Emerson Augusto Baptista

Introduction: Under-five mortality refers to the death of a child before reaching the age of five. It is a critical indicator of child health and overall development within a country. In this study, we use data from the 2015–16 National Family Health Survey (NFHS) to estimate under-five mortality at the district level in India, considering a range of socioeconomic and demographic variables. Methods: We examined the association between these variables and under-five mortality using a Bayesian hierarchical model for 677 districts, employing the Integrated Nested Laplace Approximation (INLA) approach. Results: Our findings indicate that excess under-five mortality is more prevalent in the northern and northeastern states of India. Additionally, Hindu children and those with literate mothers are less likely to die before reaching their fifth birthday. In contrast, higher risks of under-five mortality were observed among children from socially disadvantaged groups, those who were not exclusively breastfed, and those born through non-institutional deliveries. Conclusions: The results of this study underscore the urgent need for targeted strategies to address under-five mortality in India. A variety of factors, such as biophysical conditions, socio-demographic disparities, and limited access to healthcare, must be addressed not only to strengthen the health infrastructure but also to promote maternal education and reduce socioeconomic inequalities. Prioritizing the implementation of effective health policies and programs is essential for India to achieve the Sustainable Development Goal (SDG) target of reducing under-five mortality and safeguarding the health of its youngest population across regions and demographic groups.

Climate change, especially through heatwaves, significantly affects human health and is a growing global concern. Concurrently, population aging is occurring worldwide, with many countries experiencing an increase in their elderly populations. As the elderly are particularly susceptible to extreme temperatures and unevenly distributed due to internal migration of younger populations, a spatio-temporal analysis integrating temperature changes and demographic data is essential. This study focuses on Japan, a super-aged society where over 25% of the total population is 65 years or older. We examined the effects of climate and the proportion of the elderly population on heatstroke deaths through spatio-temporal analysis within a Bayesian framework. We estimated the annual relative risk of heatstroke-related deaths at the prefecture level from 2008 to 2019. The results indicate a strong spatial autocorrelation in heatstroke deaths across Japan. The spatio-temporal interaction model was the best-performing, showing that regional and temporal variations significantly impact heatstroke mortality. In this model, a one-degree increase in temperature anomaly was linked to a 0.35 (95% CI 0.25 to 0.46) times higher odds of heatstroke deaths, while a 1% increase in the population aged 65 years or older was associated with 4.85 (95% CI 0.92 to 8.65) times higher odds. We found that not only metropolitan areas but also rural areas, such as the Tohoku and Shikoku regions, face a high risk of heatstroke, emphasizing the need to address the challenges in rural communities. Our study highlights the necessity of integrating temperature changes and demographic data in a spatio-temporal context for heatstroke risk assessment. It demonstrates the profound effects of temperature anomalies and the proportion of the elderly population on heatstroke mortality. This research framework could be applicable to other countries experiencing aging and heatwave issues, aiding in the development of targeted public health interventions.

One in six Mexican adults’ lives with type 2 diabetes mellitus (T2DM), which is the third leading cause of death in the country. Analyzing the geographic distribution of T2DM mortality helps identify regions with higher mortality rates. This study aimed to examine the spatial patterns of mortality from type 2 diabetes mellitus (T2DM) across municipalities in Mexico and to analyze the main contextual factors linked to this cause of death in 2020. We employed a spatial Bayesian hierarchical regression model to estimate the risk and probability of death from type 2 diabetes mellitus (T2DM) across Mexico’s municipalities. The SMR results revealed geographic and age-specific patterns. Central Mexico and the Yucatán Peninsula exhibited the highest excess mortality rates. For the population under 50 years of age, municipalities in Oaxaca had the highest T2DM mortality rates, whereas those aged 50 years old and older had the highest rates in Tlaxcala and Puebla. Socioeconomic factors such as low levels of educational attainment, lack of health services, dietary deficiency, and marginalization were positively associated with increased T2DM mortality risk. By contrast, GDP per capita showed a negative association. High-risk areas for T2DM mortality were prominent along the south of the Pacific Coast, the Bajío, Central Mexico, and southern Yucatán for those under 50, and along a central strip extending to the Yucatán Peninsula for the older population. Significant uncertainties in mortality risk were identified, with Central Mexico, Oaxaca, Chiapas, and Tabasco showing high probabilities of excess risk for those under 50 years of age and extended risk areas along the Gulf of Mexico for those 50 years old and older. The assessment and identification of spatial distribution patterns associated with T2DM mortality, and its main contextual factors, are crucial for informing effective public health policies aimed at reducing the impact of this chronic disease in Mexico.

The percentage of the world’s population with disabilities is estimated to be 16%, although its distribution and intensity varies within nations. We aim to disentangle the degree and types of disabilities, estimate the years spent with more severe disabilities, and analyze their distribution across states and between sexes in Mexico. The Mexican Census of 2020 includes information on disabilities, which allows the study of its national distribution. We used life tables and the Sullivan method to calculate the number of years spent with disability (NYSD) and its percentage with respect to life expectancy for each state and each sex. In Mexico, the population with disabilities is estimated to be 16.5%. Of this total, 69% have milder disabilities, while the remaining 31% have more severe disabilities. At age eighteen, there is a higher NYSD from more severe disabilities for females with 5.67 years (95% CI 5.66 to 5.69) as opposed to males with 3.66 years (95% CI 3.65 to 3.67). Across states, a more homogeneous distribution with lower NYSD is observed for men (between 2.44 and 5.69 years) than for women (4.14 and 8.08 years). A north-south division can also be observed, with particularly notorious disadvantages among coastal states, which is more distinctive among women. This study shows that comparing the number of years spent with disability and the total life expectancy between subpopulations is essential for monitoring the well-being of aging populations, guiding policy decisions, and promoting a society that values and supports all individuals, regardless of their abilities.

Objectives The study explores the awareness and e-cigarette use by demographic and socio-economic characteristics of selected 14 Global Adult Tobacco Survey (GATS) countries. Design Cross-sectional. Setting 14 countries. Participants Surveyed population ≥15 years selected through multi-stage cluster sampling. Primary and secondary outcome measures We selected 14 countries from 6 different WHO regions where GATS was conducted in different years during 2011–2017. Results Awareness and usage of e-cigarette were highest in Greece and lowest in India. Females were less aware of e-cigarette across ages. The gender gap in awareness is wide in Greece post 50 years of age, while the gap is distinct in early ages in Kazakhstan and Qatar. The gender difference in use of e-cigarette was negligible in most of the countries except among the younger cohorts of Russia, Philippines Malaysia and Indonesia. Relatively higher prevalence of e-cigarette smoking among females in the older adult age was observed in some of the Asian countries like India. Multivariate analysis indicates that those who were younger, male, residing in urban areas, current tobacco smokers were more likely to use e-cigarette than their counterparts. Though prevalence of e-cigarette use increased with wealth and education, such pattern is not strong and consistent. Promotional advertisement plays important role in higher use of e-cigaratte. The predicted national prevalence of e-ciragette use was highest in Malaysia . Conclusions E-cigarette use is more among urban adults, current smokers, males and in countries with promotional advertisement of e-cigarette. Area specific interventions are needed to understand the nature of e-cigarette use. Russia, Ukraine, Costa Rica and Mexico need better understanding to explore whether e-cigaratte use is an indulgence to new mode of addiction, as youth being highly likely to adopt this practice.

The purpose of this paper is to explore the spatial heterogeneity of internal migration in China and to discuss the influence of economic, social and environmental characteristics on this demographic process. The overall results suggest that migration in China occurred from inland to coastal areas and from rural areas to urban areas. By stepwise regression, we identified that 9 out of 15 factors with potential influence on internal migration were retained, and the multicollinearity among them was reduced. In addition, we used the OLS and GWR regression analysis to discuss the global and local effects of relevant factors on internal migration. Economic scale (GDP), population concentration (population density) and demographic dividend (labour force proportion) were the three main driving forces of internal migration. In turn, internal migration further widened the gap of economic scale, population agglomeration and demographic dividend between counties and cities. Internal migration in southern coastal areas of China was most affected by economic aspects and demographic dividend. In the central China, the population was more concentrated in high-density cities, while in the eastern regions, areas with high level of education were conducive to immigration, thus forming talent reserve highlands. In the west, areas with highly educated level faced out-migration, which might cause brain drain and widen further the gap in talent reserves between the east and the west in China. From the perspective of location, the net immigration of the provincial capital was accompanied by the net immigration of the surrounding area, which was conducive to the formation of city clusters or urban sprawl. On the other side, the net immigration in prefecture-level cities often meant the net out-migration in surrounding areas. The correlation is particularly strong in eastern coastal provinces.