The incidence of type 1 diabetes among children in Finland--rural-urban difference

The aim of the study was to investigate the incidence of type 1 diabetes among children aged 14 years or under according to the level of urbanization of the place of residence of children at the time of diagnosis in Finland during 1987 to 1996. The analysis was carried out using a Bayesian approach and GIS. The incidence was the highest in the rural heartland areas while the increase in incidence was sharpest in urban areas. The level of urbanization seems to explain only a part of the spatial variation in the incidence in Finland. It is possible that some environmental risk factors for type 1 diabetes have been more prevalent in rural heartland areas than in the rest of the country. These factors might have increased in urban environments in Finland particularly during the first half of 1990s.     

HDL levels in pacific islanders

Although the concentration of high density lipoprotein (HDL) cholesterol is a sensitive index of coronary heart disease (CHD) risk in Caucasians there is little evidence for differences in HDL levels between populations with low and high prevalence of CHD. This study compares the concentrations of apolipoprotein AI, the major HDL protein, in South Pacific Islanders of different ethnic origin. In two rural populations on Ouvea, the mean AI levels were 94 and 91 mg/dl, respectively, for Melanesian and Polynesian men. These values are substantially lower than in a group of Australian men (120 20 mg/dl). A further comparison between rural and urbanized Polynesian males in Western Samoa showed that urbanization led to higher AI levels (117 mg/dl in the town versus 94 mg/dl in the village). A survey of factors that influence HDL levels suggests that the higher AI levels were due to changes in diet, including fat and alcohol consumption. The prevalence of probable CHD in Western Samoan men aged 40–69, determined by electrocardiography, was about half that reported in an Australian survey. Thus the lower AI levels in the Western Samoan men appeared not to be related to the prevalence of CHD which was less than among Australians who have higher HDL concentrations.     

传递函数模型在我国城市卫生技术人员预测中的应用

目的探讨传递函数模型在卫生人力资源预测中的应用价值.方法利用1983～2000年国家有关统计年鉴数据拟合传递函数模型,同时采用求和自回归移动平均模型(ARIMA)进行预测,并比较两者的拟合结果.结果传递函数模型与实测值比较而言,其预测误差为-0.15%,较ARIMA模型低.结论传递函数模型在预测中可以纳入有关影响因素,该预测结果理论上更符合实际情况.     

Achieving the SDGs: Evaluating indicators to be used to benchmark and monitor progress towards creating healthy and sustainable cities

In 2016, the World Health Organization declared that ‘Health is one of the most effective markers of any city’s successful sustainable development’ (World Health Organisation, 2016). With estimates that around 6.7 billion people will live in cities by 2050, 21^st century city planning decisions will play a critical role in achieving the United Nations (UN) Sustainable Development Goals (SDGs). They will determine the city structure and access to health-enhancing (or health-damaging) urban environments, and ultimately lifestyle choices that impact both individual and planetary health. Benchmarking, monitoring and evaluating city planning policies and interventions is therefore critical to optimise urban outcomes. In 2017, the UN adopted a global SDG indicator framework, calling for complementary national and regional indicators to be collected by member countries. UN Habitat has also developed an indicator action framework specifically for cities. This paper examined the extent to which the UN indicators will help cities evaluate their efforts to deliver sustainability and health outcomes. It identified inconsistencies between the two UN indicator frameworks. Many of the SDG indicators assess outcomes, rather than the comprehensive and integrated ‘upstream’ policies and interventions required to deliver outcomes on-the-ground. Conversely, the UN Habitat framework incorporates intervention indicators, but excludes health outcome indicators. A more comprehensive approach to benchmarking, monitoring and evaluating policies designed to achieve healthy and sustainable cities and assessing spatial inequities is proposed.     

北京市2008-2018年肺结核时空分布及影响因素分析

目的 分析2008-2018年北京市肺结核报告发病率的时空分布特征及影响因素。方法 肺结核病例数据来源于2008-2018年中国疾病预防控制信息系统结核病信息管理系统,采用ArcGIS 10.2软件可视化肺结核发病率的时空分布;街道/乡镇尺度上分析（Getis''s G_i^*统计量）发病率的空间聚集性;贝叶斯时空模型分析影响其时空分布的因素包括城市化率、人均GDP、每千人口医院床位数、常住外来人口和人口密度。结果 2008-2018年北京市肺结核报告发病率呈下降趋势,从58.64/10万下降到30.43/10万。通州区、昌平区等城市发展新区的发病率较高,热点集中在其局部地区;东城区、西城区等功能核心及拓展区的发病率较低,冷点也集中在该区域。肺结核发病风险与城市化率和常住外来人口相关,其中,城市化率每增加1%,患肺结核的RR值也会增加1%;常住外来人口每增加1万人,患肺结核的RR值会增加0.6%。结论 北京市肺结核的防控重点区域需关注城市发展新区;城市化进程加快的同时,需加强常住外来人口中的结核病防控,以期降低当地结核病发病率。     

China's transition: the effect of rapid urbanization on adult occupational physical activity

China has recently undergone rapid social and economic change. Increases in urbanization have led to equally rapid shifts toward more sedentary occupations through the acquisition of new technology and transitions away from a mostly agricultural economy. Our purpose was to utilize a detailed measure of urbanicity comprising 10 dimensions of urban services and infrastructure to examine its effects on the occupational physical activity patterns of Chinese adults. Longitudinal data were from individuals aged 18-55 from the years 1991-1997 of the China Health and Nutrition Survey (N=4376 men and 4384 women). Logistic multilevel regression analyses indicated that men had 68% greater odds, and women had 51% greater odds, of light versus heavy occupational activity given the mean change in urbanization over the 6-year period. Further, simulations showed that light occupational activity increased linearly with increasing urbanization. After controlling for individual-level predictors, community-level urbanization explained 54% and 40% of the variance in occupational activity for men and women, respectively. This study provides empirical evidence of the reduction in intensity of occupational activity with modernization. It is likely that urbanization will continue unabated in China and this is liable to lead to further transitions in the labor market resulting in additional reductions in work-related activity. Because occupational activity remains the major source of energy expenditure for adults, unless alternative forms are widely adopted, the Chinese population is at risk of dramatic increases in the numbers of overweight and obese individuals.     

Hypertension, urbanization, social and spatial disparities: a cross-sectional population-based survey in a West African urban environment (Ouagadougou, Burkina Faso)

Data show that hypertension has become a public health problem in developing countries. Many studies have reported social disparities among the affected populations, but few of them pointed out spatial disparities within towns. We aimed to show that hypertension could be a good indicator of the medical change that occurs unequally in towns. A cross-sectional survey was done in April and October 2004 in Ouagadougou, Burkina Faso, among 2087 adults over 35 years old in different kinds of urban areas. Social and demographic data were collected and blood pressure was measured. Prevalence of hypertension was 40.2%. Age, body mass index, level of equipment, absence of community integration, absence of occupation, duration of residence over 20 years, protein-rich diet and absence of physical activity were identified as risk factors, but there were social and spatial disparities according to location of housing (parcelled-out or non-parcelled-out areas) and to integration within the town. The high rate of hypertension found in Ouagadougou and the heterogeneity of the risk within the population highlights that social and spatial risk factors have to be taken into account for the prevention of the non-transmissible diseases in countries in full process of urbanization and medical change.     

Residence in urban and rural areas over the life course and depression among Ghanaian and South African older adults

This study assessed associations between depression and urban/rural residence from a life-course perspective within African settings. Data on Ghanaian and South African adults aged 50 years and older were taken from wave 1 of the World Health Organization Study on Global Ageing and Adult Health (SAGE). Neither urbanicity of childhood nor adulthood residence was associated with later-life depression in either country. Significant differences were also not observed for residence changes over the life course, but there were trends in the data suggestive of higher depression prevalence in Ghanaian recent rural-urban migrants and lower prevalence among South African recent urban-rural migrants.     

Association between blood cadmium and vitamin D levels in the Yangtze Plain of China in the context of rapid urbanization

BackgroundChina has experienced rapid urbanization in the past 30 years. We aimed to report blood cadmium level (BCL) in the rapidly urbanized Yangtze Plain of China, and explore the association between BCL and 25-hydroxyvitamin D (25(OH)D).MethodsOur data source was the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) cross-sectional study (ChiCTR-ECS-14005052, www.chictr.org). We enrolled 3234 subjects from 12 villages in the Yangtze Plain. BCLs were measured by atomic absorption spectrometry. 25(OH)D was measured with a chemiluminescence assay.ResultsA total of 2560 (79.2%) subjects were diagnosed with vitamin D deficiency. The median (interquartile range) BCL was 1.80 μg/L (0.60–3.42) for men and 1.40 μg/L (0.52–3.10) for women. In women, mean 25(OH)D concentrations were inversely associated with BCL (0.401, 95% confidence interval: –0.697 to –0.105 nmol/L lower with each doubling of the BCL) after adjustment for age, educational status, current smoking, body mass index, diabetes, and season. However, there was no significant difference in 25(OH)D across the BCL tertiles for men.ConclusionsBCL in Chinese residents in the Yangtze Plain were much higher than that in developed countries. An inverse association between BCL and 25(OH)D was found in general Chinese women after multivariable adjustment. Future prospective cohort and animal studies are warranted to resolve the direction and temporality of these relationships, and to elucidate the exact mechanisms involved.