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PubMed2005

[Skewed income distribution and geographical mortality differences].

BACKGROUND: A prominent theme in current health research is whether large income inequality in a society in itself has negative consequences for population health, in addition to the effects of individual risk factors. The present study investigates whether mortality in Norway during the 1990s was higher in geographical regions with particularly skewed income distributions. MATERIAL AND METHODS: Register data for all inhabitants aged 25-66 in Norway in 1992 were used (N = approx. 2.2 millions), including information about deaths 1993-99. Norwegian municipalities were grouped into 23 regions. Gini coefficients indicating the degree of inequality in the income distribution were calculated for each region. Deaths 1993-99 were analysed by means of multiple logistic regression. RESULTS: Odds ratios for deaths 1993-99 were strongly influenced by well-known individual risk factors such as sex, age, marital status, educational level, personal income, and disability. In addition, odds ratios for death were significantly associated with the regions' gini coefficients when adjustments were made for average income level in the regions. This effect of income inequality was pronounced for people with low education, but almost absent among those with higher education. Moreover, the income inequality effect was to some extent driven by special circumstances in Oslo, Norway's capital city, with its high mortality among the less educated and a particularly non-egalitarian income distribution. However, the pattern of higher mortality associated with higher levels of income inequality among the less educated was also observed in the 22 regions outside Oslo. INTERPRETATION: We found a discernible, although not very strong, association between regional income inequality and mortality levels among the less educated. Several interpretations for this statistical tendency could be proposed; the social processes generating this tendency should be clarified further.

Adult↗

PubMed2006

The effects of socioeconomic factors on the decision to be vaccinated: the case of flu shot vaccination.

BACKGROUND: Anti-influenza vaccination has proven cost-effective for society. In Israel, however, vaccination rates remain relatively low in comparison to other countries. OBJECTIVES: To analyze the socioeconomic and health status factors affecting the decision to be vaccinated against flu and to compare these factors to results from other countries in order to determine which segments of the adult population should be targeted for increased coverage in influenza vaccination programs. METHODS: Our source was the 1999/2000 Health Survey of the Central Bureau of Statistics for the group aged 25 and above, comprising 16,033 individuals. We used statistical methods such as the Probit regression model to estimate the effects of socioeconomic and health status variables on the decision to get a flu shot. The variables included gender, age, marital status, education, ethnic origin, religious affiliation and housing density, as well as chronic illnesses, smoking, hospitalizations, membership in health management organizations and kibbutz membership. RESULTS: Our findings indicate that being a post-1990 immigrant from the former Soviet Union, living in a densely populated house, being unmarried and smoking heavily are important factors in predicting the decision not to be vaccinated. In contrast, chronic illness, previous hospitalizations, older age, and kibbutz membership positively affected the decision to take the vaccine. CONCLUSIONS: It is necessary to identify the socioeconomic and health variables marking population sectors that are less likely to be vaccinated in order to design a suitable policy to encourage vaccination.

Adult↗

PubMed1991

Residues of organochlorine pesticides in human milk from mothers living in the greater Harare area of Zimbabwe.

Residue levels of the chlorinated hydrocarbons p,p -DDT, p,p, -DDE, p,p TDE, p,p -DDT, alpha-beta-gamma-hexachlorocyclohexane (HCH), heptachlor epoxide, dieldrin and polychlorinated biphenyls (PCBs) were determined in human milk of 40 Zimbabwean mothers living in the greater Harare area. Three municipal clinics and one main hospital were randomly selected as collecting points. The main organochlorine contaminants found in all the samples analysed were p,p -DDT and p,p -DDE and the mean levels of sum DDT and DDT/DDE ratio were 6 mg/kg milk fat and 0.74 respectively. In general, relatively low residue levels of alpha-beta-,gamma-HCH, heptachlorepoxide and dieldrin were detected in 58,100,63,13 and 65pc, respectively of all the milk samples analysed. Trace of the PCB congener 2,2,4,5,5'-pentachlorobiphenyl (PCB 101) were found in 15 samples and only one sample contained traces of 2,3',4,4',5-pentachlorobiphenyl (PCB 118). The results were examined with regard to health ad living condition of the mothers. From the small population observed around the greater Harare area--social status, educational background an living conditions could be described as important demographic variables influencing the frequency distribution of residual levels of sum DDT in the mother's milk.

Educational Status↗

PubMed1991

[A preliminary study of family Apgar index in the Chinese].

The present study was designed to evaluate the clinical availability of family Apgar index in Chinese people. From August 1987 to February 1988, 113 samples from 45 Chinese families were collected from our record family patients. The family members who were over 12 years of age were asked to complete a family Apgar questionnaire and CHQ during a family visit. The patients age, sex, marital status, education, religion, family role, socioeconomic status were also recorded. The result showed that there was no significant correlation between the family Apgar scores and all of the patient's characteristics (sex, age, marital status, education, religion, family role, socioeconomic status) except the score of CHQ. It is suggested that the family Apgar index is a simple and useful instrument to screen out family dysfunctional patients in daily office practice.

Asian People↗

PubMed1990

Diet, tobacco use, and fatal prostate cancer: results from the Lutheran Brotherhood Cohort Study.

A cohort of 17,633 white males age 35 and older responded to a mailed epidemiological questionnaire in 1966 and was followed until 1986 to determine the risk of cancer associated with diet, tobacco use, and other factors. During the 20-year follow-up, 149 fatal prostate cancer cases were identified. Relative risks for prostate cancer were significantly elevated among cigarette smokers (relative risk, 1.8; 95% confidence interval, 1.1-2.9) and users of smokeless tobacco (relative risk, 2.1; 95% confidence interval, 1.1-4.1). No significant associations were found with frequency of consumption of meats, dairy products, fruits, or vegetables. There were no overall significant associations between consumption of vitamin A from animal sources (retinol) and provitamin A from plant sources (carotene) and risk, but positive trends were seen for ages under 75, while inverse associations were found at older ages. Beverage consumption, including drinking coffee and alcohol, was unrelated to risk. Marital status, education, rural/urban status, and farming residence were also unrelated to the risk of fatal prostate cancer. The findings add to limited evidence that tobacco may be a risk factor for prostate cancer, but fail to provide clues to dietary or other risk factors.

Adult↗

PubMed1990

Relationship of vibriocidal antibodies to history of cholera vaccination in Thai adult volunteers.

Vibriocidal antibodies were determined by microtechnique in 5 groups of Thai adult volunteers who had never received or had received cholera vaccination within one year, more than one to five years ago, more than five to ten years ago and more than ten years ago respectively. Detailed questionnaires about socioeconomic status, educational levels and environmental factors were presented to every volunteer. There were no differences statistically in incomes, educational levels and environmental factors among the groups. It was found that the reciprocal geometric mean titers of antibodies in volunteers who had never received cholera vaccination was generally low. The reciprocal geometric mean titers of the volunteers who had received cholera vaccination within one year were statistically different from other groups (p = 0.05). There was no correlation between blood groups of volunteers and vibriocidal antibodies.

Adult↗

PubMedDate not supplied

[Social conditions and intelligence in old age].

There is a complex structure of conditions which are accepted to be of effect on development of intelligence in old age. We turned particularly to the socioeconomic conditions with their stimulating or depriving attributes. With a pathanalytic model we were able to explain about 38% of variance of intellectual performance at the first measurement point of the Bonn Longitudinal Study of Aging (BLSA). With this model we took into consideration the family environment of the aged BLSA people (60-75 yrs.) at their youth as well as some indicators of the aged peoples' socioeconomic status (educational and occupational level) in their later life history.

Adult↗

PubMed1993

[Self-assessment of health status among welders].

The study covered 371 males (including 206 arc welders) at the productive age. A significant diversify of health self-assessment was found in the examined groups. The relationship between the assessment of health and age, period of employment, social status, education, age at which the employment began, body structure, was statistically significant. There was stronger relationship with the period of employment than with the age. Positive assessment of health was more frequent among those who started their employment at the age over 24 years than among those who joined their job below 20 years of age. Negative assessment of health was observed more often among males suffering from chronic diseases than among those enjoying good health.

Adult↗

PubMed1994

Can the increasing weight of Australians be explained by the decreasing prevalence of cigarette smoking?

In Australia there has been a recent increase in the body mass index (BMI) of the population and a decrease in smoking prevalence. Data from the three risk factor prevalence surveys conducted by the National Heart Foundation of Australia in 1980, 1983 and 1989 were analysed to determine if the increase in BMI could be explained by the decrease in smoking. For men in all age groups and for women aged 50 years or over, there were parallel increases in mean BMI for current smokers, ex-smokers and never smokers. For women under 50 years, the pattern of increasing BMI over time was less clear. Mean BMI increased over time within each five-year age group and in age 'cohorts' and the pattern was independent of smoking status. For men and for both groups of women there were similar changes in mean BMI over time for most categories of employment status, education and physical activity. Thus the increase in body weight cannot be explained by the decrease in smoking rate, or by the other factors investigated in this paper.

Adult↗

PubMed1998

[Smoking during pregnancy and preterm delivery].

The purpose of the study was to evaluate the association between smoking during pregnancy and preterm birth. The overall rate of preterm delivery was 4.3%. Smokers had a 40% higher risk of preterm birth compared to non-smokers. A dose response relationship was found between smoking and risk of preterm birth. Adjustment for women's height, pre-pregnant weight, age of the mother, marital status, education, occupational status, and alcohol intake did not change the results. Among women with an intake of less than 400 mg of caffeine per day no difference in the risk of preterm birth between smokers and non-smokers was found. However, among women with an intake of more than 400 mg of caffeine per day, the risk of preterm birth was increased almost threefold among smokers compared to non-smokers. Furthermore, among women with a high intake of caffeine a dose response relationship was found between smoking and risk of preterm delivery.

Adolescent↗

PubMed1976

[On the intellectual capacity of patients suffering from ulcerative colitis--a comparative study using the HAWIE--(author's transl)].

Differing reports in the literature on the intellectual capabilities of patients with unspecific ulcerative colitis caused us to undertake a controlled test-psychological study. 30 patients with ulcerative colitis and 30 "healthy" control persons were tested with the Hamburg-Wechsler-Intelligenztest für Erwachsene (HAWIE). The patients and the controls were matched as regards age, sex, family status, education, professional status and monthly income. A statistical comparison using the Wilcoxon matched-pairs signed-ranks test showed that the two groups did not differ significantly in their intelligence quotients. Our results seem to indicate that the assumption of extraordinary intellectual capabilities of patients with ulcerative colitis is not tenable.

Adult↗

PubMed1997

The influence of some factors on the non-homogeneity in adult male life expectancy in the Slovak Republic.

Life expectancy of males in the Slovak Republic, a small postcommunist country in Central Europe, is among the lowest in Europe due to the extremely high mortality rate in middle-aged men. The relation between male life expectancy at age 20 and several variables (i.e. ethnic structure, educational status, religious belief and economic activity) was analysed by simple regressions and by multifactorial methods in all 38 districts of Slovakia. Significant negative associations were found between male life expectancy at age 20 and ethnic structure (i.e. percent of Hungarian population), economic activity (percent of men employed in agriculture) and educational status (percent of men having only a basic education). In multifactorial analysis educational status and ethnic structure entered the model. The most dramatic health decline occurred in agricultural southern districts with high percentage of Hungarian minority and with high percentage of men with the lowest educational status. Lifestyle probably presents the background of these relations, but there is a lack of reliable data from the individual districts for a more profound analysis. More sophisticated epidemiological research projects are important for the formulation of a public health strategy in Slovakia.

Adult↗

PubMed1997

Impact of chronic pain patients' job perception variables on actual return to work.

OBJECTIVE: To examine the impact of preinjury job perceptions on chronic pain patients (CPPs) return to work after pain facility treatment. DESIGN: A total of 128 CPPs completed a series of rating scales and yes/no questions relating to their preinjury job perceptions and a question relating to "intent" to return to the same type of preinjury job following pain facility treatment. These CPPs were part of a grant study for prediction of return to work, and therefore their work status was determined at 1, 3, 6, 12, 18, 24, and 30 months after treatment. The preinjury job perceptions and other demographic variables were used to predict return to work. Stepwise discriminant analysis was used to predict return to work at the 1-month and final time points utilizing the above variables. Stepwise regression analysis was used to predict mean employment status (at all time points) also using the above variables. SETTING: Multidisciplinary Pain Center. PATIENTS: Consecutive CPPs. RESULTS: For the 1-month time point, employment status was predicted by "intent," educational status, work dangerous perception complaint, job stress, job physical demands, job liking, and job role conflicts. Here, 79.49% of the CPPs were correctly classified. For the final time point, employment status was predicted by the first three predictors for the 1-month time point (in the same order) and age, job stress, and gender. Here, 74.58% of the CPPs were correctly classified. Mean employment status was predicted by "intent" and educational status. CONCLUSIONS: There is a relationship between preinjury job perceptions and actual return to work after pain facility treatment. Voiced "intent" not to return to the preinjury type of job is highly predictive of not returning to work after pain facility treatment.

Accidents, Occupational↗

PubMed1982

Socio-economic, educational, and status characteristics of Ontario interschool athletes.

Three social and education issues, i.e., socioeconomic class biases in interschool competitive sports programs, relationships between school sports participation and educational achievement/aspiration, and the influence of the status ascribed to interschool sports participation on achievement/aspiration were examined in the light of data gathered in a recent study of interschool sport programs in Ontario. Interschool athletes, when compared to other students, were found to (1) come more often from the professional and less often from the labour class; (2) more often possess higher educational aspirations; and (3) not attain higher grades in their school work. These findings were examined in relationship to factors of cost of program, perceived status of interschool sports, student identification with the values promoted in the school system, upward social mobility, and encouragement of significant others. Implications for the education system in Canada were drawn.

Achievement↗

PubMed1986

Socioeconomic status and education as risk determinants of gastrointestinal cancer.

Standardized incidence ratios were calculated for cancers of the gastrointestinal tract in different socioeconomic and educational groups in Finland. The series constituted all patients with cancers of the esophagus, stomach, colon, rectum, liver (primary only), gallbladder, and pancreas recorded in the Finnish Cancer Registry in 1971-1975 (8,802 cases). Data on socioeconomic status and education were obtained from the records of the national census of December 31, 1970. Cancers of the colon and rectum were associated with high socioeconomic status and higher levels of education, cancers of the esophagus and stomach with lower classes. These associations are most likely to be mediated by dietary habits. No clear-cut association was found for other cancers.

Adult↗

PubMed1996

Literacy and contraception: exploring the link.

OBJECTIVE: To describe what is known about the relation of literacy skills to contraceptive use and to suggest directions for future research. An overview of what is known about the literacy skills of Americans and the prevalence of inadequate functional health literacy is presented. Information about reading requirements for various methods of contraception and advice from health educators on dealing with low-literate populations are described. DATA SOURCES: MEDLINE, PsychInfo, and ERIC searches for the last 20 years were completed using the terms literacy, literacy and health, family planning, health status, educational status, risk factors, contraception, and pregnancy. METHODS OF STUDY SELECTION: The primary literature searches identified 125 articles. After reviewing abstracts for these articles, we excluded 79, because they contained no specific mention of literacy or educational status relating to contraception. TABULATION INTEGRATION, AND RESULTS: We were unable to identify and study specifically devoted to the relation between functional literacy and actual use of contraceptives. Forty-six with relevant background or related information were identified: literacy and health (19), adult literacy (nine), literacy and contraception (11), and literacy and family planning (seven). Over one-third of English-speaking and 62% of Spanish-speaking patients had inadequate or marginal functional health literacy in a study conducted at two urban public hospitals. Studies by health educators have demonstrated that information for many types of contraceptives is frequently above the patient's reading level. Available epidemiologic information on the relation between educational status and unplanned pregnancy is also presented. CONCLUSIONS: Although no study has specifically addressed how functional health literacy affects contraceptive use, it is reasonable to hypothesize that functional health literacy influences contraceptive knowledge, attitudes, and behaviors. Future research should focus on the relation between functional health literacy and actual use of various contraceptives.

Adolescent↗

PubMed1988

Very low birth weight infants at 8 and 11 years of age: role of neonatal illness and family status.

The intellectual and educational status of 108 children with very low birth weight (less than or equal to 1,500 g), born from 1965 to 1978, was evaluated and tested on standard tests (eight children with severe handicaps were excluded) at 8 years of age. Fifty-seven were further evaluated at 11 years of age. Six categorical outcomes were defined a priori, based on the Wechsler Intelligence Scale for Children-Revised IQ and discrepancies between Verbal and Performance scores and Bender Gestalt Test score. Proportions at 8 years of age were: 4.6% very low IQ (below 70), 13.9% low IQ (70 to 84), and, for those with IQ greater than 84, 12.0% language disability, 12.0% performance disability, 21.4% visual-motor disability, and 36.1% normal. Learning disabilities, determined by discrepancies between IQ and Wide Range Achievement Test scores, included 16.7% of all children. Outcome proportions at 11 years of age were essentially comparable to those at 8 years of age; outcome constancy was present in 52.6%. Ratings of neonatal illness and parent education level strongly influenced the likelihood of outcome at 8 years of age. When ratings were dichotomized (ie, low v high neonatal illness and low v high parent education), the level of neonatal illness primarily influenced the likelihood of normal outcome, whereas the level of parent education influenced the degree of severity of the disability.

Achievement↗

PubMed2005

The prevalence of obesity and its relationship with lifestyle factors in Jamaica.

We surveyed the prevalence of obesity in the general population in Jamaica, and examined the relationship between it and lifestyle. The survey population consisted of 1,935 inhabitants in Jamaica, whose body weight, height, marital status, educational history, employment status and other obesity-associated lifestyle factors were surveyed. Six major findings emerged. The first finding is that the proportion of obesity in women was very high, and there was a big gender difference. Secondly, a lower prevalence towards obesity was associated with cohabitation of the subjects in both genders, and higher educational levels in female subjects. Thirdly, the proportion of the subjects who considered their weight to be quite acceptable was higher in the obese/overweight groups in both genders. Fourthly, exercise frequency showed a negative correlation with the body mass index (BMI) in men, and the frequency of exercising was apparently lower in women than in men. Fifthly, as for dietary factors, in both genders vegetables showed a negative correlation with the BMI. Sixthly, non-smokers were also associated with a lower obesity prevalence in men. In conclusions, these findings suggest that social and lifestyle factors such as the educational level, marital status and dietary habits of the general population influence Jamaican obesity.

Adult↗