Socioeconomic Gradients and Distribution of Diabetes, Hypertension, and Obesity in India.

Importance: Cardiovascular disease and risk factors represent a major and increasing burden of death and disability in India, although socioeconomic aspects have been debated in recent years.

Objective: To conduct a comprehensive equity analysis of the socioeconomic gradients and distribution of diabetes, hypertension, and obesity in India using the latest national data set.

Design, Setting, And Participants: Cross-sectional study of data originating from the fourth Indian National Family Health Survey collected from January 20, 2015, to December 4, 2016.

Socioeconomic and gender inequalities in neonatal, postneonatal and child mortality in India: a repeated cross-sectional study, 2005-2016.

Background: In India, excess female under-5 mortality is well documented. Under-5 mortality is also known to be patterned by socioeconomic factors. This study examines sex differentials and sex-specific wealth gradients in neonatal, postneonatal and child mortality in India.

Neighborhood-level and individual-level socioeconomic status and self-reported management of ischaemic heart disease: cross-sectional results from the Korea Health Examinees Study.

Objective: Several studies identified neighbourhood context as a predictor of prognosis in ischaemic heart disease (IHD). The present study investigates the relationships of neighborhood-level and individual-level socioeconomic status with the odds of ongoing management of IHD, using baseline survey data from the Korea Health Examinees-Gem study.

Design: In this cross-sectional study, we estimated the association of the odds of self-reported ongoing management with the neighborhood-level income status and percentage of college graduates after controlling for individual-level covariates using two-level multilevel logistic regression models based on the Markov Chain Monte Carlo function.

Assessing national and subnational inequalities in medical care utilization and financial risk protection in Rwanda.

Background: Ensuring equitable access to medical care with financial risk protection has been at the center of achieving universal health coverage. In this paper, we assess the levels and trends of inequalities in medical care utilization and household catastrophic health spending (HCHS) at the national and sub-national levels in Rwanda.

Methods: Using the Rwanda Integrated Living Conditions Surveys of 2005, 2010, 2014, and 2016, we applied multivariable logit models to generate the levels and trends of adjusted inequalities in medical care utilization and HCHS across the four survey years by four socio-demographic dimensions: poverty, gender, education, and residence.

How socioeconomic status moderates the stunting-age relationship in low-income and middle-income countries.

Introduction: Reducing stunting is an important part of the global health agenda. Despite likely changes in risk factors as children age, determinants of stunting are typically analysed without taking into account age-related heterogeneity. We aim to fill this gap by providing an in-depth analysis of the role of socioeconomic status (SES) as a moderator for the stunting-age pattern.

Learning From History About Reducing Infant Mortality: Contrasting the Centrality of Structural Interventions to Early 20th-Century Successes in the United States to Their Neglect in Current Global Initiatives.

Unlabelled: Policy Points Current efforts to reduce infant mortality and improve infant health in low- and middle-income countries (LMICs) can benefit from awareness of the history of successful early 20th-century initiatives to reduce infant mortality in high-income countries, which occurred before widespread use of vaccination and medical technologies. Improvements in sanitation, civil registration, milk purification, and institutional structures to monitor and reduce infant mortality played a crucial role in the decline in infant mortality seen in the United States in the early 1900s. The commitment to sanitation and civil registration has not been fulfilled in many LMICs.

Estimating the burden of child malnutrition across parliamentary constituencies in India: A methodological comparison.

In India, data on key developmental indicators used to formulate policies and interventions are routinely available for the administrative unit of districts but not for the political unit of parliamentary constituencies (PC). Recently, Swaminathan et al. proposed two methodologies to generate PC estimates using randomly displaced GPS locations of the sampling clusters ('direct') and by building a crosswalk between districts and PCs using boundary shapefiles ('indirect').

Contextual Variation in Early Adolescent Childbearing: A Multilevel Study From 33,822 Communities in 44 Low- and Middle-Income Countries.

Purpose: Existing literature calls for a deeper examination into how local context influences adolescent sexual and reproductive health outcomes. We seek to describe individual and contextual variation in early adolescent childbearing (younger than 16 years) in 44 low- and middle-income countries by (1) examining the role of individual-level social disadvantage, (2) exploring the ecological influence of context at the country and community level, and (3) assessing whether ecological effects vary according to a woman's wealth.

Methods: We used nationally representative data from 33,822 communities in 44 low- and middle-income countries.

Sanitation in Rural India: Exploring the Associations between Dwelling Space and Household Latrine Ownership.

In 2017, the Joint Monitoring Programme estimated that 520 million people in India were defecating in the open every day. This is despite efforts made by the government, Non-Governmental Organizations (NGOs), and multilaterals to improve latrine coverage throughout India. We hypothesize that this might be because current interventions focus mostly on individual-level determinants, such as attitudes and beliefs, instead of considering all possible social determinants of latrine ownership.

Socio-economic patterning of food consumption and dietary diversity among Indian children: evidence from NFHS-4.

Background/objectives: Most interventions to foster child growth and development in India focus on improving food quality and quantity. We aimed to assess the pattern in food consumption and dietary diversity by socioeconomic status (SES) among Indian children.

Subjects/methods: The most recent nationally representative, cross-sectional data from the National Family Health Survey (NFHS-4, 2015-16) was used for analysis of 73,852-74,038 children aged 6-23 months.

Shorter Height is Associated with Diabetes in Women but not in Men: Nationally Representative Evidence from Namibia.

Objective: This study aimed to test the hypothesis that attained adult height, as an indicator of childhood nutrition, is associated with diabetes in adulthood in Namibia, a country where stunting is highly prevalent.

Methods: Data from 1,898 women and 1,343 men aged 35 to 64 years included in the Namibia Demographic and Health Survey in 2013 were analyzed. Multiple logistic regression models were used to calculate odds ratios (ORs) and 95% CIs of having diabetes in relation to height.

Change in the distribution of body mass index in Brazil: analysing the interindividual inequality between 1974 and 2013.

Background: Brazil is among the 10 countries with the highest prevalence of overweight in the world. The aim was to analyse the changes in the dispersion of body mass index (BMI) in the Brazilian population from the 1970s to 2013 in specific population groups.

Methods: Data were extracted from five national household surveys between 1974-1975 and 2013, including adults aged 20 to 64.

Clustered risk: An ecological understanding of sexual activity among adolescent boys and girls in two urban slums in Monrovia, Liberia.

Many young people experience sexual debut before they are able to manage risk in order to avoid adverse consequences. Gender norms, social position, and power can undermine an adolescent's ability to exercise agency in their first sexual encounters and negotiate safer sexual behavior. This study examines the intersection of psychosocial and interpersonal factors with the social and physical environment to form an ecological understanding of how the determinants that shape sexual activity differ between boys and girls in two urban slums in Monrovia, Liberia.

Young Adults and Adverse Childhood Events: A Potent Measure of Cardiovascular Risk.

Introduction: While cardiovascular disease is the leading cause of death, its determinants include unhealthy behaviors and clinical risk factors and are recognized as the "actual causes" of death. Risk likely accumulates over the life course, and adverse childhood experiences may increase the risk of "actual causes" of death. The objectives of the study are to determine the prevalence and test the association of adverse childhood experiences among unhealthy behaviors and risk factors as a primordial risk factor among young adults.

Effects of improved drinking water quality on early childhood growth in rural Uttar Pradesh, India: A propensity-score analysis.

Context: Recent randomised controlled trials in Bangladesh and Kenya concluded that household water treatment, alone or in combination with upgraded sanitation and handwashing, did not reduce linear growth faltering or improve other child growth outcomes. Whether these results are applicable in areas with distinct constellations of water, sanitation and hygiene (WaSH) risks is unknown. Analysis of observational data offers an efficient means to assess the external validity of trial findings.

Characteristics Associated with Household Purchases of Sugar-Sweetened Beverages in US Restaurants.

Objective: This study aimed to describe beverages purchased in restaurants among a nationally representative sample of US households.

Methods: Data were obtained from the US Department of Agriculture National Household Food Acquisition and Purchase Survey, 2012 to 2013. Survey-weighted multiple regressions assessed correlates of purchasing a sugar-sweetened beverage (SSB), purchasing a low-calorie beverage, and per capita beverage calories and grams of sugar among purchases from US restaurants (n = 14,669).

Inequities in Access to Maternal Health Care in Enugu State: Implications for Universal Health Coverage to Meet Vision 2030 in Nigeria.

We explored the equity issues in access to maternal health services in Enugu State, Nigeria. We conducted a cross-sectional survey of 1,600 women who had babies within 6 months prior to the survey, drawn from four urban and rural local government areas in Enugu State of Nigeria, using structured questionnaire. Focus group discussions were held with grandmothers and fathers of the new babies.

Association of the Trauma of Hospitalization With 30-Day Readmission or Emergency Department Visit.

Importance: Trauma of hospitalization refers to the depersonalizing and stressful experience of a hospital admission and is hypothesized to increase the risk of readmission after discharge.

Objectives: To characterize the trauma of hospitalization by measuring patient-reported disturbances in sleep, mobility, nutrition, and mood among medical inpatients, and to examine the association between these disturbances and the risk of unplanned return to hospital after discharge.

Design, Setting, And Participants: This prospective cohort study enrolled participants between September 1, 2016, and September 1, 2017, at 2 academic hospitals in Toronto, Canada.

Alcohol Outlet Density and Area-Level Heavy Drinking Are Independent Risk Factors for Higher Alcohol-Related Complaints.

Alcohol outlet density has well-documented associations with social and health indicators such as crime and injury. However, significantly less is known about the relationships among alcohol-related complaints. Bayesian hierarchical Poisson regression with spatial autocorrelation was used to model the association between on- and off-premises alcohol outlet density and area-level prevalence of current drinkers and heavy drinking, and graffiti density-an indicator of physical disorder-in association with calls from civilians reporting illegal use, alcohol sales, and other alcohol-related activities (hereafter alcohol-related complaints).

Modeling a bivariate residential-workplace neighborhood effect when estimating the effect of proximity to fast-food establishments on body mass index.

Hierarchical modeling is the preferred approach of modeling neighborhood effects. When both residential and workplace neighborhoods are known, a bivariate (residential-workplace) neighborhood random effect that quantifies the extent that a neighborhood's residential and workplace effects are correlated may be modeled. However, standard statistical software for hierarchical models does not easily allow correlations between the random effects of distinct clustering variables to be incorporated.

Is there a female disadvantage in child undernutrition in South India?: Exploring gender differences in height in infancy, childhood, and adolescence in Andhra Pradesh and Telangana.

Objective: The aim of this study was to investigate whether gender-based disparities in health and well-being extend to a female disadvantage in height in infancy, childhood, and adolescence in Andhra Pradesh and Telangana.

Methods: Using longitudinal data from the Young Lives study in Andhra Pradesh and Telangana, India, linear mixed effects and linear regression models examined associations between gender and height and the modifying influences of birth order and older siblings' gender composition.

Results: In the younger cohort, at 6-18 months, girls were 0.

Community involvement, trust, and health-related outcomes among older adults in India: a population-based, multilevel, cross-sectional study.

Objectives: this study examined whether individual and contextual measures of structural and cognitive social capital were associated with six health-related outcomes across older adults in India.

Methods: data were collected from a representative sample of adults aged 60 and above across India in 2011-12 (n = 9,174). Personal community involvement and having someone to trust represented individual measures of structural and cognitive social capital.

Azathioprine and Mycophenolate Mofetil Adherence Patterns and Predictors Among Medicaid Beneficiaries With Systemic Lupus Erythematosus.

Objective: Azathioprine (AZA) and mycophenolate mofetil (MMF) are immunosuppressants frequently used in the treatment of moderate-to-severe systemic lupus erythematosus (SLE). We studied longitudinal patterns and predictors of adherence to AZA and MMF in a nationwide US SLE cohort.

Methods: In the Medicaid Analytic eXtract (2000-2010) database, we identified patients with SLE who initiated AZA or MMF (no use in the prior 6 months) with ≥12 months of continuous follow-up.

Spatio-Temporal Distribution of Negative Emotions in New York City After a Natural Disaster as Seen in Social Media.

Disasters have substantial consequences for population mental health. We used Twitter to (1) extract negative emotions indicating discomfort in New York City (NYC) before, during, and after Superstorm Sandy in 2012. We further aimed to (2) identify whether pre- or peri-disaster discomfort were associated with peri- or post-disaster discomfort, respectively, and to (3) assess geographic variation in discomfort across NYC census tracts over time.

Education modifies the relationship between height and cognitive function in a cross-sectional population-based study of older adults in Rural South Africa.

We aimed to estimate the relationship between height (a measure of early-life cumulative net nutrition) and later-life cognitive function among older rural South African adults, and whether education modified this relationship. Data were from baseline in-person interviews with 5059 adults ≥ 40 years in the population-based "Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa" (HAALSI) study in Agincourt sub-district, South Africa, in 2015. Linear regression was used to estimate the relationship between height quintile and latent cognitive function z-score (representing episodic memory, time orientation, and numeracy), with adjustment for life course covariates and a height-by-education interaction.