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Namatovu, F., Häggström Lundevaller, E., Vikström, L. & Ng, N. (2020). Adverse perinatal conditions and receiving a disability pension early in life. PLoS ONE, Article ID e0229285.
Open this publication in new window or tab >>Adverse perinatal conditions and receiving a disability pension early in life
2020 (English)In: PLoS ONE, E-ISSN 1932-6203, article id e0229285Article in journal (Refereed) Published
Abstract [en]

Objective: The number of young adults on disability pension (DP) is increasing in European countries, creating a need to understand the related risk factors. This study aimed to determine whether adverse perinatal conditions are associated with receiving a DP early in life.

Methods: This longitudinal cohort study consisted of all persons (N = 453,223) born in Sweden during 1973–1977, observed from 1991 through 2010 when they were aged between 16 and 37 years. Statistics Sweden provided linked national data on the children and their parents. We used logistic regression to assess the association between perinatal health conditions (birth defect, Apgar score, and small for gestational age) and receiving a DP, adjusting for maternal education and the sex of the child.

Results: New recipients of DP were significantly more likely to have had a birth defect (adjusted odds ratio [AOR] 2.74, 95% CI: 2.49–3.00), to have had low Apgar score (AOR 2.12, 95% CI: 1.77–2.52), to have been small for gestational age (AOR 1.73, 95% CI: 1.54–1.94) and to be females (AOR 1.55, 95% CI: 1.46–1.64). Higher maternal education was associated with lower odds of receiving a DP (AOR 0.74, 95% CI: 0.69–0.79) for those with high school education and (AOR 0.67, 95% CI: 0.59–0.75) for those with university education. Age-stratified analysis confirmed increased odds of receiving a DP among those with birth defects and small for gestational age, but this effect reduced with increasing age. Apgar score was significantly associated with starting to receive a DP at ages 16–18 and 19–29, but not at ages 30–33. Women had lower odds of receiving a DP at ages 16–18 (AOR 0.73, 95% CI: 0.64–0.85); however, this reversed from age 19 and upwards (AOR 1.53, 95% CI: 1.41–1.67) and (AOR 2.16, 95% CI: 1.95–2.40) for the age groups of 19–29 and 30–33, respectively. Persons with high maternal education were less likely to receive a DP regardless of age at receiving a DP.

Conclusion: Having a birth defect was the strongest indicator of receiving a DP during early adulthood, followed by small for gestational age and low Apgar score. Overall, the effects of the studied perinatal health conditions were pronounced in those who received a DP at 16–18 years, but this effect weakened with increasing age at receiving a DP. Our findings suggest that policies and programs geared at promoting optimal health at birth might contribute to a reduction in receiving a DP.

Place, publisher, year, edition, pages
PLOS, 2020
Keywords
perinatal conditions, disability pension, disability
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-168471 (URN)10.1371/journal.pone.0229285 (DOI)
Projects
DISMAW
Funder
EU, Horizon 2020, 647125Marcus and Amalia Wallenberg Foundation, 2012.0141
Available from: 2020-02-27 Created: 2020-02-27 Last updated: 2020-05-13
Brunström, M., Ng, N., Dahlström, J., Lindholm, L. H., Lönnberg, G., Norberg, M., . . . Carlberg, B. (2020). Association of Physician Education and Feedback on Hypertension Management With Patient Blood Pressure and Hypertension Control. JAMA Network Open, 3(1), Article ID e1918625.
Open this publication in new window or tab >>Association of Physician Education and Feedback on Hypertension Management With Patient Blood Pressure and Hypertension Control
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2020 (English)In: JAMA Network Open, ISSN 2574-3805, Vol. 3, no 1, article id e1918625Article in journal (Refereed) Published
Abstract [en]

Importance: Elevated systolic blood pressure (SBP) is the most important risk factor for premature death worldwide. However, hypertension detection and control rates continue to be suboptimal.

Objective: To assess the association of education and feedback to primary care physicians with population-level SBP and hypertension control rates.

Design, Setting, and Participants: This pooled series of 108 population-based cohort studies involving 283 079 patients used data from primary care centers in 2 counties (Västerbotten and Södermanland) in Sweden from 2001 to 2009. Participants were individuals aged 18 years or older who had their blood pressure (BP) measured and recorded in either county during the intervention period. All analyses were performed in February 2019.

Exposures: An intervention comprising education and feedback for primary care physicians in Västerbotten County (intervention group) compared with usual care in Södermanland County (control group).

Main Outcomes and Measures: Difference in mean SBP levels between counties and likelihood of hypertension control in the intervention county compared with the control county during 24 months of follow-up.

Results: A total of 136 541 unique individuals (mean [SD] age at inclusion, 64.6 [16.1] years; 57.0% female; mean inclusion BP, 142/82 mm Hg) in the intervention county were compared with 146 538 individuals (mean [SD] age at inclusion, 65.7 [15.9] years; 58.3% female; mean inclusion BP, 144/80 mm Hg) in the control county. Mean SBP difference between counties during follow-up, adjusted for inclusion BP and other covariates, was 1.1 mm Hg (95% CI, 1.0-1.1 mm Hg). Hypertension control improved by 8.4 percentage points, and control was achieved in 37.8% of participants in the intervention county compared with 29.4% in the control county (adjusted odds ratio, 1.30; 95% CI, 1.29-1.31). Differences between counties increased during the intervention period and were more pronounced in participants with higher SBP at inclusion. Results were consistent across all subgroups.

Conclusions and Relevance: This study suggests that SBP levels and hypertension control rates in a county population may be improved by educational approaches directed at physicians and other health care workers. Similar strategies may be adopted to reinforce the implementation of clinical practice guidelines for hypertension management.

Place, publisher, year, edition, pages
American Medical Association, 2020
National Category
General Practice Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-167169 (URN)10.1001/jamanetworkopen.2019.18625 (DOI)31913490 (PubMedID)
Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-01-10Bibliographically approved
Septiono, W., Kuipers, M. A. G., Ng, N. & Kunst, A. E. (2020). Changes in adolescent smoking with implementation of local smoke-free policies in Indonesia: Quasi-experimental repeat cross-sectional analysis of national surveys of 2007 and 2013. Drug And Alcohol Dependence, 209, Article ID 107954.
Open this publication in new window or tab >>Changes in adolescent smoking with implementation of local smoke-free policies in Indonesia: Quasi-experimental repeat cross-sectional analysis of national surveys of 2007 and 2013
2020 (English)In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 209, article id 107954Article in journal (Refereed) Published
Abstract [en]

Background: Banning smoking from public places may prevent adolescent smoking, but there is little evidence on impact of smoke-free policies (SFPs) from low and middle-income countries. This study assessed to what extent the adoption of local SPFs in Indonesia between 2007 and 2013 associated with adolescent smoking.

Methods: Data on 239,170 adolescents (12–17 years old) were derived from the 2007 and 2013 national health surveys in 497 districts and 33 provinces. This study compared 2013 survey respondents living in districts/provinces that adopted SFPs between 2007 and 2013, with 2007 respondents and 2013 respondents in districts/provinces that did not adopt policies. Multilevel logistic regression analysis assessed whether SFP was associated with daily and non-daily smoking. We controlled for survey year, SFP in 2007, socio-demographics, and district characteristics.

Results: Strong district SFPs was significantly associated with lower odds of daily smoking (OR:0.81, 95 %CI:0.69-0.97), but non-significantly with non-daily smoking (OR:0.89, 95 %CI:0.76-1.05). Strong provincial SFPs was not associated with daily smoking (OR:1.02, 95 %CI:0.84–1.25), but was associated with higher odds of non-daily smoking (OR:1.22, 95 %CI:0.99-1.51). Moderately strong SFPs did not consistently show associations in the same direction. For example, moderately strong provincial SFP was associated with higher odds of daily smoking (OR:1.27, 95 %CI:1.11-1.46) and lower odds of non-daily smoking (OR:0.82, 95 %CI:0.72-0.93).

Conclusion: We did not detect a consistent short-term effect of district and province-level smoke-free policies on adolescent smoking in Indonesia. Weak implementation and poor compliance may compromise effectiveness, which would call for improvement of SFP implementation in Indonesia.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Smoking, Adolescents, Youth, Smoke-Free policy, Smoking prevalence, Indonesia
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-170551 (URN)10.1016/j.drugalcdep.2020.107954 (DOI)000527917700060 ()32171158 (PubMedID)
Available from: 2020-05-20 Created: 2020-05-20 Last updated: 2020-05-20Bibliographically approved
Vaezghasemi, M., Öhman, A., Ng, N., Hakimi, M. & Eriksson, M. (2020). Concerned and conscious, but defenceless – the intersection of gender and generation in child malnutrition in Indonesia: a qualitative grounded theory study. Global Health Action, 13(1), Article ID 1744214.
Open this publication in new window or tab >>Concerned and conscious, but defenceless – the intersection of gender and generation in child malnutrition in Indonesia: a qualitative grounded theory study
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2020 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 13, no 1, article id 1744214Article in journal (Refereed) Published
Abstract [en]

Background: Several studies in Indonesia have shown the protective effect of women-headed households on the double burden of malnutrition (coexistence of undernutrition and overnutrition in a household). Many other studies have presented a positive impact on children’s health and conditions when women are educated, have higher social capital and have control of income and its intra-household allocation. However, how women’s status affects the nutritional status of a household and, in particular, of children still remains understudied.

Objective: In this study, our aim was to explore the role of gender relations and contextual factors for overnutrition and undernutrition among children within a household.

Method: We conducted a qualitative study in two provinces of Indonesia: Central Java (urban and rural) and Jakarta (central and suburban) among 123 community members (59 men and 64 women). We utilised principles of constructivist grounded theory in conducting this study, and focus group discussions were chosen as a tool to collect data.

Results: Three categories were constructed, capturing the significance of: (i) the man is dominant within the family (gendered power relations), (ii) the environment that makes the unhealthy choice the easy choice (the emerging obesogenic environment) and (iii) parents’ being concerned but unable to control their children’s eating habits (intersection of gender and generational relations) in child malnutrition.

Conclusion: Community health and nutrition programmes should help both women and men within the context of households to acknowledge and respect women’s status. More importantly, these programmes should involve men when it comes to children’s nutritional habits and consider them as an important factor in the realisation of gender equality and empowerment. Furthermore, it is increasingly important to recognise the implication of the availability and accessibility of junk food among children.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Double burden of malnutrition, nutrition transition, gender, intersectionality, grounded theory, qualitative study, focus group discussions, Indonesia
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-170987 (URN)10.1080/16549716.2020.1744214 (DOI)32370625 (PubMedID)
Available from: 2020-05-20 Created: 2020-05-20 Last updated: 2020-05-20Bibliographically approved
Lindahl, B., Norberg, M., Johansson, H., Lindvall, K., Ng, N., Nordin, M., . . . Schulz, P. J. (2020). Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk. European Journal of Preventive Cardiology, 27(2), 209-215
Open this publication in new window or tab >>Health literacy is independently and inversely associated with carotid artery plaques and cardiovascular risk
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2020 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 27, no 2, p. 209-215Article in journal (Refereed) Published
Abstract [en]

Aims: Health literacy, the degree to which individuals understand and act upon health information, may have a pivotal role in the prevention of cardiovascular disease (CVD), with low health literacy potentially explaining poorer adherence to prevention guidelines. We investigated the associations between health literacy, ultrasound-detected carotid atherosclerosis and cardiovascular risk factors.

Methods: Baseline data (cross-sectional analysis) from a randomized controlled trial, integrated within the Västerbotten Intervention Program, Northern Sweden, was used. We included 3459 individuals, aged 40 or 50 years with ≥1 conventional risk factor or aged 60 years old. The participants underwent clinical examination, blood sampling, carotid ultrasound assessment of intima-media wall thickness (CIMT) and plaque formation, and answered a questionnaire on health literacy – the Brief Health Literacy Screen. The European Systematic Coronary Risk Evaluation and Framingham Risk Score were calculated.

Results: About 20% of the participants had low health literacy. Low health literacy was independently associated with the presence of ultrasound-detected carotid artery plaques after adjustment for age and education, odds ratio (95% confidence interval) 1.54 (1.28–1.85), demonstrating a similar level of risk as for smoking. Health literacy was associated with CIMT in men. Low health literacy was associated with higher CVD risk scores. Sensitivity analyses with low health literacy set to 9% or 30% of the study sample, respectively, yielded essentially the same results.

Conclusions: Low health literacy was independently associated with carotid artery plaques and a high level of CVD risk scores. Presenting health information in a fashion that is understood by all patients may improve preventive efforts.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
Health literacy, cardiovascular risk scores, carotid artery plaque, ultrasound
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-165791 (URN)10.1177/2047487319882821 (DOI)000491457000001 ()31615294 (PubMedID)2-s2.0-85074364646 (Scopus ID)
Available from: 2019-12-03 Created: 2019-12-03 Last updated: 2020-03-23Bibliographically approved
Ng, N., Santosa, A., Weinehall, L. & Malmberg, G. (2020). Living alone and mortality among older people in Västerbotten County in Sweden: a survey and register-based longitudinal study. BMC Geriatrics, 20, Article ID 7.
Open this publication in new window or tab >>Living alone and mortality among older people in Västerbotten County in Sweden: a survey and register-based longitudinal study
2020 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, article id 7Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Living alone is increasingly common and has been depicted as an important cause of mortality. We examined the association between living alone and mortality risks among older men and women in northern Sweden, by linking two unique longitudinal datasets.

METHODS: We used the Linnaeus database, which links several population registers on socioeconomic and health. This register-based study included 22,226 men and 23,390 women aged 50 and 60 years in Västerbotten County who had participated in the Västerbotten Intervention Program (VIP) during 1990-2006, with a total of 445,823 person-years of observation. We conducted Cox-proportional hazard regression to assess the risk of living alone on the mortality that was observed between 1990 and 2015, controlling for socio-demographic factors, chronic disease risk factors and access to social capital.

RESULTS: Older men and women who lived alone with no children at home were at a significantly higher risk of death compared to married/cohabiting couples with children at home (with an adjusted hazard ratio of 1.38, 95% CI of 1.26-1.50 in men and 1.27, 95% CI of 1.13-1.42 in women). Living alone was an even stronger factor than the well-established chronic disease risk factors and a lack of access to social capital.

CONCLUSIONS: A significant association between living alone and mortality among the older adult population in Sweden was observed. Providing good social support for older people is important in preventing the negative health impact of living alone.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Deaths, Family network, Living alone, Living arrangement, Older people, Social support
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-167215 (URN)10.1186/s12877-019-1330-9 (DOI)000513669300001 ()31906868 (PubMedID)
Funder
Riksbankens Jubileumsfond, P11–1058:1Forte, Swedish Research Council for Health, Working Life and Welfare, 2013–2056Forte, Swedish Research Council for Health, Working Life and Welfare, 2015–01499
Available from: 2020-01-13 Created: 2020-01-13 Last updated: 2020-03-18Bibliographically approved
Septiono, W., Kuipers, M. A. G., Ng, N. & Kunst, A. E. (2020). The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study.. Addiction
Open this publication in new window or tab >>The impact of local smoke-free policies on smoking behaviour among adults in Indonesia: a quasi-experimental national study.
2020 (English)In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIMS: To investigate to what extent the adoption of local smoke-free policies (SFPs) in Indonesia in 2007-2013 was associated with changes in adult smoking behaviour.

DESIGN: A quasi-experimental study.

SETTING: Indonesia, 2007 and 2013.

PARTICIPANTS: A total of 1,052,611 over-25-year-old adults. Data were derived from the 2007 and 2013 Indonesian national health survey.

MEASUREMENTS: For both years, provincial and district SFPs were identified from government documents in 497 districts, in 33 provinces. Multilevel logistic regression analysis assessed the association of adoption of provincial and district SFPs between 2007 and 2013 with smoking continuation (among ever-smokers), current smoking, and high smoking intensity (among current smokers). We controlled for survey year, SFP in 2007, socio-demographics, and district characteristics.

FINDINGS: Provincial SFP exposure was associated with lower odds of smoking continuation (strong SFP vs. no SFP: OR:0.71, 95%CI:0.66-0.76) and smoking intensity (strong SFP: OR:0.91, 95%CI:0.86-0.97), but also with higher odds of current smoking (strong SFP vs. no SFP: OR:1.08; 95%CI:1.04-1.12). District SFP exposure was associated with higher odds of smoking continuation (strong SFP vs. no SFP: OR:1.07, 95%CI:1.01-1.14) and current smoking (strong SFP vs. no SFP: OR:1.09, 95%CI:1.05-1.14), but with lower odds of smoking intensity (moderately strong SFP vs. no SFP: OR:0.95, 95%CI:0.91-0.99).

CONCLUSIONS: There may be an association between the adoption of local smoke-free policies in Indonesia and decreased adult smoking intensity. However, the evidence is inconsistent, which may reflect problems with the policy implementation and enforcement.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
Indonesia, smoke-free policy, smoking ban, smoking continuation, smoking intensity, smoking prevalence, tobacco
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-171131 (URN)10.1111/add.15110 (DOI)32386096 (PubMedID)
Available from: 2020-05-27 Created: 2020-05-27 Last updated: 2020-05-28
Sandström, G., Namatovu, F., Ineland, J., Larsson, D., Ng, N. & Stattin, M. (2020). The Persistence of High Levels of Living Alone Among Adults with Disabilities in Sweden, 1993–2011. Population: Research and Policy Review
Open this publication in new window or tab >>The Persistence of High Levels of Living Alone Among Adults with Disabilities in Sweden, 1993–2011
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2020 (English)In: Population: Research and Policy Review, ISSN 0167-5923, E-ISSN 1573-7829Article in journal (Refereed) Epub ahead of print
Abstract [en]

This study investigates how the probability to live alone has developed among working age individuals with and without disabilities in Sweden during the period 1993–2011 when extensive political reforms to improve the integration of disabled individuals in society were implemented. The results show that individuals with disabilities are approximately twice as likely to be living alone when compared to individuals without disabilities. People with disabilities were also more likely to report low life satisfaction, and this was especially true among individuals with disabilities living alone. Men and women with disabilities also tend to experience longer periods of living as a one-person household than non-disabled people. Over time we find no indications of reduced differences in family outcomes between disabled and non-disabled individuals but rather evidence to the contrary. These differences are interpreted as being the result of the disadvantage disabled individual’s experience in the partner market and that people with disabilities are less successful in forming partnerships that can lead to cohabitation and family formation. The results thus show how disabled individuals still face societal barriers that limit their possibilities to find and sustain relationships that result in stable cohabitation despite increased efforts to improve their inclusion in Swedish society.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Sweden, Disability, Living arrangements, One-person households, Disability legislation
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Population studies
Identifiers
urn:nbn:se:umu:diva-167923 (URN)10.1007/s11113-020-09570-2 (DOI)000515863100001 ()2-s2.0-85079501680 (Scopus ID)
Projects
DISMAW
Funder
EU, Horizon 2020, 647125Marcus and Amalia Wallenberg Foundation, 2012.0141
Available from: 2020-02-06 Created: 2020-02-06 Last updated: 2020-05-19
Zhang, Y., Gu, Y., Wang, N., Zhao, Q., Ng, N., Wang, R., . . . Zhao, G. (2019). Association between anthropometric indicators of obesity and cardiovascular risk factors among adults in Shanghai, China. BMC Public Health, 19(1), Article ID 1035.
Open this publication in new window or tab >>Association between anthropometric indicators of obesity and cardiovascular risk factors among adults in Shanghai, China
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, no 1, article id 1035Article in journal (Refereed) Published
Abstract [en]

Background: To determine the optimal cut-off values and evaluate the associations of body mass index (BMI), waist circumference (WC) and waist-height ratio (WHtR) with cardiovascular disease (CVD) risk factors. Methods: A large-scale cross-sectional survey was conducted among 35,256 adults aged 20-74 years in Shanghai between June 2016 and December 2017. Receiver operating characteristic (ROC) analyses were conducted to assess the optimal cut-off anthropometric indices of CVD risk factors including hypertension, diabetes, dyslipidemia and hyperuricemia. Multivariate Logistic regression models were preformed to evaluate the odds ratio of CVD risk factors. Results: The area under the curve (AUC) of WHtR was significantly greater than that of BMI or WC in the prediction of hypertension and diabetes, and AUCs were higher in women than men. The optimal cut-off values of WHtR were approximately 0.51 in both sexes, while the cut-off values of BMI and WC were higher for men compared with women. The optimal cutoff values of BMI and WC varied greatly across different age groups, but the difference in WHtR was relatively slight. Among women, the optimal threshold of anthropometric indices appeared to increase with age for hypertension and diabetes. The odds ratio between anthropometric indices and CVD risk factors were attenuated with age. WHtR had the greatest odds ratio for CVD risk factors among adults under 60 years old except for women with hypertension, while among 60-74 years, BMI yielded the greatest odds ratio in terms of all CVD outcomes except for women with diabetes. Conclusions: WHtR had the best performance for discriminating hypertension and diabetes and potentially be served as a standard screening tool in public health. The associations between three anthropometric indices and CVD risk factors differed by sex and decreased with age. These findings indicated a need to develop age- and gender-specific difference and make effective strategies for primary prevention of CVDs.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Cardiovascular diseases, Obesity, Anthropometric indices, Risk factors
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-162865 (URN)10.1186/s12889-019-7366-0 (DOI)000480259500004 ()31375086 (PubMedID)
Available from: 2019-09-05 Created: 2019-09-05 Last updated: 2019-09-05Bibliographically approved
Pujilestari, C. U., Nyström, L., Norberg, M. & Ng, N. (2019). Association between changes in waist circumferences and disability among older adults: WHO-INDEPTH study on global ageing and adult health (SAGE) in Indonesia. Obesity Research and Clinical Practice, 13(5), 462-468
Open this publication in new window or tab >>Association between changes in waist circumferences and disability among older adults: WHO-INDEPTH study on global ageing and adult health (SAGE) in Indonesia
2019 (English)In: Obesity Research and Clinical Practice, ISSN 1871-403X, E-ISSN 1878-0318, Vol. 13, no 5, p. 462-468Article in journal (Refereed) Published
Abstract [en]

Background: There is a lack of evidence regarding the impact of changes in waist circumference on disability among older populations in low- and middle-income countries (LMICs). This research examines the association between changes in waist circumference with disability in the older populations of Indonesia, and whether the associations are dependent on wealth or baseline abdominal obesity levels.

Methods: In 2007 the INDEPTH-WHO Study on global AGEing and adult health (SAGE) was conducted among 11,753 individuals aged 50 years and older in Purworejo District, Central Java Province, Indonesia. Of these, a total of 8,089 were followed up in 2010. On both occasions, individuals’ waist circumferences were measured and the 12-item version of the WHO Disability Assessment Schedule version 2 (WHODAS-II) was implemented to measure disability.

Results: A significant positive association was observed between waist circumference and disability at the baseline (β = 0.066; p < 0.001), and between the increase in waist circumference and the level of disability during the three-year follow-up period (β = 0.094; p < 0.001) after adjusting for baseline variables. This association was also significant among the poor, non-obese men, as well as poor and rich obese women. Among the non-obese women, a decrease in waist circumference was associated with more disabilities.

Conclusions: An increase in waist circumference is associated with increased disability among older people in Purworejo, Indonesia. Health promotion programmes aiming to prevent obesity could have positive effects in preventing and reducing disability among older adults.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Abdominal obesity, Waist circumference, Disability, Older people, Indonesia
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-165103 (URN)10.1016/j.orcp.2019.07.004 (DOI)000492674200007 ()31474381 (PubMedID)
Available from: 2019-11-13 Created: 2019-11-13 Last updated: 2019-11-13Bibliographically approved
Projects
Enabling a smoke free society in Indonesia ? an integrated system-based intervention [2014-08010_Forte]; Umeå UniversityNetwork for International Longitudinal Studies on Ageing (NILSA). [2015-01499_Forte]; Umeå UniversityEffective use of today?s data to train tomorrow?s researchers on ageing and health [2016-07276_Forte]; Umeå UniversityCausation and Novel Risk Modelling for Person-Centred Prevention and Control of Cardiovascular Diseases [2017-02246_VR]; Umeå UniversityMitigating poverty and disablement in older age: Understanding the complex interactions of factors influencing equitable healthy ageing in Myanmar [2018-05196_VR]; Umeå UniversitySTAR-C: Sustainable behaviour change for health supported by person-Tailored, Adaptive, Risk-aware digital Coaching in a social context [2018-01461_Forte]; Umeå UniversityDesigning implementation research for integration of tuberculosis, diabetes, and tobacco control programme: research link collaboration between India, Indonesia, and Sweden [2018-05194_VR]; Umeå University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-0556-1483

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