The Association Between Uncontrolled Diabetes and Health Care Utilization in Spain
Diabetes is one of the world’s most prevalent chronic diseases. It is currently estimated that approximately 50% of diabetes cases are considered “uncontrolled.” Although limited research is available, economic costs associated with increased health care utilization attributable to uncontrolled diabetes is a concern. A longitudinal study using 7 years (2004–2010) of administrative records of patients in Catalonia, Spain, found that male patients with poorly controlled diabetes reported excess visits to general practitioners (3%) and specialists (5.3%), and increases in annual hospital length of stay (15%). Although female patients reported more health care utilization overall, this was not attributed to uncontrolled diabetes.
Citation. Gil J, Sicras-Mainar A, Zucchelli E. Uncontrolled diabetes and health care utilization: panel data evidence from Spain. Eur J Health Econ. 2018;19(6):785–795.
Geographical Distribution of HIV/AIDS in Pakistan
Pakistan has the largest refugee population in the world. These populations often are at higher risk for HIV infection. Tirmizi et al. conducted a spatial analyses to determine clustering of HIV/AIDS cases in Pakistani counties and whether clustering corresponds to a high refugee population. Using data from the 2007–2008 Demographic Health Survey, analyses showed that Sindh, Khyber Pakhtunkhwa, and Federal Central Territory had the highest levels of HIV/AIDS cases. Trend surface analysis showed that cases increased in the northeast and southwest regions. Hot spots were observed in regions with major refugee settlements, such as Federal Central Territory (Getis-Ord General G index [Gi] z-score = 5.428; P ≤ .001). HIV programming should target areas with vulnerable refugee populations.
Citation. Tirmizi SRUH, Tirmizi ST, Khan NU. Spatial analysis of HIV/AIDS in Pakistan. Bangl J Med Sci. 2018;17(3):433–438.
Thirty Years of Brazilian Universal Health Care
In 1988, the Brazilian congress approved the Unified Healthcare System, which gave the population the right to free and comprehensive health care. To understand the health care system’s role in changing Brazil’s health profile, Marinho de Souza et al. compared the country’s burden of disease between 1990 and 2015. During this period, the child mortality rate was reduced from 52.5 to 17.0 per 1000 live births; the standardized mortality rate decreased from 1102.2 to 786.2 per 100 000; life expectancy at birth increased from 67.9 to 74.4 years; and healthy life expectancy increased from 59.4 to 64.8 years. Major contributors include declines in transmissible diseases, maternal, and infant mortality, and avoidable causes of death.
Citation. Marinho de Souza MDF, Carvalho Malta D, Barboza França E, Lima Barreto M. Changes in health and disease in Brazil and its states in the 30 years since the Unified Healthcare System (SUS) was created. Cien Saude Colet. 2018;23(6):1737–1750.
Effects of Environ-mental Tobacco Smoke on Birthweight in Africa
Gender differences in the effect of secondhand smoke (SHS) on birth weight among African children of 23 African countries were assessed using Demographic Health Survey data from 2010 to 2014. Low birth weight was more prevalent among women exposed to SHS during pregnancy, even after accounting for birth order, mother’s age and education, country, family size, cooking fuel, and other variables. Male new borns had a 1.08 (95% confidence interval = 1.02, 1.14) greater likelihood of low birth weight if their mothers were exposed to SHS than did male newborns whose mothers were not exposed. These data add to the increasing evidence base on gender differences in SHS’s effect on birth weight.
Citation. Owili PO, Muga MA, Kuo HW. Gender difference in the association between environmental tobacco smoke and birth weight in Africa. Int J Environ Res Public Health. 2018;15(7):pii: E1409.