Journal of Community Health

Since the first case detection in Nepal in 1988, the number of cases of Human Immunodeficiency Virus (HIV) are increasing. Limited studies exist concerning the knowledge on HIV among the Nepalese men. This study aimed to examine the social determinants of poor knowledge on HIV among Nepalese men aged 15–49 years based on Nepal Demographic and Health Survey (NDHS), 2011. This study is based on the secondary data of NDHS 2011. HIV knowledge was assessed by using structured qustionnaire. A Chi square test followed by logistic regression was performed to find the association of social determinants with outcome variables. Of the 3,991 participants, 1,217 (30.5 %) had comprehensive knowledge and the majority (69.5 %) had poor knowledge on HIV. More than half (54.6 %) reported that mosquito bite can transmit HIV and 26.5 % reported that sharing food can transmit HIV. Respondents who were uneducated [aOR 10.782; 95 % CI (6.673–17.421)], were manual workers [aOR 1.442; 95 % CI (1.152–1.804)], were poor [aOR 1.847; 95 % CI (1.350–2.570)]; lived in the the Eastern region [aOR 2.203(1.738–2.793)], or in the Mountain [aOR 1.542; 95 % CI (1.132–1.864)]; did not read newspaper/magazine at all [aOR 1.454; 95 % CI (1.142–1.851)] and did not listen to the radio at all [aOR 1.354; 95 % CI (1.046–1.752)] were likely to have poor knowledge of HIV. HIV prevention programs should include men incorporating appropriate educatoinal intervention to increase their knowledge.

Mặc dù đã có luật kiểm soát thuốc lá được thiết lập ở quốc gia này, nhưng tình trạng hút thuốc lá ở giới trẻ và mức độ phụ thuộc nicotine trong sinh viên lại đang là vấn đề đáng lo ngại tại Bangladesh. Nghiên cứu này nhằm xác định tỷ lệ hút thuốc và các yếu tố ảnh hưởng đến nó trong số học sinh trung học. Phương pháp lấy mẫu cụm hai giai đoạn được sử dụng để chọn trường học với xác suất tỷ lệ thuận với quy mô đăng ký học, tiếp theo là phương pháp lấy mẫu ngẫu nhiên phân tầng giữa các trường công lập và tư thục. Câu hỏi điều tra gồm 70 mục, trong đó có ‘cốt lõi GYTS’ (Khảo sát thuốc lá ở giới trẻ toàn cầu) và các câu hỏi bổ sung khác được sử dụng để thu thập thông tin liên quan. Phân tích cho thấy tỷ lệ hút thuốc là 12.3% ở nam và 4.5% ở nữ. Tuổi trung bình bắt đầu hút thuốc là 10.8 tuổi với độ lệch chuẩn là 2.7 năm. Phân tích hồi quy logistic cho thấy nam có khả năng hút thuốc cao gấp 2.282 lần so với nữ, và tỷ lệ này cao hơn 1.786 lần ở những học sinh từ 16 tuổi trở lên so với các bạn trẻ hơn. Hành vi hút thuốc của giáo viên được coi là yếu tố tiên đoán mạnh mẽ cho hành vi hút thuốc của học sinh (OR 2.206, 95% CI: 1.576, 3.088), tiếp theo là ảnh hưởng từ bạn bè (OR 1.988, 95% CI: 1.178, 3.356). Cần phải thực hiện các chương trình phòng ngừa hút thuốc hiệu quả để giảm hành vi hút thuốc. Chương trình giảng dạy ở trường có ít tác động trong việc ngăn ngừa hút thuốc, ngoại trừ hành vi hút thuốc của giáo viên.

The full impacts of the COVID-19 pandemic are yet to be determined. While highly effective vaccines are available to prevent and decrease the severity of COVID-19 infection, significant COVID-19 vaccine hesitancy remains. Understanding motivations, discouraging factors, opinions, and information sources regarding COVID-19 is essential to targeting vaccine hesitancy and improving vaccine uptake. A 25 question survey was administered to the patients of a free clinic in the Midwest to assess patient demographic data, opinions about and experience with COVID-19, the COVID-19 vaccines, and information sources. The main outcome of interest was if vaccination status influenced information sources and opinions regarding COVID-19. This study also analyzed motivating and discouraging factors for vaccination. The study had a total of 104 participants with 7 being excluded. There were a total of 97 survey responses included in this study, there were 79 vaccinated patients and 18 unvaccinated patients. This survey study found differences in information sources between vaccinated and unvaccinated groups. Opinions surrounding the COVID-19 vaccine, public health agencies, and perceived severity of COVID-19 also varied between vaccinated and unvaccinated groups. The differential information sources and opinions between vaccinated and unvaccinated groups emphasizes the importance of access to high-quality sources and educating the community to improve public health.

Injurious falls among the elderly are an increasing public-health problem in Sweden. One group particularly vulnerable to falls consists of elderly people living in residential-care facilities. The purpose of this study was to investigate the extent to which falls lead to injury within a defined population of elderly people in institutionalized care. All the elderly persons living in residential-care facilities in an urban Swedish municipality during the year 1997 (n = 469 institutional places). Falls and fall-related injuries were registered over a one-year period. Data were gathered by personnel at the time of the falls, using a form specifically designed for surveillance purposes. Of the 865 falls reported during the study period, 375 were among men, with an average age of 82 years, and 490 among women, with an average age of 85 years. Men were subject to falling to a greater extent than women. The most common location was the individual's own bedroom. Injuries were incurred in approximately one in four falls, and the head was the body part most frequently injured. Only 24 falls (2.8%) resulted in a fracture, of which 18 were hip fractures. Although elderly people living in residential-care facilities fall fairly often, serious injuries, in the form of fractures, are incurred to a relatively limited extent.

Understanding changes in substance use in a small population state is challenging. Many national datasets restrict data to reduce the probability of identifying persons. Alaska is a small population state (731,000 residents) with a large geographic region (25% the size of the lower 48), a diverse population, and highly variable seasons, with fewer than 10% of the state being road accessible. Given the uniqueness of Alaska, this project sought to understand what could be learned about addiction and its relationships with unemployment and median income in Alaska. National Survey on Drug Use and Health, State and Small Area Estimates (1999–2020) data were analyzed to measure prevalence changes. Outcome prevalence were independently correlated with median income and annual unemployment rate as the annual collection periods varied. Analyses were limited to simple bivariate analyses due to the data restrictions. Median income was found to have stronger correlational relationships and significant relationships with more negative outcomes compared to unemployment. While annual unemployment rates had statistically significant relationships with substance use outcomes, negative mental health outcomes appeared more related to unemployment than median income. Alcohol use in the past month, cigarette and tobacco use, and pain reliever misuse declined while binge drinking in the past month and illicit drug use increased. More people reported depression, serious mental illness, and suicidal ideation and planning over time peaking in the last year of data collection. While NSDUH data provide some idea of the changes in drug use over time, their effectiveness in Alaska is unknown. Many data sources claim they are nationally representative, but these statements cannot be objectively measured. We will use these outcomes and data as a baseline for future studies where we will explore state specific data sources.

The purpose of this paper is to explore the health status of Canadian Aboriginals, along with their perceived community health problems and proposed solutions to these issues. Data are drawn from the 1991 Aboriginal Peoples Survey (APS), which is a weighted random sample of the Aboriginal population. Comparisons were made with respect to group identity (North American Indian, Métis and Inuit) and geographic location (reserve, urban, rural and North) and across a series of health status and health care use indicators. Analysis reveals that geographic location, as compared with Aboriginal identity, appears to have a large impact with respect to health status and use of physician services. On-reserve Aboriginals, for example, reported a lower likelihood of having seen a physician and were more likely to rank their health as fair or poor. Location also influenced perceived community health problems and solutions. Self-identified problems included drugs, cancer and arthritis, while corresponding solutions included education, counseling and service access. Although the problems and solutions were relatively consistent across space, they too varied in their importance. In general, the results tend to reinforce the determinants of health framework, suggesting that the provision of health services is insufficient to remove health disparities on its own. Instead, broader social-welfare provisions must be considered.

Socio-economic inequality in the physical activity environment surrounding primary schools may contribute to socio-economic gradients in physical activity and childhood obesity levels. Using a cross-sectional study design, ordinary least squares and logistic regressions were fitted to assess variation in walkability and greenspace within 1 km of primary schools (n = 7133) according to area-level socio-economic position (SEP) and remoteness. Effect modification by school location (major cities or regional/remote) was assessed through stratified analyses. Walkability scores significantly increased from low to high school neighbourhood SEP (p < 0.01) and from remote/very remote to major city locations (p < 0.01). Greenspace area (hectares) in the school neighbourhood was greater in highest compared to lowest SEP areas (β = 18.75, 95%CI 6.63, 30.87) and less in major cities compared to remote/very remote locations (β = − 23.9, 95%CI − 39.7, − 8.1). Schools in highest SEP areas and major cities had higher odds of having any greenspace in their neighbourhood, compared to those in lowest SEP and remote/very remote locations (OR 5.93, (95% CI 4.50, 7.05), OR 20.19, (95% CI 16.05, 25.39) respectively). Stratified results (major cities or regional/remote locations) found the highest SEP school neighbourhoods had higher walkability scores and more greenspace compared to lowest SEP school neighbourhoods in both strata, although overall SEP gradient in walkability and greenspace area only remained in major cities. Walkability and greenspace infrastructure in the school neighbourhood could be improved in areas of lower SEP so that all school children have the opportunity for physical activity.

A telephone survey of 120 randomly selected primary care physicians in New York City was completed in October, 1984 (response rate =90%) concerning physicians' recommendations for health promotion and disease prevention. Responses from physicians with 50% or more Black and Hispanic patients were compared with responses from physicians with 50% or more White patients. The former were found to be less likely to follow guidelines from nationally recognized organizations for health promotion and disease prevention, although they were just as likely to value the importance of prevention in primary care. For example, physicians with predominantly Black and Hispanic patient populations were significantly less likely to recommend screening mammography (7% versus 23%) or recommend influenza vaccination for patients 65 or older (48% versus 74%) when compared with physicians with predominantly White patient populations. Factors that appeared to contribute to the difference in prevention practice patterns include physician training and education, the socioeconomic status of the patients, and the time physicians spend with patients. Differences in quality of preventive care provided to minority patients may be an additional factor in the disparity between the health status of White and non-White Americans.