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Comparison of methods of analysis using data of the panel study of the Federal Institute for Population Research (BIB).

The author compares methods of analysis using data from a panel study of the Federal Republic of Germany's Institute for Population Research. "This does not only involve a comparison of the methods as such, but above all also a comparison of the results (of these methods), of their presentation and of the possibilities of interpreting them. The three programmes selected for this paper represent methods for...so-called multivariate analysis, in particular for the analysis of non-metric data as they are included in the panel study...." Data are for a sample of 1,868 women interviewed at least twice and concern women's educational status and the qualities of motherhood.

Developed Countries↗

A comparative study of plasma high-density lipoprotein cholesterol in two groups of Nigerians of different socio-economic status.

Blood samples were obtained from two groups of Nigerians of different income and educational status. Group I subjects consisted of 178 males and females with high income and post-secondary-school education; and in group II were 332 males and females with low income and no secondary-school education. Plasma total cholesterol and high-density lipoprotein (HDL) cholesterol were determined in all samples. There was no significant increase in the mean plasma total cholesterol levels in group II subjects after the age of 20 years but the increase in the group I subjects was only significant in the males. The mean HDL cholesterol levels did not increase with age in both groups who were more than 20 years old. Group I males and females had significantly higher mean levels of plasma total and HDL cholesterol than the group II subjects. The female subjects in both groups had significantly higher mean plasma HDL cholesterol than their male counterparts. The mean ratios of HDL: total cholesterol for group I females were significantly higher than the mean for group I males only and not significantly different from values for group II subjects.

Adult↗

Breastfeeding. What happens during the first 12 months?

The infant feeding behaviour of 100 women was observed and documented until their infants were 12 months old. Duration of breastfeeding, reasons for weaning and the women's satisfaction with breastfeeding are discussed. Antenatal and perinatal factors are analysed, demonstrating a significant link with education status.

Attitude↗

Health care triage alternatives and the influence of health insurance, education and race.

The relationship between one of Andersen's enabling factors, health insurance status and the choice of a pharmacist as the initial contact in the health care system was examined via telephone surveys. Eighty-seven percent of the sample reported having some form of health insurance. Of all intended health care provider contacts, pharmacists were selected as the initial contact 21% of the time. Logistic regression identified insurance status, education and race as significant (alpha < 0.05) covariates in the model. The odds ratios generated from the logit model indicated that non-whites, persons with less education and no health insurance were more likely to select a pharmacist for triage. The study concluded that uninsured persons were nearly twice as likely to seek pharmacist triage than insured individuals. Pharmacists may be filling an important triage gap for individuals who have limited financial access to traditional sources of physician care.

Adolescent↗

Maternal factors related to parenting practices, developmental expectations, and perceptions of child behavior problems.

Parenting practices of a representative sample of 1,056 urban mothers with very young children were studied via the Parent Behavior Checklist (Fox, 1994) and the Behavior Screening Questionnaire (Richman & Graham, 1971). Potential determinants of parenting practices were also addressed, including maternal age, marital status, education level, number of children living at home, and family socioeconomic status. Less positive parenting practices concerning nuturing and discipline were found among mothers who were younger, had more than one child living at home, were single, had a lower income level, and had lower educational attainment. These mothers also tended to perceive their children as demonstrating more difficult behavior problems. However, the negative influence of some determinants of parenting practices, such as low income, was found to be moderated by the presence of other determinants, such as more education. The present results provide evidence that multiple determinants influence parenting practices among parents of young children.

Attitude↗

Intimate partner violence among Canadian women with activity limitations.

OBJECTIVE: To determine the prevalence of intimate partner violence (IPV) in the previous five years among women reporting activity limitations (AL). DESIGN AND SETTING: A community based, representative telephone survey of Canadians aged 15 and over. AL was assessed by the question: "Does a long term physical or mental condition or health problem reduce the amount or the kind of activity that you can do at home, at school, at work or in other activities?" Response categories were: often, sometimes, or never. PARTICIPANTS: 8771 women who had a current/former partner of whom 1483 reported AL. MAIN RESULTS: IPV was reported more often for AL (often or sometimes) compared with no AL women (emotional abuse (27.1, 26.4 v 17.7%, p<0.0001), physical-severe (7.3, 6.7 v 3.6%, p<0.0001), sexual abuse (3.5, 3.6 v 1.4%, p<0.0001)), or any IPV (30.5, 27.8 v 19.6%, p<0.0001). Adjusting for age, marital status, education, income, employment, children in the household, Aboriginal or visible minority status, place of birth, urban or rural residence, region of Canada, time in current residence, and religious attendance, AL women had higher odds of IPV (adjusted odds ratio: AL often=2.12; 95% CI: 1.64, 2.74; AL sometimes: OR=1.64; 95% CI:1.40, 2.29). CONCLUSION: These findings call for increased recognition of violence that occurs in the lives of women with AL. This community based study suggests that abuse among those reporting AL is high. Women with AL represent a high risk group to be targeted in terms of IPV prevention and intervention.

Activities of Daily Living↗

Further observations on social factors associated with duodenal ulcer in Soweto.

It has been postulated that urbanisation is an important factor in the genesis of duodenal ulcer. This study of 100 duodenal ulcer patients, and 100 hospital controls, matched according to sex, age, education and occupation, and an additional 50 unmatched endoscopically negative controls, confirmed that duodenal ulcer patients were mainly young men who were more likely to have been born in an urban area than the controls. Furthermore, a significant number of duodenal ulcer patients were born and reared in the smaller towns of South Africa and then moved to Soweto. It is suggested that frustrated aspirations in these towns might even be greater than in Soweto. In the context of the Soweto population where occupational and educational status is generally low, duodenal ulcer patients were of a higher educational and occupational category than Sowetans and unselected controls. Thus factors associated with urbanisation such as education and occupation and the pattern of urbanisation play key roles in duodenal ulcer. Investigation into particular aspects of the work situation such as the degree of autonomy exercised at work, authority over others and attitudes to supervision yielded no significant results.

Adult↗

Univariate and multivariate analysis of risk factors for ovarian cancer: case-control study, Mexico City.

Female residents of the southern part of Mexico City diagnosed with epithelial ovarian cancer between 1989 and 1992 (n = 172) were interviewed regarding reproductive events. The same information was obtained from the controls (n = 441). There was an elevated risk for ovarian cancer associated with an increased number of abortions, relative risk = 3.66 (95% confidence interval = 1.02 - 13.45) for women with four fetal losses. Ovarian cancer risk was shown to decrease as parity increased, reaching a relative risk of 0.23 (95% confidence interval = 0.09 - 0.55) in women with four or more live births in the postmenopausal group. This negative association seems less evident in overall cases. Logistic regression methods were used and abortions and high estimated number of ovulatory cycles were found to be associated with an increased risk of ovarian cancer. The inclusion of nonreproductive variables such as educational status, in the logistic model, showed that cases had a lower educational level than that of controls.

Abortion, Induced↗

Socio-economic factors, personal illness control and infant and child mortality in Pakistan.

"The hypothesis of the inverse relationship of socio-economic status of the parents and child infant mortality rates has been retested by introducing 'personal illness control' as an intervening variable. The data obtained in the 1984/1985 Pakistan Contraceptive Prevalence Survey have been used. The infant and child mortality rates have been estimated by using indirect techniques." The author finds that infant and child mortality rates are lower among upper socioeconomic groups, with mother's educational status being particularly important.

Asia↗

Female life expectancy, gender stratification, health status, and level of economic development: a cross-national study of less developed countries.

A number of studies have attempted to account for cross-national differences in life expectancy, but relatively few have focused on female life expectancy, and even fewer on the relevance of predictors linked to gender stratification theory. The present study seeks to assess the utility of gender stratification theory in accounting for cross-national differences in female life expectancy in less developed countries. An incremental model building strategy is used to develop a final model that combines predictors linked to both industrialism theory and gender stratification theory. The analysis is based on multiple regression and cross-sectional samples that vary in size from 40 to 97 countries. Evidence is presented that several aspects of women's status have a positive effect on female life expectancy. Indicators of women's educational status, women's economic status, and women's reproductive autonomy all prove to be important predictors of female life expectancy. Analysis of interaction effects suggests that the strength of the effects of some aspects of women's economic status and the effect of some aspects of health status on female life expectancy vary with the level of economic development. A comprehensive assessment of the relative strength of alternative measures of women's education is carried out, and evidence is presented that it does make a difference how the level of women's education is measured.

Adolescent↗

Views and preferences of low-literate Hispanics regarding diabetes education: results of formative research.

Hispanics are twice as likely as non-Hispanic Whites to have diabetes and are also at higher risk for diabetes-related complications and poorer outcomes. The prevalence of diabetes is inversely related to educational status. Low literacy is common, especially among older Hispanics. Little literature exists on formative research to create diabetes education materials for this audience. Two focus groups assessed views and preferences for diabetes education of low-literate, low-income, non-English-speaking urban Caribbean and Central American Hispanics with diabetes, as well as utility of materials developed specifically for this population, as part of the preliminary work for a pilot study of a diabetes intervention. Implications for practitioners and researchers are discussed.

Consumer Behavior↗

The association between socioeconomic status, health insurance coverage, and quality of life in men with prostate cancer.

The objective of this study was to examine the effect of socioeconomic status and insurance status on health-related quality of life (HRQOL) outcomes in men with prostate cancer. The design was a retrospective cohort study using multiple sites, including both academic and private practice settings. A cohort of 860 men with newly diagnosed, biopsy-proven prostate cancer of any stage was identified within CaPSURE, a longitudinal disease registry of prostate cancer patients. HRQOL was assessed with validated instruments, including the RAND 36-item Health Survey (SF-36) and the UCLA Prostate Cancer Index. Covariates included insurance status, education level, annual income, age, stage, comorbidity, Gleason grade, baseline PSA, marital status, ethnicity and primary treatment. HRQOL measurements were taken at 3-6-month intervals. Analysis of covariance was used to determine the effect of SES and insurance status on the HRQOL domains at baseline and over time. Patients with lower annual income had significantly lower baseline HRQOL scores in the all of the domains of the SF-36 and four of eight disease-specific HRQOL domains. No relationship was seen between annual income and HRQOL outcomes over time. Conversely, health insurance status was associated with HRQOL over time, but not at baseline. Health insurance status appears to have a unique effect on general HRQOL outcomes in men after treatment for prostate cancer. This study confirms the commonly held belief that patients of lower SES tend to have worse quality of life at baseline and following treatment for their disease. These findings have important ramifications for clinicians, researchers and policy makers.

Activities of Daily Living↗

[Malaria lethality in Dakar pediatric environment: study of risk factors].

To determine risk factors for fatal malaria in Senegalese children, a 3-year case-control study was carried out between October 1992 and November 1995 at the Albert Royer Hospital in Dakar. The case group included 52 children who died from documented malaria in the hospital. The matched control group consisted of children who responded favorably to hospital treatment. Exposure to risk was measured with regard to age, nutritional status, educational level of parents, self-medication prior to hospitalization, socioeconomic level, degree of fever, and blood parasite levels. Cases and controls were compared using statistical tests for matched groups. Age lower than 5 years, poor educational level of parents, delay of treatment more than 24 hours, nutritional status, and blood parasite levels greater than 5% were associated with a significantly higher risk of fatal outcome. Conversely, low socio-economic level, recent self-medication, and fever over 41 degrees C were not associated with higher fatality. These findings emphasize the need for more information campaigns to encourage people to seek institutionalized care when fever appears. Our results also suggest that prophylactic treatment may be advisable in children under 5 years of age and in some high risk groups.

Adolescent↗

Predicting school failure from information available at birth.

Information available from birth certificates was used to predict the psychological and educational status of approximately 1,000 randomly sampled first-grade children. The purpose of the research was to explore the feasibility of using birth certificate information as a cost-effective mechanism to identify children who were likely to need special educational services at public school entry. Multiple-regression and discriminant-function analyses revealed the following factors to be important in predicting psychoeducational status: birth order, race, educational status of the mother, month prenatal care began, survivorship of older siblings, and the child's legitimacy.

Achievement↗

[Various factors affecting the level of detection of schizophrenics].

Having studied the population of the schizophrenic patients registered at the psychoneurological dispensary of Samarkand (n = 678) the authors have revealed that the identification of patients depends on both age/sex structure of the general population and the educational level. It has been found that underdetection of schizophrenics in Samarkand is mainly accounted for by favourable cases of schizophrenia in particular in the following social groups: in young people under 19 years; in people with a higher educational status.

Adult↗