Associations between Natural Resource Extraction and Incidence of Acute and Chronic Health Conditions: Evidence from Tanzania
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Setting
2.2. Study Design
2.3. Data
2.4. Variables
2.4.1. Exposure Variables
2.4.2. Outcome variables
2.5. Statistical Analysis
2.6. Ethical Considerations
3. Results
Participants: Overall Characteristics
4. Discussion
Strength and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Commodity Groups | Commodity Subgroup | Example |
---|---|---|
Construction materials | Construction raw materials | Pozzolana (cement), silicate hard rock, carbonate hard rock |
Decorative stones | Dolomite, limestone, quartzite, travertine | |
Industrial minerals | Gypsum, halite, kaolin and kaolin clay, clay minerals, mica, phosphate, sylvinite | |
Gemstone | Gemstone | Chrysoprase, diamond, sapphire, tanzanite |
Metals | Precious metals | Gold |
Rate metals | Tin | |
Base metals | Copper | |
Coal 1 | Coal | Coal |
Hydrocarbons 1 | Hydrocarbons | Natural gas |
Facility Type | Type of Commodity Extraction | ||
---|---|---|---|
Construction Material | Gemstone | Metals | |
Hospital | 28% | 27% | 26% |
Health centers | 32% | 32% | 33% |
Dispensaries | 32% | 32% | 33% |
Clinics | 9% | 9% | 8% |
Type of Commodity Extraction | ||||||
---|---|---|---|---|---|---|
Disease Groups | Construction Materials | Gemstone | Metals | |||
IRR | CI | IRR | CI | IRR | CI | |
Chronic diseases | 1.472 ** | 1.023–2.118 | 0.669 * | 0.417–1.073 | 0.632 ** | 0.425–0.940 |
Respiratory infections | 1.012 | 0.891–1.148 | 1.050 | 0.870–1.267 | 0.898 * | 0.802–1.006 |
Tuberculosis (TB) | 1.075 | 0.757–1.528 | 0.890 | 0.532–1.491 | 0.797 | 0.543–1.171 |
Diarrhea | 0.932 | 0.804–1.081 | 1.180 | 0.928–1.499 | 0.875 ** | 0.770–0.994 |
Undernutrition | 0.860 | 0.661–1.119 | 0.880 | 0.547–1.415 | 0.678 *** | 0.529–0.869 |
Malaria | 0.927 | 0.641–1.341 | 1.235 | 0.872–1.750 | 1.073 | 0.840–1.370 |
Parasitic diseases | 1.025 | 0.865–1.215 | 0.961 | 0.710–1.300 | 0.818 ** | 0.695–0.962 |
Sexually transmitted diseases | 1.103 | 0.852–1.428 | 0.850 | 0.627–1.153 | 0.848 | 0.697–1.032 |
Road traffic accidents | 1.112 | 0.843–1.465 | 0.953 | 0.608–1.494 | 0.939 | 0.703–1.255 |
Mental health | 0.927 | 0.633–1.357 | 1.165 | 0.486–2.789 | 0.587 *** | 0.404–0.852 |
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Disease Groups | OPD Indicator(s) Included in Disease Group |
---|---|
Chronic diseases | Neoplasms/cancer, hypertension, other cardiovascular diseases, diabetes mellitus, bronchial asthma |
Diarrhea | Diarrhea with no dehydration, diarrhea with severe dehydration, diarrhea with some dehydration, dysentery |
Sexually transmitted diseases | HIV positive 1, genital discharge syndrome, genital ulcer syndrome, pelvic inflammation, sexually transmitted infections |
Malaria | Malaria blood smear positive, malaria mRDT positive, clinical malaria |
Mental health disorders | Psychoses, neuroses |
Parasitic infections | Intestinal worms, schistosomiasis |
Respiratory health | Pneumonia, non-severe, pneumonia, severe upper respiratory infections |
Road traffic injuries | Road traffic accidents |
Tuberculosis | Tuberculosis |
Undernutrition | Kwashiorkor, marasmic kwashiorkor, marasmus, moderate malnutrition |
Facility Type | Average Count | Median Count | Minimum | Maximum |
Hospital (N = 264) | 1.5 | 1 | 0 | 11 |
Health center (N = 816) | 4.6 | 4 | 1 | 16 |
Dispensaries (N = 6423) | 36.0 | 35 | 5 | 83 |
Health clinics (N = 166) | 0.9 | 0 | 0 | 23 |
Type of commodity extracted | Number of projects | Number of districts with projects | Percent of districts with projects | |
Construction materials | 38 | 25 | 14% | |
Gemstone | 13 | 7 | 4% | |
Metals | 32 | 22 | 12% |
Disease Group Indicator | Year of Observation | Average (2015/2019) | ||||
---|---|---|---|---|---|---|
2015 | 2016 | 2017 | 2018 | 2019 | ||
Cancer | 110 | 119 | 123 | 130 | 151 | 127 |
Cardiovascular | 2643 | 3068 | 3649 | 4661 | 5840 | 3972 |
Diabetes | 1020 | 1173 | 1392 | 1637 | 1970 | 1438 |
Diarrhea | 11,245 | 11,249 | 11,684 | 12,927 | 13,313 | 12,084 |
HIV/AIDS (+ve test results) | 1025 | 1231 | 1320 | 1401 | 1593 | 1314 |
Malaria | 39,875 | 31,125 | 29,315 | 33,182 | 36,409 | 33,981 |
Mental health | 434 | 439 | 500 | 582 | 662 | 524 |
Parasites | 6748 | 6570 | 6727 | 7772 | 8033 | 7170 |
Respiratory infection | 37,431 | 42,361 | 49,854 | 65,460 | 68,413 | 52,704 |
Road traffic accidents | 811 | 828 | 785 | 773 | 795 | 798 |
Sexually transmitted infections | 4720 | 4760 | 4973 | 6314 | 7410 | 5636 |
Tuberculosis | 266 | 265 | 252 | 279 | 267 | 266 |
Undernutrition | 476 | 425 | 342 | 371 | 350 | 393 |
Other diagnoses 1 | 51,109 | 53,944 | 58,692 | 71,227 | 83,777 | 63,750 |
Disease Groups | Type of Commodity Extraction | |||||
---|---|---|---|---|---|---|
Construction Materials | Gemstone | Metals | ||||
IRR | CI | IRR | CI | IRR | CI | |
Chronic diseases | 1.47 *** | 1.15–1.87 | 1.00 | 0.69–1.47 | 0.61 *** | 0.47–0.80 |
Respiratory infections | 1.02 | 0.90–1.16 | 1.10 | 0.90–1.34 | 0.90 * | 0.80–1.01 |
Tuberculosis | 1.14 | 0.85–1.54 | 1.28 | 0.78–2.10 | 0.76 * | 0.56–1.03 |
Diarrhea | 0.97 | 0.84–1.12 | 1.25 * | 0.99–1.59 | 0.88 ** | 0.77–0.99 |
Undernutrition | 0.90 | 0.67–1.20 | 1.06 | 0.67–1.68 | 0.69 *** | 0.55–0.88 |
Malaria | 0.96 | 0.66–1.39 | 1.23 | 0.84–1.79 | 1.08 | 0.85–1.38 |
Parasitic diseases | 1.08 | 0.93–1.26 | 1.10 | 0.83–1.47 | 0.84 ** | 0.72–0.98 |
Sexually transmitted diseases | 1.13 | 0.94–1.37 | 1.10 | 0.83–1.46 | 0.85 ** | 0.74–0.97 |
Road traffic accidents | 1.13 | 0.90–1.43 | 1.24 | 0.85–1.80 | 0.90 | 0.72–1.11 |
Mental health | 1.08 | 0.79–1.49 | 1.34 | 0.70–2.59 | 0.66 ** | 0.47–0.92 |
Disease Groups | Type of Commodity Extraction | |||||
---|---|---|---|---|---|---|
Construction Materials | Gemstone | Metals | ||||
IRR | CI | IRR | CI | IRR | CI | |
Chronic diseases | ||||||
Neoplasms/cancer | 1.46 ** | 1.07–1.99 | 0.86 | 0.48–1.54 | 0.93 | 0.65–1.33 |
Hypertension | 1.49 *** | 1.11–2.01 | 1.08 | 0.66–1.78 | 0.56 *** | 0.41–0.77 |
Other cardiovascular diseases | 1.72 *** | 1.27–2.32 | 0.74 | 0.43–1.27 | 0.62 *** | 0.44–0.88 |
Diabetes mellitus | 1.41 * | 1.00–2.00 | 0.91 | 0.53–1.56 | 0.42 *** | 0.29–0.62 |
Bronchitis asthma | 1.38 *** | 1.14–1.66 | 1.06 | 0.84–1.34 | 0.82 ** | 0.67–0.99 |
Respiratory infections | ||||||
Pneumonia non-severe | 1.01 | 0.86–1.20 | 1.25 ** | 1.01–1.54 | 0.90 | 0.78–1.02 |
Pneumonia severe | 1.04 | 0.87–1.24 | 1.40 ** | 1.04–1.87 | 0.82 ** | 0.67–0.99 |
Upper respiratory infections | 1.02 | 0.89–1.17 | 1.051 | 0.85–1.30 | 0.91 | 0.80–1.04 |
Tuberculosis | ||||||
Tuberculosis | 1.14 | 0.85–1.54 | 1.279 | 0.78–2.10 | 0.76 * | 0.56–1.03 |
Diarrhea | ||||||
Diarrhea with no dehydration | 0.98 | 0.84–1.15 | 1.190 | 0.93–1.53 | 0.89 * | 0.77–1.02 |
Diarrhea with severe dehydration | 0.86 | 0.69–1.08 | 1.49 | 0.93–2.4 | 0.91 | 0.74–1.12 |
Diarrhea with some dehydration | 1.01 | 0.85–1.20 | 1.38 *** | 1.11–1.73 | 0.91 | 0.78–1.07 |
Dysentery | 0.85 | 0.61–1.18 | 1.46 * | 0.99–2.14 | 0.76 * | 0.57–1.01 |
Undernutrition | ||||||
Kwashiorkor | 0.91 | 0.68–1.21 | 1.11 | 0.57–2.15 | 0.64 *** | 0.48–0.86 |
Kwashiorkor marasmus | 1.06 | 0.75–1.50 | 0.88 | 0.56–1.38 | 0.68 *** | 0.52–0.90 |
Malnutrition moderate | 0.94 | 0.67–1.31 | 0.93 | 0.57–1.50 | 0.72 ** | 0.56–0.93 |
Malaria | ||||||
Blood slide microscopy | 1.11 | 0.70–1.73 | 2.08 ** | 1.06–4.07 | 0.49 *** | 0.37–0.66 |
Clinical | 1.17 | 0.82–1.69 | 1.11 | 0.73–1.70 | 0.88 | 0.69–1.12 |
MRDT | 0.82 | 0.54–1.24 | 1.28 | 0.84–1.95 | 1.21 | 0.93–1.58 |
Parasite diseases | ||||||
Intestinal worms | 1.08 | 0.92–1.27 | 1.06 | 0.79–1.44 | 0.82 ** | 0.70–0.97 |
Schistosomiasis | 1.09 | 0.90–1.32 | 1.28 | 0.93–1.76 | 0.94 | 0.77–1.14 |
Sexually transmitted diseases | ||||||
HIV/AIDS +ve test results | 1.11 | 0.88–1.39 | 1.20 | 0.76–1.90 | 0.91 | 0.73–1.13 |
Genital discharge syndrome | 1.07 | 0.86–1.33 | 0.96 | 0.73–1.28 | 0.84 | 0.69–1.03 |
Genital ulcer syndrome | 1.21 | 0.96–1.52 | 1.03 | 0.80–1.34 | 0.83 ** | 0.71–0.98 |
Pelvic inflammation | 0.89 | 0.71–1.11 | 1.19 | 0.76–1.86 | 0.86 | 0.70–1.05 |
Sexually transmitted infections | 1.12 | 0.94–1.34 | 1.36 | 0.93–1.99 | 0.81 *** | 0.69–0.95 |
Road traffic accidents | ||||||
Road traffic accidents | 1.13 | 0.90–1.43 | 1.24 | 0.85–1.80 | 0.90 | 0.72–1.11 |
Mental health | ||||||
Psychoses | 1.03 | 0.70–1.50 | 1.65 | 0.75–3.65 | 0.54 *** | 0.35–0.84 |
Neuroses | 1.23 | 0.92–1.64 | 1.23 | 0.70–2.16 | 0.74 ** | 0.57–0.96 |
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Lyatuu, I.; Loss, G.; Farnham, A.; Lyatuu, G.W.; Fink, G.; Winkler, M.S. Associations between Natural Resource Extraction and Incidence of Acute and Chronic Health Conditions: Evidence from Tanzania. Int. J. Environ. Res. Public Health 2021, 18, 6052. https://doi.org/10.3390/ijerph18116052
Lyatuu I, Loss G, Farnham A, Lyatuu GW, Fink G, Winkler MS. Associations between Natural Resource Extraction and Incidence of Acute and Chronic Health Conditions: Evidence from Tanzania. International Journal of Environmental Research and Public Health. 2021; 18(11):6052. https://doi.org/10.3390/ijerph18116052
Chicago/Turabian StyleLyatuu, Isaac, Georg Loss, Andrea Farnham, Goodluck W. Lyatuu, Günther Fink, and Mirko S. Winkler. 2021. "Associations between Natural Resource Extraction and Incidence of Acute and Chronic Health Conditions: Evidence from Tanzania" International Journal of Environmental Research and Public Health 18, no. 11: 6052. https://doi.org/10.3390/ijerph18116052