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Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh: an analysis over a 24-year period

Khan, Jahangir ORCID: https://orcid.org/0000-0002-6151-764X, Trujillo, Antonio J, Ahmed, Sayem, Siddiquee, Ali Tanweer, Alam, Nurul, Mirelman, Andrew J, Koehlmoos, Tracey Perez, Niessen, Louis ORCID: https://orcid.org/0000-0002-8639-5191 and Peters, David H (2015) 'Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh: an analysis over a 24-year period'. International Journal of Epidemiology, Vol 44, Issue 6, pp. 1917-1926.

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Abstract

Background:
Little is known about long-term changes linking chronic diseases and poverty in low-income countries such as Bangladesh. This study examines how chronic disease mortality rates change across socioeconomic groups over time in Bangladesh, and whether such mortality is associated with households falling into poverty.

Methods:
Age-sex standardized chronic diseases mortality rates were estimated across socioeconomic groups in 1982, 1996 and 2005, using data from the health and demographic surveillance system in Matlab, Bangladesh. Changes in households falling below a poverty threshold after a chronic disease death were estimated between 1982–96 and 1996–2005.

Results:
Age-sex standardized chronic disease mortality rates rose from 646 per 100 000 population in 1982 to 670 in 2005. Mortality rates were higher in wealthier compared with poorer households in 1982 [Concentration Index = 0.037; 95% confidence interval (CI): 0.002, 0.072], but switched direction in 1996 (Concentration Index = −0.007; 95% CI: −0.023, 0.009), with an even higher concentration in the poor by 2005 (Concentration Index = −0.047; 95% CI: −0.061, −0.033). Between 1982–96 and 1996–2005, the highest chronic disease mortality rates were found among those households that fell below the poverty line. Households that had a chronic disease death in 1982 were 1.33 (95% CI: 1.03, 1.70) times more likely to fall below the poverty line in 1996 compared with households that did not.

Conclusions:
Chronic disease mortality is a growing proportion of the disease burden in Bangladesh, with poorer households being more affected over time periods, leading to future household poverty.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
WT Geriatrics. Chronic Disease > Chronic Disease > WT 500 General works
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1093/ije/dyv197
Depositing User: Jessica Jones
Date Deposited: 25 Jan 2016 16:14
Last Modified: 06 Sep 2019 11:09
URI: https://archive.lstmed.ac.uk/id/eprint/5514

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