Viewpoint

Measuring health and disability

To evaluate whether sleep disturbances vary along a continuum of functional limitations in a large nationally representative sample of US adults.

Using 2014-2015 National Health Interview Survey data (n = 33,424), we considered associations between each of 5 sleep disturbance measures (duration, trouble falling asleep, trouble staying asleep, use of sleep medications, waking rested) and Functional Limitations Index score, which distinguishes among adults with little-or-no (least-limited), moderate (somewhat-limited), and high functional limitations (most-limited).

Somewhat-limited and most-limited respondents reported significantly worse sleep health for all sleep disturbance measures than people with little-or-no limitations, even controlling for body mass index, psychological distress, and 14 health indicators.

People with significant self-reported limitations in physical functioning, independent of specific disabilities or disabling condition, report more sleep disturbances. Clinicians may want to evaluate the sleep health of patients with functional limitations.

Equity in education is a central issue for researchers and policymakers, and inequality in access to education for students with disabilities is one of the most critical challenges. Existing studies treat school-age children with different kinds of disabilities as a homogeneous group due to sample size limitations, while this study sheds light on the interaction between education systems and heterogeneous disabilities using census data from eight developing countries in 2006-2012, overcoming the problem of small sample size. We find that there are consistent gaps in education indicators between students with and without disabilities and students with different kinds of disabilities.

Monitoring physical activity among young adolescents with disabilities is a top academic priority. People with disabilities are a diverse group with various abilities in different human functioning. Therefore, we used a novel approach through functional limitations as a marker for disabilities and examined physical activity levels.

To investigate the levels and differences in light (LPA) and moderate-to-vigorous (MVPA) intensity physical activity between young adolescents with and without functional limitations.

The study included young adolescents (n = 1436) aged 11–15 years olds who attended general schools that were part of the 2016 Finnish School-aged Physical Activity (FSPA) study. PA levels were measured by hip-worn accelerometers during seven consecutive days. The data were disaggregated by the following functions related to; seeing, hearing, speaking, moving, breathing, and remembering or concentrating. Multiple general linear regression models were run to test the differences in amount of time of LPA and MVPA.

One in six young adolescents had disabilities. Young adolescents with functional limitations had 7 min.day⁻¹ less LPA (p = 0.021) and 8 min.day⁻¹ less MVPA (p = 0.011) than their peers without functional limitations. After controlling for gender, age, and device wear time, the differences in LPA among young adolescents with and without functional limitations were the same, however MVPA was no longer significantly less. Results varied according to different functional limitations.

There were significant variations in physical activity behaviours by functional limitations and activity intensity. As such, tailored approaches to physical activity promotion may be dependent on understanding functional limitations as an indicator to disabilities.

Dengue has been estimated to cause a substantial health and economic burden in Vietnam. The most recent studies have estimated that it is responsible for 39 884 disability-adjusted life years (DALYs) annually, representing an economic burden of US$94.87 million per year (in 2016 prices). However, there are alternative burden estimates that are notably lower. This variation is predominantly due to differences in how the number of symptomatic dengue cases is estimated. Understanding the methodology of these burden calculations is vital when interpreting health economic analyses of dengue. This review aims to provide an overview of the health and economic burden estimates of dengue in Vietnam. We also highlight important research gaps for future studies.