Living environment is a social determinant of health

Rural communities, with low income and literacy rate; living under harsh weather conditions are vulnerable to suffer from common respiratory ailments.  

 

Using standard questionnaires, 438 women were interviewed in March 2008 for eye and respiratory symptoms suffered by them and by one of the youngest child less than 5 years of age during the past four weeks. An illness in past four weeks was defined for history of two or more symptoms suffered by either mother or child or both.  Socioeconomic indicators were studied for association with eye or respiratory symptoms defined as illness. 

 

Forty percent of mothers reported illness as defined above. Median household income was ~USD 75/month, 67 % lived in low quality house construction, and others in mixed type (24%) and concrete houses (9%), all used wood or biomass for heating and cooking purpose, 12% reported poor stove condition in terms of smoke outlet, and others reported as satisfactory ( 31%), good (46%), or excellent (11%) stove condition; a median of six hours was reported as duration stove burning per day.  Literacy rate was 26 % and 8.6% of women reported use of tobacco, or snuff in any form.  Adjusted analysis showed that history of common illnesses as defined were negatively associated with log transformed monthly income (p< 0.04), poor stove condition (OR 2.6, 95% CI 1.14,5.7), type of house construction (p< 0.02), mixed type of house construction (OR 2.4 95% CI 1,19, 5.01), poor type of house construction (OR 2.9 95% CI= 1.34, 6.50) compared to concrete type of house construction adjusted for literacy status and habit of tobacco use.

 

Low income, poor housing and in efficient stoves were independently associated with eye and respiratory conditions in residents.  Improvement in living environment is a major social determinant of disease and health in such populations.