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Common and long-running concern across the world relates to the impact of increasing population aging on health care utilization and more evidence about the inequality in health care utilization by older adults in low- and middle income countries (LMICs) is necessary for assessing the capacity of health care systems in LMICs to align with the universal health coverage agenda. In this paper, using data from WHO Study on global Ageing and adult health (SAGE) in China, Ghana, India, Mexico, Russian Federation and South Africa, multi-national magnitude in inequality of health care use is measured by concentration index in each country. The results show that a pro-rich inequality in health care utilization existed: China Mexico and Ghana show up with a high degree of inequality in outpatient service utilization; most of the countries show up with low level of inequality for inpatient service (except China). Then especially India, but also Ghana, South Africa and China, show up with high degree of inequality and inequity in chronic diseases service utilization. However, there doesn't appear to be one system characteristic of inequality in health care utilization since these six countries all have very diverse characteristics with different stages of the demographic and epidemiological transitions. The decomposition shows that income itself is the most important but not the only driving factor. And distribution of education, health insurance and urban/rural residents are the prime other contributors to health inequality. Also, this paper shows that inequalities for non-communicative diseases service utilization in LMICs produce big challenges, which underlines the role of prevention and health promotion throughout the life course to help reduce burden due to non-communicable diseases. This paper provides a number of new insights on population aging's impact on health care utilization in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

These days, as a consequence of the increase in life expectancy, the pathologies with which we live are also on the rise. This development is the result of what Omran (1971) has defined as epidemiological transition, i.e. the widespread transition from acute to chronic-degenerative diseases. This article takes into consideration one of the most feared pathologies by those over sixty-five: Alzheimer's. Globally, one case of Alzheimer's is diagnosed every 3 seconds (WHO, 2018) and it is considered a fatal disease in the US and UK. In order to account for the complexity of Alzhiemer's, a disease with significant social repercussions, the DIS (diseaseillness- sickness) triad developed by Twaddle (1968), and taken up by several authors (Hoffman 2002, Maturo 2007), has been employed. Examining Alzheimer's from these different perspectives (social-medical-individual) allows us to differentiate it from other diseases. People with Alzheimer's are able to develop their own illness (subjective experience of a pathology) only at an early stage of its progression, because the disease involves irreversible cognitive impairment and the loss of numerous functions related to memory. This is why Alzheimer's can be understood to be a disease without illness. [ABSTRACT FROM AUTHOR]

Low- and middle-income countries (LMICs), particularly those in sub-Saharan Africa, are projected to see the highest increase in chronic non-communicable diseases (NCDs) in the next two decades as part of an epidemiological transition. Although this trend of increasing NCDs is occurring in what may seem a world away, these changing morbidity and mortality patterns in Sub-Saharan Africa have implications for health patterns in the United States (U.S.). Foreign-born Africans represent one of the fastest growing immigrant groups in the U.S. How is the growing heterogeneity within the U.S. black population impacting our understanding of and response to racial and ethnic health disparities in chronic non-communicable conditions? This paper examines the impact of black immigrants on the chronic health experiences of U.S. residents over the course of a decade. Using ten waves of the National Health Interview Survey (2003-2012), I compare the non-communicable health experiences of African-born immigrants, Caribbean/Latin American born-blacks, native-born non-Hispanic, native-born Hispanic blacks, and native-born non-Hispanic whites. Focusing on conditions such as diabetes, heart diseases, hypertension, and stroke, I develop three types of models: one examining differences by race only, one examining differences by race and ethnicity, and one examining differences by race, ethnicity, and nativity. I find significant differences among these models that help clarify the impact of black immigration on NCD disparities. Implications for research and policy are considered. [ABSTRACT FROM AUTHOR]

Given the growing double burden of disease from the coexistence of communicable and noncommunicable diseases in Sub-Saharan Africa (SSA), this paper investigated mortality in Ghana, Cameroon, South Africa, and Kenya in relation to the epidemiological transition. Using life table techniques, we demonstrate the magnitude and toll of the double burden by assessing the change in life expectancy from the absence of communicable or noncommunicable diseases in these countries for the year 2009. Eliminating communicable diseases increased life expectancy at birth by 11.63 years in Ghana, 14.01 years in Kenya, 18.44 years in Cameroon, and 20.59 years in South Africa. Eliminating noncommunicable diseases increased life expectancy at birth by 10.22 years in Ghana, 14.15 years in Kenya, 16.57 years in Cameroon, and 8.46 years in South Africa. Further, when dichotomized by sex, the increase in life expectancy from removing communicable diseases was 1.05 times the increase of eliminating noncommunicable diseases for females and 1.21 for males in Ghana; 0.86 times the increase of eliminating noncommunicable diseases for females, but 1.42 times for males in Cameroon; 3.18 times the increase of removing noncommunicable diseases for females and 3.26 times for males in South Africa; 1.08 times the increase of eliminating noncommunicable diseases for females, but 0.90 times for males in Kenya. Our findings suggest that noncommunicable and communicable diseases warrant equal attention and resources, and caution over-reliance on descriptive constructs like the epidemiological transition framework to explain and prioritize policies and programs in combatting life-threatening diseases. [ABSTRACT FROM AUTHOR]

This study, using the American Changing Lives survey, further clarifies the relationship between socioeconomic status, behavioral and psychosocial risk factors, and health by focusing on transitions between health states. Two central questions frame the analysis. First, to what extent is education an independent predictor of health, controlling for income and psychosocial and behavioral factors? Most studies find that there is an unexplained association between education and health even after controlling for these factors. But is this true for all health transitions (from good health to bad health and from bad health to worse health or death)? Second, when examining different transitions, are risky behaviors and psychosocial factors just as likely to reduce the association between income and health as they are to reduce the association between education and health? We find that these intervening variables are just as likely to reduce the association between income and health, as they are to reduce the association between education and health. This lends support to the idea that income and education may be advantageous for health for similar reasons; there may be a similar underlying benefit to both income and education, which reduces risky behaviors and increases positive psychosocial attributes. [ABSTRACT FROM AUTHOR]