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16. Socioeconomic correlates of trauma: An analysis of emergency ward patients in Yaoundé, Cameroon

Author

Kacker, Seema, Bishai, David, Mballa, Georges Alain Etoundi, Monono, ME, Schneider, Eric B, Ngamby, Kouo, Hyder, Adnan A, and Juillard, Catherine J

Subjects
Public Health, Health Sciences, Clinical Research, Physical Injury - Accidents and Adverse Effects, 7.1 Individual care needs, Management of diseases and conditions, 8.1 Organisation and delivery of services, Health and social care services research, Disputed aetiology and other, Injuries and accidents, Good Health and Well Being, Accidental Falls, Accidents, Traffic, Adolescent, Adult, Aged, Aged, 80 and over, Cameroon, Child, Child, Preschool, Emergency Service, Hospital, Female, Humans, Infant, Injury Severity Score, Male, Middle Aged, Prospective Studies, Registries, Sex Factors, Social Class, Trauma Centers, Wounds and Injuries, Young Adult, Socioeconomic status, Trauma, Global health, Epidemiology, Clinical Sciences, Nursing, Public Health and Health Services, Orthopedics, Biomedical and clinical sciences, Clinical sciences, Dentistry, Health sciences
Abstract

IntroductionInjury is a significant and increasingly common cause of morbidity and mortality in sub-Saharan Africa; however, the social and economic factors underlying these trends are not well understood. We evaluated the relationship between socioeconomic status (SES) and trauma outcomes using a prospective registry of patients presenting to the largest trauma hospital in Yaoundé, Cameroon.MethodsTrauma patients (n=2855) presenting to the emergency ward at Central Hospital, Yaoundé between April 15 and October 15, 2009 were surveyed regarding demographic and socioeconomic background, nature and severity of injuries, treatment, and disposition. A wealth score was estimated for each patient, corresponding to an SES index constructed using principle components analysis of the urban Cameroonian Demographic and Health Survey. Logistic regression was used to evaluate the effects of SES on care-seeking behaviour, injury severity, and treatment outcome.Main outcome measuresSES wealth score, care-seeking prior to visiting hospital, injury severity, treatment outcome.ResultsPatients aged 1-89 presented with road traffic injuries (59.83%), falls (7.76%), and penetrating trauma (6.16%), and had higher SES than the broader urban Cameroonian population. Within the Yaoundé sample, being in the lowest SES quintile was associated with an increased likelihood of having sought care elsewhere before presenting to the hospital (aOR=3.28, p

Published
2016

23. Studies in historical living standards and health : integrating the household and children into historical measures of living standards and health

Author

Schneider, Eric B., Allen, Robert C., and Oxley, Deborah

Subjects
339.4, Economic and Social History, Economic history, Development economics, History of Britain and Europe, History of North America, Living Standards, Health History, Real Wages, Family Income, Monte Carlo Simulation, Energy Cost Accounting, American Slaves, Children's Growth
Abstract

This dissertation attempts to integrate the household and children more fluidly into measures of well-being in the past. In part one, I develop a Monte Carlo simulation to test some of the assumptions of Allen’s welfare ratio methodology. These included his assumptions that family size was constant over time, that there were no female-headed households and that women and children did not participate in the labour force. After all of the adjustments, it appears that Allen’s welfare ratios underestimate the welfare ratios of a demographically representative group of families, especially if women and children’s labour force participation is included. However, the predicted distributions also highlight the struggles of agricultural labourers, who are given separate consideration. Even the average agricultural labourers’ family with women and children working would have had to rely of self- provisioning, gleaning, poor relief or the extension of the working year to make ends meet at the poorest point in their family life cycle. Part two adjusts Floud et al.’s estimates of calorie availability in the English economy from 1700 to 1909 for the costs of digestion, pregnancy and lactation. Taken together, these three additional costs reduced the amount calories available by around 15 per cent in 1700 but only by 5 per cent in 1909 because of the changing composition of the English diet. Part three presents a new adaptive framework for studying changes in children’s growth patterns over time and a new methodology, longitudinal growth studies, for measuring gender disparities in health in the past. An adaptive framework for understanding growth provides a more parsimonious explanation for the vast catch-up growth achieved by slave children in the antebellum American South. The slave children were only able to achieve this catch-up growth because they were programmed for a tall height trajectory by relatively good conditions in utero. Finally, impoverished girls experienced greater catch-up growth than boys in two schools in late-nineteenth century Boston, USA and early-twentieth century London, suggesting that girls were deprived relative to boys before entering these institutions.

Published
2014

45. Did smallpox cause stillbirths? : Maternal smallpox infection, vaccination, and stillbirths in Sweden, 1780–1839

Author

Schneider, Eric B., Edvinsson, Sören, Ogasawara, Kota, Schneider, Eric B., Edvinsson, Sören, and Ogasawara, Kota

Abstract

While there is strong evidence that maternal smallpox infection can cause foetal loss, it is not clear whether smallpox infections were a demographically important cause of stillbirths historically. In this paper, we use parish-level data from the Swedish Tabellverket data set for 1780–1839 to test the effect of smallpox on stillbirths quantitatively, analysing periods before and after the introduction of vaccination in 1802. We find that smallpox infection was not a major cause of stillbirths before 1820, because most women contracted smallpox as children and were therefore not susceptible during pregnancy. We do find a small, statistically significant effect of smallpox on stillbirths from 1820 to 1839, when waning immunity from vaccination put a greater share of pregnant women at risk of contracting smallpox. However, the reduced prevalence of smallpox in this period limited its impact on stillbirths. Thus, smallpox was not an important driver of historical stillbirth trends.

Published
2023
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