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- Khatun, Masuma, 1969-, et al.
(författare)
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The influence of factors identified in adolescence and early adulthood on social class inequities of musculoskeletal disorders at age 30 : A prospective population-based cohort study
- 2004
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Ingår i: International Journal of Epidemiology. - : International Epidemiological Association. - 0300-5771 .- 1464-3685. ; 33:6, s. 1353-1360
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Tidskriftsartikel (refereegranskat)abstract
- Background Social class inequities have been observed for mostmeasures of health. A greater understanding of the relativeimportance of different explanations is required. In this prospectivepopulation-based cohort study we explored the contribution offactors, ascertained at different stages between adolescenceand early adulthood, to social class inequities in musculoskeletaldisorders (MSD) at age 30.Methods We used data from 547 men and 497 women from a townin north Sweden who were baseline examined at age 16 and followedup to age 30. Using logistic regression models, we estimatedthe unadjusted odds ratios (OR) for MSD for blue-collar versuswhite-collar workers in men and women separately. We assessedthe contribution of different factors identified between adolescenceand early adulthood by comparing the unadjusted OR for socialclass differences with OR adjusted for these explanatory factors.Results We found significant class differences at age 30 withhigher MSD among blue-collar workers (OR = 2.03 in men [95%CI: 1.42, 2.90] and 1.98 in women [95% CI: 1.29, 3.02]). Afteradjustment for explanatory factors, class differences decreasedand were no longer significant, with OR of 1.20 in men (95%CI: 0.76, 1.95) and 1.18 in women (95% CI: 0.69, 2.03). Schoolgrades at age 16; being single and alcohol consumption at age21; having children, restricted financial resources, physicalactivity, alcohol consumption, smoking, and working conditionsat age 30 were important for men; parents' social class, schoolgrade, smoking and physical activity at age 16; being singleat age 21; and working conditions at age 30 were important forwomen.Conclusion The accumulation of adverse behavioural and socialcircumstances from adolescence to early adulthood may be anexplanation for the class differences in MSD at age 30. Interventionsaimed at reducing health inequities need to consider exploratoryfactors identified at early and later stages in life, also includingstructural determinants of health.
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| 2. |
- Novak, Masuma, 1969, et al.
(författare)
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BRAC initiative towards promoting gender and social equity in health: a longitudinal study of child growth in Matlab, Bangladesh.
- 2004
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Ingår i: Public health nutrition. - 1368-9800. ; 7:8, s. 1071-9
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Tidskriftsartikel (refereegranskat)abstract
- To explore the effect of BRAC (formerly Bangladesh Rural Advancement Committee) initiatives towards promoting gender and social equity in health among children of poor mothers who are BRAC members.A cohort of 576 children from the prospective study of a BRAC- International Centre for Diarrhoeal Disease Research, Bangladesh joint research project was analysed. Data were collected three times during 1995-1996 with approximately 4-month intervals. Stunting, defined as height-for-age below minus two standard deviations from the reference median, was the outcome health measure. The study children were stratified into three groups according to their mother's social and BRAC membership status: poor and BRAC member (BM), poor non-member (TG) and non-poor non-member (NTG).Matlab, rural area of Bangladesh.Children aged 6-72 months.The overall prevalence of stunting was 76%; the highest prevalence was found among TG (84.6%) children and no significant difference was observed between BM and NTG children (67.3% and 69.4%, respectively). In all groups, a significantly larger proportion of girls was stunted compared with boys in the first round. Group-level analysis showed that stunting decreased among all children except BM boys at the end of third round, with the largest decline among BM girls. In contrast, stunting prevalence increased among BM boys. A similar trend was found in the individual-level analysis, where a larger proportion of BM girls recovered from stunting compared with other groups and no recovery was observed among BM boys. At the end of the third round, the nutritional status of BM girls was almost equal to that of the BM boys, while gender inequity remained large among TG and NTG children.The BRAC initiative appeared to contribute to a significant equity gain in health for girls, as well as to decreased differences in ill health between the poor and the non-poor.
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