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T Chandola

Publications and source records attributed to T Chandola.

15 recordsLinked to original sources
PubMed2006

Childhood IQ in relation to obesity and weight gain in adult life: the National Child Development (1958) Study.

OBJECTIVE: To examine the relation of childhood intelligence (IQ) test results with obesity in middle age and weight gain across the life course. METHODS: We analysed data from the National Child Development (1958) Study, a prospective cohort study of 17 414 births to parents residing in Great Britain in the late 1950s. Childhood IQ was measured at age 11 years and body mass index (BMI), an indicator of adiposity, was assessed at 16, 23, 33 and 42 years of age. Logistic regression (in which BMI was categorised into obese and non-obese) and structural equation growth curve models (in which BMI was retained as a continuous variable) were used to estimate the relation between childhood IQ and adult obesity, and childhood IQ and weight gain, respectively. RESULTS: In unadjusted analyses, lower childhood IQ scores were associated with an increased prevalence of adult obesity at age 42 years. This relation was somewhat stronger in women (OR(per SD decrease in IQ score) [95% CI]: 1.38 [1.26, 1.50]) than men (1.26 [1.15, 1.38]). This association remains statistically significant after adjusting for childhood characteristics, including socio-economic factors, but was heavily attenuated following control for adult characteristics, particularly education (women: 1.11 [0.99, 1.25]; men: 1.10 [0.98, 1.23]). When weight gain between age 16 and 42 years was the outcome of interest, structural equation modelling revealed that education and dietary characteristics in adult life mediated the association with childhood IQ. CONCLUSIONS: A lower IQ score in childhood is associated with obesity and weight gain in adulthood. In the present study, this relation appears to be largely mediated via educational attainment and the adoption of healthy diets in later life.

Adolescent↗
PubMed2005

Do changes in effort-reward imbalance at work contribute to an explanation of the social gradient in angina?

AIMS: To determine whether an increase in effort-reward imbalance over time increases the risk of angina, and whether such increases are associated with lower occupational position. METHODS: Effort-reward imbalance (ERI) at work was measured in the Whitehall II occupational cohort of London based civil servants at baseline (1985-88) and in 1997. Coronary heart disease was measured in a self-reported health questionnaire by combining the Rose Angina Questionnaire with doctor diagnosed angina in 2001. RESULTS: Among men, increase in ERI over time was associated with an increased risk of incident angina. Moreover, as increases in ERI were more common among lower grade civil servants, change in imbalance, to some extent, contributed to explaining the social gradient in angina. Among women, increases in imbalance were not associated with risk of angina, and therefore did not contribute to the explanation of the social gradient. CONCLUSIONS: Reductions in effort-reward imbalance at work may reduce the risk of coronary heart disease among men.

Adaptation, Psychological↗
PubMed2003

Social inequalities in health by individual and household measures of social position in a cohort of healthy people.

STUDY OBJECTIVE: It is increasingly recognised that different dimensions of social inequality may be linked to health by different pathways. Furthermore, factors operating at the individual level such as employment conditions may affect health in a different way from household level factors. The paper examines the associations between self rated health and four measures of social position- occupational class, household social advantage, personal and household income. DESIGN: Multilevel logistic regression models were used to predict self rated health using longitudinal data from the British Household panel survey (BHPS) with respondents nested within households. Separate analyses were carried out for economically active and inactive respondents. SETTING: Interview based surveys of adults living within households that are representative of British households. PARTICIPANTS: Adult respondents from the BHPS. MAIN RESULTS: Occupational class has relatively strong effects on the self rated health of the economically active, although household level factors also seem to influence their health. Household social advantage has relatively strong effects on the self rated health of the economically inactive. CONCLUSIONS: The paper found evidence in support of the view that different dimensions of social inequality have different pathways to self rated health. There are unexplained similarities in health between household members, which require further investigation.

Adolescent↗
PubMed2002

Development and validation of a short measure of health status for individuals with acute myocardial infarction: the myocardial infarction dimensional assessment scale (MIDAS).

The purpose of this study was to develop and validate a disease-specific health status measure for individuals with myocardial infarction (MI). The development of the myocardial infarction dimensional assessment scale (MIDAS) followed three main stages. Stage 1 consisted of in-depth, semi-structured, exploratory interviews conducted on a sample of 31 patients to identify areas of salience and concern to patients with MI. These interviews generated 48 candidate questions. In stage 2 the 48-item questionnaire was used in a postal survey to identify appropriate rephrasing/shortening, to determine acceptability and to help identify sub-scales of the instrument addressing different dimensions of MI. Finally, in stage 3 the construct validity of MIDAS subscales was examined in relation to clinical and other health outcomes. A single centre (district general hospital) in England was used for stages 1 and 3 and a national postal survey was conducted for stage 2. A total of 410 patients were recruited for the national survey (stage 2). Full data were available on 348 (85%) patients. One hundred and fifty-five patients were recruited to test construct validity (stage 3). The MIDAS contains 35 questions measuring seven areas of health status: physical activity, insecurity, emotional reaction, dependency, diet, concerns over medication and side effects. The measure has high face, internal and construct validity and is likely to prove useful in the evaluation of treatment regimes for MI.

Activities of Daily Living↗
PubMed2002

Distinctive features of age-specific fertility profiles in the English-speaking world: common patterns in Australia, Canada, New Zealand and the United States, 1970-98.

The paper seeks to identify common features in the fertility patterns of the English-speaking world and provide a model basis for comparison of fertility between countries and over time. Attention is focused on the heterogeneity within the fertility patterns of Australia, Canada, New Zealand, and the United States, similar to that reported earlier for the UK and the Irish Republic. The recent age-specific fertility patterns of these countries display a marked 'bulge' in fertility of women under age 25. A mixture model with two-component Hadwiger functions provides a suitable fit. The heterogeneity thus suggested is related to the proportion of births outside marriage. Additionally, there is some evidence that, in the United States, and lesser extent in New Zealand, this heterogeneity in fertility patterns may be explained by ethnic difference in the timing and number of births.

Australia↗
PubMed2002

Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care.

OBJECTIVE: To determine what aspects of healthcare provision are most likely to influence satisfaction with care and willingness to recommend hospital services to others and, secondly, to explore the extent to which satisfaction is a meaningful indicator of patient experience of healthcare services. DESIGN: Postal survey of a sample of patients who underwent a period of inpatient care. Patients were asked to evaluate their overall experience of this episode of care and to complete the Picker Inpatient Survey questionnaire on specific aspects of their care. SAMPLE: Patients aged 18 and over presenting at five hospitals within one NHS trust in Scotland. METHOD: 3592 questionnaires were mailed to patients' homes within 1 month of discharge from hospital during a 12 month period. Two reminders were sent to non-responders; 2249 (65%) questionnaires were returned. RESULTS: Almost 90% of respondents indicated that they were satisfied with their period of inpatient care. Age and overall self-assessed health were only weakly associated with satisfaction. A multiple linear regression indicated that the major determinants of patient satisfaction were physical comfort, emotional support, and respect for patient preferences. However, many patients who reported their satisfaction with the care they received also indicated problems with their inpatient care as measured on the Picker Inpatient Survey; 55% of respondents who rated their inpatient episode as "excellent" indicated problems on 10% of the issues measured on the Picker questionnaire. DISCUSSION: The evidence suggests that patient satisfaction scores present a limited and optimistic picture. Detailed questions about specific aspects of patients' experiences are likely to be more useful for monitoring the performance of various hospital departments and wards and could point to ways in which delivery of health care could be improved.

Adolescent↗
PubMed2001

Ethnic and class differences in health in relation to British South Asians: using the new National Statistics Socio-Economic Classification.

The paper examines the use of the new measure of social class in the UK, the National Statistics Socio-Economic Classification (NS-SEC) and other socio-economic variables in explaining differences in health between British South Asians and the majority White population. There are a number of hypotheses which try to explain ethnic differences in health and yet there have been relatively few empirical studies which test the explanatory value of these hypotheses. Cross sectional data from the fourth National Survey of Ethnic Minorities (1993-1994) with 2860 white, 1268 Indian and 1771 Pakistani and Bangladeshi adult respondents are analysed. The associations of self-rated health with ethnicity, social class, local area deprivation and standard of living are analysed. Pakistani and Bangladeshi respondents have the poorest self-rated health, followed by Indians. Differences in self-rated health between ethnic groups reduce to non-significance after adjusting for social class, local area deprivation and standard of living. There is some evidence of social class differences in the health of Indians and not much evidence for Pakistanis and Bangladeshis. The NS-SEC is useful in explaining ethnic differences in health. The poorer health of Indians, Pakistanis and Bangladeshis compared to Whites may be largely understood in terms of factors related to occupational social class, material living conditions and local area deprivation.

Bangladesh↗
PubMed2001

The fear of crime and area differences in health.

A number of studies have shown that major health inequalities exist between different areas within the UK. However, there has been some debate about the mechanisms underlying area differences in health. One of the mechanisms which could explain area differences in health is the fear of crime in the local area or neighbourhood. This study examines data from the 1996 British Crime Survey (N=16,090). The fear of crime was found to be associated with self-rated health even after adjusting for health behaviours and a number of individual and household level socio-economic factors. Area differences in self-rated health were reduced to non-significance after health behaviours, socio-economic factors and the fear of crime were adjusted for in the regression model. There is some evidence that fear of crime is associated with health and it may have an important role in explaining area differences in health.

Adolescent↗
PubMed2001

An assessment of the construct validity of the SF-12 summary scores across ethnic groups.

BACKGROUND: The aim of the study was to determine the construct validity of the 12-item Short Form health survey questionnaire (SF-12) across ethnic groups in a large community sample of the United Kingdom. METHODS: A postal survey was carried out in English using a questionnaire booklet, containing the SF-12 and a number of other items relating to experiences of chronic illness and utilization of health care services. The dataset was the National Survey of NHS Patients. The sample consisted of 1000 residents within each Health Authority in England who were randomly selected from the electoral registers, giving an initial sample of 100000. RESULTS: A total of 61 426 (61.4 per cent) questionnaires were returned; 94.3 per cent of respondents classified themselves as white and 5.7 per cent classified themselves as members of other ethnic groups. Construct validity of the SF-12 was assessed by comparing results from the two summary scores (the Mental Health Component Summary (MCS) score and the Physical Health Component Summary (PCS) score) with overall self-assessed health and limiting longstanding illness. Although there were generally consistent patterns of association between overall self-assessed health or limiting longstanding illness and the MCS and PCS scores in all the ethnic groups, there were significant differences between the MCS and PCS scores of Indians, Pakistanis and Bangladeshis who understood English fluently and those who did not. Furthermore, there were differences in the completion rates of the SF-12 between ethnic groups and a reversal of the general pattern of increasing MCS scores with increasing age in Bangladeshis. CONCLUSION: The results indicate that the use of the SF-12 to measure the health of ethnic minorities seems acceptable in most instances, but may prove problematic in those instances where respondents complete the questionnaire via an untrained translator, such as a friend or family member. The systematic differences in MCS and PCS scores between ethnic minorities who understood English fluently and those who did not suggest that the meaning of specific SF-12 items may change when informally translated. Future research using the SF-12 to measure the health status of ethnic minorities in the United Kingdom via postal surveys must include questions on whether respondents completed the questionnaires via informal translations. In general, those wishing to measure the health of members of ethnic groups who are unable to read English might consider using different techniques to gain the information from these groups.

Adult↗
PubMed2000

Social class differences in mortality using the new UK National Statistics Socio-Economic Classification.

Social class differences in health in the UK have usually been demonstrated by the Registrar General's social classification (RGSC). It is being replaced by the new UK National Statistics Socio-Economic Classification (NS-SEC). The NS-SEC is explicitly based on differences between employment relations and conditions. The mechanisms underlying social class differences in health remain debatable. Some studies have hypothesised that class differences in work characteristics and employment conditions may explain part of the observed class differences in health. This study investigates the associations of the NS-SEC and other measures of socio-economic status (SES) with mortality outcomes in a 7-year panel study representative of British private households and their members (the British Household Panel Survey, n = 10264). The NS-SEC was neither significantly associated with mortality for respondents of all ages nor with mortality for a younger subsample who were under 65 years at the initial survey. Other measures of SES, especially income and housing tenure showed significant patterns of inequalities in mortality. It may be useful to use other measures of SES along with the NS-SEC when analysing social inequalities in health and mortality.

Adult↗
PubMed2000

Validating self-rated health in different ethnic groups.

BACKGROUND: Subjective accounts of health status are increasingly utilized in social surveys and medical research to assess functioning and well-being. Despite the fact that substantial research evidence suggests that self-rated health is meaningful and provides valid and reliable data, some authors have raised concerns that different social groups may interpret the notion of health in different ways, and hence complete health measures in systematically different ways. This study evaluates the validity of using self-rated health status to measure health status in different ethnic groups. METHODS: Logistic regression models were used to examine the association of self-rated health with more objective measures of morbidity in different ethnic groups. SAMPLE: Two sources of data were used--the Health Survey for England (HSE) 1991-96 combined file and the Fourth National Survey of Ethnic Minorities (Ethmins4). MEASURES OF HEALTH: Hypertension, presence of cardiovascular disease or diabetes, limiting health and number of visits to a doctor. Self-rated health was measured on 5-point scale ranging from excellent to very poor. RESULTS: Poorer self-rated health was associated with greater morbidity within each ethnic group. Furthermore, there was little evidence that the association of self-rated health with more objective measures of morbidity differed between ethnic groups. CONCLUSION: The evidence reported here suggests that the use of a single item measure of self-rated health to measure health status in different ethnic groups is valid. Further research might usefully explore the validity of using more comprehensive profile measures of health status in different ethnic groups.

England↗
PubMed2000

The new UK National Statistics Socio-Economic Classification (NS-SEC); investigating social class differences in self-reported health status.

BACKGROUND: The new UK National Statistics Socio-Economic Classification (NS-SEC) is theoretically based on differences in employment relations and conditions. Differences in employment relations could account for some of the often observed social class differences in health in the United Kingdom. This study investigates the associations of the NS-SEC with a well-validated health outcome measure--the Short Form health survey (SF-36). METHODS: Data from the Oxford Healthy Lifestyles Survey III (OHLS III, n = 6,454), a cross-sectional survey of adult men and women aged 18-64 randomly selected from the counties of Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire, were analysed. The associations of the NS-SEC with the SF-36 physical and mental summary scores are investigated in a series of regression models controlling for age, lifestyle factors, housing and neighbourhood conditions. RESULTS: There are significant social class differences in the SF-36 physical and mental summary scores after controlling for age. When lifestyle, housing and neighbourhood conditions are controlled for, these differences reduce to non-significance. CONCLUSION: The NS-SEC shows significant social class differences in health, further evidence for its construct validity. Social class differences in housing, neighbourhood and lifestyle factors appear to have a large role in understanding class differences in health. As it is grounded in theory, the NS-SEC is likely to prove a valuable tool for explanations of inequalities in health.

Adolescent↗
PubMed1999

Recent European fertility patterns: fitting curves to 'distorted' distributions.

Recent patterns of fertility in Europe show marked differences between countries. Recent United Kingdom and Irish fertility curves show 'distortions' in terms of a 'bulge' in early age fertility, distinct from the smoother curves of other European countries. These patterns may not be adequately described by mathematical functions used by previous studies to model fertility curves. A mixture model with two component distributions may be more appropriate. The suitability of the simple and mixture Hadwiger functions is examined in relation to the fertility curves of a number of European countries. While the simple Hadwiger model fits recent period age-specific fertility distributions for some countries, others which display a 'bulge' in early age fertility distributions for some countries, others which display a 'bulg' in early age fertility require a mixture Hadwiger model. Some of the parameters of the Hadwiger models appear to be related to familiar demographic indices. The simple and mixture Hadwiger models appear useful in describing and comparing fertility patterns across European countries.

Europe↗
PubMed1998

Social inequality in coronary heart disease: a comparison of occupational classifications.

The British Registrar General's Social Classification has been strongly criticised for its lack of explanatory value. Furthermore, studies of social inequality in coronary heart disease (CHD) outcomes have often found associations between measures of inequality and heart disease unaccounted by conventional CHD risk factors. Alternative occupational classifications such as the Erikson-Goldthorpe schema and the Cambridge scale could be used to explore potential causal narratives which explain such residual associations. Results from a longitudinal study of adults in Britain show that the Cambridge scale has the strongest association with CHD and part of its strength is due to its strong association with CHD related health behaviours. Women classified by their partner's occupation had stronger associations with CHD compared to classifications by their own occupation. Job strain may not account for the observed social inequalities in CHD. The Cambridge scale shows stronger patterns of linear association with CHD than the RGSC and should be included in other studies of social inequality in health in the U.K.

Adult↗