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PubMed1991

Health status and health practices--Alameda and beyond.

Using the population of St John's, Newfoundland, we did a constructive replication of previous studies testing the association between health practices and health status. A telephone questionnaire was applied to all adults in a probabilistic sample of households (3300 subjects, 85% response rate). Several health practices and preventive behaviours indexes were developed and tested. An additive index of six practices (breakfast, sleeping, drinking, smoking, weight and exercise) using the Alameda County definitions, and an additive score of five practices (excluding breakfast and with revised definitions for smoking, drinking and exercise) were analysed using log-linear models; there was association between the indexes and self-assessed health status when controlling for sex, age and education, with the exception of the six-practice index in males. The association between these two indexes and several variables and constructs of health status showed that the best relationships were with self-assessed health status and with a construct including variables measuring subjective health.

Adult↗

PubMed1992

[Effect of seasonal and intermittent work at high altitude on health status].

Health status of 7 men was examined in order to study the effect of duty work cycle of 3-d stay at the altitude of 2,000 m and one-day holiday at 600 m for a period of 6 months from May to October. Their usual works were desk work and road patrol. Total hemoglobin concentration in blood increased significantly after work at high altitude, which was considered to be a compensatory response to the hypoxic state. Subjective symptoms were obtained by a self-administered questionnaire before (April), during (June and October) and after (November) work at high altitude. Fatigue was observed in three out of the seven subjects in June, which subsequently disappeared in October. Dyspnea was observed also in June in three of the subjects, which disappeared in two, persisted in one, and newly appeared in another subject in November. In contrast, a tendency of favorable effects of the work environment on nausea and lumbago was observed. Blood pressure and pulse rate were measured for 24 h. The mean systolic blood pressure during 24 h decreased in two of five subjects in October and November, and the mean values during the working hours decreased in two in October from 145 to 131 mmHg and from 147 to 129 mmHg, respectively. The blood pressure measured at health examination correlated well with the mean blood pressure during 24 h and working hours. The mean pulse rate during 24 h and working hours increased in one in June, October and November. These results indicate that adaptive responses to low barometric pressure environment developed during a work period of 5 months at high altitude.(ABSTRACT TRUNCATED AT 250 WORDS)

Altitude↗

PubMed1997

Self-rated health status as a health measure: the predictive value of self-reported health status on the use of physician services and on mortality in the working-age population.

The validity of various self-reported health assessments in predicting physician contracts and all-cause mortality was investigated in a prospective study in Finland. The follow-up periods were one year for the use of physician services and ten years ten months for the mortality. The study cohort comprised 1340 men and 1500 women, 35-63 years of age at the beginning of the study. The initial health assessments were derived from postal questionnaires in 1980 (response rate 77.5%). The survey was repeated one year later to verify the stability of the respondents' perceived health status. The data on the physician contacts and mortality were registered independently. The stability of perceived health status was relatively good and the perceived health was inversely associated with the number of physician contacts per year. A consistent inverse association, standardized by age, sex and social status, was observed between perceived health status and perceived physical fitness and mortality, while the predictive value of self-reported chronic diseases was low. The results suggest that the subjective health assessments are valid health status indicator in middle-aged populations, and they can be used in cohort studies and population health monitoring.

Adult↗

PubMed1998

Health status and health care costs for publicly funded patients with schizophrenia started on clozapine.

OBJECTIVE: The study examined the effect of clozapine treatment on the health care costs and health status of people with schizophrenia who are supported by public funds. METHODS: Thirty-three patients with schizophrenia hospitalized in a state facility were interviewed within one week of starting clozapine and six months later. Health status was assessed with four clinical rating scales measuring severity of psychopathology, negative symptoms, depression, and quality of life. Cost and health care utilization data were collected for the six months before and after initiation of clozapine. RESULTS: Only 52 percent of the subjects stayed on clozapine for six months. Subjects who continued on clozapine were more likely to be discharged within six months than those who did not continue. Six months after clozapine was started, health care costs showed a sayings of $11,464 per person, even after adjustment for pretreatment costs, and health status was improved. CONCLUSIONS: For subjects who continued on clozapine for six months, clozapine treatment was associated with reduced days of psychiatric hospital care, reduced overall costs despite increased outpatient treatment and residential costs, and improved health status.

Adult↗

PubMed2005

Quantifying the effect of health status on health care utilization using a preference-based health measure.

The purpose of this study was to quantify the effect of health status on current and future payments and number of visits to health professionals in a large, representative community sample in British Columbia, Canada. The study population was comprised of all respondents to the 1994/5 cycle of the Canadian National Population Health Survey (NPHS) who were 12 years of age or older and residing in the province of British Columbia (N = 2084). Health status was measured with the Health Utilities Index (HUI). Two outcomes were defined for each subject: (a) the sum of all healthcare costs covered by the Medical Services Plan, incurred during a given fiscal year, and (b) the total number of visits to all health practitioners during the same year. Outcome data were obtained for a period 1994-1998. We examined the relationship between the HUI and healthcare use in a multivariate log-linear model. In the full sample, better health in 1994-1995 was associated with lower healthcare cost and lower number of visits from 1994 through 1998. The overall adjusted cost ratio was 0.89 (99% CI = 0.85, 0.94) and the overall adjusted visit ratio was 0.91 (99% CI + 0.87, 0.95). The effect of health status on the costs of care and on the number of visits was similar in men and women, was stronger in persons less than 45 years of age compared to those 45+, and was not different according to place of residence. We conclude that the HUI is a strong predictor of health services use over 5 years. A 0.1 improvement in health utility is associated with a 10% reduction in the costs of care and number of visits to health professionals.

Adult↗

PubMedDate not supplied

Hospital utilization in Ontario and the United States: the impact of socioeconomic status and health status.

UNLABELLED: We compared hospital use in Ontario and the United States for persons with different socioeconomic and health status. METHODS: Cross-sectional study using the 1990 Ontario Health Survey and the 1990 National Health Interview Survey. RESULTS: Admission rates averaged 31% higher in Ontario than in the United States, but international differences varied markedly across income and health status. At each level of health status, poor Canadians received one quarter to one third more admissions than their counterparts in the United States. However, higher income Canadians reporting excellent to good health had 50% more admissions than Americans, whereas those reporting fair or poor health had 10% fewer admissions. CONCLUSIONS: The observation that higher income sick persons receive less hospital care in Ontario than in the U.S. provides support at the population level for what has been observed for specific technologies. This represents, in part, a redistribution of inpatient care to those most vulnerable to illness, such as the poor, who receive substantially more hospital care in Ontario.

Adult↗

PubMed1999

[Study on oral health status and health behavior of workers at government office].

The purpose of this study was to investigate the oral health status and health behavior of the adult population in the workplace. In 1998, oral health examination of 388 workers (male: 287, female: 101) at a government office was performed. A questionnaire was administered to obtain data regarding oral symptoms and health behavior. The results were as follows: Overall, 48% needed treatment for dental caries, 44% needed calculus removal, and 23% needed treatment for periodontal disease. Although there were no oral health complaints, 20% had early caries, 40% had dental calculus, and 19% had periodontitis. Compared to males, more females brushed their teeth, had home dentists (44%) and received more regular dental health check-ups at least once a year (48%). For males, those with home dentists had higher FT and DMFT in the twenties and thirties. There was no relationship between oral health status and regular check-ups in both males and females. The results revealed that receiving regular dental check-ups from home dentists was not popular in Japan. Further, the role of home dentists is not preventive oriented. It was concluded that it is necessary to provide regular oral health examination and health promotion programs for adult population at the workplace in Japan.

Adult↗

PubMed1983

A health status and health service utilization study of a peri-urban community in Kwazulu.

A community survey was undertaken in a district in Kwazulu, adjacent to Pietermaritzburg. Natal, in order to determine health status and health service utilization patterns at a local level. This low-cost survey was labour-efficient and yielded useful data for the evaluation and planning of local health services. It was found that child health and delivery services were under-utilized while family planning and antenatal care services were comparatively well used. 'Traditional' practitioners' services were used regularly by 51% of the mothers and childminders interviewed. The use of the services of general medical practitioners was less significant. Some 36% of the children under 5 years of age were found to be malnourished, and 29% had conditions requiring medical treatment. The findings of this study indicate that a major discrepancy exists between the local need for health services and utilization of the available services. The introduction of community health workers is proposed as a possible solution.

Adolescent↗

PubMed1994

Health-related worries, perceived health status, and health care utilization.

This study examines the association of health-related worries (over cancers, diabetes, work-related stress, heart attack, obesity, general physical fitness, and/or other health conditions) and perceived health status (excellent, good, fair or poor) to the utilization of health care services for 19, 139 Japanese local public service employees. Data on health-related worries and health status were obtained from a self-administered questionnaire survey in 1988 and analyzed in relation to the subsequent 12-month utilization of health care. Results showed that perceived health status was associated with the utilization for almost all medical conditions and so was worry over a specific condition and the subsequent utilization of health care services. The implication of these findings is that measures targeting the relief of an employee's health-related worries, through either health consultation or other health programs, may contribute to the reduction of an employee's health care utilization and costs.

Adult↗

PubMed1978

Measures of community health status for health planning.

The National Health Planning and Resources Development Act of 1974 (P.L. 93-641) requires health systems agencies (HSAs) to assess the health status of their area populations but limits their data-collecting activity. Numerous measures of health status have been devised, but many of these require data that are not yet available or are available only on the national level. Proposed measures are reviewed, and the problems of applying them to the measurement of health status in small areas, under current technical and practical constraints, are discussed. Several measures have promise for giving reasonable results, but only with further development of data sources, estimation techniques, and social indicator models; under present constraints, HSAs will have to work with less precise and less useful methods.

Health Status Indicators↗

PubMed1998

Identifying health status and health risks of older rural residents.

Older rural residents are vulnerable in both health status and access to health services. This descriptive study was designed to assess the general health status and risk factors of older rural residents age 65 and over. Cluster analysis methods were used to group older adults into unique clusters of individuals with similar health risks. Although strategies are generally targeted at those with limitations in two or more activities of daily living, community health nurses might need to initiate interventions much earlier. Findings of this study can help community health providers, policymakers, and administrators strategically plan to meet the health care needs of various groups of at-risk older rural populations.

Aged↗

PubMed2006

Differences in health status and health behaviour among young Swiss adults between 1993 and 2003.

OBJECTIVE: Very few studies specifically have examined the health status of 20-year-olds. The purpose of the present study is to examine the changes in health status and behaviour among young Swiss adults between 1993 and 2003. METHODS: The present study used data from the Swiss Federal Surveys of Adolescents, conducted in 1993 and 2003 among 20-year-olds in Switzerland. The study sample included military recruits and a representative community cohort. More than 20,000 subjects participated in each survey. RESULTS: Young adults in 2003 reported fewer traffic- and sports-related accidents, but more work-related and other accidents versus young adults in 1993. A greater percentage of men were overweight or obese in 2003. Also in 2003, a greater percentage of males and females regularly used alcohol, cigarettes and cannabis. In particular, the number that smoked cigarettes daily increased by almost 30% and daily cannabis users increased more than two-fold. Young adults reported higher rates of inter-personal violence and theft in 2003. Compared to 1993, in 2003 young adults were more likely to report a sense of coherence; they also had fewer thoughts of suicide, but a greater sense that life is meaningless. CONCLUSIONS: Our study provides the first Swiss data comparing the health status of 20-year-olds a decade apart. The findings suggest a significant increase in substance use. Health prevention efforts among young adults ages 18-24 should focus on substance use. In addition, developing strategies to decrease interpersonal violence, delinquent behaviour, and obesity should be a major public health priority.

Accidents↗

PubMed2006

Cardiovascular health status and health risk assessment method of preference among worksite employees.

We investigated whether employees (n = 62) selecting a self-report Health Risk Assessment (HRA) would be at increased CVD risk compared to employees (n = 114) choosing an HRA with measurement of cardiovascular (CVD) health indicators. Participants were mostly middle-aged (44.1 +/- 0.8 yr) men (71.6%) displaying borderline features of the cardiometabolic syndrome. Although there were no significant differences between the groups regarding their measured CVD health status or self-reported lifestyle habits, employees in both groups consistently over-stated their level of cardiovascular health. Contrary to reports in the literature, cardiovascular health status did not appear to influence employee HRA method of preference.Editors' Strategic Implications: These findings await replication in other samples, both more diverse and less self-selected. Nonetheless, the authors' methods and their conclusions about workers' over-estimation of their health and the lack of differences across assessment methods will be useful to employers, health professionals, and all practitioners with an interest in health risk assessments.

Adult↗

PubMed1993

The Seattle appropriate level of care survey: health status and health services use in ambulatory persons with AIDS.

We surveyed 77 persons with AIDS, their physicians and their social workers during the autumn of 1987 to ascertain health status and to quantify use of health services in Seattle, Washington. Participants included the majority (59%) of persons living with AIDS in the area. Information was gathered regarding demography, health status, functional status, medical history and the use of health services. The validity of self-assessed general health was corroborated by the physician-rated Karnovsky score (kappa = 0.59), by social worker assessment (kappa = 0.41), and by correlation with functional status (r = 0.6-0.8). We found more frequent use of health services (categorized into skilled services, chore services and physician services) among AIDS patients who were dependent in basic and instrumental daily activities, had low income, had poor self-assessed general health, lived alone or lacked an available support person at home. These associations persisted in multivariate analyses, and accounted for 6-23% of the variability in service use. We conclude that health and functional status of persons with AIDS can be estimated via mailed questionnaires and accounts for a modest amount of the variability in use of health services.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Motherhood, health status, and health care.

This study examines the impact of multiple roles and stressors on women of childbearing age, and compares the health status of women with and without children and their ability to access health care. Motherhood has many complex interactions with income level, availability of health insurance, and available social and income support. A cumulative burden of multiple stressors (eg, being poor, uninsured, less educated, employed full-time, or being a single mother) relates to worse health status, levels of depression, and opportunities for obtaining health care. Multiple stressors seem to have a stronger effect on mothers than on nonmothers. Research should focus on identifying vulnerable groups and combinations of stressors for women both with and without children, and how to mitigate adverse impacts on physical and mental health.

Adolescent↗

PubMed1994

Functional status and health status.

Functional status assessment originated in clinical practice in rehabilitation. Health status assessment, a growing part of health services research, grew from the need to survey the health of large populations. In spite of many common interests, the two fields have had little cross-fertilization. The origins and current status of health status measurement are described, including examples of the most frequently used instruments. Conceptual and methodological issues shared by the two fields are examined with the aim of determining what might be of value to rehabilitation. Health-related quality of life provides a conceptual framework that could broaden the rehabilitation perspective. Health status measures may not be appropriate for clinical management but might be useful as quality of care and outcome indicators.

Activities of Daily Living↗

PubMed2003

Health status and health seeking behaviour of the elderly persons in Dagoretti division, Nairobi.

OBJECTIVE: To determine the health status and the health seeking behaviour of the elderly people aged 65 years and above. DESIGN: A descriptive cross sectional study of individuals interviewed through questionnaires and focus groups discussions. SETTING: Dagoretti Division, Nairobi Province, Kenya. SUBJECTS: Four hundred non-institutionalised elderly persons. RESULTS: Four hundred people including 276(69%) women and 124(31%) males were interviewed; 44% had no independent source of livelihood and 51% were widowed. The majority 376(92.5%) of the respondents had been sick within the last three months, preceding the study with 111(27.8%) being sick all the time. The prevalent diseases included musculoskeletal (80%), respiratory (68%), sight (44%) and dental conditions(40%). Three hundred and sixteen (79%) of the respondents were functionally independent in activities of daily living. One hundred and sixty one (40.3%) were satisfied with their current way of life while (63%) perceived themselves as healthy, 24.8% of the respondents lived alone. The reported social problems included:- economic dependency (96%), poor housing (76%), loneliness (60%) and feeling not needed (42%) of the respondents. Only 26% were on treatment, lack of money hindered health care access to 73% of the respondents (p<0.001). Sixty two per cent of the respondents were buying over-the-counter drugs. Walking was under taken by 217(67%) as a physical exercise, and (26%) of the respondents consumed addictive drugs. The focus groups criticised the lack of health facilities for the elderly in the community. CONCLUSION: The effects of ageing, low economic status and inadequate access to health care contributed to the elderly poor health status. The use of over-the-counter drugs was indicative of the inefficient health facilities in meeting the health needs of the elderly. The study points out the need to formulate policies that will target on the health needs of the elderly.

Activities of Daily Living↗

PubMed1989

Health status and health care in rural Australia: a case study.

Knowledge of the health status of, and patterns of health care service utilization by rural Australian communities, is scant. This deficiency limits attempts to formulate policies designed to bring about efficient, effective and equitable delivery of health care services. This article reports the results of a health interview survey conducted in the Wimmera region of Victoria during spring 1984. The results demonstrate not only that patterns of morbidity in rural areas differ from the Australian average, but also that the health status of rural dwellers is worse than that of most Australians. Evidence suggests that while accessibility is not the most significant determinant of utilization of health care services, distance from services does affect propensity to use them.

Adolescent↗