INTRODUCTION

The social determinants of health refer to an individual's social, political, and economic situation and environment, which can have an impact on their health. On the other hand, disability-adjusted life years (DALYs) reflect the mortalities and morbidities incurred due to disease and injury.

This study aims to analyze the social determinants of health indicators and their association with communicable, non-communicable, and injury-related DALYs and deaths.

Data from World Health Organization, World Bank, and International Labor Organization were used and considered for the 17 Social Determinants of Health categories. Logistic regression was used to determine the relationship of social determinants of health indicators with communicable, non-communicable, and injury-related DALYs and deaths.

Results show that an increase in the population, monetary poverty, adult illiteracy, and fine particulate matter increase IPNN DALYs. This study also found correlations of socioeconomic factors to NCD deaths and DALYs attributable to the environment. NCD DALYs and deaths are found to increase with the number of poor living with 3.10 dollars a day, while median daily per capita income, and increase in persons above retiring age receiving pension decrease NCD DALYs attributable to the environment. Focusing on injury DALYs and deaths, an increase in the number of poor living at 3.10 dollars a day, non-agricultural informal employment, and total average concentration of f ine particulate matter increases injury DALYs while the latter is observed to decrease when there is an increase in the medial daily per capita income, agricultural employment outside the formal sector, and vulnerable persons covered by social assistance.

Socio-economic factors such as income, employment, education, and social welfare program affect morbidity, disability, and mortality.

INTRODUCTION

The social determinants of health refer to an individual's social, political, and economic situation and environment, which can have an impact on their health. On the other hand, disability-adjusted life years (DALYs) reflect the mortalities and morbidities incurred due to disease and injury.

This study aims to analyze the social determinants of health indicators and their association with communicable, non-communicable, and injury-related DALYs and deaths.

Data from World Health Organization, World Bank, and International Labor Organization were used and considered for the 17 Social Determinants of Health categories. Logistic regression was used to determine the relationship of social determinants of health indicators with communicable, non-communicable, and injury-related DALYs and deaths.

Results show that an increase in the population, monetary poverty, adult illiteracy, and fine particulate matter increase IPNN DALYs. This study also found correlations of socioeconomic factors to NCD deaths and DALYs attributable to the environment. NCD DALYs and deaths are found to increase with the number of poor living with 3.10 dollars a day, while median daily per capita income, and increase in persons above retiring age receiving pension decrease NCD DALYs attributable to the environment. Focusing on injury DALYs and deaths, an increase in the number of poor living at 3.10 dollars a day, non-agricultural informal employment, and total average concentration of f ine particulate matter increases injury DALYs while the latter is observed to decrease when there is an increase in the medial daily per capita income, agricultural employment outside the formal sector, and vulnerable persons covered by social assistance.

Socio-economic factors such as income, employment, education, and social welfare program affect morbidity, disability, and mortality.

BACKGROUND

Social determinants of health are wider set of forces and systems that greatly influence an individual’s health outcomes.

This study aims to determine the socio-economic indicators that influence certain health indicators focusing on maternal and children under-5 health.

Selected data from from the World Health Organization (WHO), World Bank, and International Labor Organization (ILO) were primarily used to model health outcomes such as mortality rates, disability-adjusted life years, and deaths and injuries due to occupational injuries. A total of 194 countries were considered as respondents in this study. Linear hierarchical multiple regression was used to determine the relationship of social determinants of health on life expectancy at birth, maternal mortality ratio (per 100,000 live births), under-5 years mortality ratio, prevalence of overweight in children under-5 years, and death rate (per 100,000 population).

Data from 194 countries shows that the global average life expectancy is 55.7 years. The global average maternal mortality ratio is 1119.509 per 100,000 live births, and maternal mortality is significantly increased by factors such as increase in total vulnerable employment, total unemployment, and CPIA gender equality rating. Focusing on children’s health outcomes, the global average under-5 mortality rate was 102.247 per 100,000 live births. Mortality rate for children under-5 increases with total vulnerable employment and total unemployment, while adult literacy rate, 1 medical doctor per 10,000 population, and food safety level decreases under-5 mortality rates. The global overweight prevalence in children under-5 is 10.389%. The increase in average monthly earnings of employees working in service and sales increases its prevalence. For death rate, the global average is 682.818 per 100,000 population. This is further positively affected by an increase in rural population and total unemployment. On the other hand, adult literacy rate decreases death rate.

Socio-economic factors such as income, education, employment, and government support influence maternal and children under-5 health indicators. Thus, programs, projects, and activities that aim to positively affect the health of the public should be holistic and should also focus on positively altering the health behavior of the public.

Introduction. The ever-increasing global road traffic accidents is caused by several risk factors: human factors, vehicle factors, and road environmental factors. In the Philippines, 12,000 road users die annually due to road crashes and almost one-third are alcohol-related crashes.

Objectives. This study aims to investigate the effects of suspected alcohol intoxication on the severity of injuries among drivers and passengers in a major urban region in the Philippines using the Metro Manila Accident Recording and Analysis System (MMARAS) of the Metropolitan Manila Development Authority from 2005 to 2020.

Methods. The Metro Manila Accident Recording and Analysis System (MMARAS) was used to determine the data on trends and association for alcohol-related road crashes, while descriptive and inferential statistics such as logistic and multinomial regression were used to determine trends and associations.

Results. Suspected alcohol intoxication road crash cases in Metro Manila have decreased from 45 cases in 2005 to 31 cases in 2020. The year 2011 recorded the highest cases of alcohol-suspected road crashes. The years 2010, 2011, and 2012 recorded the highest number of driver's death while 2005, 2006, 2014, and 2019 recorded higher deaths for passengers. Cars and motorcycles are the most commonly involved vehicles in alcohol-suspected road crashes, while Quezon City (n=307) and Marikina City (n=267) are the common places of incidence for drunk-driving accidents. On the other hand, alcohol intoxication increases the risk of driver's death (OR=9.16; 95% CI [5.388-15.574]) and injury (OR=5.22; 95% CI [4.487-6.074]). While intoxicated, hitting an object (OR = 12.557; 95% CI [1.478-106.694]) and truck collisions (OR=7.176; 96% CI [1.261-40.817]) can increase the risk for driver's death. Meanwhile, side swipe (OR=2.330; 95% CI [1.029-5.277]) and angle impact (OR= 7.972; 95% CI [1.804-35.227]), increase the odds for driver injuries.

Conclusion. Suspected alcohol intoxication road crashes can be prevented; however, a collaborative effort is needed. The government is responsible for road safety education as well as effectively enforcing road safety-related laws, while the road users shall use the roadways responsibly.

Introduction. With the growing number of females employed as factory workers, it is important to look into the phenomenon of burnout and related organizational climate affecting these workers.

Objectives. The objectives of the study were: 1) to determine the effect of organizational climate on burnout among female factory workers; and 2) to look into the association between burnout as well as illnesses, injuries, hazard exposures and organizational climate factors.

Methods. The secondary data used for this study was from a cross-sectional study involving 344 female factory workers. This paper is a continuing analysis of the previous paper of the same author which focused on establishing indices for burnout. This paper proceeds with correlation analysis between burnout and associated organizational factors, illnesses, and injuries in the workplace.

Results. There was a total of 344 female respondents with mean age of 26 (SD=5.02), and majority were single (69.21%). Burnout score was significantly positively correlated with all experienced workplace accidents. Female workers getting wounded due to sharp objects has a strong positive relationship with burnout score. Eye infection, dust inhalation, electrical accidents, and getting caught in machine parts have a moderate positive relationship with burnout score. Meanwhile, for illnesses, the following have a weak positive relationship with burnout - headache, cough and colds, genitourinary infections and bodyache. Organizational Climate Factors such as Autonomy on Quality, Physical Work Content, and Personal Worker Perception Index were significant factors to increasing the relative risk for more sickness experienced among the female workers. Strong positive relationship existed with burnout score and excessive noise in workplace. Dust, intoxicating odors, and high temperatures have a moderately strong positive relationship. Organizational factors significant in predicting burnout were Autonomy on Quality, Skilled Work Content, Physical Work Content, Hazardous Work Content, Health, Safety, and Compensation, and Upskilling and Training Index. Results also showed that a higher autonomy on speed, how much work was done, and how work was done decreases probability of burnout. Linear regression showed that Burnout was also associated with workplace accidents, self-reported illnesses, and hazard exposures as independent variables.

Conclusion. This study has come up with correlational analysis between burnout and organizational factors, as well as with illnesses, injuries and hazard exposures in the occupational setting. This is a significant study as basis for policy and program formulation by industries concerned as well as the government.

INTRODUCTION: Metro Manila, the metropolitan center and seat of the national government, is composed of 16 cities and 1 municipality, and considered as the second-most populous region in the Philippines. Transport is a key sector that is needed for accessibility and economic progress. Yet, the question on safety of the roads of Manila remains as road crashes continue to be reported. OBJECTIVE: The study aims to determine the trend of road crashes in Metro Manila, and the factors associated with both fatality and injury among three types of road users – the drivers, the passengers, and the pedestrians. METHODS: A retrospective analysis of 523,059 road crash data between 2016 to 2020 was done. Using descriptive statistics, the road crash variables analyzed in the study were (1) crash classification according to damage to property, fatal, and non-fatal crash, (2) road user type according to driver, passenger, and pedestrian, (3) vehicle type, (4) junction type, and (5) risky road user behavior. Logistic and multinomial regression models were used to determine whether these variables were significant with road user fatality and injury. RESULTS: The analysis of the MMARAS database (n=523,059) showed an increasing trend of road crashes occurred since 2016 and peaked in 2019, and declined in 2020. Majority (436,367, 83.426%) were damage to property, followed by non-fatal or injurious cases (84751, 16.203%) and fatal outcomes (1941, 0.371%). Drivers have the greatest number of fatalities and injuries compared to passengers and pedestrians. Cars (513482 52.322%) and motorcycles (136641, 13.923%) remain the major types of vehicles involved in road crashes. The factors that were significantly associated with increased odds ratio for driver death were involvement of pedicabs (OR=10.937, p=0.000), motorcycles (OR=55.061, p=0.000), bus (OR=5.835, p=0.000), truck (OR=7.073, p=0.000), hit object (OR=11.007, p=0.000), self-accident (OR=6.149, p=0.000), and collisions in bridges/flyovers (OR=2.713, p=0.010)). The factors that were significantly associated with increased odds ratio for passenger fatality were the involvement of motorcycle (OR=3.75, p=0.021), angle impact (OR=42.01, p=0.002), multiple collision (OR=18.42, p=0.040), self-accident (OR=32.66, p=0.010), and lost control (OR=82.98, p=0.001). The factors significantly associated with pedestrian fatality were hit and run (OR=56.04, p=0.000), hit pedestrian (OR=1085.17, p=0.000), and crashes in bridges/flyover (OR=4.20, p=0.025). Meanwhile, multinomial regression showed that classification of crash and vehicle type were significantly associated with fatal and non-fatal crashes. CONCLUSION The study showed the trend of fatality and injury among drivers, passengers, and pedestrians from 2016-2020, and factors of road crashes in Metro Manila including vehicle type, road behaviors, collision type and junction type.

INTRODUCTION: Although Occupational Health and Safety (OSH) has been introduced as early as 1971, the protection of workers remained insufficient globally as 360 million occupational accidents occurred annually. In the Philippines, the incidence rate of occupational injury is 4.27 percent which indicates that there are around 4 cases of occupational injuries with workdays lost per 100 workers. OBJECTIVE: The study aims to determine the trend of work-related injuries using hospital data entries from 2010-2020, and factors that contribute to work-related injuries and worker fatalities in the Philippines. METHODS: The work-related data from the Department of Health’s Online National Electronic Injury Surveillance System (ONEISS) from 2010 to 2020 was processed and analyzed in the study using exploratory data analysis presented as table and graphs, and logistic regression and phi-coefficient analysis for statistical inference. The relationships between patient fatality, type of injury sustained, and external factors for occupational injuries and fatalities were analyzed. RESULTS: A total of 72,897 (6.6%) work-related injuries and worker fatalities were analyzed in this study. The reports of occupational injuries and fatalities increased and peaked in 2019 and declined by 2020. Phi coefficient determined that all injuries sustained were significantly associated with work-related activities. Phi coefficient showed that all types of injuries were significantly associated with patient fatality. The external causes that were found to be significantly associated with patient fatality using phi coefficient were contact with sharp objects, exposure to forces of nature, fall, and transport and vehicular crash. Fall was significantly associated with patient fatality while also increasing its odds (OR=2.57, 95% CI: 1.76 – 3.75), and increased odds for multiple injuries (OR=2.30, 95% CI: 2.17 – 2.45), abrasion (OR=2.10, 95% CI: 1.97 – 2.24), and fracture (OR=9.66, 95% CI: 8.92 – 10.46). Transport/vehicular crash was significantly associated with increased patient fatality (OR=2.94, 95% CI: 2.22 – 3.88), multiple injuries (OR=6.77, 95% CI: 6.48 – 7.07), abrasion (OR=12.87, 95% CI: 12.34), and fracture (OR=4.12, 95% CI: 3.82 – 3.45). CONCLUSION The study determined the relationship between work-related injuries, patient fatalities, types of injuries, and external causes of injuries based on the ONEISS data from 2010 to 2020. It is recommended that the study results be used in evaluating work-related accidents and in conducting comprehensive health assessments.

Introduction: Small-scale mining (SSM) has been in the Philippines since the early 1900s and significant contributor to the local economy. SSM has contributed 14% of the country's total Gross Domestic Product and has a revenue share of about 19 billion pesos (380 million USD). Objectives: This study aims to document mining occupational safety and health in SSM in the Philippines and identify best practices among miners and communities to reduce toxic chemical use in mining. It also aims to evolve laws and legislative measures on mining in the country as the basis for more aggressive policies and programs for SSM in the Philippines. Methods: The data were based on gray literature, peer-reviewed journals, databases, government statistics, and secondary literature. Data were analyzed through critical appraisal on the impacts of mining in terms of occupational safety, mining issues, hazards, and disasters, environmental and health impact, as well as documentation of best practices in mining to reduce the use of toxic chemicals, and the current laws and legislations on mining in the Philippines. Results: SSM or artisanal mining is categorized as part of the informal sector of the market economy. In the Philippines, the leading types of accidents in the mines are being hit by falling objects, suffocation from chemical fumes, and crushing injuries, exposure to intense heat, poor ventilation, vibration, dust, fumes, repetitive stress injury, intense noise, manual handling (e.g., lifting) of heavy machinery, and biological and chemical hazard. Occupational illnesses include skin diseases, emphysema, chronic obstructive lung disease, and hearing loss. Due to these risks, the Philippines has adopted mercury-free mining, cyanide reduction, and green and climate-smart mining. The use of borax in recovering gold from ore instead of mercury originated in the Philippines, which is now widely known as the mercury-free gravity-borax method adopted in Africa and Asia. The Philippines also has a plethora of laws covering mining as a whole. Developmental directives include enacting specific SSM laws and regulations, including a separate set of safety rules, and decentralizing the issue and control of SSM permits and licenses through local government units. Some noted legislative measures, Presidential Decrees, and Administrative Orders have been crafted to cover the safety net, equity, safety, and health for small-scale miners, among the most vulnerable working populations. Discussion: Hazards and risks have been documented in SSM in the Philippines. However, the policies, legislation, and protective measures on SSM warrant more comprehensive coverage, implementation, and provision of social safety nets. Conclusion The study concludes that mining in the Philippines continues to be a problem as it produces adverse effects on workers' health, the community, and the environment. It is crucial to ensure the health and safety of mining workers, and all players and stakeholders must fulfill their respective roles. Governments and communities need to perform their regulatory and monitoring functions dutifully to build up their capacities to benefit mining communities that contribute much to the local economy.
Occupational Injuries ; Mining

Introduction: Pesticides are widely used in the agricultural sector to increase production by cutting down costs and improving the quality of produce. However, these chemicals come with serious health effects when an individual is exposed to large quantities at once, or low quantities over time. Objectives: The objective of the study is to investigate the knowledge, attitude, and practices of farmers, as well as investigate the correlation among knowledge, attitude, and practice variables. Methods: This research study used a cross-sectional design. Samples were drawn based on a multistage sampling of 387 agricultural workers. The target site was in Southern Philippines and the sample was selected using multi-stage sampling from the identified municipalities. Survey questionnaires were given to the respondents to measure knowledge, attitude, and practices (KAP) on pesticide exposure among farmers. The data were encoded using SPSS 13.0. The statistics used were both descriptive and inferential. Correlation analysis was used to study the relationship among knowledge, attitudes, and practices. Results: The results showed that farmers used pesticides in their farms on an average of 2.31 days per week (SD 2.13). The respondents reported that they were exposed to pesticides for about 3.46 months per cropping season (SD: 2.76), as well as from 3.34 (SD 5.92) cropping seasons per year. The mean score of the respondents on the knowledge aspect of the questionnaire was 5.91 out of 10 items (SD 3.28). The average score on practices on pesticide use among respondents was 3.37 (SD 1.75) with 8 items to evaluate practices. Lastly, the mean score on attitude on pesticide use among respondents was 5.34 (SD 3.31) over 12 items. Analysis showed a moderate correlation between knowledge and attitude with Pearson’s r = 0.651 (P <0.0001), also a moderate correlation between knowledge and practices at r = 0.521 (P <0.0001), and a moderate correlation between practices and attitudes at r = 0.443 (P <0.0001). Factor analysis revealed three components for items within practices and attitudes and two for items within knowledge. Conclusion Pesticide use in the Philippines continues to present various challenges in terms of its safety to humans and the environment. Farmers do not have adequate knowledge of pesticides and their proper management from use to disposal. They need to improve knowledge, encourage a healthy and safe attitude and correct practices on the hazards from pesticides, as well as its proper usage and handling. It is recommended that capacity building and training for farmers are initiated to address inadequacies in their knowledge, attitudes and practices.
Knowledge ; Attitude ; Farmers

Introduction: Companies and hospitals in the healthcare industry, like other businesses, are not exempted from the rising labor costs and growing dissatisfaction among employees. The assessment and optimization of total rewards management (TRM) are important since TRM consists of monetary and non-monetary rewards given to employees in exchange for their time, talents, and efforts. Objective: This study assessed the TRM in Philippine healthcare companies. This study also looked into the organizational structure of various health-service companies and their TRM, and the difference between companies with TRM and without TRM in terms of pay, benefits, work-life balance, career development, and performance recognition. Method: A total of 74 human resource personnel were randomly sampled from healthcare companies in the Philippines. A survey questionnaire was administered with items on TRM philosophy divided into five parts – pay, benefits, work-life balance, career development, and performance recognition. High mean scores per TRM component correspond to higher levels of agreement to positive statements to the corresponding TRM component. Chi-square test was used to determine the association between various demographic variables and the existence of a TRM philosophy in a company. T-test was used to determine whether the differences in the mean scores per TRM component were statistically significant or not. Results: Less than half (44%) of the included companies have TRM and companies in Metro Manila were more likely to have an existing TRM philosophy. Companies in the healthcare sector usually disseminate information on TRM during town hall meetings, and not during onboarding. Employees in the healthcare companies had strict work schedules as most employers did not allow flexi-time arrangements. This may have contributed to burnout and stress that are common in most companies. Lastly, employees working in companies with a TRM philosophy do not experience significantly better pay, benefits, work-life balance, career development, and performance recognition than those working in companies without TRM. Conclusion These findings suggest that even companies with an established TRM philosophy need significant improvement in their TRM processes for TRM to translate to better pay, benefits, work-life balance, career development, and performance recognition.
Work-Life Balance