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  • 1
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    Association between Practising Religion and Cardiovascular Disease Risk among Ghanaian Non-Migrants and Migrants in Europe: The RODAM Study
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 5 ( 2021-03-02), p. 2451-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 5 ( 2021-03-02), p. 2451-
    Abstract: (1) Background: Sub-Saharan African migrants residing in high-income countries are more affected by cardiovascular diseases (CVDs) and associated risk factors than host populations for unclear reasons. The aim was to explore the associations of religion and religious affiliations with CVD risk among Ghanaian non-migrants and migrants in Europe. (2) Methods: The 10-year CVD risk was estimated using pooled cohort equations for 3004 participants from the cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) study. Logistic regression analyses were conducted to assess associations between religion and elevated CVD risk (score ≥ 7.5) with adjustment for covariates. (3) Results: Religious men in Europe had a lower 10-year CVD risk compared with non-religious men (adjusted OR 0.51; 95% confidence interval 0.30–0.85), specifically men affiliated with Seventh-Day Adventism (0.24; 0.11–0.53) followed by other affiliations (0.32; 0.11–0.94) and Roman Catholicism (0.42; 0.21–0.86). The opposite was found in Ghana, with religious women having higher odds for elevated 10-year CVD risk (1.53; 1.02–2.30) compared with their non-religious counterparts, specifically women affiliated with Reformed Christianity (1.73; 1.03–2.90) and other denominations (2.81; 1.20–6.54). Associations were not significant for men in Ghana and women in Europe. Adjustments for social support, stress, and health behaviors did not meaningfully alter the associations. (4) Conclusions: Christian religious Ghanaian men living in Europe seem to have lower CVD risk compared with their non-religious counterparts, while Christian religious women in Ghana appear to have increased CVD risk. Further unravelling the contributing factors and the differences between sex and environmental settings is needed.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18052451
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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  • 2
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    The Magnitude and Directions of the Associations between Early Life Factors and Metabolic Syndrome Differ across Geographical Locations among Migrant and Non-Migrant Ghanaians—The RODAM Study
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 22 ( 2021-11-15), p. 11996-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 22 ( 2021-11-15), p. 11996-
    Abstract: Background: Early-life factors (ELFs) such as childhood nutrition and childhood socio-economic status could be the drivers of the increase in metabolic syndrome (MetSyn) among African populations, but data are lacking. This study evaluated whether markers of childhood nutritional status and childhood socio-economic status were associated with MetSyn in adulthood among migrant Ghanaians living in Europe and non-migrant Ghanaians living in Ghana. Methods: Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2008 migrants and 2320 non-migrants aged ≥25 years, were analysed for this study. We used leg-length to height ratio (LHR), which is an anthropometric marker of childhood nutritional status, and parental education, which is a marker of childhood socio-economic status, as proxies. Adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for demographic and lifestyle factors. Results: Parental education was higher among Ghanaians in Europe than among residents in rural and urban Ghana. The prevalence of MetSyn was 18.5%, 27.7% and 33.5% for rural, urban, and migrant residents, respectively. LHR was inversely associated with MetSyn among migrants. Compared with high paternal education, individuals with low paternal education had lower odds of MetSyn in migrants (AOR 0.71 95% CI 0.54–0.94). In contrast, compared with high maternal education, individuals with intermediate maternal education had higher odds of MetSyn in urban Ghanaians (AOR 4.53 95% CI 1.50–3.74). No associations were found among rural Ghanaians. Conclusion: The magnitude and direction of the associations between ELFs and MetSyn differ across geographical locations. Intermediate maternal education was positively associated with MetSyn among urban Ghanaians, while LHR and low paternal education were inversely associated with MetSyn among migrant Ghanaians. Further research into the interplay of genetics, environment and behaviour is needed to elucidate the underlying pathological mechanisms of MetSyn amongst migrants.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph182211996
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 3
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    Healthcare Utilisation of Moluccans in the Netherlands: Equal Care for Equal Need after 60 Years of Residence in the Host Country?
    MDPI AG ; 2020
    In:  International Journal of Environmental Research and Public Health Vol. 17, No. 23 ( 2020-11-24), p. 8710-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 23 ( 2020-11-24), p. 8710-
    Abstract: Background: In many countries, recent migrants have difficulties using healthcare to the same extent as host populations. It is uncertain whether these differences persist for long-settled migrants. This study examined healthcare utilisation of Moluccans in 2012, more than 60 years after they migrated from Indonesia to the Netherlands. Methods: A survey was held among 715 Moluccans and 3417 Dutch persons. Differences in healthcare utilisation were assessed using regression analyses adjusting for age, gender, indicators of health, religious affiliation, and education. Results: Moluccans had lower rates of healthcare use, including visits to the general practitioner (odds ratio (OR) = 0.67), outpatient medical specialist (OR = 0.50), dentist (OR = 0.65), and physiotherapist (OR = 0.56), as well as the use of paid housekeeping services (OR = 0.37). Among those who visited a healthcare service, no difference was found between Moluccans and Dutch in the frequency of visits, except for physiotherapist visits (rate ratio (RR) = 0.51). For the risk of hospitalisation, no difference was found; however, of those admitted to the hospital, the frequency of admission was lower among Moluccans than Dutch (RR = 0.74). Conclusions: Despite their long residence in the host country, equal utilisation of healthcare services has not been achieved for Moluccans in the Netherlands. Demand-based factors (e.g., family networks, health beliefs, and use of traditional medicine) may contribute to the persistence of such differences and require further investigation.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph17238710
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
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  • 4
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    Reduced Rank Regression-Derived Dietary Patterns Related to the Fatty Liver Index and Associations with Type 2 Diabetes Mellitus among Ghanaian Populations under Transition: The RODAM Study
    MDPI AG ; 2021
    In:  Nutrients Vol. 13, No. 11 ( 2021-10-20), p. 3679-
    Details
    In: Nutrients, MDPI AG, Vol. 13, No. 11 ( 2021-10-20), p. 3679-
    Abstract: The Fatty Liver Index (FLI) is a proxy for the steatotic component of non-alcoholic fatty liver disease (NAFLD). For sub-Saharan African populations, the contribution of dietary factors to the development of NAFLD in the etiology of type 2 diabetes mellitus (T2DM) remains to be clarified. We identified sex-specific dietary patterns (DPs) related to the FLI using reduced ranked regression (RRR) and evaluated the associations of these DPs with T2DM. This analysis used data from the RODAM, a multi-center cross-sectional study of Ghanaian populations living in Ghana and Europe. The daily intake frequencies of 30 food groups served as the predictor variables, while the FLI was the response variable. The odds ratios and 95% confidence intervals for T2DM were calculated per one standard deviation increase in the DP score using logistic regression. In males, the DP score explained 9.9% of the variation in their food intake and 16.0% of the variation in the FLI. This DP was characterized by high intakes of poultry, whole-grain cereals, coffee and tea, condiments, and potatoes, and the chance of T2DM was 45% higher per 1 DP score-SD (Model 2). Our results indicate that the intake of modernized foods was associated with proxies of NAFLD, possibly underlying the metabolic pathways to developing T2DM.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    URL: Article
    DOI: 10.3390/nu13113679
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2518386-2
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  • 5
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    Cardiovascular Risk Estimation Based on Country-of-Birth- and Country-of-Residence-Specific Scores among Migrants in the Netherlands: The HELIUS Study
    MDPI AG ; 2023
    In:  International Journal of Environmental Research and Public Health Vol. 20, No. 6 ( 2023-03-15), p. 5148-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 20, No. 6 ( 2023-03-15), p. 5148-
    Abstract: Background: Regional and country-specific cardiovascular risk algorithms have been developed to improve CVD risk prediction. But it is unclear whether migrants’ country-of-residence or country-of-birth algorithms agree in stratifying the CVD risk of these populations. We evaluated the risk stratification by the different algorithms, by comparing migrant country-of-residence-specific scores to migrant country-of-birth-specific scores for ethnic minority populations in the Netherlands. Method: data from the HELIUS study was used in estimating the CVD risk scores for participants using five laboratory-based (Framingham, Globorisk, Pool Cohort Equation II, SCORE II, and WHO II) and three nonlaboratory-based (Framingham, Globorisk, and WHO II) risk scores with the risk chart for the Netherlands. For the Globorisk, WHO II, and SCORE II risk scores, we also computed the risk scores using risk charts specified for the migrant home country. Risk categorization was first done according to the specification of the risk algorithm and then simplified to low (green), moderate (yellow and orange), and high risk (red). Results: we observed differences in risk categorization for different risk algorithms ranging from 0% (Globorisk) to 13% (Framingham) for the high-risk category, as well as differences in the country-of-residence- and country-of-birth-specific scores. Agreement between different scores ranged from none to moderate. We observed a moderate agreement between the Netherlands-specific SCORE II and the country-of-birth SCORE II for the Turkish and a nonagreement for the Dutch Moroccan population. Conclusion: disparities exist in the use of the country-of-residence-specific, as compared to the country-of-birth, risk algorithms among ethnic minorities living in the Netherlands. Hence, there is a need for further validation of country-of-residence- and country-of-birth-adjusted scores to ascertain appropriateness and reliability.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph20065148
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
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  • 6
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    Association between Depressed Mood and Sleep Duration among Various Ethnic Groups—The Helius Study
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 13 ( 2021-07-03), p. 7134-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 13 ( 2021-07-03), p. 7134-
    Abstract: Background: We examined the association between depressed mood (DM) and sleep duration in a multi-ethnic population in Amsterdam, and the extent to which DM accounts for both short and long sleep. Methods: Cross-sectional data using 21,072 participants (aged 18–71 years) from the HELIUS study were analyzed. Sleep duration was classified as: short, healthy, and long ( 〈 7, 7–8, and ≥9 h/night). A Patient Health Questionnaire (PHQ-9 sum score ≥10) was used to measure DM. The association between DM and sleep duration was assessed using logistic regression. The extent to which DM accounted for short and long sleep was assessed using a population attributable fraction (PAF). Results: DM was significantly associated with short sleep in all ethnic groups after adjustment for other covariates (OR 1.9 (1.5–2.7) in Ghanaians to 2.5 (1.9–32) in the Dutch). DM was not associated with long sleep except in the Dutch (OR 1.9; 1.3–2.8). DM partly accounted for the prevalence of short sleep with PAF ranging from 3.5% in Ghanaians to 15.5% in Turkish. For long sleep, this was 7.1% in the Dutch. Conclusions: DM was associated with short sleep in all ethnic groups, except in Dutch. If confirmed in longitudinal analyses, strategies to reduce depression may reduce the prevalence of short sleep in concerned groups.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18137134
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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  • 7
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    Do Diabetes Mellitus Differences Exist within Generations? Three Generations of Moluccans in The Netherlands
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 2 ( 2021-01-09), p. 493-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 2 ( 2021-01-09), p. 493-
    Abstract: Background: Diabetes mellitus (DM) is known to be more prevalent among migrants compared to their host populations. It is unclear whether DM prevalence differs between generations among migrants. We investigated the differences in DM prevalence among three generations of Moluccans, who have been living for over 65 years in the Netherlands, compared to the Dutch population. Methods: In this cross-sectional study, data of a healthcare insurance database on hospital and medication use (Achmea Health Database) were used. The dataset contained 5394 Moluccans and 52,880 Dutch persons of all ages. DM differences were assessed by means of logistic regression, adjusting for age, sex, urbanization, and area socio-economic status. Results: The prevalence of DM was higher in all generations of Moluccans compared to the Dutch. The adjusted odds ratios (AORs) for DM were significantly higher in total group of Moluccans compared to the Dutch (AOR 1.60, 95% CI 1.42–1.80) and across the first and second generation of Moluccans compared to the Dutch (first generation (1.73, 1.47–2.04) and second generation (1.44, 1.19–1.75). Higher AOR were found for first generation men (1.55, 1.22–1.97) and first (1.90, 1.52–2.37) and second (1.63, 1.24–2.13) generation Moluccan women compared to the Dutch. AOR for the third generation Moluccans was increased to a similar extent (1.51, 0.97–2.34), although not statistical significant. Conclusions: Our findings show higher odds of DM across generations of Moluccans compared to the Dutch. DM prevention strategies for minorities should be targeted at all migrant generations in host countries.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18020493
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
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