Literacy And Health Status In Developing Countries

Grosse, Robert N.

doi:10.1146/annurev.publhealth.10.1.281

Cited by 17 publications

(21 citation statements)

References 24 publications

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“…Pandemic onset time and physical geography, which may be important in explaining country-wide variance in mortality, vary little within the city of Chicago and are, therefore, unlikely to be important factors in explaining the observed differential mortality. Illiteracy was positively associated with mortality and transmissibility, likely contributing to lower access to medical care as well as decreased awareness and adoption of intervention measures proposed by public health officials, which increases risk of infection and poor clinical outcome (18). The latter explanation may be particularly relevant to the city of Chicago, where strict public health measures, including mandatory quarantines, school closings, and bans on public gatherings, are believed to have significantly reduced the size of the pandemic (34).…”

Section: Discussionmentioning

confidence: 99%

“…We constructed a Poisson model with generalized estimating equations (GEEs) model to explore the fine-scale effects of sociodemographic factors, including illiteracy, homeownership, unemployment, and population density, on influenza mortality. Illiteracy has been cited as the closest approximation of socioeconomic and health status (18), whereas high rates of homeownership and low rates of unemployment are often considered predictors of improved financial security, access to healthcare resources, and general health status (19). To test the robustness of our results to the possibility that the pandemic virus (or a related virus) infected significant numbers of individuals in the spring of 1918 (referred to as a herald wave), we used simulations to investigate the impact of an unobserved herald wave on the observed sociodemographic relationships.…”

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confidence: 99%

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Disparities in influenza mortality and transmission related to sociodemographic factors within Chicago in the pandemic of 1918

Grantz

Rane

Salje

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

145

164

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Social factors have been shown to create differential burden of influenza across different geographic areas. We explored the relationship between potential aggregate-level social determinants and mortality during the 1918 influenza pandemic in Chicago using a historical dataset of 7,971 influenza and pneumonia deaths. Census tract-level social factors, including rates of illiteracy, homeownership, population, and unemployment, were assessed as predictors of pandemic mortality in Chicago. Poisson models fit with generalized estimating equations (GEEs) were used to estimate the association between social factors and the risk of influenza and pneumonia mortality. The Poisson model showed that influenza and pneumonia mortality increased, on average, by 32.2% for every 10% increase in illiteracy rate adjusted for population density, homeownership, unemployment, and age. We also found a significant association between transmissibility and population density, illiteracy, and unemployment but not homeownership. Lastly, analysis of the point locations of reported influenza and pneumonia deaths revealed fine-scale spatiotemporal clustering. This study shows that living in census tracts with higher illiteracy rates increased the risk of influenza and pneumonia mortality during the 1918 influenza pandemic in Chicago. Our observation that disparities in structural determinants of neighborhood-level health lead to disparities in influenza incidence in this pandemic suggests that disparities and their determinants should remain targets of research and control in future pandemics.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Disparities in influenza mortality and transmission related to sociodemographic factors within Chicago in the pandemic of 1918

Grantz

Rane

Salje

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

145

164

View full text Add to dashboard Cite

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“…Literacy rates are also higher in Kerala (94%) than Bihar (62%) (Office of the Registrar General and Census Commissioner, India 2011) and higher literacy has also been linked to higher utilization of health services (Grosse & Auffrey 1989).…”

Section: Our Focusmentioning

confidence: 99%

“…The first is that utilization in Kerala is almost 5 times higher in Kerala than Bihar across all categories. This is expected due to better availability of health services as well as higher literacy, which is linked to higher utilization (Grosse & Auffrey 1989). The second point of interest is the comparison of utilization between non--elderly and elderly.…”

Section: Impact Of Gender On Utilizationmentioning

confidence: 99%

Impact of the Elderly on Household Health Expenditure in Bihar and Kerala, India

Loutfi

Lévesque

Mukherjee

2018

Journal of Health Management

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Ageing in India is leading to an increase in chronic diseases. Given the limited health insurance coverage, this could lead to a variety of economic- and access-related consequences for the households. Against this backdrop, this article aims at examining the impact of the presence of the elderly on household health expenditure, avoidance of treatment, loss of income and use of alternate sources of funding to pay for care. The article uses data from 2004 National Sample Survey Organisation survey on healthcare for two Indian states, namely, Bihar and Kerala. The rate of catastrophic health expenditure (CHE) is found to be higher in Kerala and is associated with a higher proportion of households having elderly members, who, in turn, have higher incidence of chronic disease. While the presence of elderly in the household, incidence of chronic disease and treatment from private sources are linked to CHE, our results suggest that other groups, such as households without elderly, may simply be delaying the economic consequences of paying for healthcare by borrowing. Though the ageing population is leading to increased health expenditure for households due to increased chronic illness, the impact of using private treatment is much less clear.

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“…Literate women are less likely to experience poverty [26,27], more likely to maintain adequate nutritional status [28,29] and make decisions with respect to health and well-being [30,31], access and use information [32,33], and have fewer children [34]. These gains resulting from improvements in female literacy reduce maternal morbidity and maternal mortality.…”

Section: Introductionmentioning

confidence: 99%

Maternal Mortality and Female Literacy Rates in Developing Countries during 1970–2000: A Latent Growth Curve Analysis

Pillai

Maleku

Wei

2013

International Journal of Population Research

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Background. The gross longitudinal relationship between female literacy and maternal mortality ratios has not been adequately investigated even though the knowledge of the relationship is crucial for designing maternal mortality reduction programs through female literacy campaigns and improvements. The objective of the study was to examine the dynamic relationship between female literacy and mortality ratios. A longitudinal study design spanning three decades, 1970-2000, was used. Country level data on 143 nations belonging to six geographical regions for the duration 1970-2000 were secured from websites hosted by global agencies such as World Bank and the United Nations were utilized. Maternal mortality ratios ranged from 147 to 271 across the six regions. The longitudinal relationship between female literacy rates and maternal mortality ratios was examined using a latent growth curve approach. The study found that rates of change in female literacy and maternal mortality ratios are negatively related. Steady rates of increase in female literacy were associated with declining maternal mortality ratios as well. We find that female literacy programs are of immense value in reducing maternal mortality ratios given their ability to yield sustained reductions in mortality levels in developing countries.

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Literacy And Health Status In Developing Countries

Cited by 17 publications

References 24 publications

Disparities in influenza mortality and transmission related to sociodemographic factors within Chicago in the pandemic of 1918

Disparities in influenza mortality and transmission related to sociodemographic factors within Chicago in the pandemic of 1918

Impact of the Elderly on Household Health Expenditure in Bihar and Kerala, India

Maternal Mortality and Female Literacy Rates in Developing Countries during 1970–2000: A Latent Growth Curve Analysis

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