1.Social determinants of health: Analysis of the effect of socio-environmental factors to diseases, injury-related DALYs, and deaths based on WHO, ILO, and WB data
Jinky Leilanie Lu ; Paolo L. Conception
Acta Medica Philippina 2025;59(Early Access 2025):1-13
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.
OBJECTIVESThis study aims to analyze the social determinants of health indicators and their association with communicable, non-communicable, and injury-related DALYs and deaths.
METHODSData 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.
RESULTSResults 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.
CONCLUSIONSocio-economic factors such as income, employment, education, and social welfare program affect morbidity, disability, and mortality.
Human ; Social Determinants Of Health ; Disability-adjusted Life Years ; Injury ; Wounds And Injuries ; Morbidity ; Mortality
2.Coping strategies to achieve food security among households with children in an urban poor community in Quezon City during COVID-19
Eryn M. Kiunisala ; Beatrice Ysabel G. Dy ; Ralph Alexander T. Flores ; Ramon Raphael M. Montierro ; Renaeus Arlchristian Rualdo D. Torres ; Kim Leonard G. Dela luna ; Ernani R. Bullecer
Acta Medica Philippina 2025;59(1):48-56
BACKGROUND
In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children.
OBJECTIVESThis study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used.
METHODSA descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI.
RESULTSSociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level. The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%).
CONCLUSIONLow CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.
Human ; Food Insecurity ; Adaptation, Psychological ; Nutritional Status ; Food Security
3.Issues and challenges of older persons and research and health facility-based assessors in the conduct of comprehensive geriatric assessment in the Philippines: A descriptive study
Angely P. Garcia ; Eunice U. Mallari ; Jan Michael M. Herber ; Kerry Joana P. Ong ; Shelley Ann F. Dela vega
Acta Medica Philippina 2025;59(8):52-64
BACKGROUND AND OBJECTIVES
The comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary evaluation and management process to identify and address the needs of an older person (OP). However, there are several challenges faced in its implementation which limit its full potential and utility to promote healthy aging. This paper aimed to describe the issues and challenges of those involved in the conduct of the traditional paper-based CGA, specifically older persons and the research and health facility-based assessors.
METHODSThis is a descriptive convergent parallel mixed-methods study utilizing both quantitative and qualitative data from the UP Manila Wellness Initiative for Seniors and Elders research program. Mixed methods of data collection were conducted online, namely survey and focus group discussions (FGD). Purposively recruited OPs aged 60 years and above who previously underwent CGA served as online survey respondents. Similarly, purposively recruited healthcare professionals (HCP) who conduct research-based and facility-based CGA participated in the FGDs. STATA and NVivo PRO Plus were used to analyze the quantitative and qualitative data, respectively. Descriptive statistics were used namely frequencies, percentages, mean, standard deviation, and median. Guided by the interpretivist paradigm, thematic analysis was conducted. Triangulation of results was done by the multidisciplinary team.
RESULTSA total of 30 OPs with mean age of 67.1 years (SD±5.7) responded to the online survey. A total of 10 healthcare professionals, mostly geriatricians, participated in two separate FGDs.
Most (83%) liked the comprehesiveness of the CGA. However, OPs had difficulties with the following: follow-ups (43%), sensitive questions (40%), and recall (23%). Thirty percent (30%) rated the CGA as long to too long. HCP assessors’ challenges were related to the participants/patients, assessors, and operational factors. Participant/ patient-related factors include health conditions, follow-up issues, language, sensory impairment, and familiarity with the tools. Assessors-related factors include competency, missing information, illegible handwriting, and asking sensitive questions. Operations-related factors include the length of the questionnaire and process, physical set up, fragmented system, data storage and protection, and inadequate human resource.
CONCLUSIONThe common issues and challenges identified by the older persons and healthcare professional assessors in the conduct of paper-based CGA include the length of the CGA, sensitive questions, and follow-up issues. Addressing these issues and challenges is necessary to maximize the utility of the comprehensive geriatric assessment in promoting healthy aging. With the advent of technology, digitizing the paper-based CGA is a promising approach to address these challenges.
Geriatric Assessment ; Philippines
4.Factors associated with stunting among infants and young children in the Fourth District of Camarines Sur, Philippines
Jeena Sandra R. Manrique-de hitta ; Kim Leonard G. Dela luna ; Anna Paulina S. Rodriguez ; Mildred O. Guirindola
Acta Medica Philippina 2025;59(9):62-71
OBJECTIVE
This study aimed to investigate the determinants linked to stunting among infants and young children aged 0-23 months in the Fourth District of Camarines Sur.
METHODSAn analytical cross-sectional study was conducted among 628 primary caregivers with infants and young children aged 0-23 months in four municipalities of the Fourth District of Camarines Sur, Philippines, using a two stage stratified random sampling design. Data on sociodemographic and economic factors were collected through face-to-face interviews. Infant and young child feeding (IYCF) indicators were assessed using a list-based approach, while weight and length were evaluated using the World Health Organization Anthro Plus software. Descriptive statistics and multiple logistic regression were done using R statistical software version 4.3.1.
RESULTSThe study revealed that the prevalence of stunting was of significant public health concern, reaching 42.8%. Holding other variables constant, age of the child (OR=0.77; 95% CI: 0.63-0.94), having college undergraduate mothers (OR=0.26; 95% CI: 0.05-1.28), and belonging to a poor income household (OR=0.40; 95% CI: 0.14-0.88) were associated with stunting among infants aged 0.01-6.00 months. Moreover, after controlling for the confounding effects of other variables, age (OR=1.09; 95% CI: 1.05-1.14) and sex of the child (OR=1.55; 95% CI: 1.05-2.28) were associated with stunting among older children aged 6.00-23.99 months.
CONCLUSIONThis study emphasizes the challenge of stunting in the Fourth District of Camarines Sur. None of the IYCF indicators were associated with stunting; however, maternal education, the child’s age, sex, and socioeconomic status were identified as significant factors influencing stunting. Addressing these determinants through targeted interventions focusing on improving maternal education and enhancing socio-economic conditions were crucial to reducing stunting in the study areas.
Human ; Growth Disorders ; Risk Factors ; Nutritional Status ; Infant Nutrition Disorders
5.Micronutrient intake and diet quality of overweight/obese Filipino adults in the National Capital Region, Philippines
Jade Q. Florento ; Kim Leonard G. Dela luna ; Charina A. Javier ; Eldridge B. Ferrer
Acta Medica Philippina 2025;59(10):85-94
OBJECTIVES
This study aims to describe the micronutrient intake and diet quality of overweight and obese Filipino adults in the National Capital Region (NCR). Specifically, it seeks to assess micronutrient inadequacy among these individuals and analyze differences in food intake based on their sociodemographic profiles and lifestyle habits.
METHODSThis analytical cross-sectional study utilized data from the Expanded National Nutrition Survey (ENNS) conducted in 2018, 2019, and 2021 by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). A total of 3,154 overweight and obese subjects were included. ANOVA and Kruskal-Wallis tests were employed to analyze the food groups consumed by these adults.
RESULTSMajority of overweight and obese adults were found to be inadequate in vitamin A (81.7%), vitamin C (88.4%), thiamin (62.5%), riboflavin (70.7%), iron (69.8%), and calcium (88.7%). Significant differences were observed in the mean intake of various food groups across different age groups, sexes, civil statuses, wealth quintiles, educational attainments, employment statuses, and smoking and drinking statuses.
CONCLUSIONFilipino adults who are overweight and obese, and residing in urban settings face significant challenges related to micronutrient inadequacy. When their food intake was assessed based on sociodemographic and lifestyle characteristics, it was found that their diets were more calorie-dense than nutrient-dense. To address this issue, it is recommended to encourage a wider variety of nutrient-dense foods among overweight and obese adults.
Food Intake ; Eating ; Micronutrients ; Overweight ; Obesity ; Nutritional Status
6.The why behind the care: A reflective journey in nursing research
Philippine Journal of Nursing 2025;95(1):98-99
This essay laid out the development of a nurse's identity from clinical practitioner to developing researcher, with a focus on the importance of patient-centered and nurse-centered care as the cornerstone pillars of nursing research. Through narrative and application of qualitative and participatory research approaches, the author showed the intersection of everyday experience, philosophical inquiry, and scholarly pursuit along the path toward becoming a nurse researcher. The article examined how emotional experiences within the perioperative environment have instigated research questions aimed at improving patient and nurse well-being. Through the incorporation of academic models and theoretical perspectives, the author presented an emerging investment in health equity, social determinants of health, and collective inquiry, framing this individual path within the greater nursing science mission.
Human ; Reflective Practice ; Cognitive Reflection ; Nursing Research ; Patient-centered Care ; Social Determinants Of Health
7.Differences in the nutritional status among beneficiaries of a civil society organization according to sociodemographic and economic covariates.
Kim Leonard Dela LUNA ; Alvin Duke SY ; Raycha Lei Concess RAMA-SABANDAL ; Carlos Bernard JACINTO ; Rowel MALIMBAN ; Bernardyn Eliza SALES ; Ryann MAROLLANO ; Alberto MARIN ; Christle Grace CUBELO
Philippine Journal of Health Research and Development 2025;29(3):70-78
BACKGROUND
High-risk areas in the Philippines still experience a high prevalence of undernutrition. The efforts of the governments are not enough to reach those who are in need; hence, the presence of Civil Society Organizations (CSOs) is crucial. One CSO has implemented health and nutrition technical programs to increase the number of well-fed children in four selected areas in the Philippines.
OBJECTIVESThis study aims to shed light on the differences in the nutritional status of the children when they are characterized according to their sociodemographic and economic covariates.
METHODOLOGYAn analytical cross-sectional design was used to survey 692 households, including 764 children aged 0–5 years old. Descriptive analysis and the Chi-Square test of difference were used to answer the objectives.
RESULTSThe study results show that no significant differences were observed when the nutritional status of the children was characterized according to the sociodemographic of the caregiver, food consumption score (FCS) and food security status, water, hygiene and sanitation (WASH) practices, and economic indicators, except weight-for-height and marital status of caregivers, and weight-for-age and livelihood and economic support received by their caregivers (P = 0.02).
CONCLUSIONThe majority of children, regardless of their nutritional status, share the same experience and resources in terms of sociodemographics of caregivers, FCS and food security status, WASH practices, and economic indicators. CSO can boost the impact of their health and nutrition interventions by harmonizing their efforts with government programs, leading to better-targeted and more efficient outcomes.
Human ; Government ; Nutritional Status ; Malnutrition ; Philippines
8.Health profile of workers from different industries in Singapore.
Sin Eng CHIA ; Mei Ling TAN ; Elise CHEOK ; Peh Woon ONG
Singapore medical journal 2025;66(5):271-277
INTRODUCTION:
Workplace safety and health are interrelated - a worker who is not healthy may cause safety lapses at the workplace; conversely, safety lapses could affect the health of the workers. This study was part of a larger Total Workplace Safety and Health (WSH) programme run by the Workplace Safety and Health Council, Singapore. The objectives were to obtain a baseline health profile of workers across four major industries and identify important health risks for targeted workplace interventions.
METHODS:
Five service providers (SPs) were appointed to run the Total WSH programme. As part of the programme, SPs conducted an anonymous basic health survey among workers of participating companies.
RESULTS:
The responses of 6,373 respondents from the cleaning, construction, manufacturing, and transport and storage industries were studied. The overall response rate was 62%. Key health issues identified were high rates of obesity (22%) and smoking (24%) and low prevalence of regular exercise and healthy dietary habits. Chronic disease rates were similar to population self-reported rates (hypertension 15%, high lipid 12% and diabetes mellitus 6%). The workers reported high work stress (13%).
CONCLUSION
Health issues are prevalent in the workforce and may affect work and employee safety. It is increasingly important for employees' health to be considered in risk assessments and prioritised in workplace safety and health management systems and strategies. Health promotion interventions should be targeted, and multilevel and multicomponent initiatives should be integrated with pre-existing occupational safety programmes.
Humans
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Singapore/epidemiology*
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Occupational Health
;
Male
;
Female
;
Adult
;
Middle Aged
;
Industry
;
Workplace
;
Health Surveys
;
Surveys and Questionnaires
;
Smoking/epidemiology*
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Obesity/epidemiology*
;
Health Status
;
Occupational Stress/epidemiology*
;
Young Adult
9.Development and validation of the sarcopenia composite index: A comprehensive approach for assessing sarcopenia in the ageing population.
Hsiu-Wen KUO ; Chih-Dao CHEN ; Amy Ming-Fang YEN ; Chenyi CHEN ; Yang-Teng FAN
Annals of the Academy of Medicine, Singapore 2025;54(2):101-112
INTRODUCTION:
The diagnosis of sarcopenia relies on key indicators such as handgrip strength, walking speed and muscle mass. Developing a composite index that integrates these measures could enhance clinical evaluation in older adults. This study aimed to standardise and combine these metrics to establish a z score for the sarcopenia composite index (ZoSCI) tailored for the ageing population. Additionally, we explore the risk factors associated with ZoSCI to provide insights into early prevention and intervention strategies.
METHOD:
This retrospective study analysed data between January 2017 and December 2021 from an elderly health programme in Taiwan, applying the Asian Working Group for Sarcopenia criteria to assess sarcopenia. ZoSCI was developed by standardising handgrip strength, walking speed and muscle mass into z scores and integrating them into a composite index. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cut-off values, and multiple regression analysis identified factors influencing ZoSCI.
RESULTS:
Among the 5047 participants, the prevalence of sarcopenia was 3.7%, lower than the reported global prevalence of 3.9-15.4%. ROC curve analysis established optimal cut-off points for distinguishing sarcopenia in ZoSCI: -1.85 (sensitivity 0.91, specificity 0.88) for males and -1.97 (sensitivity 0.93, specificity 0.88) for females. Factors associated with lower ZoSCI included advanced age, lower education levels, reduced exercise frequency, lower body mass index and creatinine levels.
CONCLUSION
This study introduces ZoSCI, a new compo-site quantitative indicator for identifying sarcopenia in older adults. The findings highlight specific risk factors that can inform early intervention. Future studies should validate ZoSCI globally, with international collaborations to ensure broader applicability.
Humans
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Sarcopenia/physiopathology*
;
Male
;
Aged
;
Female
;
Retrospective Studies
;
Hand Strength
;
Taiwan/epidemiology*
;
ROC Curve
;
Aged, 80 and over
;
Risk Factors
;
Walking Speed
;
Geriatric Assessment/methods*
;
Prevalence
;
Muscle, Skeletal
;
Middle Aged
10.Health-related quality of life in Singapore: Population norms for the EQ-5D-5L and EORTC QLQ-C30.
Jaclyn TAN ; Mervyn Jr LIM ; Ravindran KANESVARAN ; Richard NORMAN ; Wen Yee CHAY ; Mohamad Farid Bin HARUNAL RASHID ; Mihir GANDHI ; Madeleine KING ; Nan LUO
Annals of the Academy of Medicine, Singapore 2025;54(3):147-159
INTRODUCTION:
Comparison of patient health-related quality of life (HRQOL) scores to a reference group is needed to quantify the HRQOL impact of disease or treatment. This study aimed to establish population norms for 2 HRQOL questionnaires-EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core Question-naire 30 (EORTC QLQ-C30) according to age, sex and ethnicity-and to explore relationships between the EQ-5D-5L, EORTC QLQ-C30 and sociodemographic characteristics. We used a representative sample of adult Singapore residents aged 21 years and above.
METHOD:
This study used data collected from a cross-sectional household survey in which 600 adult Singaporeans completed questions on sociodemo-graphic characteristics-the EQ-5D-5L and the EORTC QLQ-C30. Multiple linear regression analyses were conducted to explore associations between sociodemographic characteristics, the EQ-5D-5L scores and the EORTC QLQ-C30 scores. Regression-based population norms were computed for each subgroup using a post-stratification method.
RESULTS:
In multiple linear regression analysis, age was significantly associated with EQ-5D-5L index and visual analogue scale (VAS) scores, while no sociodemographic characteristics were significantly associated with EORTC QLQ-C30 summary scores. The normative EQ-5D-5L index and VAS scores decreased in adults aged 65 years and above, and EQ-5D-5L index scores were slightly lower in females than males and in non-Chinese than Chinese. The normative EORTC QLQ-C30 summary scores were slightly higher in Chinese than in the non-Chinese group and in the 45-64 age group than other age groups.
CONCLUSION
This study provides population norms for the EQ-5D-5L and EORTC QLQ-C30 for the general adult population in Singapore. Future studies of patient populations in Singapore using EQ-5D-5L or QLQ-C30 can use these normative data to interpret the HRQOL data collected.
Humans
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Quality of Life
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Singapore
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Male
;
Female
;
Middle Aged
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Adult
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Cross-Sectional Studies
;
Aged
;
Surveys and Questionnaires
;
Young Adult
;
Health Status
;
Age Factors
;
Linear Models
;
Aged, 80 and over


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