International Journal of Public Health

Hypertension is a major public health problem with prevalence ranging 22–30% in urban India. There are few data on hypertension epidemiology in rural India. We conducted a survey to estimate prevalence, awareness, treatment, control and risk factors for hypertension in a rural population in south India. We did cross-sectional survey in 11 villages in Tamil Nadu. We collected data on behavioral risk factors, anthropometric and blood pressure measurements. We defined hypertension according to WHO criteria. Study population included 10,463 subjects aged 25–64 years. Among them, 4,900 (46.8%) were males. Hypertension was present for 2,247 (21.4%) subjects and 1,682 (74.9%) among hypertensives were newly detected. Overall 20% were on treatment and 6.6% had blood pressure control. Age ≥35 years, BMI ≥ 23 kg/m2 and central obesity were risk factors significantly associated with hypertension (p < 0.05). In addition, alcohol consumption, higher education level were risk factor among males and family history of hypertension was risk factor among females (p < 0.05). Hypertension is an emerging challenge in rural India. We need health promotion programs and reorientation of primary health care to improve hypertension detection and management.

This study aimed to investigate the relationship between housing, demographic, socio-economic, social factors and health, in poor urban communities in Johannesburg, South Africa. Data were drawn from a survey of 1,427 households in Johannesburg. The outcome health variable was a composite measure of chronic ill-health. Housing variables included type of housing, tenure and access to services. Multivariate regression analysis assessed the relationship between housing and health, after adjustment for demographic, socio-economic and social factors. The prevalence of chronic health problems was 25.1% (95% CI 22.8–27.6%). Factors independently associated with the risk of chronic ill-health among household heads included older age (OR, 3.06 [2.37–3.95]), female gender (OR, 2.83 [2.01–3.97]), long-term residence (OR, 2.01 [1.10–3.67]), unemployment (OR, 0.49 [0.36–0.67]), and living in formal housing (OR, 0.66 [0.45–0.98]). The health of the household heads residing in informal housing was significantly better than in formal housing. Explanations for this counter-intuitive finding include the fact that the informal housing dwellers were younger and recent migrants (the ‘healthy migrant’ phenomenon). Policy implications of the results are identified.

This study aims to identify subgroups of consumers based on the health motives underlying their food choice in Western Balkan Countries. The survey (n = 2943) was based on the Food Choice Questionnaire (FCQ) and elicited information on socio-demographic characteristics, consumption frequency of healthy food products, nutrition knowledge and impulsiveness. Analysis of the FCQ data focused on items of “health and natural content” and “weight control” factors to identify clusters. The biggest group of the sample was weight control and health-concerned individuals (34 %), mainly urban women older than 50. The second group of respondents (31 %) was moderately motivated about health and weight. A third group was health concerned but paid less attention to weight control (21 %), mainly comprising men and people living with children. The last group consisted of unconcerned young men (14 %) eating less fruit and showing higher impulsiveness. Western Balkan consumers differ in the importance they attach to health and natural content and weight control. This insight is needed to target interventions.

This paper reflects on experiences of Australian public health researchers and members of research policy advisory groups (PAGs) in working with PAGs. It considers their benefits and challenges for building researcher and policy actor collaboration and ensuring policy relevance of research. Four research projects conducted between 2015 and 2020 were selected for analysis. 68 PAG members from Australian federal, state and local governments, NGOs and academics participated in providing feedback. Thematic analysis of participant feedback and researchers’ critical reflections on the effectiveness and capacity of PAGs to support research translation was undertaken. PAGs benefit the research process and can facilitate knowledge translation. PAG membership changes, differing researcher and policy actor agendas, and researchers’ need to balance policy relevance and research independence are challenges when working with PAGs. Strategies to improve the function of health policy research PAGs are identified. The paper suggests a broader adapted approach for gaining the benefits and addressing the challenges of working with PAGs. It opens theoretical and practical discussion of PAGs’ role and how they can increase research translation into policy.

To document the association between economic development, income inequality, and health-related public infrastructure, and health outcomes among Chinese adults in midlife and older age. We use a series of multi-level regression models with individual-level baseline data from the China Health and Retirement Longitudinal Survey (CHARLS). Provincial-level data are obtained both from official statistics and from CHARLS itself. Multi-level models are estimated with different subjective and objective health outcomes. Economic growth is associated with better self-rated health, but also with obesity. Better health infrastructure tends to be negatively associated with health outcomes, indicating the likely presence of reverse causality. No supportive evidence is found for the hypothesis that income inequality leads to worse health outcomes. Our study shows that on top of individual characteristics, provincial variations in economic development, income inequality, and health infrastructure are associated with a range of health outcomes for Chinese midlife and older adults. Economic development in China might also bring adverse health outcomes for this age group; as such specific policy responses need to be developed.

Self-rated health can be influenced by several characteristics of the social environment. The aim of this study was to evaluate the relationship between self-rated health and self-assessed social class in Slovenian adult population. The study was based on the Countrywide Integrated Non-communicable Diseases Intervention Health Monitor database. During 2004, 8,741/15,297 (57.1%) participants aged 25–64 years returned posted self-administered questionnaire. Logistic regression was used to determine unadjusted and adjusted estimates of association between poor self-rated health and self-assessed social class. Poor self-rated health was reported by 9.6% of participants with a decrease from lower to upper-middle/upper self-assessed social class (35.9 vs. 3.7%). Logistic regression showed significant association between self-rated health and all self-assessed social classes. In an adjusted model, poor self-rated health remained associated with self-assessed social class (odds ratio for lower vs. upper-middle/upper self-assessed social class 4.23, 95% confidence interval 2.46–7.25; P < 0.001). Our study confirmed differences in the prevalence of poor self-rated health across self-assessed social classes. Participants from lower self-assessed social class reported poor self-rated health most often and should comprise the focus of multisectoral interventions.

To investigate the association between personal, relational and school factors with involvement in fights with weapon among Brazilian school-age youth. Using data from the Adolescent School-Based Health Survey 2015 (n = 102.072), we conducted multilevel logistic regression models. IFW was associated with female sex (OR = 0.45), and with older age (OR = 1.15), previous involvement in physical violence (OR = 2.05), history of peer verbal (OR = 1.14) and domestic victimization (OR = 2.11), alcohol use (OR = 2.42) and drug use (OR = 3.23). The relational variables (e.g., parent’s supervision) were mostly negatively associated with IFW. At the school level, attending public school and attending schools in violent surroundings were both positively associated with IFW. The intraclass correlation coefficient estimated in the empty model showed that 5.77% of the variance of IFW was at school level. When all individual- and school-level variables were included in the model, the proportional changes in variance were 61.7 and 71.55%, respectively. IFW is associated with personal, relational and school factors. Part of the variance in IFW by school is explained by characteristics of the school context.

The aim of this study was to assess the prevalence of fruits and vegetable consumption and associated factors among university students from 26 low, middle and high income countries. Using anonymous questionnaires, data were collected in a cross-sectional survey from 17,789 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Overall, 82.8 % of the university students consumed less than the recommended five servings of fruits and/or vegetables. The mean fruit and vegetable consumption varied by country, ranging from ≤2.5 mean daily servings in Jamaica, Philippines and Barbados to ≥3.9 mean daily servings in Mauritius, Tunisia and Ivory Coast. In multivariate logistic regression analysis, sociodemographic factors, psychosocial factors, and behavioural factors (inadequate dietary behaviours, binge drinking and physical inactivity) were associated with low prevalence of fruit and vegetable intake. Findings stress the need for intervention programmes aiming at increased consumption of fruit and vegetables considering the identified sociodemographic, psychosocial and behavioural risk factors.