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Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries. An analysis of the PURE study data

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dc.contributor.authorMiller, Victoria
dc.contributor.authorYusuf, Salim
dc.contributor.authorChow, Clara K.
dc.contributor.authorDehghan, Mahshid
dc.contributor.authorCorsi, Daniel J.
dc.contributor.authorLock, Karen
dc.contributor.authorPopkin, Barry
dc.contributor.authorRangarajan, Sumathy
dc.contributor.authorKhatib, Rasha
dc.contributor.authorLear, Scott A.
dc.contributor.authorMony, Prem
dc.contributor.authorKaur, Manmeet
dc.contributor.authorMohan, Viswanathan
dc.contributor.authorVijayakumar, Krishnapillai
dc.contributor.authorGupta, Rajeev
dc.contributor.authorKruger, Annamarie
dc.contributor.authorTsolekile, Lungiswa
dc.contributor.authorMohammadifard, Noushin
dc.contributor.authorRahman, Omar
dc.contributor.authorRosengren, Annika
dc.contributor.authorAvezum, Alvaro
dc.contributor.authorOrlandini, Andrés
dc.contributor.authorIsmail, Noorhassim
dc.contributor.authorLopez-Jaramillo, Patricio
dc.contributor.authorYusufali, Afzalhussein
dc.contributor.authorKarsidag, Kubilay
dc.contributor.authorIqbal, Romaina
dc.contributor.authorChifamba, Jephat
dc.contributor.authorOakley, Solange Martinez
dc.contributor.authorAriffin, Farnaza
dc.contributor.authorZatonska, Katarzyna
dc.contributor.authorPoirier, Paul
dc.contributor.authorWei, Li
dc.contributor.authorJian, Bo
dc.contributor.authorHui, Chen
dc.contributor.authorXu, Liu
dc.contributor.authorXiulin, Bai
dc.contributor.authorTeo, Koon
dc.contributor.authorMente, Andrew
dc.contributor.researchgroupMasiraspa
dc.date.accessioned2022-02-23T22:11:08Z
dc.date.available2022-02-23T22:11:08Z
dc.date.issued2016-10-05
dc.descriptionDigitalspa
dc.description.abstractMethods We assessed fruit and vegetable consumption using data from country-specific, validated semi-quantitative food frequency questionnaires in the Prospective Urban Rural Epidemiology (PURE) study, which enrolled participants from communities in 18 countries between Jan 1, 2003, and Dec 31, 2013. We documented household income data from participants in these communities; we also recorded the diversity and non-sale prices of fruits and vegetables from grocery stores and market places between Jan 1, 2009, and Dec 31, 2013. We determined the cost of fruits and vegetables relative to income per household member. Linear random effects models, adjusting for the clustering of households within communities, were used to assess mean fruit and vegetable intake by their relative cost. Findings Of 143 305 participants who reported plausible energy intake in the food frequency questionnaire, mean fruit and vegetable intake was 3·76 servings (95% CI 3·66–3·86) per day. Mean daily consumption was 2·14 servings (1·93–2·36) in low-income countries (LICs), 3·17 servings (2·99–3·35) in lower-middle-income countries (LMICs), 4·31 servings (4·09–4·53) in upper-middle-income countries (UMICs), and 5·42 servings (5·13–5·71) in high-income countries (HICs). In 130 402 participants who had household income data available, the cost of two servings of fruits and three servings of vegetables per day per individual accounted for 51·97% (95% CI 46·06–57·88) of household income in LICs, 18·10% (14·53–21·68) in LMICs, 15·87% (11·51–20·23) in UMICs, and 1·85% (−3·90 to 7·59) in HICs (ptrend=0·0001). In all regions, a higher percentage of income to meet the guidelines was required in rural areas than in urban areas (p<0·0001 for each pairwise comparison). Fruit and vegetable consumption among individuals decreased as the relative cost increased (ptrend=0·00040). Interpretation The consumption of fruit and vegetables is low worldwide, particularly in LICs, and this is associated with low affordability. Policies worldwide should enhance the availability and affordability of fruits and vegetables.spa
dc.description.researchareaCiencias Médicas y de la Saludspa
dc.format.extent9 pspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.doihttps://doi.org/10.1016/S2214-109X(16)30186-3
dc.identifier.urihttps://repositorio.udes.edu.co/handle/001/6138
dc.language.isoengspa
dc.publisherScienceDirectspa
dc.publisher.placeReino Unidospa
dc.relation.citationendpagee703spa
dc.relation.citationissue10spa
dc.relation.citationstartpagee695spa
dc.relation.citationvolume4spa
dc.relation.indexedScopusspa
dc.relation.ispartofjournalThe Lancet Global Healthspa
dc.rights© 2016 The Author(s). Published by Elsevier Ltd.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial 4.0 Internacional (CC BY-NC 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/spa
dc.sourcehttps://www.sciencedirect.com/science/article/pii/S2214109X16301863?via%3Dihub#!spa
dc.titleAvailability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries. An analysis of the PURE study dataspa
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttp://purl.org/redcol/resource_type/ARTspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa
dcterms.audienceTodas las Audienciasspa
dspace.entity.typePublication
oaire.accessrightshttp://purl.org/coar/access_right/c_f1cfspa
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
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