Gender Inequalities in Noncommunicable Disease Risk Factors Among Indonesian Urban Population

Christiani, Yodi; Byles, Julie; Tavener, Meredith; Dugdale, Paul

doi:10.1177/1010539515626265

Cited by 15 publications

(21 citation statements)

References 20 publications

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“…However, in this study, these differences can be accounted, at least in part, by the disparities in the socioeconomic factors between men and women. 9 This article supports the emphasis on gender inequities advocated by the United Nations Development Programme.…”

supporting

confidence: 65%

Gender Issues and Public Health

Low

Binns

2016

Asia Pac J Public Health

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Gender is one of the most important considerations in public health research and program implementation. Basic issues such as protecting women from violence, upholding their rights to property and equality in access to health, education, employment, and political participation are important to society and for public health. Gender inequality exists both within and outside the health system and is linked with poverty, ethnicity, and sociocultural practices that hinder the advancement of women. This is manifested as poor access to health resources, discrimination, sexual abuse, and violence. For example, due to gender power imbalance and lack of negotiating skills, in aspects of sexual and reproductive health, condom use may be difficult. 1,2 This may lead to unintended pregnancies and expose women to a higher risk of sexually transmitted diseases and HIV infection. The issues of gender equality need to be continuously examined and addressed throughout the Asia Pacific region and the education programs of our APACPH (Asia Pacific Academic Consortium for Public Health) institutions. Each year, the United Nations Development Programme publishes a report that includes the gender inequality index. 3 Between 1990 and 2015, progress has been made in most world regions and the East Asia and Pacific regions are now at a similar level to parts of Europe. South Asia lags behind and is only slightly ahead of sub-Saharan Africa. Of course, there is much variation between and with the individual countries of APACPH. Goal 3 of the United Nations Sustainable Development goals is our fundamental objective in public health; "ensure healthy lives and promote well-being for all at all ages." 3 Achieving goal 5, "achieve gender equality and empower all women and girls" is an important prerequisite to achieving goal 3. In basic public health statistics, women are often shown to better off than men. The best overall indicator of public health is life expectancy and in all countries of the Asian Pacific region, women live longer than men and the gap is widening in many countries (Table 1). 4 Until the 1980s, the Indian subcontinent was an anomaly where men lived longer than women, but this was reversed by 1990. At the beginning of life, more boys are born than girls (and selective abortion is an issue), but infant mortality is higher in boys. 5 Asia has the highest male-female sex ratio at birth in the world, and this was the case in China, although this may change with recent population policy reforms. 6 But, health is more than just longevity and these overall statistics can obscure important gender differences in morbidity and quality of life. Noncommunicable diseases, primarily cardiovascular diseases, respiratory diseases, diabetes mellitus, and cancers are the leading causes of death and disability in the Asia Pacific region responsible for 80% of all deaths in a region. 7 Obesity is an increasing problem in our region and

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supporting

confidence: 65%

Gender Issues and Public Health

Low

Binns

2016

Asia Pac J Public Health

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“…3 BOH da dâhil olmak üzere sağlığı ilgilendiren olay ve durumlar sağlığın sosyal belirleyicilerinin, dolayısıyla da hem ekonomik durumun ve insani gelişmişliğin hem de toplumsal cinsiyet eşitsizliğinin etkisi altındadır. 14,15…”

Section: öZunclassified

“…Ancak kadınların prematür BOH ölüm oranları ile KCUE değerleri arasında, erkelerinkine kıyasla daha büyük bir korelasyon katsayısı hesaplanmış olması, her ne kadar iki ilişki de zayıf olsa bile, kadınların eşitsizlikten daha fazla etkilendiğini düşündürmektedir. Bu durum kadınların ekonomi, sağlık, eğitim ve siyaset alanında erkeklerle eşit fırsatlar yakalayamadığına işaret ediyor olabilir.Christiani ve arkadaşlarının 2016'da yayımlanan çalışmasında araştırmamızla paralel sonuçlara ulaşılmış olup toplumsal cinsiyet eşitsizliğinin kadınların BOH morbiditesini ve BOH risklerini daha fazla arttırdığı sonucuna ulaşılmıştır 15. Ayrıca DSÖ ve Uluslararası Diyabet Federasyonu ortak raporunda da toplumsal cinsiyet eşitsizliğinin BOH oranlarını etkilediği belirtilmektedir 20.…”

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Relationship Between Noncommunicable Disease Mortality Rates with Human Development Index and Global Gender Gap Index

Öztürk

Uyar

2020

Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi

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“…The development of T2DM has been closely linked to multiple risk factors, such as an unhealthy diet, physical inactivity, tobacco use, high blood pressure, high body mass index (BMI), sleep and pulse rate, c-reactive protein and sociodemographic factors such as age, gender, ethnicity, and highest level of education attained (Amalia, Cadogan, Prabandari, & Filippidis, 2019;Christiani, Byles, Tavener, & Dugdale, 2015;De Rekeneire et al, 2006;International Diabetes Federation, 2015;Monterrosa, Haffner, Stern, & Hazuda, 1995;Quatromoni, P. A., Copenhafer, D. L., D'Agostino, R. B., & Millen, 2002;World Health Organization, 2011b). These risk factors were established by epidemiological studies exploring them as independent variables in direct relationship with diabetes (Lidfeldt, Nerbrand, Samsioe, & Agardh, 2005;Ng, Sutradhar, Yao, Wodchis, & Rosella, 2020;Persson et al, 2000;Tripathy, Thakur, Jeet, & Jain, 2018).…”

Section: Introductionmentioning

confidence: 99%

Towards a Parsimonious Pathway Model of Modifiable and Mediating Risk Factors Leading to Diabetes Risk

Lee

et al. 2021

Preprint

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Background: The development of diabetes mellitus has been closely linked to multiple risk factors, of which modifiable factors are of particular interest for disease prevention. Yet few studies have assessed the system of pathways though which risk factors lead to diabetes, and how the different groups of risk factors may interact,both as independent or mediating factors. Methods: We aimed to develop a broad pathway model for diabetes risk with modifiable lifestyle risk factors as the start point, hypothesising that Lifestyle Risk (physical inactivity, smoking, poor diet and insufficient sleep) would impact Diabetes Risk (HbA1c) through the mediating factor of Physiological Load (BMI, resting pulse rate, CRP, systolic and diastolic blood pressure). The lifestyle and physiological factors were grouped via principal components analysis and a summary index respectively. Non modifiable risk factors, such as sociodemographics were specified as covariates. We used structural equation modeling to test this model, first using Wave 5 data from the Indonesian Family Life Survey (IFLS), as this was the only wave that collected all indicators of interest. To fit in longitudinal data from an earlier wave (IFLS4), we further tested a smaller model with the two Lifestyle Risk indicators available. Results: Both models showed indirect effects of Lifestyle Risk on Diabetes Risk via Physiological Load, with the cross-sectional model also showing a direct effect. The effect sizes were within the range of other studies that assessed the variables separately. Conclusion: Taken together, the results support the model of an indirect effect of Lifestyle Risk on Diabetes through Physiological Load. Specifying Lifestyle Risk as an observable, composite variable incorporates the cumulative effect of risk behaviour and differentiates this study from previous studies assessing it as a latent construct. We were able to assess causality with retrospective cohort data. Finally, the parsimonious model groups and summarises the multifarious risk factors and illustrates parsimonious and modifiable pathways that could be applied in chronic disease prevention efforts.

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Gender Inequalities in Noncommunicable Disease Risk Factors Among Indonesian Urban Population

Cited by 15 publications

References 20 publications

Gender Issues and Public Health

Gender Issues and Public Health

Relationship Between Noncommunicable Disease Mortality Rates with Human Development Index and Global Gender Gap Index

Towards a Parsimonious Pathway Model of Modifiable and Mediating Risk Factors Leading to Diabetes Risk

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