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Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012
Ethnic diversity has been a topic of contention across the globe, contrasted with economic development, social security, and political stability. The link between health and ethnic diversity is not yet well established especially in low-middle- income countries. Our study aims to explore the associa...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021188/ https://www.ncbi.nlm.nih.gov/pubmed/36962189 http://dx.doi.org/10.1371/journal.pgph.0000267 |
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author | Wasko, Zahia Dambach, Peter Kynast-Wolf, Gisela Stieglbauer, Gabriele Zabré, Pascal Bagagnan, Cheik Schoeps, Anja Souares, Aurélia Winkler, Volker |
author_facet | Wasko, Zahia Dambach, Peter Kynast-Wolf, Gisela Stieglbauer, Gabriele Zabré, Pascal Bagagnan, Cheik Schoeps, Anja Souares, Aurélia Winkler, Volker |
author_sort | Wasko, Zahia |
collection | PubMed |
description | Ethnic diversity has been a topic of contention across the globe, contrasted with economic development, social security, and political stability. The link between health and ethnic diversity is not yet well established especially in low-middle- income countries. Our study aims to explore the association between ethnic diversity and all-cause mortality in rural areas of Burkina Faso. We used data from the Nouna Health & Demographic Surveillance System (HDSS) collected between 2000 and 2012. To derive Standardized Mortality Ratios (SMR), the observed number of deaths was compared to the expected deaths based on the entire HDSS taking into account sex, age, rainy season, calendar year, and village. SMR were calculated for ethnic and religious diversity on a village level (using the Simpson Index), sub-region, wealth, and distance to Healthcare Facilities (HCF). Furthermore, we modeled SMR with a multilevel random intercept Poisson regression considering individual ethnic and religious groups in addition to the above-mentioned village-level information. Village wealth (poorest fifth: SMR 1.07; 95% CI: 1.02–1.13, richest fifth: SMR 0.85; 95% CI: 0.82–0.88), distance to HCF (within the village: SMR 0.88; 95% CI: 0.85–0.91, further than 5km: SMR 1.13; 95% CI: 1.10–1.16), and sub-region showed significant associations with overall mortality. Villages belonging to the third with the highest ethnic diversity had lowered SMR (0.86; 95% CI: 0.84–0.89) compared to the entire HDSS, while those belonging to the lowest diversity third yielded elevated SMR (1.13; 95% CI: 1.09–1.17). The multilevel model confirmed the association. Our study showed that historically established ethnic diversity in rural areas of Burkina Faso was associated with lower all-cause mortality. Generally, the literature suffers from a lack of standardization in defining ethnic diversity, along with measuring it. More research is needed to understand this relation and to establish it in different settings. |
format | Online Article Text |
id | pubmed-10021188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-100211882023-03-17 Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 Wasko, Zahia Dambach, Peter Kynast-Wolf, Gisela Stieglbauer, Gabriele Zabré, Pascal Bagagnan, Cheik Schoeps, Anja Souares, Aurélia Winkler, Volker PLOS Glob Public Health Research Article Ethnic diversity has been a topic of contention across the globe, contrasted with economic development, social security, and political stability. The link between health and ethnic diversity is not yet well established especially in low-middle- income countries. Our study aims to explore the association between ethnic diversity and all-cause mortality in rural areas of Burkina Faso. We used data from the Nouna Health & Demographic Surveillance System (HDSS) collected between 2000 and 2012. To derive Standardized Mortality Ratios (SMR), the observed number of deaths was compared to the expected deaths based on the entire HDSS taking into account sex, age, rainy season, calendar year, and village. SMR were calculated for ethnic and religious diversity on a village level (using the Simpson Index), sub-region, wealth, and distance to Healthcare Facilities (HCF). Furthermore, we modeled SMR with a multilevel random intercept Poisson regression considering individual ethnic and religious groups in addition to the above-mentioned village-level information. Village wealth (poorest fifth: SMR 1.07; 95% CI: 1.02–1.13, richest fifth: SMR 0.85; 95% CI: 0.82–0.88), distance to HCF (within the village: SMR 0.88; 95% CI: 0.85–0.91, further than 5km: SMR 1.13; 95% CI: 1.10–1.16), and sub-region showed significant associations with overall mortality. Villages belonging to the third with the highest ethnic diversity had lowered SMR (0.86; 95% CI: 0.84–0.89) compared to the entire HDSS, while those belonging to the lowest diversity third yielded elevated SMR (1.13; 95% CI: 1.09–1.17). The multilevel model confirmed the association. Our study showed that historically established ethnic diversity in rural areas of Burkina Faso was associated with lower all-cause mortality. Generally, the literature suffers from a lack of standardization in defining ethnic diversity, along with measuring it. More research is needed to understand this relation and to establish it in different settings. Public Library of Science 2022-05-06 /pmc/articles/PMC10021188/ /pubmed/36962189 http://dx.doi.org/10.1371/journal.pgph.0000267 Text en © 2022 Wasko et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Wasko, Zahia Dambach, Peter Kynast-Wolf, Gisela Stieglbauer, Gabriele Zabré, Pascal Bagagnan, Cheik Schoeps, Anja Souares, Aurélia Winkler, Volker Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 |
title | Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 |
title_full | Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 |
title_fullStr | Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 |
title_full_unstemmed | Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 |
title_short | Ethnic diversity and mortality in northwest Burkina Faso: An analysis of the Nouna health and demographic surveillance system from 2000 to 2012 |
title_sort | ethnic diversity and mortality in northwest burkina faso: an analysis of the nouna health and demographic surveillance system from 2000 to 2012 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021188/ https://www.ncbi.nlm.nih.gov/pubmed/36962189 http://dx.doi.org/10.1371/journal.pgph.0000267 |
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