Biomedical subjects

K Bloomfield

Publications and source records attributed to K Bloomfield.

10 recordsLinked to original sources

PubMed2006

[The construction of an empirically based social status index through optimal scaling as illustrated by Germany].

Numerous epidemiological studies have shown an association between social status and disease. In alcohol research, socio-economic status (SES) has been associated with drinking patterns, misuse and alcohol problems. SES is a construct which is usually built by using the indicators education, occupation or income separately or combined as a summary score. However, either approach involves theoretical assumptions about the explanatory value of a chosen indicator before the data have been analysed. In this study we have created a gender-specific metric social status indicator for Germany by using all three single SES-indicators (education, occupation, income). We used national representative data from a postal survey from 2000. The age range was restricted to 25 - 59 years. To construct the indicator we used optimal scaling (categorical principal components analysis). Therefore no theoretical assumptions were necessary about the hierarchical order of educational or occupational categories. The optimal-scaling approach allows variables to be scaled on different levels. We used education and occupation as the original categorical data and income (equivalent income) as continuous data. The result of the scaling is a two-dimensional solution. The first dimension explains that variance which could be described by status consistencies (corresponding levels for education, occupation and income). The second dimension of the indicator results from the low correlation between education and income for some individuals (status inconsistencies). The two-dimensional indicator yields differentiated results which would not be visible using a one-dimensional SES-indicator such as education or a summary score. With regard to drinking patterns there are clear differences between middle or low-educated women or men with higher incomes and other social groups. Middle or low-educated men or women with a high income are more likely to be heavy episodic drinkers than people in other social status groups.

Adult↗

PubMed2001

[Reducing income inequity and boosting social capital: new responsibilities in social epidemiological research].

This paper focuses on the fact that there are not only large inequalities in health between but also within countries. The question is raised as to whether these two types of health inequalities are caused by similar processes, and whether understanding these processes could lead to new strategies for reducing such differences. Many studies in Germany have demonstrated that mortality and morbidity are much higher for low-status as compared to high-status population groups. These health inequalities are usually explained by differences in working and living conditions, in health behaviour and in health services utilisation. For some years there has been an extensive discussion in the international Public Health community on health inequalities between countries and on how they can be explained by income inequalities, with the term "social capital" becoming a central issue. This debate has been largely neglected in Germany, but such groundwork now offers an important opportunity for a more comprehensive discussion in this country as well.

Adult↗

PubMed2001

[The influence of regional differences in drinking style on hazardous use, excessive drinking, abuse and dependence].

INTRODUCTION: Previous research in Germany identified a "north-south" gradient in the hazardous use of alcoholic drinks, but this had methodological limitations. The present study estimates the hazardous use of alcohol more reliably. In addition, regional differences in drinking style and their relation to indicators of problematic alcohol use are examined. METHODS: Data are from 1995 and 1997 representative samples of the non-institutionalised German general population aged 18 to 59 years. Based on 15,017 complete observations prevalence rates for abstinence, hazardous consumption (>30 g ethanol per day for men; >20 g ethanol per day for women), two or more CAGE-symptoms, and heavy episodic drinking (5+ drinks consumed in a day) were calculated and a cluster analysis was performed with regard to the 16 German federal states. RESULTS: Regional differences exist in the prevalence of abstinence and hazardous drinking, but a "north-south" gradient was not evident. However, cluster analysis results suggest a "north-south" difference in drinking style, i.e. the quantity-frequency pattern of beer, wine, and spirits consumption. Compared with the northern German federal states, those in the south experienced more beer and less wine and spirits consumption in combination with a lower frequency of drinking beer and spirits. No cluster difference was found for hazardous drinking, lifetime prevalence of 2+ CAGE items or consumption of 5+ drinks in a day. Yet, mean consumption of ethanol was significantly higher in the north. CONCLUSIONS: Research suggesting more hazardous consumption in southern Germany must be tempered by these findings that found no 'north-south' gradient in several different indicators of problematic alcohol use. Different drinking styles in northern and southern states do not result in differences concerning prevalence of binge drinking nor alcohol-related problems. Drinking style only made a difference in the mean consumption of ethanol. Methodological differences between the reported studies are discussed.

Adolescent↗

PubMed2000

Prevalence of alcohol use and the association between onset of use and alcohol-related problems in a general population sample in Germany.

AIMS: This paper examines the prevalence of alcohol use, alcohol-related problems and onset of regular alcohol use, including its association with the prevalence of CAGE symptoms. DESIGN AND PARTICIPANTS: Data come from three nationally representative samples of the non-institutionalized German general population aged 18-59 years which were conducted annually between 1994 and 1996. Subjects (n = 7501) were surveyed through telephone interviews. FINDINGS: Overall, men were more likely to drink alcohol, to be heavier drinkers and to experience more alcohol problems than women. Prevalence of 12-month use was constant across age among males, but decreased with age among women. Prevalence of heavier drinking, however, increased with age in both sexes. While for both sexes the median age of onset decreased towards younger cohorts, the prevalence of regular use at younger ages increased more strongly among females compared to males. In all cohorts of both sexes, an association between early age of onset and negative consequences measured by the CAGE questionnaire could be observed. Odds ratios were significantly lower for life-time experience of at least two CAGE symptoms among respondents if they had started regular alcohol use later than their peers. CONCLUSIONS: The results indicate a narrowing of the gender gap due to an increasing prevalence of regular alcohol use for females across cohorts. Gender differences with regard to heavier drinking are still prominent. The findings confirm those of related studies in which early age of onset of regular alcohol use was found to be a significant predictor for life-time alcohol-related problems.

Adolescent↗

PubMed1999

[Realm and goals of social epidemiology. A contribution to determining current status in relation to German language discussion].

A first approach to the word "social epidemiology" is provided by the two components social and epidemiology. They suggest that the social dimension of the distribution of morbidity and mortality should be analysed by means of epidemiological methods. The interest in this topic has risen considerably in recent years, but it is difficult to exactly specify the questions "social-epidemiologists" are analysing or should be analysing. That is why the "Social Epidemiology Working Group" is now reviewing the state of the art of social epidemiology discussions in the German-speaking countries. The overview shows the broad spectrum of social epidemiology topics, but also the difficulties in providing a clear definition. In a brief description of the Anglo-American discussion it is pointed out that social epidemiology have to deal with similar problems there, and that they classify their work as epidemiology rather than social epidemiology. The paper concludes with recommendations by the Working Group concerning the main topics and objectives of current socio-epidemiological research.

Epidemiologic Factors↗

PubMed1998

West German drinking patterns in 1984 and 1990.

Basic drinking patterns are examined with regard to sociodemographic correlates for the years 1984/1986 and 1990/1992 by a secondary analysis of data from representative samples of the former West German general population. Data come from the National Health Survey of the German Cardiovascular Prevention Study in which the former West German non-institutionalized general population aged 25-69 years was sampled through multistage probability methods. In 1984, 91% of West Germans were drinkers, 16% were daily drinkers, and 8% consumed a mean of 60 g or more of ethanol per day. These figures decreased slightly but significantly by 1990. Despite a downward trend in consumption between 1984 and 1990, Germany remains a 'wet' culture.

Adult↗

PubMed1997

[Trends in alcohol consumption and predictors for increased alcohol consumption in former East Germany--analysis of the 1st and 2nd stages of the German Cardiovascular Prevention Study].

In comparison to other European and western countries, the social epidemiology of alcohol consumption and alcohol abuse in the general population remains under-researched in Germany. In an attempt to begin to fill this gap, data sets from the German Cardiovascular Prevention Study (DHP), now available as public use files, are analysed. The goals of the present study are: (1) to investigate the data sets from the first and second stages of the DHP (1984, 1987) for possible trends in drinking patterns in the German general population, and (2) through use of logistic regression, to identify sociodemographic correlates of heavy drinking. The frequency of consumption of various types of alcoholic beverages declined slightly to moderately among both men and women between 1984 and 1987. The percentage of persons who drank alcohol also declined. Mean consumption of alcohol remained basically unchanged between the two points: about 30 g per day for men and about 13 g per day for women. The second goal of the research was to identify sociodemographic correlates of heavy drinking. It was found that women of a particular age group, 30-39 years, are inclined to be heavy drinkers in comparison to women of other ages. Also among women, higher socioeconomic status showed a positive relationship to heavy drinking: however, income showed a negative influence. Only through the interactions with age and with level of secondary education was income positively related to heavy drinking. Among men, those with four children or more showed greater odds to be heavy drinkers. But the odds for heavy drinking decline among older men who live with their partners, while the odds for heavy drinking are higher for older men who live alone. The chances of being a heavy drinker are also considerably higher for employed men in comparison to men not employed; however, employed men of higher socioeconomic status have reduced odds of being heavy drinkers. These findings suggest that the research results from other countries with regard to predictors of heavy drinking may not be entirely applicable to the German general population. In any case, more detailed research into the social epidemiology of alcohol consumption in Germany is warranted. New and more specific knowledge can then be used to help develop public health measures for certain population subgroups who are identified as being at risk for alcohol abuse or alcohol problems on account of their heavy alcohol consumption.

Adult↗

PubMed1993

A comparison of alcohol consumption between lesbians and heterosexual women in an urban population.

An elevated rate of alcohol problems is believed to exist in the gay and lesbian community. However, prevalence estimates suggesting this have generally been based on convenience samples which have over-represented bar patrons and clinical sources. Recent epidemiological studies examining risk factors for AIDS have gathered information on alcohol consumption as well as sexual orientation. Data based on improved sampling methods are now available for estimating drinking rates of lesbians and gay men. This study compares the drinking patterns of heterosexual women and lesbian/bisexual women who were recruited through a random sampling design in San Francisco, CA. Contrary to previous research, no statistically significant differences in alcohol consumption and drinking patterns between these two groups were found.

Adolescent↗

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Deinstitutionalization↗