Table 4 Hierarchical bivariate and multivariable determinants of NCD DALYs among adolescents in 194 countries, 2015
Domain/Indicator | Outcome: DALYs attributed to NCDs among adolescents (rate, 2015) | ||||
|---|---|---|---|---|---|
| Â | Bivariate | Multivariable | |||
| Â | R-Square | Î’ estimate (Standard error) P-value | StB | Î’ estimate (Standard error) P-value | |
Level 3 Model- Distal: Macro Structural Factors a | |||||
Conflict | Source & Year | Â | Â | Â | Â |
Battle related deaths (total; log) | World Bank, 2013 | 1% | −23.5 (16.92) 0.1673 | − 0.10 | – |
Internally displaced persons (total; log) | World Bank, 2013 | 1% | −21.8 (24.92) 0.3838 | − 0.07 | – |
Refugee populations by country of asylum (total; log) | World Bank, 2014 | 16% | −58.3 (10.31) <.0001 | − 0.39 | −19.8 (8.13) 0.0156 |
Governance | |||||
Political stability/absence of terrorism | World Bank, 2013 | 0% | −11.3 (60.98) 0.8534 | −0.01 | – |
Government effectiveness 1 | World Bank, 2013 | 11% | −264.4 (56.03) <.0001 | −0.33 | − 442.4 (44.27) <.0001 |
Corruption 1 | World Bank, 2013 | 10% | −245.9 (56.74) <.0001 | −0.31 | – |
Environment | |||||
 Frequency of natural disasters (total; log) |  | 0% | −72.2 (84.02) 0.3914 | −0.07 | – |
 Cost damage of natural disasters (USD; log) |  | 2% | −11.7 (6.91) 0.0924 | −0.13 | – |
| Â | Distal Model R2: 38% | ||||
Level 2 Model- Intermediate I: National Structural Factors b | |||||
 Infrastructure and Urbanization | |||||
  Urbanization (% of population; log) | UNICEF, 2016 | 14% | − 597.0 (111.74) <.0001 | −0.37 | − 261.0 (120.39) 0.0316 |
  Access to electricity (% population; cubed) | World Bank | 9% | −0.00057 (0.00014) <.0001 | −0.30 | − 0.0005 (0.00016) 0.0014 |
 Population Density | |||||
  Population density (people per m2 land; log) | World Bank | 2% | −91.2 (43.15) 0.036 | −0.16 | −52.8 (33.41) 0.1162 |
 Telecommunications Access | |||||
  Mobile cellular subscriptions (per 100 people; log) | World Bank, 2014 | 3% | − 266.1 (114.17) 0.0209 | −0.17 | – |
  Internet users (per 100 people; log) | World Bank, 2014 | 6% | −147.7 (43.14) 0.0008 | −0.25 | – |
 National Wealth | |||||
  GDP per capita, 5 year lag (USD; log) 3 | World Bank, 2014 | 11% | −172.9 (37.70) <.0001 | −0.33 | – |
 Health Spending | |||||
  Government expenditure on health, 2 year lag (% of total health expenditure; log) | WHO, 2013 | 1% | −165.0 (151.16) 0.2766 | −0.08 | – |
  Total health expenditure per capita, 2 year lag (PPP, NCU per USD; log) 3 | WHO, 2013 | 12% | − 169.7 (34.83) <.0001 | −0.34 | −111.3 (62.56) 0.0771 |
| Â | Intermediate I Model R2: 47% | ||||
Level 3- Intermediate II: Community, Household & Individual Factors c | |||||
 Socioeconomic Status (Education and Employment) | |||||
  Adult literacy rate (% of adults ages 15+ years; cubed) | World Bank | 1% | −0.00024 (0.00022) 0.2767 | −0.10 |  |
  Primary school enrolment ratio (gross %; log) | World Bank, 2003–2014 | 1% | 719.0 (499.43) 0.1519 | 0.11 |  |
  Secondary school enrolment ratio (gross %; log) | World Bank, 2013 | 7% | − 496.9 (144.18) 0.0007 | −0.27 |  |
  Employment to population ratio (% of adults 15+ years; log) | World Bank | 4% | 724.5 (282.59) 0.0112 | 0.19 |  |
 Youth Empowerment | |||||
  Youth literacy rate (% total 15–24 year olds; squared) | World Bank, 2014 | 3% | −0.1 (0.03) 0.0718 | −0.16 | – |
  Female youth literacy rate (% 15–24 year olds; squared) | World Bank, 2014 | 2% | −0.04 (0.03) 0.1169 | − 0.14 | – |
  Youth unemployment rate (% total 15–24 year olds; log) | World Bank, 2013 | 1% | −95.3 (76.09) 0.212 | − 0.10 | – |
  Adolescent fertility rate (births per 1000 females aged 15–19 years; log) | World Bank, 2009–2014 | 12% | 256.0 (52.22) <.0001 | 0.34 | 224.4 (66.17) 0.0009 |
 Women Empowerment and Gender Equity | |||||
  Total fertility rate (births per woman; log) | World Bank, 2013 | 7% | 454.5 (122.04) 0.0003 | 0.27 | – |
  Adult female literacy rate (% females 15+ years who can read and write; cubed) | World Bank | 0.5% | −0.016 (0.021) 0.4481 | −0.07 | – |
  Women in parliament (% of parliamentary seats held by women; log) | World Bank, 2014 | 4% | −92.3 (35.97) 0.0111 | −0.19 | – |
  Secondary school gender parity index (ratio of girls to boys in secondary education; log) | World Bank, 2013 | 3% | − 877.5 (416.20) 0.0366 | −0.17 | − 700.4 (341.58) 0.0422 |
  Tertiary school gender parity index (ratio of girls to boys in tertiary education; log) | World Bank, 2013 | 6% | − 206.4 (66.82) 0.0024 | − 0.25 | – |
 Income Equity | |||||
  GINI index (log)2 | World Bank, 2012 | 12% | 1072.6 (269.17) 0.0001 | 0.35 | – |
 Access to Health Services and Commodities | |||||
  Out of pocket expenditure as % of total health expenditure (log) | WHO, 2013 | 0.06% | −23.7 (75.81) 0.7544 | −0.02 | – |
  Physician density per 1000 population (log) | WHO, 2003–2013 | 10% | − 177.1 (47.11) 0.0003 | − 0.32 | – |
| Â | Intermediate II Model R2: 62% | ||||