Why have physical activity levels declined among Chinese adults? Findings from the 1991–2006 China health and nutrition surveys

Between 1991 and 2006, average weekly physical activity among adults in China fell by 32%. This paper discusses why total and occupational physical activity levels have fallen, and models the association between the rapid decline and various dimensions of exogenous community urbanization. We hypothesize that a) physical activity levels are negatively associated with urbanization; b) urbanization domains that affect job functions and opportunities will contribute most to changes in physical activity levels; and c) these urbanization domains will be more strongly associated for men than for women because home activities account for a larger proportion of physical activity for women. To test these hypotheses, we used longitudinal data from individuals aged 18–55 in the 1991–2006 China Health and Nutrition Surveys. We find that physical activity declines were strongly associated with greater availability of higher educational institutions, housing infrastructure, sanitation improvements and the economic wellbeing of the community in which people function. These urbanization factors predict more than four-fifths of the decline in occupational physical activity over the 1991–2006 period for men and nearly two-thirds of the decline for women. They are also associated with 57% of the decline in total physical activity for men and 40% of the decline for women. Intervention strategies to promote physical activity in the workplace, at home, for transit and via exercise should be considered a major health priority in China.     

Epidemiology of dry eye disease in Africa: The sparse information,gaps and opportunities

Dry eye disease (DED) is an increasingly significant clinical problem in developing countries and/or emerging economies. Existing studies on DED conducted in these areas have largely reported on associations between DED and infectious disease (trachoma) and malnutrition (hypovitaminosis A), but current trends of industrialization, urbanization, and modernization in these areas could result in a shift to other forms of DED. Herein, we review the epidemiology of DED in these geographic areas, highlighting potential causes and risk factors of DED while presenting information on diagnostic tools and algorithms and insight into some treatment modalities of DED that could prove useful to clinicians and investigators in these regions.     

Coping with urbanization: A cardiometabolic risk?: The THUSA study

An assessment of specific coping styles in rural-urban Africans is done to evaluate its contribution as cardiometabolic risk factor. In total, 608 apparently healthy Africans were included in a cross-sectional comparative study from the North-West Province in South Africa. The adapted and translated COPE Questionnaire classified participants according to their responses into active (AC) or passive (PC) copers. Fasting resting metabolic syndrome (MS) indicators using the WHO definition (glucose, high density lipoproteins, waist/hip ratio, hypertension prevalence, and triglyceride) and associated MS values, i.e. fibrinogen were obtained. The Finapres recorded resting blood pressure continuously. Co-variates for all statistical analyses included age, body mass index (BMI) and lifestyle factors (alcohol consumption, smoking habits and physical activity). The only MS values prevalent in urbanized participants were higher hypertension prevalence rates and fibrinogen (women only) compared to their rural counterparts. Adding coping styles, it was mainly the urbanized AC participants that indicated higher MS values (hypertension prevalence, glucose and fibrinogen) when compared to their rural and PC counterparts. In conclusion, urbanization is associated with enhanced blood pressure and fibrinogen (women) values only. Coping as cardiometabolic risk is accentuated in the urbanized AC group, especially the men. The urbanized AC group with their higher blood pressure values and more MS indicators appears to have behaviorally an AC style but physiologically a dissociated AC style.     

Child overweight and undernutrition in Thailand: Is there an urban effect?

An urban advantage in terms of lower risk of child undernutrition has been observed in many developing countries, but child obesity is often more prevalent in urban than rural areas. This study aimed to assess whether urban-rural disparities in undernutrition and obesity were attributable to concentrations of socioeconomically advantaged children into urban communities or to specific aspects of the urban environment. A sample of 4610 children ages 2-10 years was derived from the 2004 Round of the Kanchanaburi Demographic Surveillance System, monitoring health and demographic change in the province of Kanchanaburi, Thailand. We used multi-level logistic regression to model the odds of short stature, underweight, and obesity for children in 102 communities. Models tested whether child socioeconomic conditions accounted for urban-rural disparities or if aspects of the social and physical environment accounted for disparities, adjusting for child characteristics. 27.8% of children were underweight, while 19.9% had short stature, and 8.3% were obese. Bivariate associations showed urban residence associated with lower risk of undernutrition and a greater risk of obesity. Urban-rural disparities in odds of short stature and underweight were accounted for by child socioeconomic characteristics. Urban residence persisted as a risk factor for obesity after adjusting for child characteristics. Community wealth concentration, television coverage, and sanitation coverage were independently associated with greater risk of obesity. Undernutrition was strongly associated with household poverty, while household affluence and characteristics of the urban environment were associated with odds of obesity. Further research is needed to characterize how urban environments contribute to children's risks of obesity in developing countries.     

Acute glomerulonephritis—changing patterns in Singapore children

This study compared the pattern of acute glomerulonephritis (AGN), a disease known to be influenced by socioeconomic and environmental factors, in children 12 years and under, for the years 1971 and 1985. All children admitted to the four major paediatric departments with haematuria and at least two of the following (oedema, hypertension or oliguria) had an initial diagnosis of AGN. A sample population from one unit from 1980 to 1984 showed that over 70% of these children had evidence of a post-streptococcal aetiology. In 1971, 411 children were admitted with AGN, as compared with only 58 in 1985. The age-sex-race standardized rates for 1971 and 1985 were 0.632 and 0.023/1,000 children 12 years and under, respectively (P<0.001). The mean age of presentation was lower in 1971. Over this period, Singapore saw a threefold rise in the gross national product, accompanied by rapid urbanization. On analysis of the housing pattern, only 31% of the children lived in high-rise apartments in 1971, in contrast with 86% in 1985 (P<0.001). The majority of non-apartment dwellers had homes in runal districts. From an epidemiological perspective, factors which could have led to the highly significant decline in prevalence of AGN in Singapore children included improvement in the socioeconomic status and health care system, and urbanization of the country.     

Child health in an urbanizing world

The aim of this study is to document and comment on the effects of urbanization on child health, internationally, using published reports and the author's personal experience. Urbanization is having profound effects on the health and well-being of infants and children in industrialized and developing countries. This will affect generations into the future. The changes are not confined to cities and large towns; they rapidly influence transitional societies in remote and rural areas, because globalization is changing infant feeding practices and children's diets and lifestyles. In developing countries, overcrowding and environmental pollution are massive problems made worse by undernutrition and infections, particularly respiratory and diarrhoeal diseases. In developed societies there are many other problems, e.g. injuries, poisonings, violence, drug abuse, exposure to industrial and atmospheric pollutants, including pesticides, sexually transmissible diseases, and "lifestyle", diseases including obesity and cardiovascular disease risk. There is an urgent need for paediatricians, health planners, policy-makers, governments and the community to understand these issues and work towards minimizing their harmful effects on children.

Conclusion: Urbanization has profound effects on child health, globally; these must be recognised so that harmful influences of urbanization can be reduced for the benefit of all children.     

城市化发展对蜚蠊群落结构的影响及其防制对策研究

目的了解城市化发展对室内蜚蠊群落的影响。方法粘捕盒法。结果2004-2005年,苏州市城区室内蜚蠊平均密度为0.53只/(盒.夜),德国小蠊、美洲大蠊和黑胸大蠊的构成比分别为80.30%、17.04%和2.66%;1997-2001年为0.05只/(盒.夜),3种蜚蠊的构成比依次为86.69%、7.37%和5.95%,两个时间段蜚蠊密度与构成比差异均有统计学意义(u=15.19,P<0.05;P<0.01)。2004-2005年,老城区蜚蠊平均密度为0.49只/(盒.夜),德国小蠊、美洲大蠊和黑胸大蠊的构成比分别为75.71%、22.31%和1.98%,新建城区平均密度为0.58只/(盒.夜),3种蜚蠊的构成比依次为84.52%、12.19%和3.28%,老城区与新建城区的密度和构成比差异同样具有统计学意义(u=7.66,P<0.01)。结论城市化发展包括城区改造、面积扩大和人口增长,对蜚蠊群落结构和数量有较大影响。     

Periurban Trypanosoma cruzi-infected Triatoma infestans, Arequipa, Peru

In Arequipa, Peru, vectorborne transmission of Chagas disease by Triatoma infestans has become an urban problem. We conducted an entomologic survey in a periurban community of Arequipa to identify risk factors for triatomine infestation and determinants of vector population densities. Of 374 households surveyed, triatomines were collected from 194 (52%), and Trypanosoma cruzi-carrying triatomines were collected from 72 (19.3%). Guinea pig pens were more likely than other animal enclosures to be infested and harbored 2.38x as many triatomines. Stacked brick and adobe enclosures were more likely to have triatomines, while wire mesh enclosures were protected against infestation. In human dwellings, only fully stuccoed rooms were protected against infestation. Spatially, households with triatomines were scattered, while households with T. cruzi-infected triatomines were clustered. Keeping small animals in wire mesh cages could facilitate control of T. infestans in this densely populated urban environment.     

城镇化社区老年群体患病行为与护理现状的调查研究

目的 调查城镇化社区老年群体患病行为与护理现状.方法 采用问卷调查法,抽取绍兴市已达老龄化的城镇化社区中的300例老年人进行问卷调查.结果 城镇化社区老年人患慢性病较多,自我健康管理能力欠缺,社区卫生服务资源利用率低,尤其在疾病预防和健康管理方面.结论 建立以社区为范畴、家庭为单位,分层护理、预防和治疗性护理相结合的新型社区老年健康护理模式更为符合城镇化社区老年护理的特点.     

Trends in prevalence of diabetes in Asian countries

Diabetes is a major lifestyle disorder,the prevalence of which is increasing globally.Asian countries contribute to more than 60% of the world’s diabetic population as the prevalence of diabetes is increasing in these countries.Socio-economic growth and industrialization are rapidly occurring in many of these countries.The urban-rural divide in prevalence is narrowing as urbanization is spreading widely,adversely affecting the lifestyle of populations.Asians have a strong ethnic and genetic predisposition for diabetes and have lower thresholds for the environmental risk factors.As a result,they develop diabetes at a younger age and at a lower body mass index and waist circumference when compared with the Western population.The adverse effect of physical inactivity and fatty food are manifested as the increasing rate of overweightness and obesity,even among children.The health care budgets for the disease management are meager and the health care outcome is far from the optimum.As a result,complications of diabetes are common and the economic burden is very high,especially among the poor strata of the society.National endeavors are urgently needed for early diagnosis,effective management and for primary prevention of diabetes.This editorial aims to highlight the rising trend in prevalence of diabetes in Asia,its causative factors and the urgent need to implement national strategies for primary prevention of type 2 diabetes.