Multiple faces of the health transition

“Preventable” hospitalizations have been proposed as indicators of health plan performance. Preventable hospitalizations present a broader view and refer to those admissions 'resulting from diseases preventable through population-based health promotion strategies, eg. alcohol-related conditions' and those 'avoidable through injury prevention (eg. road traffic accidents). Ambulatory Care-Sensitive Conditions Hospitalizations (ACSCs) analyses may also be used to identify or evaluate interventions that are likely to be effective in fulfilling health needs. The objective of this study is to know the composition and the tendency among the elderly and the ACSC and to correlate this to the coverage and access to primary care services in Rio de Janeiro, Brazil, between 2000 and 2010. We observed the tendency of reduced ACSC mainly of the chronic lung diseases during this period. We found a high correlation between the interventions in elderly primary care and the decrease of ACSC, what indicates effectiveness of the health program. The elderly men have more risk to ACSC than women. The results show that the study of ACSC is relevant for monitoring the performance of the health system with regard to improving the quality of life for elderly people.

The study uses data from Kenya Demographic and Health Survey 2008-9 to examine regional differences in under-five mortality. The data is analysed using logistic regression and the findings suggest that there are significant regional differences in under-five mortality. The differences however become less significant when the model controls for demographic variables and there is no significant difference when socio-economic and environmental variables are introduced in the model. This suggests that other than the demographic, socio-economic and environmental factors there are other factors probably population distribution, distribution of basic infrastructure and health care services and ecological or climatic that may have confounding the effects. The findings support the notion that interventions aimed at reducing under-five mortality should be tailored to take into account regional variations. There is need for further research to establish the potential determinants behind the observed differentials in under-five mortality

The health is an essential element for human to work. Improving health care contribute on quality of human capital in the future (Anand and Sen, 2000: 2038). Human capital is the value of learning and experience of someone at work who can improve productivity and income (Perkin, 2001: 206). Hence, the role of health is very important to improve the individual's income.
One of important aspect of health development is the maternal health. Indonesia has a relatively high maternal mortality ratio. Improve maternal health is 5th goal of the Millennium Development Goals (MDGs). One of its indicator is reduced by three quarters the maternal mortality ratio (MMR), between 1990 and 2015.
On the other hand, maternal health became an important factor in preparing for childbirth. Good Maternal health will also influence the birth of healthy babies. A healthy baby will determine the quality of human resources in the future (Wilhelmson and Gerdtham, 2006). Qualified human sources will also determine the quality of labor in promoting economic growth. This means that maternal health contributes to the quality of human capital, while the quality of human capital will determine the success of economic growth or growth of Gross Domestic Product .

The study examines how health outcomes at older ages are associated with socioeconomic status (SES) in rural and urban Vietnam and how such patterns of health inequality have changed over the last 10 years (2001-2011). Vietnam has witnessed rapid economic development, a significant increase in income inequality, and major health-sector reforms. These factors may have implications for older adults’ health. Research related to the wellbeing of older adults is becoming more important as Vietnam begins a period of rapid population aging. The share of Vietnam’s population age 60 and older is estimated to grow from 8% in 2010 to 31% in 2050 and by then, the number of Vietnamese older adults will increase by 335%. Analyzing nationally representative data from the 2011 Vietnam National Aging Survey (the country’s first national survey of older persons) in conjunction with the 2001 Vietnam National Health Survey (the country’s most comprehensive health survey), this study addresses three specific research questions including: Are there socioeconomic gradients of self-rated health among older persons in rural and urban Vietnam in 2001 and 2011? Did inequality pattern that existed in 2001 remain consistent or altered across the two time periods? Were consistencies or alterations uniform across rural and urban locations?

The purpose of our study is to explain the socio-epidemiological relationship of poverty and suicide. We used two waves of data from the Seoul Welfare Panel Survey from 2009 to 2010. And A multinomial logistic regression analysis was performed targeting a total of 5,749 subjects of over 15 years old. The results of the study can be summarized as follows. First, the suicidal ideation and poverty status of individuals can change rapidly in a short period of time, such as in one year, but when looking at a whole group, the size of the poverty group and the rate of suicidal ideation generally remained constant. Second, we found that poverty was a significant factor of suicidal ideation from cross-sectional analysis of first wave. Third, the prevalence of suicidal ideation in the poverty group at the time of first wave was reduced at a rate 2.26 times more than that of the highest level of household income group at the time of second wave. Fourth, the suicidal ideation of individuals who belonged to the poverty group at the first wave but had escaped from poverty at the second wave ceased having suicidal ideation at a rate 2.05 times higher than members of the non‐poverty group. We found that suicidal ideation is concentrated in the poverty group and the transition of suicidal ideation is sensitive in this group.

Thomas McKeown (1912—88) was best known for his interpretation of demographic trends. He concluded that improved nutrition played an important role in population growth. Following the publication of McKeown’s work on population his theories were widely criticised. This year (2013) the 25th anniversary of his death and it is appropriate to examine some of the developments in nutrition and public health that have occurred since his death that provide support for his theory.
The science of nutrition has made great advances since the McKeown began his work and we are now aware of the value of adequate nutrition in reducing rates of nutrition and infection. In the Asia Pacific region improvement in population nutritional status as shown by height, is paralleled by declines in child mortality and increases in life expectancy. This is illustrated by data from China, Korea, Japan and Australia where the decline in infant mortality and total mortality in Australia parallels the increase in height of the population. But population health is also influenced by a rise in chronic disease, which is due in part to poor nutrition in the first 1000 days of life interacting with changes in nutrition and lifestyle later in life.

Diabetes is public a health problem in Mexico. A demographic and epidemiological profile of diabetes in adults as the basis evaluate the economic expenses of diabetes and their financial implications, as well as exploring projections of expenses of medical attention to this disease in Mexican adult population.Using National Health and Nutrition surveys, expenditure was estimated on hospital discharges and budgeting in health institutions. We estimated expenses in one medical office consultation were: 503.34 pesos in IMSS (approximately 39 USD), 372 pesos en ISSSTE (approximately 29 USD), 91 pesos in SSA (approximately 7 USD).

Purpose: The migration of working-age adults from rural China altered traditional patterns of intergenerational support among elderly persons who remain in rural regions. This survey examines how intergenerational support influences on the trend of ADL of the rural elderly.
Methods: Data derived from a 3-wave longitudinal survey conducted from 2001 to 2006. The baseline survey, and two follow-up surveys were carried out with 1,634, 1,368, and 1,067 elderly in rural Anhui Province. This study employs Individual Growth Model to estimate the effect of intergenerational support on the trend of their ADL.
Results: The results show that receiving financial or instrumental support from adult children accelerates the descending rate of older parents' ADL, and providing intergenerational financial or instrumental support to adult children, and stronger emotional cohesion with children decelerate the descending rate of their ADL. Life Satisfaction and depression affect on their ADL. The study reveals the mechanisms of the effect linking intergenerational support to their health status with direct and indirect paths.
Conclusions: The results revealed intergenerational support based on demand of the elderly, under the condition of permission, the altruism behavior of the elderly could improve their physical health.

This paper examines and demonstrates importance of the adult modal age at death (M) in longevity research. Unlike the life expectancy at birth (e0) and median age at death, M is determined solely by old-age mortality as far as mortality follows a bathtub curve. It represents the location of “old-age death heap” in the age distribution of deaths, and captures mortality shifts more accurately than conditional life expectancies such as e65. Although M may not be directly determined from erratic mortality data, a recently developed method for deriving M from the P-spline-smoothed mortality curve based on penalized Poisson likelihood is highly effective in estimating M. Patterns of trends and differentials in M can be noticeably different from those in other lifespan measures, as indicated in some examples. In addition, major mathematical models of adult mortality such as the Gompertz, logistic and Weibull models can be reformulated using M, which plays critical roles as the mortality level parameter in those models.

Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. The prevalence of chronic diseases and risk factors appears to have been increasing in both Europe and other developed countries indicating an expansion of morbidity as indicated by disease. It is likely that better treatment, preventive measures (such as cancer screening and treatment of cardiovascular risk factors) and increases in education levels have contributed to the declines in mortality and increases in life expectancy. It should be noted that, the increases in presence of disease appear to be less associated with disability. This paper examines whether there has been an expansion or compression of morbidity in Spain. It uses trends in mortality and morbidity from major causes of death and links of these with mortality to provide estimates of life expectancy with and without diseases and loss of functioning. The analysis uses a repeated cross-sectional Spanish health survey in 2001 and 2009 for measues of morbidity, the Spanish National Health Survey, mortality information comes from the National Statistics Institute database. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population.