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Globally, rapid economic growth has contributed to an overall increase in the incidence of childhood obesity. Although the prevalence of obesity has been well recognized, the disparities related to a region's socioeconomic environment in terms of the incidence of obesity are still less understood. Therefore, the purpose of this study was to examine the spatial pattern of childhood obesity and identify the potential associations between childhood obesity and socioeconomic environment in the northeastern region of Thailand, Isaan. Using nationally collected obesity data from children aged 0-5 years in 2019, we employed a geographic information system (GIS) to perform obesity cluster analysis at the smaller regional level, investigating a total of 322 districts in study area. Global and local statistical approaches were applied to calculate spatial associations between the socioeconomic status of neighborhoods and childhood obesity. The study revealed that 12.42% of the total area showed significant clusters at the district level, with high values observed in the western and northeastern areas. The results of the spatial statistical model revealed that childhood obesity was significantly positively associated with areas exhibiting high levels of socioeconomic environment factors. Identifying the associated factors and highlighting geographic regions with significant spatial clusters is a powerful approach towards understanding the role of location and expanding the knowledge on the factors contributing to childhood obesity. Our findings, as a first step, offer valuable references that could support policy-makers and local authorities in enhancing policy development with the aim of reducing childhood obesity and improving public health.

Reducing the disparities in healthcare access is one of the important goals in healthcare services and is significant for national health. However, measuring the complexity of access in truly underserved areas is the critical step in designing and implementing healthcare policy to improve those services and to provide additional support. Even though there are methods and tools for modeling healthcare accessibility, the context of data is challenging to interpret at the local level for targeted program implementation due to its complexity. Therefore, the purpose of this study is to develop a concise and context-specific methodology for assessing disparities for a remote province in Thailand to assist in the development and expansion of the efficient use of additional mobile health clinics. We applied the geographic information system (GIS) methodology with the travel time-based approach to visualize and analyze the concealed information of spatial data in the finer analysis resolution of the study area, which was located in the border region of the country, Ubon Ratchathani, to identify the regional differences in healthcare allocation. Our results highlight the significantly inadequate level of accessibility to healthcare services in the regions. We found that over 253,000 of the population lived more than half an hour away from a hospital. Moreover, the relationships of the vulnerable residents and underserved regions across the province are underlined in the study and substantially discussed in terms of expansion of mobile health delivery to embrace the barrier of travel duration to reach healthcare facilities. Accordingly, this research study addresses regional disparities and provides valuable references for governmental authorities and health planners in healthcare strategy design and intervention to minimize the inequalities in healthcare services.

Aim: Limited data are available on the association between oral function and frailty, especially in developing countries. Additionally, the association between objectively assessed chewing function and frailty has not been well studied. The present cross-sectional study tested the hypothesis that objectively measured poor chewing ability is associated with frailty in community-dwelling older Thai adults., Methods: The study population comprised 141 people in Nakhon Pathom, Thailand (median age 72 years). Demographic and clinical data were collected at a community center. Participants were asked to chew a gum designed for assessing chewing ability. The differences in gum color before and after chewing (ΔE*ab) were calculated and used as the exposure variable, where a lower ΔE*ab indicates lower chewing ability. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and used as the outcome variable. Participants with three or more components were considered frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were carried out to assess the association of objective chewing ability with frailty., Results: Of the 141 participants, 32 (22.7%) were categorized as frail and 78 (55.3%) as pre-frail. In the analysis adjusted for demographic and health characteristics, the adjusted odds ratio of the presence and severity of frailty was significantly higher in participants with lower ΔE*ab (adjusted odds ratio for one decrease in ΔE*ab 1.05, 95% confidence interval 1.01-1.10, P = 0.03)., Conclusions: Objectively measured chewing ability was significantly associated with frailty in community-dwelling older Thai adults. Geriatr Gerontol Int 2018; 18: 860-866., (© 2018 Japan Geriatrics Society.)