unmet treatment needs suggest a poor accessibility and availability of oral health care, in addition to a low utilization of preventive or therapeutic oral health services.
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Affiliation(s)
- Sudhanshu Sanadhya
- Post Graduate Student, Department of Public Health Dentistry, Pacific Dental College and Hospital , Airport Road, Debari, Udaipur - 313024, Rajasthan, India
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Kishore J, Kohli C, Sharma PK, Sharma E. Noncommunicable disease risk profile of factory workers in Delhi. Indian J Occup Environ Med 2013; 16:137-41. [PMID: 23776324 PMCID: PMC3683183 DOI: 10.4103/0019-5278.111761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Noncommunicable diseases (NCDs) are becoming more prevalent in India. The data for presence of NCDs and its risk factors among factory workers is deficient in India. Materials and Methods: A cross-sectional comparative study was carried out among 37 factory workers and equal number of comparable subjects from general population. Screening for presence of diabetes along with its risk factors was made in both the groups using pretested predesigned World Health Organization STEPwise approach to surveillance (WHO STEPS) questionnaire in rural area of Delhi. Data was analyzed using SPSS version 16 software. The estimation of risk in two groups was done with calculation of odds ratio (OR). P values less than 0.05 were considered significant. Results: A total of 74 participants were included in the present study. Hypertension and diabetes was present in 13.5 and 5.4% of factory workers and four (10.8%) and three (8.8%) subjects in comparative group, respectively. Seven (18.9%) factory and eight (21.6%) non-factory subjects fell in the category of current smoker or smokeless tobacco users. High density lipoprotein levels were found abnormal among one (2.7%) factory worker and nine (24.3%) subjects in comparative group (P-value = 0.01). Behavioral risk factors, alcohol consumption, and fruits and vegetable intake were significantly different among two groups. Conclusion: Factory workers were having better profile than non-factory subjects except for risk factors such as alcohol intake and inadequate fruits and vegetable intake. However, healthy worker effect phenomenon cannot be ruled out.
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Affiliation(s)
- Jugal Kishore
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
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Mou J, Griffiths SM, Fong H, Dawes MG. Health of China's rural-urban migrants and their families: a review of literature from 2000 to 2012. Br Med Bull 2013; 106:19-43. [PMID: 23690451 DOI: 10.1093/bmb/ldt016] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Socioeconomic transformation in China at the beginning of the twenty-first century has led to rapid urbanization and accelerated rural-urban migration. As a result, the concerns about public health problems triggered by increasing internal population mobility have been more widely studied in recent years. SOURCES OF DATA Published data in Chinese and English on health of migrants and their families in mainland China from 2000 to 2012. AREAS OF AGREEMENT The shifting patterns of disease distribution due to rural-urban migration, health equity and health reform strategies that cater for this specific yet substantial subpopulation are outstanding concerns. Infectious diseases, mental health, occupational health and women's health are emerging public health priorities related to migration. AREAS OF CONTROVERSY The high mobility and large numbers of Chinese rural-urban migrants pose challenges to research methods and the reliability of evidence gained. GROWING POINTS While the theme of working migrants is common in the literature, there have also been some studies of health of those left behind but who often remain unregistered. Migration within China is not a single entity and understanding the dynamics of new and emerging societies will need further study. AREAS TIMELY FOR DEVELOPING RESEARCH Social, economic, emotional, environmental and behavioural risk factors that impact on health of migrants and their families call for more attention from health policy-makers and researchers in contemporary China.
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Affiliation(s)
- Jin Mou
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Cui X, Rockett IRH, Yang T, Cao R. Work stress, life stress, and smoking among rural-urban migrant workers in China. BMC Public Health 2012; 12:979. [PMID: 23151299 PMCID: PMC3584974 DOI: 10.1186/1471-2458-12-979] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 09/20/2012] [Indexed: 12/02/2022] Open
Abstract
Background Stimulated by rapid modernization and industrialization, there is massive rural–urban migration in China. The migrants are highly susceptible to smoking and mental health problems. This study examined the association between both perceived work stress and perceived life stress with smoking behavior among this group during the period of migration. Methods Participants (n = 1,595) were identified through stratified, multi-stage, systematic sampling. Smoking status separated non-smokers from daily and occasional smokers, and migration history, work stress, and life stress were also measured. Analyses were conducted using the Chi-square test and multiple logistic regression. Two models were utilized. The first was the full model that comprised sociodemographic and migration-related characteristics, as well as the two stress variables. In addressing potential overlap between life and work stress, the second model eliminated one of the two stress variables as appropriate. Results Overall smoking prevalence was 64.9% (95% CI: 62.4-67.2%). In the regression analysis, under the full model, migrants with high perceived life stress showed a 45% excess likelihood to be current smokers relative to low-stress counterparts (OR: 1.45; 95% CI: 1.05 – 2.06). Applying the second model, which excluded the life stress variable, migrants with high perceived work stress had a 75% excess likelihood to be current smokers relative to opposites (OR: 1.75; 95% CI: 1.26–2.45). Conclusions Rural–urban migrant workers manifested a high prevalence of both life stress and work stress. While both forms of stress showed associations with current smoking, life stress appeared to outweigh the impact of work stress. Our findings could inform the design of tobacco control programs that would target Chinese rural–urban migrant workers as a special population.
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Affiliation(s)
- Xiaobo Cui
- Department of Health Education, Capital Medical University, Beijing, China
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Lam KKF, Johnston JM. Health insurance and healthcare utilisation for Shenzhen residents: a tale of registrants and migrants? BMC Public Health 2012; 12:868. [PMID: 23061720 PMCID: PMC3584814 DOI: 10.1186/1471-2458-12-868] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 09/25/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Shenzhen's rapid growth and urbanisation has attracted a large, mobile, migrant working population. This article explores health protection through the means of social health insurance between migrants and registrants and their point of access to healthcare. METHODS A cross-sectional questionnaire survey was conducted in Shenzhen, with a random sample of 793 registered and 750 non-registered residents. Chi-square test and multivariate logistic regression were applied to analyse the association between health insurance coverage with Hukou registration status and healthcare utilisation. RESULTS Amongst 1543 respondents, 43.1% of non-registered residents were uninsured. Being non-registered strongly predicted for no insurance (OR = 5.00; CI 3.53,7.07) and have purchased additional/ private insurance (OR = 2.99; CI 1.66,5.37). Migrants who self-reported chronic health conditions were also more likely to utilise health services in general (OR = 2.77; CI 1.18,6.52). CONCLUSIONS Inadequate health insurance coverage for migrants as observed in Shenzhen remains a challenge for the Chinese health reform. Our results suggest that the current insurance system must seek to include migrants in order to achieve universal coverage and improved health protection for its population.
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Affiliation(s)
- Kelvin K F Lam
- Department of Community Medicine, School of Public Health, The University of Hong Kong, 5/F William MW Mong Block, Faculty of Medicine Building, 21 Sassoon Road, Hong Kong, China
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