Pathways to health: direct and indirect effects of early life conditions on later health

Background: Health knowledge is developed through the experiences gathered by an individual, which makes him or her able to understand health problems. In Indian context, the study assess health knowledge of women of age group 15 to 49 years and its association with the prevalence of short-term morbidities, medical care and medical expenditure among children in age group 0-59 months.
Methods:The health knowledge and practice index and other several variables are constructed based on the information available from nationwide data (IHDS, 2005). Principal Component Analysis (PCA) is used to construct health knowledge index. Binary logistic regression and multinomial logistic regression analysis and MCA are used Results: Though, there is positive impact of education on health, still, immaculate health knowledge is required for mother to understand her child’s health problems. Enhanced health knowledge among mothers’ causes reduction in the prevalence of short-term morbidities among their children. Besides medical care, spending on medical care is also dependent on the fact that, to what extent women rationally take decision on taking care of their children’s health. . Willingness to pay for medical care is guided by their health knowledge. Health knowledge is established as a key determinant of prevalence of child morbidities.

The conventional trickle-down model of community effects on body weight status is theoretically flawed. A better understanding of the association between community contextual effects and youth’s body weight status is needed to improve the existing theory and inform public health policy. We propose to integrate an ecological approach with a life course perspective and introduce human agency and its dynamic interactions with contextual factors into our model. Drawing upon longitudinal and multilevel data, we study body weight changes captured by both general and central obesity measures in Chinese youth. We employ a difference-in-difference model to adjust for “pretreatment heterogeneity bias”. We examine three dimensions of individual agency and their interactions with urbanization and fast-food restaurant, two important community factors in China, and thereby account for “treatment effect heterogeneity bias”. Our preliminary results highlight some complex patterns of body weight changes as Chinese youth transitioned from early childhood to late adolescence.

In this paper, we investigate associations between socioeconomic conditions in childhood and adulthood and obesity/overweight status in adulthood utilizing the Korean National Health and Nutrition Examination Survey (KNHANES) conducted in 2007–2009. Identifying factors that affect obesity/overweight status is increasingly important in Korea given the sharp rise in the prevalence of obesity/overweight during the past decades. Specifically, we assess (i) whether the inverse relationship between adult SES and obesity/overweight, which is commonly found in the United States and some European countries, is also observed in Korea; (ii) whether childhood SES is associated with obesity/overweight independent of adult SES; and (iii) whether these relationships vary by gender. The preliminary results show that there is a strong relationship between childhood SES and adult obesity among South Koreans, and adult SES attenuated this relationship in women only. We also find that men with lower childhood SES are likely to have lower risk of obesity while low childhood and low adult SES predict higher risk of obesity/overweight for women.

The body of research on the ‘health-wealth gradient’ during childhood in developed country setting is extensive. However, the epidemiologic and nutritional transition profile that characterize developing countries suggest that health-wealth gradient in these setting can vary from current findings.

The aim of this paper is to determine whether there is a health-wealth gradient for children’s nutritional status in rural Malawi, and whether the gradient changes as children get older. This analysis uses anthropometric data collected from children aged 0-5 in 2008 and 2006 and 2008 panel household data. The panel data allows for use of contemporaneous household wealth and change in household wealth measures. The investigation reveals that children in wealthier household have decreased risk of stunting but this is not significant until the oldest age groups (48-59 months old). At the oldest ages, effect of household wealth on stunting risk is robust to parent’s education, an alternative measure of household resources. There is no apparent health wealth gradient across the ages studied here but there is evidence of an emerging wealth gradient as children age.

Malaria is a major risk to lives and development in Nigeria and other pan endemic regions. Pregnant women and children are at greater risk of this vector borne disease. Several efforts had been put in place towards prevention and treatment but negligible success hard been recorded.
Studies on malaria related maternal mortality in Nigeria have focused largely on preventive behaviours and healthcare providers’ knowledge of treatment regimen. Negligible attention has been paid to adherence of the care seekers to treatment in relevant contexts. Employing both qualitative and quantitative data collection techniques, the study established that adherence to malaria treatment among pregnant women in the area was influenced by social, residential and demographic factors in both rural and urban areas of the state. Expectant mothers without formal education reported high adherence to medication (r=-631 p< .034) than those of higher educational status, indicating that the level of education does not necessarily influence adherence to medication.

A substantial body of literature has focused on early familial life as a source of longevity differential in very old age. The channels through which early life environment is hypothesized to influence mortality in later life are diverse and could be direct or indirect. In this paper we discuss early-life factors which could affect an individual’s chance to reach the advanced ages, with a particular focus on siblings of centenarians. Using an event-history database that links age at death of individuals to their childhood characteristics gathered from the 1901 and 1911 Canadian census records and to their adult characteristics, we address two questions: Are early-life conditions associated with longevity among the oldest old; and Do adult SES and mariage mediate the effect of early-life environment on later life survival? Non-parametric analysis are performed to estimate the effect of each early-life and adult variables using the Kaplan-Meier estimator as well as gender-specific proportional hazard models with a Gompertz specification of the risk of mortality. The results of this study will shed light on the extent to which the effect of early life conditions on mortality later in life is mediated by the attained socioeconomic position in adulthood or marital status.

Millennium Development Goals has also targeted to reduce the Infant Mortality Rate by 30 per 1000 live births and improve the child health. In India, Infant Mortality has declined substantially during the last decade but at the same time, a large number of children suffer from various early childhood morbidities. Child health is a major public-health challenge and social-welfare problem. Using the data from 60th round of NSS, this paper tries to examine the prevalence of childhood morbidity among children in the age group 0-4 years and their sought treatment. The household economic burden in the treatment of these diseases was assessed by calculating various direct and indirect costs.
The results indicate that the incidence of hospitalization was higher among male child, compared to female child. Diarrhea/Dysentery and Respiratory including ear/nose/throat was the most common problem for which children took treatment both as inpatient and outpatient and about three fourth children had sought treatment from private hospitals.

The incidence of cancer is rising in African countries It has been noted that about 650,000 people in Africa develop cancer annually. Because treatment remains largely unavailable or inaccessible, about 510,000 cancer deaths occur annually, an 80 percent mortality ratio. More than one-third of the cancer deaths in Africa are due to cancers that are easily preventable and/or treatable if detected early. Cancer kills more people in Uganda compared to Tuberculosis, Malaria and HIV/AIDS combined, health experts have said.
The study combined several research methods that included secondary data from various reports, news articles, journals and documents dotted around in different agencies, which have tried to address the cancer challenge, environment impacts of cancer and development issues of the country. Observation was also utilized to analyze the relationship between magnitude of cancer and people’s laxity to receive diagnosis for their health problems with a focus on the different health issues and how they affect people’s health
To this day Uganda has the highest infection rates in the world with 60% of cancer infections. Survival rates of preventable and treatable cancer infections stand at 10%. Experts blame this on patients who go for diagnosis at later stages of illness when treatment is often least effective.

Birth-preparedness and complication readiness (BP/CR) is a comprehensive strategy aimed at promoting the timely utilization of skilled maternal and neonatal health care. The key elements include: knowledge of danger signs; plan for where to give birth, plan for a birth attendant, for transportation, for saving money, for potential blood donor and plan for a decision maker as well. This paper analyzes the individual, familial and contextual factors affecting the BP/CR in most populous state of India. Birth preparedness Index (BPI) and Social Composite Index (SCI) was computed to trace the study objective. Data and enough evidences from surveys reveal that government health facility was not the preferred choice for obstetric emergency by majority of mothers. Every eight families out of 10 saved money for delivery. Preparedness for transport was found low due to easy availability of local transport but again lack of maintained roads is a matter of concern for delays in study area. Only few families identified potential blood donor for emergency. BP Index increased from 33% to 54 percent. Increases in six of the seven components of the BPI were significantly associated. Women who have higher social Index (higher agency) have a better birth plan as compare to those women who have low social Index.

The present paper aims to explore the affect of poor reproductive health on type and age at menopause and post menopausal health status. A community-based retrospective study was conducted in India on 2,600 households. A sample of 247 women with menopause/hysterectomy (<50 years) was identified and interviewed.

Results indicate that the foundation for any health disability during middle age is often laid during the reproductive years. Abortion, age at first pregnancy, complications during last pregnancy, cesarean delivery, and heavy blood loss during menses were the reasons for hysterectomy. Women with higher education, high SLI, and late age at first pregnancy were found to be less vulnerable to early menopause. Religion, educational level, SLI, BMI, hysterectomy, high parity, abortion, complications during child birth, sterilization as contraception, and experience of irregularities during menopausal transition had the adverse effect on the health status of women after menopause and affected age at natural menopause.

With the increase in life expectancy, there is a need to look beyond the perspective in terms of providing care, as poor menstrual and maternal health not only affect a woman during reproductive ages, but also vibrates beyond reproduction. Segmentation of life can never lead to healthy life.