Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T17:13:28.414Z Has data issue: false hasContentIssue false
  • English
  • Français

HEALTH RISK TRANSITION AND LOW MORTALITY PATTERNS AMONG A NATIONAL COHORT OF ASPIRATIONAL THAI OPEN UNIVERSITY STUDENTS

Published online by Cambridge University Press:  25 October 2017

Matthew Kelly Open the ORCID record for Matthew Kelly [Opens in a new window] ,
Chalapati Rao ,
Sam-Ang Seubsman  and
Adrian Sleigh
Matthew Kelly*
Affiliation:
Department of Global Health, Research School of Population Health, Australian National University, Australiaand
Chalapati Rao
Affiliation:
Department of Global Health, Research School of Population Health, Australian National University, Australiaand
Sam-Ang Seubsman
Affiliation:
Faculty of Human Ecology, Sukhothai Thammathirat Open University, Muang Thong Thani, Nonthaburi, Thailand
Adrian Sleigh
Affiliation:
Department of Global Health, Research School of Population Health, Australian National University, Australiaand
*
1Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Summary

In the last 50 years Thailand has achieved advanced demographic and health transitions. Many infectious diseases are controlled and infant and maternal mortality rates are among the lowest in the region. Within such a low mortality setting, however, substantial variations in health persist, with education being a major driver. This paper assesses the ongoing mortality transition in Thailand, examining relationships between risk factors and mortality outcomes among a large nationwide cohort of distance-learning Open University students, as well as examining the differential mortality benefit enjoyed by this educated group when compared with the general Thai population. The cohort comprised 87,151 participants, who in 2005 completed a questionnaire collecting detailed information on socio-demographics, health behaviours and health outcomes. Participants were aged 15–87 at baseline and lived in all regions of the country. Cohort members’ citizen identification numbers were matched with official death registration records to identify mortality among participants. A total of 1401 deaths were identified up to November 2016. Results show cohort study participants experiencing mortality at approximately one-third of the rate of the general population in the same age and sex groups. The gap between the mortality rates in the two groups widened with increased age. Differential risk factor prevalence among the two populations, particularly lower overweight and obesity prevalence and lower cigarette smoking rates in the cohort, can explain some of this variation. The largely unmeasurable effect of aspiration for life improvement through distance education while embedded in their communities is shown by this study to have a powerful effect on mortality risk. With overall education levels, including higher education, rising in Thailand this growing group of educated aspirational Thais may represent future trends in Thai mortality. Identifying the drivers and characteristics of this mortality variation can help inform policies to provide health services and to help reduce mortality in the whole population.

Type
Research Article
Information
Journal of Biosocial Science , Volume 50 , Issue 4 , July 2018 , pp. 540 - 550
Copyright
Copyright © Cambridge University Press, 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aekplakorn, W., Hogan, M. C., Tiptaradol, S., Wibulpolprasert, S., Punyaratabandhu, P. & Lim, S. S. (2008) Tobacco and hazardous or harmful alcohol use in Thailand: joint prevalence and associations with socioeconomic factors. Addictive Behaviors 33(4), 503–514.Google Scholar
Assanangkornchai, S., Sam-Angsri, N., Rerngpongpan, S. & Lertnakorn, A. (2010) Patterns of alcohol consumption in the Thai population: results of the National Household Survey of 2007. Alcohol and Alcoholism 45(3), 278–285.Google Scholar
Aungkulanon, S., Tangcharoensathien, V., Shibuya, K., Bundhamcharoen, K. & Chongsuvivatwong, V. (2016) Post universal health coverage trend and geographical inequalities of mortality in Thailand. International Journal for Equity in Health 15(1), 190.Google Scholar
Baker, D. P., Leon, J., Smith Greenaway, E. G., Collins, J. & Movit, M. (2011) The education effect on population health: a reassessment. Population and Development Review 37(2), 307–332.Google Scholar
Caldwell, J. C. (1986) Routes to low mortality in poor countries. Population and Development Review 12(2), 171–220.Google Scholar
Caldwell, J. C. (2001) Population health in transition. Bulletin of the World Health Organization 79, 159–160.Google Scholar
Carmichael, G. (2011) Exploring Thailand’s mortality transition with the aid of life tables. Asia Pacific Viewpoint 52(1), 85–105.Google Scholar
Cutler, D., Deaton, A. & Lleras-Muney, A. (2006) The determinants of mortality. Journal of Economic Perspectives 20(3), 97–120.CrossRefGoogle Scholar
Frenk, J., Bobadilla, J. L., Stern, C., Frejka, T. & Lozano, R. (1991) Elements for a theory of the health transition. Health Transition Review 1(1), 21–38.Google Scholar
Kc, S. & Lentzner, H. (2010) The effect of education on adult mortality and disability: a global perspective. Vienna Yearbook of Population Research 8, 201–235.Google Scholar
Keyes, C. F. (1991) The proposed world of the school: Thai villagers entry into the bureaucratic school system. In Keyes, C. F. (ed.) Reshaping Local Worlds: Rural Education and Cultural Change in Southeast Asia. Yale University Press, New Haven, pp. 87–138.Google Scholar
Koch, E., Romero, T., Romero, C. X., Aguilera, H., Paredes, M., Vargas, M. & Ahumada, C. (2010) Early life and adult socioeconomic influences on mortality risk: preliminary report of a ‘pauper rich’ paradox in a Chilean adult cohort. Annals of Epidemiology 20(6), 487–492.Google Scholar
National Statistics Office Thailand (2007) The 2007 Household Socio-Economic Survey. NSO, Bangkok.Google Scholar
OECD & UNESCO Institute for Statistics (2005) World Education Indicators 2005 Education Trends in Perspective. OECD Publishing.Google Scholar
Sleigh, A. C., Seubsman, S.-A. & Bain, C. (2008) Cohort profile: the Thai Cohort of 87,134 Open University students. International Journal of Epidemiology 37(2), 266–272.Google Scholar
Soares, R. R. (2007) On the determinants of mortality reductions in the developing world. Population and Development Review 33(2), 247–287.Google Scholar
Son, M., Armstrong, B., Choi, J.-M. & Yoon, T.-Y. (2002) Relation of occupational class and education with mortality in Korea. Journal of Epidemiology and Community Health 56(10), 798–799.Google Scholar
Vathesatogkit, P., Batty, G. D. & Woodward, M. (2014) Socioeconomic disadvantage and disease-specific mortality in Asia: systematic review with meta-analysis of population-based cohort studies. Journal of Epidemiology and Community Health 68(4), 375–383.Google Scholar
Woodward, M., Peters, S. A. E., Batty, G. D., Ueshima, H., Woo, J., Giles, G. G. et al. (2015) Socioeconomic status in relation to cardiovascular disease and cause-specific mortality: a comparison of Asian and Australasian populations in a pooled analysis. BMJ Open 5(3), doi: 10.1136/bmjopen-2014-006408.CrossRefGoogle Scholar
World Bank (2016) Mortality Database. URL: http://data.worldbank.org/indicator/SP.DYN.IMRT.IN (accessed 28th March 2017).Google Scholar
WHO (2016) WHO Global BMI Database. URL: http://apps.who.int/bmi/index.jsp (accessed 28th March 2017).Google Scholar
WHO (2017) WHO Mortality Database. URL: http://www.who.int/healthinfo/statistics/mortality_rawdata/en/ (accessed 28th March 2017).Google Scholar
WHO Country Office for Thailand (2007) Prevalence of Tobacco Use. URL: http://www.searo.who.int/thailand/areas/tobaccoprevalence/en/ (accessed 28th March 2017).Google Scholar
Yiengprugsawan, V., Banwell, C., Zhao, J., Seubsman, S.-A. & Sleigh, A. C. (2014) Relationship between body mass index reference and all-cause mortality: evidence from a large cohort of Thai adults. Journal of Obesity 2014, ID 708606, doi: 10.1155/2014/708606.Google Scholar
Yiengprugsawan, V., Carmichael, G. A., Lim, L. L. Y., Seubsman, S.-A. & Sleigh, A. C. (2010) Has universal health insurance reduced socioeconomic inequalities in urban and rural health service use in Thailand? Health & Place 16(5), 1030–1037.Google Scholar