广东省城市居民吸烟与被动吸烟现状及控烟态度调查

目的了解城市居民吸烟状况与被动吸烟状况,了解居民对吸烟与被动吸烟危害的认知与态度状况,为开展针对性的控烟工作提供依据。方法采用随机偶遇抽样方法,在广州市、江门市、增城市医院、商场、车站等候室、政府对外办公大楼4类公共场所抽取18岁及以上人群进行面对面问卷调查,问卷采用中国控烟办公室统一设计的《成人被动吸烟调查问卷》。结果共调查城市居民599人,其中吸烟者190人,吸烟率为31．7％;男性吸烟率为56．6％,女性为3．2％;30-岁组吸烟率为最高,为42．6％;不同文化程度调查对象吸烟率的差异无统计学意义（P〉0．05）。392名不吸烟者中,162人处于被动吸烟状况,被动吸烟率为41．3％,男性被动吸烟率为37．6％,女性为43．1％。调查对象中,家里、室内娱乐场所和室内工作场所全部禁烟的比例分别为32．2％、12．3％和40．9％。非吸烟者对吸烟危害知识的知晓率高于吸烟者,支持公共场所禁烟的比例也高于吸烟者。结论广东省城市居民吸烟和被动吸烟状况严重,居民对公共场所禁烟的支持程度较高,吸烟者对吸烟危害认识不足,应加强吸烟危害健康教育,推动各类公共场所禁烟立法。     

Impact of Urban Sprawl on Overweight,Obesity, and Physical Activity in Sydney,Australia

Obesity and inadequate physical activity are major risk factors for many diseases. The built environment plays an important role in influencing participation in physical activity. We aimed to determine whether urban sprawl in Sydney, Australia is associated with overweight/obesity and levels of physical activity. We used a cross-sectional multilevel study design to relate urban sprawl (based on population density) measured at an area level to overweight/obesity and levels of physical activity measured at an individual level whilst controlling for individual and area level covariates in metropolitan Sydney. Individual level data were obtained from the 2002 and 2003 New South Wales Population Health Survey. We had information on 7,290 respondents. The mean population density was 2,168 persons per square kilometer (standard deviation = 1,741, range = 218–7,045). After controlling for individual and area level covariates, for an inter-quartile increase in sprawl, the odds of being overweight was 1.26 (95% CI = 1.10–1.44), the odds of being obese was 1.47 (95% CI = 1.24–1.75), the odds of inadequate physical activity was 1.38 (95% CI = 1.21–1.57), and the odds of not spending any time walking during the past week was 1.58 (95% CI = 1.28–1.93). Living in more sprawling suburbs increases the risk of overweight/obesity and inadequate physical activity despite the relatively low levels of urban sprawl in metropolitan Sydney. Modifications to the urban environment to increase physical activity may be worthwhile.     

Years off Your Life? The Effects of Homicide on Life Expectancy by Neighborhood and Race/Ethnicity in Los Angeles County

Homicide is one of the leading causes of death in Los Angeles County and is known to be elevated in low-income urban neighborhoods and in black males. However, because homicide occurs primarily among young adults, mortality rate statistics may underrepresent its importance. We estimated the impact of homicide on life expectancy by demographic group and geographic area in Los Angeles County, 2001–2006. Life expectancy estimates were calculated using mortality records and population estimates for Los Angeles County. Cause elimination techniques were used to estimate the impact of homicide on life expectancy. Homicide was estimated to reduce life expectancy by 0.4 years for Los Angeles County residents and by 2.1 years for black males. The impact of homicide on life expectancy was higher in low-income neighborhoods. In some low-income urban neighborhoods, homicide was estimated to decrease life expectancy in black males by nearly 5 years. Homicide causes substantial reductions in life expectancy in Los Angeles County. Its impact is magnified among black males and in low-income urban areas, underscoring the need for homicide reduction in urban centers.     

Food insecurity and mental health: Surprising trends among community health volunteers in Addis Ababa,Ethiopia during the 2008 food crisis

The 2008 food crisis may have increased household food insecurity and caused distress among impoverished populations in low-income countries. Policy researchers have attempted to quantify the impact that a sharp rise in food prices might have on population wellbeing by asking what proportion of households would drop below conventional poverty lines given a set increase in prices. Our understanding of the impact of food crises can be extended by conducting micro-level ethnographic studies. This study examined self-reported household food insecurity (FI) and common mental disorders (CMD) among 110 community health AIDS care volunteers living in Addis Ababa, Ethiopia during the height of the 2008 food crisis. We used generalized estimating equations that account for associations between responses given by the same participants over 3 survey rounds during 2008, to model the longitudinal response profiles of FI, CMD symptoms, and socio-behavioral and micro-economic covariates. To help explain the patterns observed in the response profiles and regression results, we examine qualitative data that contextualize the cognition and reporting behavior of AIDS care volunteers, as well as potential observation biases inherent in longitudinal, community-based research. Our data show that food insecurity is highly prevalent, that is it associated with household economic factors, and that it is linked to mental health. Surprisingly, the volunteers in this urban sample did not report increasingly severe FI or CMD during the peak of the 2008 food crisis. This is a counter-intuitive result that would not be predicted in analyses of population-level data such as those used in econometrics simulations. But when these results are linked to real people in specific urban ecologies, they can improve our understanding of the psychosocial consequences of food price shocks.     

There's always Plan B: adolescent knowledge, attitudes and intention to use emergency contraception

Background

It can prove challenging to create social marketing materials aimed at a specific subsection of the population, especially when the topic is relatively new and possibly misunderstood. Therefore, the objective of this study was to assess adolescent knowledge of and attitudes towards emergency contraception (EC), with the goal of creating a locally relevant social marketing campaign and intervention.

Methods

This qualitative study consisted of 18 in-depth interviews and four focus groups (n=29) with adolescents and young adults ages 15 to 21 years, conducted in New York City between August and December 2006.

Results

While respondents seemed generally aware of EC's existence, most were unclear about circumstances warranting its use and its mechanism of action. The FDA change to behind-the-counter availability appeared to increase knowledge and access to EC, although substantial barriers to EC access and use remain, including price.

Conclusions

Further work remains in educating those in need of EC, especially adolescents under the age of 18 years. Results from this study initiated a social marketing campaign and intervention aimed at increasing adolescent knowledge of and access to EC.     

城镇居民基本医疗保险未成年人缴费测算方法与理论研究

未成年人的医疗保障是我国当前城镇居民基本医疗保险中的重要内容之一,但当前关于未成年人医疗保险缴费标准和筹资水平的研究还较少。本文通过比较与分析未成年人基本医疗消费支出、医疗保险基金补偿支出、医疗保险支付意愿等,对未成年人基本医疗保险缴费的相关理论进行归纳总结,为提高城镇居民医疗保险中的未成年人的保障提供参考和借鉴。     

医改和城乡统筹背景下,加强社区卫生服务能力建设的思考

社区卫生服务是新医改和城乡统筹的关键环节,同时医改和城乡统筹也给社区卫生发展带来了很好的机遇.抓住机遇加强社区卫生服务能力建设,完善服务功能,使其有能力为广大居民提供"有效、经济、方便、综合、连续"的卫生服务,担当起城市公共卫生体系和基本医疗服务体系的网底角色,真正发挥起"守门人"的作用.     

我国城乡居民医疗保健支出现状分析

目的 了解我国城乡居民卫生费用及医疗保健支出情况,为完善卫生系统筹资战略提供客观依据.方法 采用1999年至2007年统计年鉴数据,对我国城乡居民卫生费用及医疗保健支出现状及变化趋势进行分析.结果 城乡卫生费用筹资额定比增长了200%;城乡居民人均医疗保健支出增长幅度差异明显(城市为152.86%,农村为172.77%);居民医疗保健支出随人均收入变化而稳步增长,但健康消费总体水平仍很低,尤其是农村居民;2003年以来农村居民医疗保健支出收入弹性比城镇居民大,相对差距正逐步缩小.结论 应重点增加农村居民收入,提高社会边际医疗保健支出倾向;改善医疗卫生服务条件,扩大医疗保障覆盖面,带动城乡居民医疗保健的合理消费;重视文化因素的作用,提高全民健康投资意识和自我保健能力.     

安徽省城市大中学校学生生活相关行为调查

目的研究安徽省城市大中学校学生生活相关行为状况,为制定干预措施提供科学依据。方法采用全国统一设计的《中国青少年健康相关行为调查问卷》,以经济水平好、中、差的不同,选择安徽省合肥市、芜湖市、宿州市3个市为调查地。在调查地随机抽取初中、高中、职业学校、大学共10 813名大中学生进行问卷调查,对其中生活相关行为习惯进行描述性分析和显著性卡方检验。结果过去7d内每天至少活动60m in、连续步行或骑车30分钟以上、参加课外活动和每周上1~2节体育课的报告率分别为19.6%、39.0%、16.8%和88.9%。过去7d内活动1~3d的为48.4%;没有参加活动的达18.1%（其中高三学生明显增加达27.0%）;每周不参加课外活动或很少参加的占61.29%。报告有44.8%的学生每天课外学习3h以上,高中生高达49.3%;有30%以上的学生每天上网、玩电子游戏和看电视超过1h。自认为学习成绩差的学生活动少而且每天上网、玩电子游戏和看电视时间较多。结论安徽省城市大中学校学生每天身体活动量严重不足,学校应积极开展增强学生体质的工作。     

Epidemiological Transition and the Double Burden of Disease in Accra,Ghana

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities.