Background Indonesia continues to encounter a significant public health crisis due to stunting. Maternal knowledge is the key driver of nutritional practices and outcomes. This study aimed to develop a maternal/caregiver stunting knowledge index (SKI), analyze disparities in urban-rural knowledge, and identify the key determinant factors driving these disparities.
Methods This cross-sectional study analyzed data points from the 2024 Indonesian Nutritional Status Survey, involving 294,538 mothers and caregivers. Data regarding stunting knowledge, sociodemographic, maternal, and caregiver characteristics, child characteristics, area of residence, and variables related to maternal health knowledge and utilization were collected via interviews conducted with mothers. Height-for-Age Z-score (HAZ) was calculated using age and height measurements. Knowledge level was measured using a constructed SKI categorized as low, moderate, or high. Chi-square tests and multivariate logistic regression were used to identify the predictors of low SKI and risk(s) for stunting.
Results The prevalence of low SKI scores was significantly higher in rural areas, and maternal education was the strongest determinant of low SKI scores in both regions. In rural areas, limited access to formal health information (e.g., lack of a Maternal and Child Health book) was a major predictor. Low SKI was associated with higher odds for stunting risk (urban: adjusted odds ratio [aOR], 1.617; rural: aOR, 1.576), whereas high awareness of the long-term impacts of stunting provided a significant protective effect.
Conclusion Urban-rural knowledge disparities were concentrated among caregivers with lower education and limited health service utilization. Interventions should be tailored regionally, targeting caregivers with low education levels and emphasizing the long-term consequences of stunting to promote preventive behaviors.
Background This study examined disparities in 1-year mortality rates between infants born to married and unmarried single-parent families, emphasizing the need for targeted health policies.
Methods Data from 3,298,263 cases, obtained from the South Korea National Statistical Office (2010–2017), were analyzed. T-tests and chi-square tests were used to assess the demographic characteristics of the study group. The number of deaths per 1,000 live births was calculated, and logistic and multivariable logistic regressions were employed to compare infant mortality rates between family types. Additional stratified analyses, based on gestational age and birth weight, further elucidated the relationship between parental marital status and infant mortality.
Results Infants from unmarried families exhibited a 3.34-fold higher crude odds ratio (OR) for 1-year mortality (95% confidence interval [CI], 2.56–4.36; P<0.001) than that from married families. After adjusting for confounders, the adjusted OR was 1.40 (95% CI, 1.03–1.92). Stratification by gestational age and birth weight revealed crude ORs of 4.62 (95% CI, 3.34– 6.39) in non-preterm infants (≥37 weeks) and 4.76 (95% CI, 3.46–6.56) in non-low-birth-weight infants (≥2.5 kg), highlighting a more pronounced disparity in infants born at or above normal weight and full term. No significant difference (P>0.05) was found in the crude OR for 1-year mortality rates among low-birth-weight (<2.5 kg) or preterm (<37 weeks) infants between the two-family types.
Conclusion This study highlights the significant disparity in infant mortality rates based on parental marital status, underscoring the need for enhanced social support and tailored policies for unmarried single-parent families.
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Single-Parent Family Status and Health Outcomes: Scoping Review with ☸️SAIMSARA
Background Among the issues caused by the increase of one-person households the health problems and primary medical needs of one-person elderly households among the issues with the increase in one-person households is very important. The purpose of this study was to identified health care needs and problems of one-person elderly households by comparing health behavior, health status, disease prevalence rate, and medical needs to one-person elderly households and multi-person households.
Methods Data were obtained from the 2017 Community Health Survey. In this study, 66,211 people who were over 60 years of age without missing variables were included in the final analysis.
Results One-person households showed poorer overall health behaviors, such as nutritional behaviors, exercise behaviors, drinking and smoking behaviors, and poorer subjective and objective health status than multi-person households. Furthermore, albeit the high requirement of medical services for mental health outcomes such as suicide attempts, the rate of not receiving services was also high indicating high barriers to receive and access health care.
Conclusion Comprehensive and direct comparison of health and medical factors revealed the medical vulnerability and unmet needs in terms of health promotion in the single-person elderly households. These results can be applied as the basic information to understand the needs and medical problems of these risk groups by primary medical doctors who predominantly treat single-person elderly households and can also be used as basic data for policy development in order to solve these unmet medical care needs.
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Background This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population.
Methods Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups.
Results For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population.
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Methods Patients who visited the Gangnam Severance Hospital from February 2010 to May 2015 for a health checkup were enrolled in this study. Baseline characteristics, laboratory data, and the organs (stomach, colon, thyroid, brain, prostate, lung, liver, kidney, pancreas, adrenal gland, and heart) of patients were examined. Data regarding patients’ dietary patterns were also obtained. Overall, 1,514 Korean Americans (group 1) and 1,514 native Koreans (group 2) were enrolled.
Results The following diseases were more prevalent in group 1 than in group 2: reflux esophagitis (12.9% vs. 10%), gastric ulcer (3.0% vs. 5.5%), colorectal polyp (37.7% vs. 28.7%), hemorrhoids (32.2% vs. 29.9%), and benign prostatic hyperplasia (30.2% vs. 14.3%). Although not statistically significant, coronary artery disease has a high prevalence rate of >20% in both groups. Dietary patterns were not significant between the two groups.
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Results The estimate for self-rated health was 0.612 times lower (95% confidence interval [CI], 0.503–0.746; P<0.0001) for those with zero offspring. The estimate for self-rated health was 0.736 (95% CI, 0.635–0.853; P<0.0001) for those with five offspring or more. The estimate for self-rated health was 0.707 (95% CI, 0.528–0.947; P=0.020) for males with zero offspring. The estimate for self-rated health was 0.563 (95% CI, 0.422–0.751; P<0.001) for females with no offspring and for females with five or more offspring. The estimate for self-rated health was 0.686 times lower (95% CI, 0.573–0.822; P<0.0001) for those with five or more offspring compared to females with two offspring.
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Background Recently, the mass media serves a major role in the public health education, but have not been proven whether they are being appropriately utilized in the elderly. The aim of this study was to identify the elderly person's concern in the mass media health information and utilization behavior. Methods: Between March to June 2008, one to one survey with the elderly people over 60 years was performed in two elderly welfare centers, one public health center, and two secondary hospitals outpatients and inpatients in Seoul and Chungju.Results: A total of 999 subjects were included. By multivariate analysis, factors signifi cantly associated with low concern in the mass media health information were low educational level, non-exercise group, and low concern in own health (P = 0.001, 0.009, < 0.001, respectively). The most frequently utilized health information source was the mass media. By comparing the frequency of health information utilization, women, low educational level, low income, non-exercise group, underweight, low level of self-evaluated health status, and low concern in health information were signifi cantly associated with the lowest quintile of utilization (P value: < 0.001, 0.005, 0.05, < 0.001, 0.002, 0.03, 0.005, respectively). However, the presence of chronic diseases, such as hypertension, diabetes, had no association.Conclusion: In community-dwelling elderly, important factors associated with concern in and utilization of the mass media health information were concern in health, self-evaluated health status, exercise status and socioeconomic factors such as education or income level, rather than comorbid chronic disease.
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Background : Recently, physicians have been challenged to see more patients per office session while maintaining patient satisfaction. We examined the variables related to patient satisfaction with the time spent with physician during office visit.
Methods : In the department of family medicine of an university hospital, a trained researcher observed patient visits by VTR and collected additional data using medical record reviews and patient exit questionnaires from July 1 to July 31, 2002 The data was analyzed statistically by SPSS ver11.0/PC+.
Results : Visits by 103 patients were observed in this study. Age, functional health status, time of Dr.'s talking to patients and the ratio of Dr.'s talking time to visit length were significantly associated with patient satisfaction (P＜0.05). Sex, marital status, education level, new vs. established patient, reason for visit, visit length, number of problems, number of medications, body mass index, and satisfaction for time spent were not significantly associated with patient satisfaction. According to logistic regression analysis, greater patient satisfaction were associated with better perceived health status, with more ratio of Dr.'s talking time to visit length and with age younger than 40 years.
Conclusion : Physician can enhance patient satisfaction during an office visit by spending sufficient time to talk with patients during each visit and should take an interest in elderly patients and patients with multiple problems.
Background : According to different characteristics of health dimensions and its consisting item contents, valid and useful health status assessment tool for the elderly is rare. Because of the continuous increase in elderly population with functional disability in Korea, the need for a valid Korean health status assessment tool for the elderly is growing. Therefore, we have attempted to develop a Korean Health Status Measure for the Elderly in this study.
Methods : We gathered important health related items from 671 individuals aged 60 years and over to form item pool with interview. Then we classified all items into representative items according to its meaning with the experts in geriatrics. With these representative items we constructed a preliminary questionnaire. After wards we performed a pilot study for evaluating understandability, accessibility, item analysis, reliability and for detecting other modifiable limitations. After completing the pilot study we finally developed the Korean Health Status Measure for the Elderly (KoHSME V1.0)
Results : The number of collected health related items were 2,500 in the item pool. After classification of items in the pool, 40 representative items were selected for constructing preliminary version of the KoHSME. And we added 3 items of ‘general health perception’ dimension to 40 common representative items to construct a preliminary version of the KoHSME. It took an average of 18.8 minutes to complete the preliminary questionnaire by the elderly in the pilot study. Most responders (90.9%) thought the questionnaire was not difficult to understand. After the pilot study we added 2 items (wearing clothes, pain frequency) and omitted 1 item (eating). Finally, the KoHSME V1.0 questionnaire consisted of 44 items and 6 domains such as physical function, emotional function, social function, pain, sexual function, and general health perception. All items were Likert scale except pain intensity item, which was visual analogue scale.
Conclusion : The KoHSME V1.0 to assess health status and quality of life for the Korean elderly was developed. We think the KoHSME V1.0 is a reliable instrument for assessing health related to quality of life in the elderly. After documenting the validity, the KoHSME V1.0 can be a useful tool for comprehensive assessment of health status in the eelderly and for the medical outcome study.
Background : Since recent economic crises (IMF) in Korea, the number of new homeless is increasing(that is, ‘IMF style homeless’). There are only few studies on the health problem of this uniquely formed population. We have attempted to estimate the problem of health behavior and health status of this population.
Methods : Some homeless who agreed to enter the asylum during the winter were taken for medical check-up in Sunbuk Community Health Center from November to December, 1998. The participants filled up a self-reported questionnaire and physical examination, laboratory test, and chest x-ray were performed.
Results : Among ‘IMF style homeless’, the prevalence of hypertension(30.9% in primary screening, 7.3% in secondary screening), diabetes mellitus(9.4% in primary screening, 3.5% in secondary screening), syphilis(7.3%), and hepatitis B antigen carrier(5.3%) was higher than among the general population. But we could not find statistical difference according to the duration of homelessness. We found higher smoking rate and higher alcohol drinking amount per week in homeless than in the general population. The amount of alcohol drinking per week larger among those who had been homeless for more than 3 months (p<0.01).
Conclusion : The prevalence of chronic diseases in homeless was higher than in the general population, but statistical difference according to the duration of homelessness could not be found. The longer the duration of homelessness, the larger the amount of alcohol drinkin was seeing.
Background : This study was performed to investigate the relationship of health behaviors and physical health status in the elderly. Therefore, we evaluated the significance of health behaviors and acquire useful data for health promotion in the elderly.
Methods : The elderly 65-years old or over were recruited and enrolled at a medical service practiced in 8 different rural areas in 1997. A total of 217 completed questionnaires were obtained. The questionnaire consisted of the variables of sociodemography, health behavior, physical health status, health concern, and depression. The data were analysed by Mantel-Haenszel test for linear association, t-test, ANOVA, and multiple regression analysis.
Results : Among the health behaviors eating breakfast and physical activity were related to physical health status. Factor of the level of practicing health behavior was related to physical health status, especially to the admission history, and disability in work because of illness. The predictors of health status score were health concern and total health behaviors. Only physical activity among the health behaviors was the significant predictor of physical health status.
Conclusion : The result that health behaviors are related to health status in the middle-aged is applicable to the elderly. And physical activity is the predictor of physical health status in the elderly. These results suggest health behaviors will be helpful to the elderly's health.(J Koean Acad Fam Med 1998;19:538~548)
BACKGROUND The purpose of this study was to evaluate the association between social support and health status for the elderly in a rural area where social network has been decreased. METHODS One hundred and 58 elderly patients who visited free medical services participated in the survey that contained items about social support, heath status, socioeconomic status, health behaviors, and depression.
Subjects were divided into three groups according to their social support index scores and two groups according to their health status. The health behaviors, socioeconomic status, and depression were considered as confounders. The associations between social support and confounders were analyzed by oneway analysis of variance, Cochran Mantel-Haenszel test, x2-test, and t-test. Then, multiple logistic regression analyses were done to find the adjusted association between social support and health status. RESULTS Social support was related to education (P=0.012), economic level (P=0.007), smoking status (P=0.028), depression score (P<0.001), and health status (P<0.001).
Health status was related to age (P=0.02), economic level (P<0.001), and depression score (P<0.001). The unadjusted prevalence odds ratios (POR) for poor health status were 7.3 (95% CI: 2.8-19.2) in the poorly supported group and 1.3 (95% CI: 0.5-3.5) in moderately supported group compared with the highly supported group. The corresponding adjusted POR increased to 14.3 (95% CI: 2.8-73.3) in poorly supported group and 6.2 (95% CI: 1.2-31.9) in moderately supported group. CONCLUSION The poor social support was associated with poor health status and the relationship increased more with adjustment of confounders. Several methods to improve social support is necessary to maintain and enhance health status in the rural elderly.
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