Public Awareness Toward Healthy Life: Sample from Iraqi Community 2020

Background: People must develop a healthy lifestyle to have a longer and healthier life. Objective: to study the Public awareness toward healthy life of Iraqi community, and it relation with some of demographic variables. Method & persons: A cross-sectional study conducted from 20 th June – 20 th September 2022, through online questionnaire (google form) distributed through any available channels (e-mails, Viber, Chat, Messenger, WhatsApp, Telegram, Facebook groups) Results: Nine hundred and fifty-six Iraqi persons enrolled in this study, with age mean and standard deviation 32.67± 11.954; the highest percentage of participants 589(51.2%) aged ≤ 29 years, females 577(60.4%), currently married 480(50.2%), medical & health field worker 458(47.9%), while all the non-medical persons 498, (52.1%), {students 212(22.2%), government non-medical worker 146(15.3%). most of the participants 812(84.9%) had once to twice brushing their teeth, and 408(42.7%) had sometimes using Dental floss, while 376(39.3%) of them never using dental floss, and only 39(41.1%)of the participant had regular teeth examination also good overall teeth health only in 387(40.5%). Acceptant-lifestyle 767(80.2%), and only 15(1.6%) had food & water intake poor lifestyle, while in overall-checkup the majority had poor overall-checkup 561(58.7%), then acceptable overall checkup 290(30.3%). Conclusion: Most of the participant had acceptance lifestyle in concerned food and water but had poor Overall checkup for vision, teeth


INTRODUCTION:
Introduction: A group of people's behavior in specific time and place is referred to as their "life style," which includes their daily routine at and outside of their homes . [1]Despite all efforts to encourage individuals to lead healthy lifestyles, quite a few of them remain opposed to it, suffering several illnesses such as hypertension, diabetes mellitus, and other illnesses, therefore we attempt to instill in them the value of leading healthy lives. [2]In European communities who follow western lifestyles, a healthy weight, lots of physical exercise, quitting smoking, moderate alcohol consumption, and a good diet are all linked to a lower incidence of Colorectal cancer [3] .The risk of coronary artery disease was highest in individuals who reported job stress and an unhealthy lifestyle; the risk was almost half as high in those who reported job stress but maintained good lifestyles.Most families were trapped in throughout the pandemic and lockdown, unable to leave their houses for work or engage in routine daily activities like exercising, which could have had an impact on their health and wellness. [4]The majority of people have experienced unpleasant life events as a result of these constraints and lifestyle adjustments, which have had an impact on the entire system and society. [5]After the pandemic, maintaining a healthy lifestyle is of utmost importance; but, because of our busy daily schedules, we often neglect to take care of ourselves in terms of our eating, drinking, daily exercise, and sleeping habits.Regular doctor visits are crucial to the delivery of healthcare.According to the definition given by the American Medical Association (AMA), a routine medical checkup is "a routine health-care process commonly done by health-care institutions for both genders and for all age groups at different periods according to the patient risk factors". [6]Adults who underestimate the need of preventive measures suffer from illnesses that are only discovered later, increased mortality and disability. [7]Therefore it is essential to identify healthy behaviors, such as good eating, in order to reduce the burden of chronic disease and risk factors with financial implications. [8]Depending on social support, lifestyle interventions for middle-aged and older persons may be difficult and have different results.Therefore, it is crucial to look at the factors that may contribute to a healthy lifestyle. [8]Populations from Finland, the Scandinavian nations, and Russia have been found to consume healthful foods in different ways depending on their socioeconomic and socio demographic backgrounds in the studies, better education and female sex were linked to more frequent consumption of fruits and vegetables.Additionally, socio demographic elements including higher wealth, education, and age have been linked to healthy eating habits in a number of different nations. [9]Cardiovascular disease (CVD) has a greater impact on the development of younger people in Arabian countries than it does in western nations.Due to a lack of commitment to a healthy lifestyle, two of the five patients with (CVD) came back within a year and one of the five patients with (CVD) came back within three months.By incorporating recent findings into ongoing research and practice to promote a healthy lifestyle, we could increase the prognosis for patients with cardiovascular disease (CVD). [10]Study done by bayad in February 2021on Iraqi Sample According to the study, Kurdish consumers place a high value on the freshness of food products and their organic status.They also worry about their eating habits and the accompanying health benefits.Additionally, it was discovered that Kurdish consumers had a high level of understanding regarding the effects of food on health, which caused the most crucial element in their decision to buy to be the quality of the goods. [11]nfo@journalofbabylon.com | jub@itnet.Objective: to study the Public awareness toward healthy life: sample from Iraqi community, and study it with some of demographic variables.

Method :
Study design and settings: A cross-sectional study conducted from 20 th June -20 th September 2022, through online questionnaire distributed through any available channels (e-mails, Viber, Chat, Messenger, WhatsApp, Telegram, Facebook groups) Subjects: Any adult can be involving in this online survey with any age over 18 years, both genders, all educational levels, any economic level.
Excluded criteria: incomplete sheet will be excluded Tools: the questionnaire developed after reading many published researches and after taken opinion of six experts (three consultants community medicine, and three consultant family physicians) additionally pilot study done with 20 participants excluded from the study and all consideration taken.
The questionnaire consists of five parts: the first part consists of eight questions of demographic variable (age, gender, marital status, job, residence, monthly income, percent chronic disease, regular doctor checkup in general).The second part consists of nine question about medical condition and health checkups (percent chronic disease, regular doctor checkup in general, Regular vision examination, Regular teeth checkup, Regular blood pressure, Regular blood sugar test, & Lipid profile regular checkup).The third part food style (food services, main food services, place food, types of food, fast food weekly, vegetables daily, daily fruit, snickers daily, water drinking water types, water amount daily, adding salt to food sugar intake overall.Fourth part consists of four questions (dental floss usage, regular teeth examination, teeth brushing, overall teeth health style).
Ethical consideration: Approval was obtained from the Resafa directorate.Also, there is a statement in the beginning of the online questionnaire.

Data collection and Data analysis:
Data collected through google form as excel sheets file, scored and coded and change to SPSS ver.26, then analyzed, frequencies and percentage calculated and association calculated by chi square test, yate correction and p value considered significant if its less than 0.05.In concern teeth health, most of the participants 812(84.9%)had once to twice brushing their teeth, and 408(42.7%)had sometimes using Dental floss, while 376(39.3%) of them never using dental floss, and only 39(41.1%)of the participant had regular teeth examination also good overall teeth health only practice in 387(40.5%),as appeared in table (2)  Most of participants did not have regular vision examination 658(68.8%),not have regular teeth checkup 564(59.0%),not have regular blood pressure checkup 602(63.0%),not have regular blood sugar examination 764(79.9%),and not have lipid profile checkup 802(83.9%),as shown in figure (1)  Current study shows in figure (2) that overall food & water intake; the participants had acceptant lifestyle 767(80.2%),and only 15(1.6%) had food & water intake poor lifestyle, while in overall checkup the majority had poor overall checkup 561(58.7%),then acceptable overall checkup 290(30.3%),and only 105(11%) had good overall checkup for their health The study found a statistical significant relationship between the overall food &water intake with participant's age, gender, marital status, monthly income, but no significant finding with their residence, and job.As listed in the table (3)  Also, the current study revealed of a statistical significant finding between the Overall checkup with participant's age, marital status, monthly income, and their job but no significant relation with their gender, and residence.As listed in the table (4)  info@journalofbabylon.com| jub@itnet.

DISCUSSION:
It is well known that altering lifestyle choices can lower the risk of lifestyle-related diseases, and several efforts are being made to avoid them, including health education.This study investigated the lifestyle knowledge of local inhabitants by investigating their opinions on their health and lifestyles, age, and illnesses connected to lifestyle.
In concern of participants' age: since more than half of the study's participants589 are under 29, this may be because the questionnaire was on Google form and most of the young people uses social media, and they liked the title of the questionnaire, according to the age structure of Iraq people most of them are below the age of 50.their youth may help to explain why they have poor overall checkups in more than half of them.The participants' age had statistical significant relationship with overall food &water intake and the Overall checkup ,astudy was done by Amanda D in 2009 Participants over the age of 51 were more likely than younger participants to report having undergone certain screening health tests, Older participants were morelikely to undergo an annual health check [12] About the participants' gender: more than half of the participant are female 577, this is may be female use social media more than men since male spend more time outside the house.Also The participants' gender had statistical significant finding with overall food & water intake, but not with the Overall checkup.This is similar to a study examines 4 food choice behaviors in a large sample of young adults from 23 countries and tests 2 possible explanatory mechanisms for the gender differences-women's greater likelihood of dieting and women's greater beliefs in the importance of healthy diets. [13]Another study done in kingdom saudia Arabia (KSA) by AL-kahil etal the result showed that there is no evidence for the impact of gender [14] Nearly half of the participant 458 are from medical/ health field may be groups and social media applications which we share the link of the questionnaire was contain medical and healthcare workers.The job had not statistical significant finding with the overall food & water intake, but had significant finding with the Overall checkup.And this was supported by AL-kahil study done in KSA etal in 2020 Regular doctor checkup: nearly half of the participant answer was (no) for regular doctor check this maybe due to most of the participant are young and these group rarely checkup regularly.we are unexpectedly found that more than half of the participant are with chronic illness despite of their younger age, and they already operate in settings where their health can be checked without a regular visit to the doctor.Also, the majority of participants is currently married and has multiple responsibilities, making health care their least important concern.In addition, the majority of participants are women, who in our community rarely visit the doctor by themselves and instead always go with other family members, making routine checkups more challenging .Additionally, since the majority of participants have low income, regular check-ups are challenging for them.Additionally, since the majority of primary healthcare facilities lack all of the necessary tests, private testing is more expensive as a result.These factors all contribute to the fact that the majority of participants don't undergo routine teeth examinations [15] info@journalofbabylon.com| jub@itnet.Teeth brushing was practicing by more than two third of the participant twice daily, The American Dental Association advises cleaning the teeth twice a day for two minutes each time. in reality, we think that a wide gap continues to exist this result may be most of the participant are medical worker and female and young aged female have more time and the dental knowledge are more in the younger due to large campaigns about oral health done these days, health care worker has more knowledge about oral health.women have superior periodontal and dental health because they are more conscious of their oral hygiene.According to the research, women are more likely than men to take dental care products with them and to brush their teeth three or more times each day.However, further research is needed to draw firm conclusions .According to Nanys et al study [16] Dental floss is approved to prevent proximal caries, which cannot be prevented by brushing the teeth, this practice is now being introduced in Iraq, thus we need more social education about it, which may explain low numbers of flossing among participants and there are wrong ideas that floss only used when food trap between teeth and should not use regular because harm that its causing.More than one third of the participant 376 are never do flossing.Also there are other method for interdental cleansing like tooth pick.A study done in KSA in 2019 to assess the knowledge and awareness among adult from 1011 adult participant only 14% use dental floss. [17]gular teeth examination: here in Iraq person rarely visit dentist routinely because we lack medical insurance system therefore most of them visit dentist on urgent issues like pain or sever esthetic demand this explain nearly two third of the participant does not visit dentist regularly This study has shredded light on healthy lifestyle awareness concerned food intake, water intake & overall health checkup for vision, teeth, blood pressure, sugar, lipid and regular doctor checkup in general among the population of Iraq.The results of this study are encouraging, in that overall health awareness levels were high among participants; this may be because the majority are young age which are more familiar with healthy ways by the social media educational video and knowledge however, in reality, we think that a wide gap continues to exist between the high awareness levels reported and the actual practice as shown in participants suffering from chronic diseases In spite that chronic disease present in 489(51.2%) of participants, only 111(11.6%)had regular doctor checkup in general and 421(44.0%)answered with Some times do doctor checkup.this is less than that found by AL-Kahil et al in KSA [14] which was about 34% this may be explained by high cost of routine doctor checkup and accessibility of heath care in public sector compared to it in KSA.