Obesity inequality and the changing shape of the bodyweight distribution in China

Using data from the China Health and Nutrition Survey (CHNS), this study analyses changes in bodyweight (BMI and waist circumference) distributions between 1991 and 2011 among adults aged 20+ in China. To do so, we quantify the source and extent of temporal changes in bodyweight and then decompose the increase in obesity prevalence into two components: a rightward shift of the bodyweight distribution (mean growth) and a (re)distributional skewing. Our analysis reveals a clear rightward distributional shift combined with a leftward skewing. Although the relatively large size of this skewing in the first decade analysed reflects an increase in obesity inequality, this inequality growth subsides in the second decade. Nevertheless, over the entire 20-year period, obesity inequality increases significantly, especially among females, younger age groups, rural residents and individuals with low socioeconomic status

Court Judgment Decision Support System Based on Medical Text Mining

Medical damage is a common problem faced by hospitals around the world and is widely watched by countries and the World Health Organization. As the number of medical damage dispute lawsuit cases rapidly grows, many countries in the world face the problem how to improve the efficiency of the judicial system under the premise of guaranteeing the quality of the trial. Therefore, in addition to reforming the system, the decision support system will effectively improve judicial decisions. This paper takes medical damage judgment documents in China as example, and proposes a court judgment decision support system (CJ-DSS) based on medical text mining and the automatic classification technology. The system can predict the trail results of the new lawsuit documents according to the previous cases verdict - rejected and non-rejected. Combined with the cases, the study in this paper found that combined feature extraction method does improve the performance of three kinds of classifiers - Support Value Machine (SVM), Artificial Neural Network (ANN) and K-Nearest Neighbor (KNN), the degree of improved performance is different from using DF-CHI combined feature extraction method. In addition, integrated learning algorithm also improves the classification performance of the overall system

Socioeconomic Position and the Health Gradient in Cuba: Dimensions and Mechanisms

Background: To throw light on the under-researched association between socioeconomic position (SEP) and health in Cuba, this study examined SEP gradients in health and their underlying mechanisms among urban Cuban adults aged 18-65. Methods: By applying linear regressions to data from the 2010 National Survey on Risk Factors and Chronic Diseases, the analysis explored the SEP-health gradient along three SEP dimensions-education, occupation, and skin colour-using ten health measures: Self-reported health (SRH), general and abdominal obesity, hypertension, high glucose, high cholesterol, high triglycerides, low high-density lipoprotein cholesterol, metabolic syndrome, and cumulative risk factors. Regressions also included behaviours and health-related risk perceptions (tobacco and alcohol consumption, diet, physical activity, and risk-related behaviours). It thus investigated the SEP-health gradient and its underlying mechanisms via both behaviours and health-related risk perceptions. Results: Once controlling for gender, age, marital status, region and provincial dummies, the analysis detected educational gradients in SRH (estimated coefficient [95% CI]: Middle-level education = 3.535 [1.329, 5.741], p \u3c 0.01; high-level education = 5.249 [3.050, 7.448], p \u3c 0.01) that are partially explainable by both health-affecting behaviours (tobacco and alcohol consumption, diet, physical and sedentary activity) and risk perceptions. Using objective measures of health, however, it found no SEP-health gradients other than hypertension among people identified as having Black skin color (adjusted for demographic variables, 0.060 [0.018, 0.101], p \u3c 0.01) and high cholesterol among those identified as having Mulatto or Mestizo skin color (adjusted for demographic variables,-0.066 [-0.098,-0.033], p \u3c 0.01). Conclusions: In terms of objective health measures, the study provides minimal evidence for an SEP-health gradient in Cuba, results primarily attributable to the country\u27s universal healthcare system-which offers full coverage and access and affordable medications- A nd its highly developed education system

Income-related health inequality among Chinese adults during the COVID-19 pandemic: evidence based on an online survey

Background: Partial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic. Methods: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities. Results: Most participants reported their health status as “very good” (39.0%) or “excellent” (42.3%). CCI of SRH and mental health were − 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%), p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health).Conclusions: Per capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups

Housing Poverty and Healthy Aging in China: Evidence from the China Health and Retirement Longitudinal Study

Background: Although prior research on the housing–health linkage suggested that those with poor housing conditions are more likely to report poor health, it is dominated by Western studies and offers little evidence on the housing–health relation in China. Scarce is empirical evidence on the potentially detrimental impact of either qualitative or quantitative housing poverty on health outcomes, especially for seniors in China. This paper aims to fill this void by using data from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS) to provide a comprehensive analysis of the demographic, socioeconomic, and behavioral factors that contribute to changes in healthy aging among Chinese adults aged 60 and over. Methods: Data collected from 8839 adults aged 60 and over in the 2011 and 2015 CHARLS (3732 in 2011 and 5107 in 2015) were used. We first used six blood-based biomarkers to construct a composite measure of the Chinese Healthy Aging Index (CHAI, ranging from 0 (healthiest) to 12 (unhealthiest)) and then assessed the psychometric properties of the CHAI score, including acceptability, internal consistency, convergent validity, discriminative validity and precision. In addition, we employed both mean-based Blinder–Oaxaca and unconditional quantile regression decomposition to decompose the change in healthy aging within the 2011–2015 period. Results: We overall identified a decrease in CHAI score from 5.69 in 2011 to 5.20 in 2015, which implies an improvement in healthy aging during this period. Our linear decomposition revealed that dependent on the type of measure used (whether quality, quantity, or combined quality–quantity), housing poverty explained 4–8% of the differences in CHAI score. Our distributional decompositions also highlighted an important role for housing poverty in the change in healthy aging, accounting for approximately 7–23% of the explained portion. Within this latter, the relative contribution of housing quantity and quality poverty was more pronounced at the median and upper end of the CHAI distribution. We also found household expenditure to be significantly associated with healthy aging among older Chinese adults and made the largest contribution to the improvement in healthy aging over time. Conclusions: The association between housing poverty and CHAI is independent of household expenditure. Regardless of type, housing poverty is positively associated with a decrease in healthy aging. Thus, improved housing conditions boost healthy aging, and housing amelioration initiatives may offer the most effective solution for augmenting healthy aging in China. Improvement of flush toilets and the access to potable water and a separate kitchen require particular attention. Since high-density congested housing has a negative impact on healthy aging, more attention can also be paid to improvements in the available space for older people. Especially at an institutional level, the government may extend the housing policy from a homeownership scheme to a housing upgrading scheme by improving housing conditions

Income-related health inequality in urban China (1991-2015): The role of homeownership and housing conditions

Unprecedented economic growth has been experienced over the several decades worldwide, but such rapid economic growth wasn’t accompanied by equally-substantial improvement in health, especially health inequalities between the rich and poor. This study examines the role of housing in income-related health inequalities (income-health gradient) in urban China. We here analyze 1991-2015 China Health and Nutrition Survey data to ask how housing affects income-related health inequalities in urban China. We find pro-poor inequalities in self-reported bad health but pro-rich inequalities in objective bad health (general overweight/obesity, central obesity and high blood pressure). Housing conditions serve to reduce the health gradient, especially for objective health. On the contrary, homeownership exacerbates the health gradient. Improving housing conditions thus appears to be an effective way of reducing the income-health gradient in urban China

Income-related health inequality in urban China (1991–2015): The role of homeownership and housing conditions

International audienceUnprecedented economic growth has been experienced over the several decades worldwide, but such rapid economic growth wasn't accompanied by equally-substantial improvement in health, especially health inequalities between the rich and poor. This study examines the role of housing in income-related health inequalities (income-health gradient) in urban China. We here analyze 1991–2015 China Health and Nutrition Survey data to ask how housing affects income-related health inequalities in urban China. We find pro-poor inequalities in self-reported bad health but pro-rich inequalities in objective bad health (general overweight/obesity, central obesity and high blood pressure). Housing conditions serve to reduce the health gradient, especially for objective health. On the contrary, homeownership exacerbates the health gradient. Improving housing conditions thus appears to be an effective way of reducing the income-health gradient in urban China