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In this study, we examine the concepts of spatial dependence and spatial heterogeneity in the effect of macro-level and micro-level factors on stunting among children aged under five in Uganda. We conducted a cross-sectional analysis of 3624 Ugandan children aged under five, using data from the 2016 Ugandan Demographic and Health Survey. Multilevel mixed-effect analysis, spatial regression methods and multi-scale geographically weight regression (MGWR) analysis were employed to examine the association between our predictors and stunting as well as to analyse spatial dependence and variability in the association. Approximately 28% of children were stunted. In the multilevel analysis, the effect of drought, diurnal temperature and livestock per km 2 on stunting was modified by child, parent and household factors. Likewise, the contextual factors had a modifiable effect on the association between child's sex, mother's education and stunting. The results of the spatial regression models indicate a significant spatial error dependence in the residuals. The MGWR suggests rainfall and diurnal temperature had spatial varying associations with stunting. The spatial heterogeneity of rainfall and diurnal temperature as predictors of stunting suggest some areas in Uganda might be more sensitive to variability in these climatic conditions in relation to stunting than others.

• The incidence rate of dementia was higher among females - 9.3 per 1000 persons years at risk. • There are spatial variations in the risk of dementia across Denmark among persons aged 65 and above. • The risk intensity was higher among persons living in Copenhagen, southern Jutland and Funen areas. • Individual socioeconomic factors and population density reduces the risk intensity across the country. Dementia is a major global public health concern that is increasingly leading to morbidity and mortality among older adults. While studies have focused on the risk factors and care provision, there is currently limited knowledge about the spatial risk pattern of the disease. In this study, we employ Bayesian spatial modelling with a stochastic partial differential equation (SPDE) approach to model the spatial risk using complete residential history data from the Danish population and health registers. The study cohort consisted of 1.6 million people aged 65 years and above from 2005 to 2018. The results of the spatial risk map indicate high-risk areas in Copenhagen, southern Jutland and Funen. Individual socioeconomic factors and population density reduce the intensity of high-risk patterns across Denmark. The findings of this study call for the critical examination of the contribution of place of residence in the susceptibility of the global ageing population to dementia. [ABSTRACT FROM AUTHOR]

Globally, it is estimated that about 30% of ever-partnered women have experienced some form of intimate partner violence (IPV)—physical assault, sexual assault, or emotional abuse. The prevalence of IPV in sub-Saharan Africa is considerably higher than the global estimate. In Ghana, it is estimated that 24% of women have experienced physical and/or sexual IPV in their lifetime. Studies point to the association between alcohol misuse by intimate male partners and violence against women. However, there has been no consideration for potential spatial variation or heterogeneity in this association. Using estimates from the 2008 Ghana Demographic and Health Survey Data, we employed geographically weighted regression (GWR) analysis to examine spatial variations in the relationship between male partner's alcohol misuse and IPV among women in Ghana. We fitted three models to assess the relationship using a step-wise approach. The first model has alcohol misuse as the only predictor, whereas the second model included other male partner characteristics, such as post-secondary education and employment status. The final introduced female characteristics as additional covariates. The result of the GWR analysis shows that the effect of alcohol misuse on IPV is elevated in the south-western part of Ghana. The findings suggest the potential influence of place-based or contextual factors on the association between alcohol misuse and women's exposure to IPV. [ABSTRACT FROM AUTHOR]

In this study, we examine the association between social frailty and depression among older adults in Ghana over time. We employed longitudinal data analysis to examine the association between social frailty, socioeconomic status and depression using data from the WHO-SAGE survey. Our descriptive and cross-tabulation analyses show that the prevalence of depression and social frailty among older adults decreased considerably in 2014/2015 compared to 2007/2008. The finding also reveals a huge reduction in social frailty among older adults in northern Ghana–the most deprived regions in Ghana–compared to those in southern Ghana. The multivariate panel data analysis reveals that depression was significantly associated with social isolation, financial needs, and physical needs. The findings suggest an over time decline in social frailty and depression among older adults, as well as, reduction in regional differences in social frailty and depression among older adults in Ghana. [ABSTRACT FROM AUTHOR]

Objectives: In our study, we examine how geographic region of residence may predict childhood malnutrition, expressed as stunting, wasting and underweight, among children under the age of 5 years in Uganda.Methods: Using data from the 2016 Uganda Demographic and Health Survey, we performed an incremental multivariate multilevel mixed-effect modelling to examine the effect of a child, parental and household factors on the association between region of residence and each indicator of childhood malnutrition.Results: Approximately 28%, 3% and 9% of children under age 5 suffered from stunting, wasting and underweight, respectively. The bivariate result shows that the proportion of children suffering from stunting and underweight was relatively lower in the Kampala region compared with the other regions. With the exception of the Northern region (6.44%), wasting was higher (4.12%) among children in the Kampala region. Children in the other regions were more likely to experience stunting and underweight. When controlling for child, parent and household factors, children in the other regions were less likely to suffer from underweight and stunting, compared with those in Kampala region. Children in the other regions, except the Northern region, were less likely to be wasted compared with those in Kampala region.Conclusion: Our finding suggests that child, parental and household characteristics have effects on the association between region of residence and childhood malnutrition. Addressing individual and household socioeconomic disparities may be vital in tackling regional differences in childhood malnutrition. [ABSTRACT FROM AUTHOR]

Background: There is a growing understanding of the role played by 'neighbourhood' in influencing health status. Various neighbourhood characteristics—such as socioeconomic environment, availability of amenities, and social cohesion, may be combined—and this could contribute to rising health inequalities. This study aims to combine a data-driven approach with clustering analysis techniques, to investigate neighbourhood characteristics that may explain the geographical distribution of the onset of myocardial infarction (MI) risk. Methods: All MI events in patients aged 35–74 years occurring in the Strasbourg metropolitan area (SMA), from January 1, 2000 to December 31, 2007 were obtained from the Bas-Rhin coronary heart disease register. All cases were geocoded to the census block for the residential address. Each areal unit, characterized by contextual neighbourhood profile, included socioeconomic environment, availability of amenities (including leisure centres, libraries and parks, and transport) and psychosocial environment as well as specific annual rates standardized (per 100,000 inhabitants). A spatial scan statistic implemented in SaTScan was then used to identify statistically significant spatial clusters of high and low risk of MI. Result: MI incidence was non-randomly spatially distributed, with a cluster of high risk of MI in the northern part of the SMA [relative risk (RR) = 1.70, p = 0.001] and a cluster of low risk of MI located in the first and second periphery of SMA (RR 0.04, p value = 0.001). Our findings suggest that the location of low MI risk is characterized by a high socioeconomic level and a low level of access to various amenities; conversely, the location of high MI risk is characterized by a high level of socioeconomic deprivation—despite the fact that inhabitants have good access to the local recreational and leisure infrastructure. Conclusion: Our data-driven approach highlights how the different contextual dimensions were inter-combined in the SMA. Our spatial approach allowed us to identify the neighbourhood characteristics of inhabitants living within a cluster of high versus low MI risk. Therefore, spatial data-driven analyses of routinely-collected data georeferenced by various sources may serve to guide policymakers in defining and promoting targeted actions at fine spatial level. [ABSTRACT FROM AUTHOR]

Research has suggested that children who move home report poorer mental health than those who remain residentially stable. However, many previous studies have been based on cross sectional data and have failed to consider major life events as confounders. This study uses longitudinal data from ALSPAC, a UK population based birth cohort study, and employs within-between random effect models to decompose the association between moving in childhood and poor mental health. Results suggest that while unobserved between-individual differences between mobile and non-mobile children account for a large portion of this association, within-individual differences remain and indicate that moving may have a detrimental impact upon subsequent mental health. There is heterogeneity in children's response to moving, suggesting that a dichotomy of movers vs stayers is overly simplistic. [ABSTRACT FROM AUTHOR]