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Delpierre C, Kelly-Irving M, Munch-Petersen M, Lauwers-Cances V, Datta GD, Lepage B, Lang T. SRH and HrQOL: does social position impact differently on their link with health status? BMC Public Health 2012; 12:19. [PMID: 22233446 PMCID: PMC3287252 DOI: 10.1186/1471-2458-12-19] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 01/10/2012] [Indexed: 12/29/2022] Open
Abstract
Background Self-rated Health (SRH) and health-related quality of life (HRQoL) are used to evaluate health disparities. Like all subjective measures of health, they are dependent on health expectations that are associated with socioeconomic characteristics. It is thus needed to analyse the influence played by socioeconomic position (SEP) on the relationship between these two indicators and health conditions if we aim to use them to study health disparities. Our objective is to assess the influence of SEP on the relationship between physical health status and subjective health status, measured by SRH and HRQoL using the SF-36 scale. Methods We used data from the French National Health Survey. SEP was assessed by years of education and household annual income. Physical health status was measured by functional limitations and chronic low back pain. Results Regardless of their health status, people with lower SEP were more likely than their more socially advantaged counterparts to report poor SRH and poorer HRQoL, using any of the indicators of SEP. The negative impact of chronic low back pain on SRH was relatively greater in people with a high SEP than in those with a low SEP. In contrast, chronic low back pain and functional limitations had less impact on physical and mental component scores of quality of life for socially advantaged men and women. Conclusions Both SRH and HRQoL were lower among those reporting functional limitations or chronic low back pain. However, the change varied according SEP and the measure. In relative term, the negative impact of a given health condition seems to be greater on SRH and lower on HRQoL for people with higher SEP in comparison with people with low SEP. Using SRH could thus decrease socioeconomic differences. In contrast using HRQoL could increase these differences, suggesting being cautious when using these indicators for analyzing health disparities.
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Jesdale BM, Mitchell JW. Reported excellent health among men in same-sex and mixed-sex couples: Behavioral Risk Factor Surveillance System, 1993-2010. JOURNAL OF HOMOSEXUALITY 2012; 59:788-807. [PMID: 22853180 PMCID: PMC5495025 DOI: 10.1080/00918369.2012.694755] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Self-reported excellent health was examined across sexual orientation among male adult couples using 18 years of data from the Behavioral Risk Factor Surveillance System. Men in same-sex couples were more likely to report being in excellent health (28.7%) than men in unmarried and married mixed-sex couples (20.4% and 23.2%). After adjusting for other demographic and health factors, men in same-sex couples remained more likely to report excellent health than men in unmarried mixed-sex couples, but not than men in married mixed-sex couples. Reporting only adverse health disparities provides a partial picture of sexual minority health, and discounts the role of resilience and other health promoting factors in these populations.
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Affiliation(s)
- Bill M Jesdale
- University of California Berkeley, Department of Environmental Sciences, Policy & Management, Berkeley, California 94720-3114, USA.
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Hobfoll SE, Hall BJ, Canetti D. Political violence, psychological distress, and perceived health: A longitudinal investigation in the Palestinian Authority. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2012; 4:9-21. [PMID: 22328960 PMCID: PMC3275891 DOI: 10.1037/a0018743] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
One thousand one hundred and ninety six Palestinian adults living in the West Bank, Gaza Strip, and East Jerusalem were interviewed beginning in September 2007 and again at 6- and 12-month intervals. Using structural equation modeling, we focused on the effects of exposure to political violence, psychosocial and economic resource loss, and social support, on psychological distress, and the association of each of these variables on subjective health. Our proposed mediation model was partially supported. Exposure to political violence, psychosocial resource loss, and social support were related to subjective health, fully mediated by their relationship with psychological distress. Female sex and being older were also directly related to poorer subjective health and partially mediated via psychological distress. Greater economic resource loss, lower income, and poorer education were directly related to poor subjective health. An alternative model exploring subjective health as a mediator of psychological distress revealed that subjective health partially mediated the relationship between resource loss and psychological distress. The associate between female sex, education, income, and age on psychological distress were fully mediated by subjective health. Social support and exposure to political violence were directly related to psychological distress. These results were discussed in terms of the importance of resource loss on both mental and physical health in regions of chronic political violence and potential intervention strategies.
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Benzeval M, Green MJ, Leyland AH. Do social inequalities in health widen or converge with age? Longitudinal evidence from three cohorts in the West of Scotland. BMC Public Health 2011; 11:947. [PMID: 22192620 PMCID: PMC3265552 DOI: 10.1186/1471-2458-11-947] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 12/22/2011] [Indexed: 11/30/2022] Open
Abstract
Background Existing studies are divided as to whether social inequalities in health widen or converge as people age. In part this is due to reliance on cross-sectional data, but also among longitudinal studies to differences in the measurement of both socioeconomic status (SES) and health and in the treatment of survival effects. The aim of this paper is to examine social inequalities in health as people age using longitudinal data from the West of Scotland Twenty-07 Study to investigate the effect of selective mortality, the timing of the SES measure and cohort on the inequality patterns. Methods The Twenty-07 Study has followed three cohorts, born around 1932, 1952 and 1972, from 1987/8 to 2007/8; 4,510 respondents were interviewed at baseline and, at the most recent follow-up, 2,604 were interviewed and 674 had died. Hierarchical repeated-measures models were estimated for self-assessed health status, with and without mortality, with baseline or time-varying social class, sex and cohort. Results Social inequalities in health emerge around the age of 30 after which they widen until the early 60s and then begin to narrow, converging around the age of 75. This pattern is a result of those in manual classes reporting poor health at younger ages, with the gap narrowing as the health of those in non-manual classes declines at older ages. However, employing a more proximal measure of SES reduces inequalities in middle age so that convergence of inequalities is not apparent in old age. Including death in the health outcome steepens the health trajectories at older ages, especially for manual classes, eliminating the convergence in health inequalities, suggesting that healthy survival effects are important. Cohort effects do not appear to affect the pattern of inequalities in health as people age in this study. Conclusions There is a general belief that social inequalities in health appear to narrow at older ages; however, taking account of selective mortality and employing more proximal measures of SES removes this convergence, suggesting inequalities in health continue into old age.
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Whiners and deniers - what does self-rated health measure? Soc Sci Med 2011; 75:1-9. [PMID: 22265085 DOI: 10.1016/j.socscimed.2011.10.030] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 08/24/2011] [Accepted: 10/28/2011] [Indexed: 11/21/2022]
Abstract
Self-rated health is a widely used measure of health typically obtained from a question, "How do you rate your health?" Despite the measure's popularity, debates continue as to what exactly self-rated health captures. This study augments the rich literature on the construct of self-rated health using a unique measurement approach. We conceptualize self-rated health as consisting of two components: latent health and reporting behaviour. We operationalize a preference-standardized health-related quality of life as a measure of latent health, and its systematic deviation from self-rated health as a measure of reporting behaviour. Using the 2005 Canadian Community Health Survey, we assess comparatively how the deviations between self-rated health and latent health, measured by the Health Utilities Index Mark 3, vary systematically by demographic, socioeconomic, and cultural factors. We present reporting behaviour by these factors in terms of pessimism and optimism relative to the assessment of the average Canadian. Our analysis shows reporting behaviour statistically and clinically significantly varies by age and socioeconomic status: those aged 80+ years and those with less income and education exhibit optimism about their health. In addition, our analysis indicates a tendency for persons with healthier lifestyles to be slightly pessimistic about their health. Our results imply that it may be misleading to take self-rated health at face value as a measure of health status for applications where preferences should be standardized. For this popular measure to continue to play an important role in population health research and policy development, its users must acknowledge and understand the determinants of self-rated health, including reporting behaviour.
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Hatch SL, Frissa S, Verdecchia M, Stewart R, Fear NT, Reichenberg A, Morgan C, Kankulu B, Clark J, Gazard B, Medcalf R, Hotopf M. Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study. BMC Public Health 2011; 11:861. [PMID: 22078667 PMCID: PMC3227613 DOI: 10.1186/1471-2458-11-861] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 11/11/2011] [Indexed: 11/22/2022] Open
Abstract
Background Responses to public health need require information on the distribution of mental and physical ill health by demographic and socioeconomic factors at the local community level. Methods The South East London Community Health (SELCoH) study is a community psychiatric and physical morbidity survey. Trained interviewers conducted face-to-face computer assisted interviews with 1698 adults aged 16 years and over, from 1076 randomly selected private households in two south London boroughs. We compared the prevalence of common mental disorders, hazardous alcohol use, long standing illness and general physical health by demographic and socioeconomic indicators. Unadjusted and models adjusted for demographic and socioeconomic indicators are presented for all logistic regression models. Results Of those in the sample, 24.2% reported common mental disorder and 44.9% reported having a long standing illness, with 15.7% reporting hazardous alcohol consumption and 19.2% rating their health as fair or poor. The pattern of indicators identifying health inequalities for common mental disorder, poor general health and having a long term illness is similar; individuals who are socioeconomically disadvantaged have poorer health and physical health worsens as age increases for all groups. The prevalence of poor health outcomes by ethnic group suggests that there are important differences between groups, particularly for common mental disorder and poor general health. Higher socioeconomic status was protective for common mental disorder, fair or poor health and long standing illness, but those with higher socioeconomic status reported higher levels of hazardous alcohol use. The proportion of participants who met the criteria for common mental disorder with co-occurring functional limitations was similar or greater to those with poor physical health. Conclusions Health service providers and policy makers should prioritise high risk, socially defined groups in combating inequalities in individual and co-occurring poor mental and physical problems. In population terms, poor mental health has a similar or greater burden on functional impairment than long term conditions and perceived health.
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Affiliation(s)
- Stephani L Hatch
- King's College London, Psychological Medicine, Institute of Psychiatry, 10 Cutcombe Road, London SE5 9RJ, UK.
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Peersman W, Cambier D, De Maeseneer J, Willems S. Gender, educational and age differences in meanings that underlie global self-rated health. Int J Public Health 2011; 57:513-23. [DOI: 10.1007/s00038-011-0320-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Revised: 10/06/2011] [Accepted: 10/24/2011] [Indexed: 11/24/2022] Open
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Foraker RE, Rose KM, Chang PP, McNeill AM, Suchindran CM, Selvin E, Rosamond WD. Socioeconomic status and the trajectory of self-rated health. Age Ageing 2011; 40:706-11. [PMID: 21737460 DOI: 10.1093/ageing/afr069] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND self-rated health (SRH) likely reflects both mental and physical health domains, and is assessed by asking individuals to describe their health status. Poor SRH is associated with disease incidence and subsequent mortality. Changes in SRH across time in persons with different incident diseases are uncharacterised. METHODS SRH was assessed in the Atherosclerosis Risk in Communities study via annual telephone interviews over a median of 17.6 years. Individual quadratic growth models were used for repeated measures of SRH in persons who remained disease-free during follow-up (n = 11,188), as well as among those who were diagnosed with myocardial infarction (MI; n = 1,071), stroke (n = 809), heart failure (HF; n = 1,592) or lung cancer (n = 433) and those who underwent a cardiac revascularisation procedure (n = 1,340) during follow-up. RESULTS among disease-free participants and across time, there was a trend for lowest mean SRH among persons living in low socioeconomic areas and highest mean SRH among persons living in high socioeconomic areas. Factors contributing to the decline in SRH over time included advanced age, lower educational attainment, smoking and obesity. CONCLUSION addressing factors related to poor SRH trajectories among patients pre- and post-incident disease may favourably affect health outcomes among patients regardless of type of disease.
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Affiliation(s)
- Randi E Foraker
- Division of Epidemiology, The Ohio State University, Columbus, 43210, USA.
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El-Gasim M, Munoz B, West SK, Scott AW. Discrepancies in the concordance of self-reported vision status and visual acuity in the Salisbury Eye Evaluation Study. Ophthalmology 2011; 119:106-11. [PMID: 21962256 DOI: 10.1016/j.ophtha.2011.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 07/01/2011] [Accepted: 07/06/2011] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To examine the association between self-rated vision and distance visual acuity by race and other factors. DESIGN Cross-sectional analysis within a longitudinal, population-based cohort study. PARTICIPANTS AND CONTROLS Two thousand five hundred twenty individuals, 65 to 84 years of age, including 666 black participants and 1854 white participants. METHODS All participants reported their self-rated vision score. Binocular distance visual acuity was assessed. Based on the level of visual acuity and the self-reported vision score, participants were placed into concordant and discrepant groups. MAIN OUTCOME MEASURES Multinomial logistic regression models were used to examine the characteristics associated with concordant and discrepant groups. RESULTS Black participants were more likely to be represented in the discordant group that reported good vision but had acuity worse than 20/40. In the multivariate analysis, a per-year decrement in years of education received increased the odds of being in both discrepant groups, one that reported good vision but had a visual acuity worse than 20/40 (odds ratio, 1.21; P<0.0001) and the other discrepant group that reported bad vision but had a visual acuity of 20/40 or better (odds ratio, 1.04; P<0.0001). A per-year decrement in years of education received also seemed to explain the excess risk of black race in the discrepant group that reported good vision but had a visual acuity worse than 20/40. CONCLUSIONS Given the socioeconomically driven discrepancies in self-reported vision status, self-reported vision status should be used cautiously in surveillance surveys, especially when assessing vision inequalities between socioeconomic groups. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Mahmood El-Gasim
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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211
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Norberg M, Lindvall K, Jenkins PL, Emmelin M, Lönnberg G, Nafziger AN. Self-rated health does not predict 10-year weight change among middle-aged adults in a longitudinal population study. BMC Public Health 2011; 11:748. [PMID: 21958199 PMCID: PMC3190356 DOI: 10.1186/1471-2458-11-748] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Accepted: 09/30/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There is a worldwide obesity epidemic, but lack of a simple method, applicable for research or clinical use, to identify individuals at high risk of weight gain. Therefore, the relationship of self-rated health and 10-year percent weight change was evaluated to determine if self-rated health would predict weight change. METHODS From 1990 to 2008, adults aged 30, 40, 50 and 60 years were invited to health surveys that included self-rated health and measured weight and height. ANOVA was used to evaluate the relationship of 10-year percent weight change and self-rated health. RESULTS The study population consisted of 29,207 participants (46.5% men). There was no relationship between baseline self-rated health and 10-year percent weight change for middle-aged men or women. CONCLUSIONS Self-rated health is not able to predict weight change over a 10-year period in this age group.
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Affiliation(s)
- Margareta Norberg
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, S-901 87 Umeå, Sweden
- Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, S-901 87 Umeå, Sweden
- Centre for Population Studies, Ageing and Living Conditions Programme, Umeå University, S-901 87 Umeå, Sweden
| | - Kristina Lindvall
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, S-901 87 Umeå, Sweden
- Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, S-901 87 Umeå, Sweden
| | - Paul L Jenkins
- The Research Institute, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326, USA
- New York Center for Agricultural Medicine and Health, Bassett Healthcare, One Atwell Road, Cooperstown, NY 13326, USA
| | - Maria Emmelin
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, S-901 87 Umeå, Sweden
- Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, S-901 87 Umeå, Sweden
- Department of Clinical Sciences, Social Medicine and Global Health, Lund University, Box 117, S-221 00 Lund, Sweden
| | - Göran Lönnberg
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, S-901 87 Umeå, Sweden
- Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, S-901 87 Umeå, Sweden
| | - Anne N Nafziger
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, S-901 87 Umeå, Sweden
- Bertino Consulting, 3078 New Williamsburg Drive, Schenectady, NY 12303, USA
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Kelly-Irving M, Delpierre C, Schieber AC, Lepage B, Rolland C, Afrité A, Pascal J, Cases C, Lombrail P, Lang T. Do general practitioners overestimate the health of their patients with lower education? Soc Sci Med 2011; 73:1416-21. [PMID: 21924535 DOI: 10.1016/j.socscimed.2011.07.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Revised: 06/24/2011] [Accepted: 07/15/2011] [Indexed: 11/18/2022]
Abstract
This study sought to ascertain whether disagreement between patients and physicians on the patients' health status varies according to patients' education level. INTERMEDE is a cross-sectional multicentre study. Data were collected from both patients and doctors via pre- and post consultation questionnaires at the GP's office over a two-week period in October 2007 in 3 regions of France. The sample consists of 585 eligible patients (61% women) and 27 GPs. A significant association between agreement/disagreement between GP and patient on the patient's health status and patient's education level was observed: 75% of patients with a high education level agreed with their GP compared to 50% of patients with a low level of education. Patients and GPs disagreed where patients with the lowest education level said that their health was worse relative to their doctor's evaluation 37% of the time, versus 16% and 14% for those with a medium or high education level respectively. A multilevel multivariate analysis revealed that patients with a low educational level and medium educational level respectively were at higher risk of being overestimated by GP's in respect of self-reported health even if controlling for confounders. These findings suggest that people with a lower education level who consider themselves to have poor health are less reliably identified as such in the primary care system. This could potentially result in lack of advice and treatment for these patients and ultimately the maintenance of health inequalities.
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Arnadottir SA, Gunnarsdottir ED, Stenlund H, Lundin-Olsson L. Determinants of self-rated health in old age: a population-based, cross-sectional study using the International Classification of Functioning. BMC Public Health 2011; 11:670. [PMID: 21867517 PMCID: PMC3175467 DOI: 10.1186/1471-2458-11-670] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 08/25/2011] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas. METHODS The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF. RESULTS Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p < 0.001), upper extremity capacity (adjOR = 1.13, p = 0.040), household physical activity (adjOR = 1.01, p = 0.016), and older age (adjOR = 1.09, p = 0.006); but decreased with more depressive symptoms (adjOR = 0.79, p < 0.001). CONCLUSIONS The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due to their potential for change through public health interventions. The use of ICF conceptual framework and widely accepted standardized assessments should make these results comparable and relevant in an international context.
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Affiliation(s)
- Solveig A Arnadottir
- Department of Community Medicine and Rehabilitation, Division of Physiotherapy, Umeå University, Sweden.
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Fujishiro K, Landsbergis PA, Diez-Roux AV, Stukovsky KH, Shrager S, Baron S. Factorial invariance, scale reliability, and construct validity of the job control and job demands scales for immigrant workers: the multi-ethnic study of atherosclerosis. J Immigr Minor Health 2011; 13:533-40. [PMID: 20582720 DOI: 10.1007/s10903-010-9364-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Immigrants have a different social context from those who stay in their home country or those who were born to the country that immigrants now live. Cultural theory of risk perception suggests that social context influences one's interpretation of questionnaire items. We examined psychometric properties of job control and job demand scales with US- and foreign-born workers who preferred English, Spanish, or Chinese (n = 3,114, mean age = 58.1). Across all groups, the job control scale had acceptable Cronbach's alpha (0.78-0.83) and equivalent factor loadings (ΔCFI < 0.01). Immigrants had low alpha (0.42-0.65) for the job demands scale regardless of language, education, or age of migration. Two job-demand items had different factor loadings across groups. Among immigrants, both scales had inconsistent associations with perceived job stress and self-rated health. For a better understanding of immigrants' job stress, the concept of job demands should be expanded and immigrants' expectations for job control explored.
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Affiliation(s)
- Kaori Fujishiro
- National Institute for Occupational Safety and Health, 4676 Columbia Pkwy (R-15), Cincinnati, OH 45226, USA.
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215
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Petek D, Künzi B, Kersnik J, Szecsenyi J, Wensing M. Patients' evaluations of European general practice--revisited after 11 years. Int J Qual Health Care 2011; 23:621-8. [PMID: 21831966 DOI: 10.1093/intqhc/mzr052] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Davorina Petek
- Department of Family Medicine, Medical School University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia.
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Algurén B, Fridlund B, Cieza A, Sunnerhagen KS, Christensson L. Factors associated with health-related quality of life after stroke: a 1-year prospective cohort study. Neurorehabil Neural Repair 2011; 26:266-74. [PMID: 21825005 DOI: 10.1177/1545968311414204] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In line with patient-centered health care, it is necessary to understand patients' perceptions of health. How stroke survivors perceive their health at different time points after stroke and which factors are associated with these feelings provide important information about relevant rehabilitation targets. OBJECTIVE This study aimed to identify the independent factors of health-related quality of life (HRQoL) from a biopsychosocial perspective using the methods of multivariate regression at 3 different time points poststroke. METHODS Included in the study were 99 patients from stroke units with diagnosed first-ever stroke. At admission and at 6 weeks, 3 months, and 1 year poststroke, HRQoL was assessed using the EuroQoL-5D Visual Analogue Scale (EQ-5D VAS). Consequences in Body Functions and Activities and Participation, and Environmental Factors were documented using 155 categories of the International Classification of Functioning, Disability and Health (ICF) Core Set for Stroke. RESULTS For a period of 1 year, problems with recreation and leisure, personality functions, energy and drive functions, and gait pattern functions were repeatedly associated with worse HRQoL. Whereas Body Functions and Activities and Participation explained more than three-fourths of the variances of HRQoL at 6 weeks and 3 months (R² = 0.80-0.93), the variation at 1 year was best explained by either Body Functions or Environmental Factors (R² = 0.51). CONCLUSIONS The results indicate the importance of Body Functions and Activities and Participation (mainly personality functions and recreation and leisure) on HRQoL within 3 months poststroke, but increased impact of Environmental Factors on HRQoL at 1 year.
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Kouvonen A, De Vogli R, Stafford M, Shipley MJ, Marmot MG, Cox T, Vahtera J, Väänänen A, Heponiemi T, Singh-Manoux A, Kivimäki M. Social support and the likelihood of maintaining and improving levels of physical activity: the Whitehall II Study. Eur J Public Health 2011; 22:514-8. [PMID: 21750013 PMCID: PMC3402714 DOI: 10.1093/eurpub/ckr091] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Evidence on the association between social support and leisure time physical activity (LTPA) is scarce and mostly based on cross-sectional data with different types of social support collapsed into a single index. The aim of this study was to investigate whether social support from the closest person was associated with LTPA. Methods: Prospective cohort study of 5395 adults (mean age 55.7 years, 3864 men) participating in the British Whitehall II study. Confiding/emotional support and practical support were assessed at baseline in 1997–99 using the Close Persons Questionnaire. LTPA was assessed at baseline and follow-up in (2002–04). Baseline covariates included socio-demographics, self-rated health, long-standing illnesses, physical functioning and common mental disorders. Results: Among participants who reported recommended levels of LTPA at baseline, those who experienced high confiding/emotional support were more likely to report recommended levels of LTPA at follow-up [odds ratio (OR): 1.39, 95% confidence interval (CI): 1.12–1.70 in a model adjusted for baseline covariates]. Among those participants who did not meet the recommended target of LTPA at baseline, high confiding/emotional support was not associated with improvement in activity levels. High practical support was associated with both maintaining (OR: 1.34, 95% CI: 1.10–1.63) and improving (OR: 1.25, 95% CI: 1.02–1.53) LTPA levels. Conclusion: These findings suggest that emotional and practical support from the closest person may help the individual to maintain the recommended level of LTPA. Practical support also predicted a change towards a more active lifestyle.
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Affiliation(s)
- Anne Kouvonen
- Warsaw School of Social Sciences and Humanities, Wroclaw Faculty, Wroclaw, Poland.
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218
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Paljärvi T, Suominen S, Car J, Mäkelä P, Koskenvuo M. Subjective Measures of Binge Drinking, Suboptimal Subjective Health and Alcohol-Specific Hospitalizations Among Working-Aged Adults: A Prospective Cohort Study. Alcohol Alcohol 2011; 46:607-13. [DOI: 10.1093/alcalc/agr072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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219
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Clarke A, Friede T, Putz R, Ashdown J, Martin S, Blake A, Adi Y, Parkinson J, Flynn P, Platt S, Stewart-Brown S. Warwick-Edinburgh Mental Well-being Scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment. BMC Public Health 2011; 11:487. [PMID: 21693055 PMCID: PMC3141456 DOI: 10.1186/1471-2458-11-487] [Citation(s) in RCA: 239] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 06/21/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Understanding and measuring mental health and wellbeing amongst teenagers has recently become a priority. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 16 years and over in the UK. We report here a study designed to establish the validity and reliability of WEMWBS in teenagers in the UK. METHODS WEMWBS and comparator scales, together with socio-demographic information and self-reported health, were incorporated into a self-administered questionnaire given to pupils aged 13 to 16 years in six schools in Scotland and England. Psychometric properties including internal consistency, correlations with comparator scales, test-retest stability and unidimensionality were investigated for WEMWBS. Twelve focus groups were undertaken to assess acceptability and comprehensibility of WEMWBS and were taped, transcribed and analysed thematically. RESULTS A total of 1,650 teenagers completed the questionnaire (response rate 80.8%). Mean WEMWBS score was 48.8 (SD 6.8; median 49). Response scores covered the full range (from 14 to 70). WEMWBS demonstrated strong internal consistency and a high Cronbach's alpha of 0.87 (95% CI (0.85-0.88), n = 1517). Measures of construct validity gave values as predicted. The correlation coefficient for WEMWBS total score and psychological wellbeing domain of the Kidscreen-27 was 0.59 (95% CI [0.55; 0.62]); for the Mental Health Continuum Short Form (MHC-SF) was 0.65, 95% CI [0.62; 0.69]; and for the WHO (WHO-5) Well-being Index 0.57 (95% CI [0.53; 0.61]). The correlation coefficient for the Strengths and Difficulties Questionnaire (SDQ) was -0.44 (95% CI [-0.49; -0.40]) and for the 12-item General Health Questionnaire (GHQ12) -0.45 (95% CI [-0.49; -0.40]). Test-retest reliability was acceptable (Intraclass correlation coefficient (ICC) 0.66 (95% CI [0.59; 0.72] n = 212)). Confirmatory factor analysis demonstrated one underlying factor. WEMWBS was significantly associated with the Family Affluence Score (WEMWBS increased with increasing household socio-economic status) and had a positive association with the physical health dimension of the Kidscreen-27, but was unrelated to age, gender or location/school. Eighty students took part in focus groups. In general, although some students considered some items open to misunderstanding or misinterpretation, WEMWBS was received positively and was considered comprehensible, and acceptable. CONCLUSIONS WEMWBS is a psychometrically strong population measure of mental wellbeing, and can be used for this purpose in teenagers aged 13 and over.
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Affiliation(s)
- Aileen Clarke
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Tim Friede
- University Medical Center, Göttingen, Dept. of Medical Statistics, 37073 Göttingen, Germany
| | - Rebecca Putz
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Jacquie Ashdown
- NHS Birmingham East and North,4th Floor, Waterlinks House Richard Street.Aston, Birmingham, B7 4AA, UK
| | - Steven Martin
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Amy Blake
- The Caludon Centre, Coventry and Warwickshire Partnership Trust, Clifford Bridge Road, Coventry CV2 2TE, UK
| | - Yaser Adi
- College of Medicine, King Saud University; Shaikh Abdullah Bahamdan Research Chair for Evidence-Based Health Care and Knowledge Translation; P.O.Box 2925, Riyadh 11461, Saudi Arabia
| | - Jane Parkinson
- NHS Health Scotland, Elphinstone House, 65 West Regent Street, Glasgow G2 2AF, UK
| | - Pamela Flynn
- Department of Sports Studies, University of Stirling, Stirling, FK9 4LA, UK
| | - Stephen Platt
- Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
| | - Sarah Stewart-Brown
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
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220
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Dockray S, Steptoe A. Chronotype and diurnal cortisol profile in working women: differences between work and leisure days. Psychoneuroendocrinology 2011; 36:649-55. [PMID: 20950941 DOI: 10.1016/j.psyneuen.2010.09.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 09/15/2010] [Accepted: 09/16/2010] [Indexed: 10/18/2022]
Abstract
The influence of chronotype on the diurnal profile of salivary cortisol was examined in a sample of 187 healthy women: 21 evening chronotype, 24 morning chronotype and 142 intermediate chronotype. Saliva samples were collected at waking, 30 min post-awakening, at 1000 h, 1200 h, 1500 h, 1700 h and at bedtime on one work and one leisure day. Several components of the diurnal profile were examined including the cortisol awakening response, the total cortisol output and the diurnal profile on both the work and the leisure day, a significant main effect of time emerged (both p<0.01). After adjustment for age, smoking status, self-rated health, time of waking, and sleep problems, no effect of chronotype was evident for cortisol in the evening, the cortisol awakening response, or total cortisol output over the working day. However, on the leisure day, total cortisol output was greater in evening-types than intermediate or morning-types, after adjustment for covariates (p=0.029). The present data indicate that chronotype has a limited impact on the diurnal cortisol profile of healthy women, and may be somewhat impervious to individual preferences for morning or evening activity.
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Affiliation(s)
- Samantha Dockray
- Department of Epidemiology and Public Health, University College London, London, UK.
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221
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Eriksson M, Ng N, Weinehall L, Emmelin M. The importance of gender and conceptualization for understanding the association between collective social capital and health: a multilevel analysis from northern Sweden. Soc Sci Med 2011; 73:264-73. [PMID: 21689877 DOI: 10.1016/j.socscimed.2011.05.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 05/03/2011] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
Abstract
Growing research on social capital and health has fuelled the debate on whether there is a place effect on health. A central question is whether health inequality between places is due to differences in the composition of people living in these places (compositional effect) or differences in the local social and physical environments (contextual effects). Despite extensive use of multilevel approaches that allows controlling for whether the effects of collective social capital are confounded by access to social capital at the individual level, the picture remains unclear. Recent studies indicate that contextual effects on health may vary for different population subgroups and measuring "average" contextual effects on health for a whole population might therefore be inappropriate. In this study from northern Sweden, we investigated the associations between collective social capital and self-rated health for men and women separately, to understand if health effects of collective social capital are gendered. Two measures of collective social capital were used: one conventional measure (aggregated measures of trust, participation and voting) and one specific place-related (neighbourhood) measure. The results show a positive association between collective social capital and self-rated health for women but not for men. Regardless of the measure used, women who live in very high social capital neighbourhoods are more likely to rate their health as good-fair, compared to women who live in very low social capital neighbourhoods. The health effects of collective social capital might thus be gendered in favour for women. However, a more equal involvement of men and women in the domestic sphere would potentially benefit men in this matter. When controlling for socioeconomic, sociodemographic and social capital attributes at the individual level, the relationship between women's health and collective social capital remained statistically significant when using the neighbourhood-related measure but not when using the conventional measure. Our results support the view that a neighbourhood-related measure provides a clearer picture of the health effects of collective social capital, at least for women.
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Affiliation(s)
- Malin Eriksson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 87 Umeå, Sweden.
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222
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Housing and health in three contrasting neighbourhoods in Accra, Ghana. Soc Sci Med 2011; 72:1864-72. [PMID: 21561698 DOI: 10.1016/j.socscimed.2011.03.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2009] [Revised: 02/23/2011] [Accepted: 03/22/2011] [Indexed: 11/23/2022]
Abstract
Although the literature on housing and health is extensive, most research comes from developed countries. Relatively little work on the topic has been done in developing countries such as Ghana where socio-economic and cultural characteristics are generally different. This paper reports on primary research that investigates the relationship between housing and self reported general and mental health in Accra, Ghana. The study focused on how the social and economic dimensions of housing, specifically, demand, control and material attributes (affordability, dwelling type) influence individuals' attachment to their home as a refuge for daily living. A cross-sectional survey was administered to a randomly selected sample (n = 562) in three contrasting neighbourhoods. Overall, housing conditions, demand and control residents have to where they live, emerged as significant predictors of self reported general and mental health status. The influence of these variables superseded well known correlates of health status, income and educational attainment, attesting to their importance in a worsening housing environment. The findings point to the need for policy that recognizes that housing is not only a physical shelter but also an important health resource.
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223
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Ploubidis GB, Grundy E. Health Measurement in Population Surveys: Combining Information from Self-reported and Observer-Measured Health Indicators. Demography 2011; 48:699-724. [DOI: 10.1007/s13524-011-0028-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Abstract
Our primary aim is to develop and validate a population health metric for survey-based health assessment that combines information from both self-reported and observer-measured health indicators. A secondary objective is to use this index to examine gender and socioeconomic differentials in the health status of older people. We use data from the second wave of the English Longitudinal Study of Ageing (ELSA) conducted in 2004 (N = 8,870). Information from three observer-measured and three self-reported health indicators was combined, using a latent variable modeling approach. A model that decomposed the manifest health indicators to valid health, systematic error, and random error was found to fit the data best. The latent health dimension represented somatic health, and was tested against three external criteria: height, waist-hip ratio, and smoking status. We present the Latent Index of Somatic Health (LISH), as well as a procedure for deriving the LISH in surveys employing both self- and observer-measured health indicators. Observer-measured and self-reported indicators were found to be equally biased in indexing population somatic health, with the exception of self-reports of functional limitations, which was the most reliable somatic health indicator. As expected, results showed that women had worse health than men and that socioeconomic advantage is associated with better somatic health.
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Affiliation(s)
- George B. Ploubidis
- Centre for Population Studies, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, 49/50 Bedford Square, London WC1B3DP, England
| | - Emily Grundy
- Centre for Population Studies, Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, 49/50 Bedford Square, London WC1B3DP, England
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Shirom A, Melamed S, Berliner S, Shapira I. The effects of vigour on measures of obesity across time. Br J Health Psychol 2011; 17:129-43. [DOI: 10.1111/j.2044-8287.2011.02026.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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225
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Welin C, Wilhelmsen L, Welin L, Johansson S, Rosengren A. Perceived Health in 50-Year-Old Women and Men and the Correlation With Risk Factors, Diseases, and Symptoms. ACTA ACUST UNITED AC 2011; 8:139-49. [DOI: 10.1016/j.genm.2011.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2011] [Indexed: 11/16/2022]
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226
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Schytt E, Hildingsson I. Physical and emotional self-rated health among Swedish women and men during pregnancy and the first year of parenthood. SEXUAL & REPRODUCTIVE HEALTHCARE 2011; 2:57-64. [DOI: 10.1016/j.srhc.2010.12.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 11/23/2010] [Accepted: 12/31/2010] [Indexed: 11/16/2022]
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227
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Relationships between self-rated health, quality of life and sleep duration in middle aged and elderly Australians. Sleep Med 2011; 12:346-50. [DOI: 10.1016/j.sleep.2010.09.013] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 09/05/2010] [Accepted: 09/08/2010] [Indexed: 10/18/2022]
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228
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Giver H, Faber A, Strøyer J, Hannerz H, Albertsen K. Do lifestyle factors and general health predict dropout among recently qualified eldercare workers? A two-year follow-up study. Scand J Public Health 2011; 39:280-6. [PMID: 21321046 DOI: 10.1177/1403494810396555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The eldercare sector in Denmark as in many industrialised countries is characterised by difficulties in retaining labour. Research suggests a possible imbalance between lifestyle and health among eldercare trainees and the demanding work encountered as eldercare employees. The aim of the present study was to determine the predictive effect of lifestyle and self-rated health on dropout from the Danish eldercare sector two years after qualification. METHODS We included 4,526 female eldercare trainees in the analyses of lifestyle parameters and 5,023 in the analyses of self-rated health. The participants in this prospective study were recruited from 27 of the 28 Danish colleges for eldercare. We linked survey data with national register data to obtain information about labour market attachment two years after qualification. RESULTS The results of the present study showed that the poorer self-rated health, the higher the risk for dropout from the labour market (p < 0.0001). However, the results were less consistent regarding the predictive effect of a detrimental lifestyle. We found that overweight/obesity (p = 0.0021 and p = 0.0012) as well as smoking (p = 0.0017) decreased the risk of dropout from eldercare into education. We found no support for increased likelihood of dropout among physically inactive. CONCLUSIONS The results of the present study show that a poorer self-rated health is a predictor for dropout, not only from the eldercare two years after qualification, but from the labour market as a whole. However, the results were less consistent regarding the predictive effect of a detrimental lifestyle on dropout.
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Affiliation(s)
- Hanne Giver
- National Research Centre for the Working Environment, Copenhagen, Denmark.
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229
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DeSalvo KB, Muntner P. Discordance between physician and patient self-rated health and all-cause mortality. Ochsner J 2011; 11:232-40. [PMID: 21960756 PMCID: PMC3179188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Self-assessments of health are a strong predictor of mortality. Whether self-assessment of health provides additional information beyond a physician's assessment is unclear. METHODS We analyzed data on 14,530 US adults from the Third National Health and Nutrition Examination Survey. General self-rated health (GSRH)-"In general, would you say your health is Excellent, Very Good, Good, Fair, or Poor?"-and a single question to physician examiners following a medical examination rating participants' health, both on a 5-point scale of Excellent, Very Good, Good, Fair, or Poor were assessed for the period 1988-1994. All-cause mortality was assessed through December 31, 2006 (n = 3,460 deaths). RESULTS Agreement between participant GSRH and physician-assessed health was 53.8% (42.1% Excellent/Very Good, 8.7% Good, and 3.0% Fair/Poor; weighted Kappa statistic = 0.20). After adjustment, participants who reported better GSRH compared to the physician assessment of their health experienced lower mortality (hazard ratio = 0.76, 95% CI: 0.66-0.87). Also, participants reporting worse health than the physician assessment experienced higher mortality (hazard ratio = 1.45, 95% CI 1.24-1.70). CONCLUSIONS Individuals who reported worse health than was assessed by a physician had increased mortality. These results warrant evaluation of whether GSRH collection in the clinical setting improves outcomes.
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Affiliation(s)
- Karen B. DeSalvo
- General Internal Medicine and Geriatrics, Tulane University School of Medicine, New Orleans, LA
- Health Systems Management & Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Paul Muntner
- General Internal Medicine and Geriatrics, Tulane University School of Medicine, New Orleans, LA
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL
- Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL
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230
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Chow SKY, Chan WC. Depression: Problem-solving appraisal and self-rated health among Hong Kong Chinese migrant women. Nurs Health Sci 2010; 12:352-9. [PMID: 20727087 DOI: 10.1111/j.1442-2018.2010.00537.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This cross-sectional survey explored the depression status of new migrant women and its relationship with self-rated health in the Hong Kong Chinese context. A convenience sample of 68 migrant women volunteered to participate in the study. The data were collected by using the Problem Solving Inventory, the Center for Epidemiological Studies-Depression questionnaire, and a self-rated health scale. The respondents were found to have a lesser degree of problem-solving appraisal, compared with other populations, and almost half of the volunteers were found to be depressed. Approximately 50% of the women reported their general health as "excellent", "very good", or "good". The Pearson's correlation showed a positive significant correlation between problem-solving appraisal, depression, and self-rated health. The results of the regression analysis showed that family income, self-rated health, and problem-solving confidence are predictive factors of depression. Community nurses could consider using multidisciplinary interventions that focus on life-skills training in order to promote the psychological and general wellness of migrant women in addition to the use of counseling or medication interventions.
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Affiliation(s)
- Susan K Y Chow
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
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231
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de Castro AB, Gee GC, Takeuchi DT. Examining alternative measures of social disadvantage among Asian Americans: the relevance of economic opportunity, subjective social status, and financial strain for health. J Immigr Minor Health 2010; 12:659-71. [PMID: 19434494 PMCID: PMC2891922 DOI: 10.1007/s10903-009-9258-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Socioeconomic position is often operationalized as education, occupation, and income. However, these measures may not fully capture the process of socioeconomic disadvantage that may be related to morbidity. Economic opportunity, subjective social status, and financial strain may also place individuals at risk for poor health outcomes. Data come from the Asian subsample of the 2003 National Latino and Asian American Study (n = 2095). Regression models were used to examine the associations between economic opportunity, subjective social status, and financial strain and the outcomes of self-rated health, body mass index, and smoking status. Education, occupation, and income were also investigated as correlates of these outcomes. Low correlations were observed between all measures of socioeconomic status. Economic opportunity was robustly negatively associated with poor self-rated health, higher body mass index, and smoking, followed by financial strain, then subjective social status. Findings show that markers of socioeconomic position beyond education, occupation, and income are related to morbidity among Asian Americans. This suggests that potential contributions of social disadvantage to poor health may be understated if only conventional measures are considered among immigrant and minority populations.
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Affiliation(s)
- A B de Castro
- School of Nursing, University of Washington, Seattle, WA 98195-7263, USA.
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232
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Zeitlhofer J, Seidel S, Klösch G, Moser D, Anderer P, Saletu B, Bolitschek J, Popovic R, Lehofer M, Mallin W, Fugger B, Holzinger B, Kerbl R, Saletu A, Machatschke IH, Pavelka R, Högl B. Sleep habits and sleep complaints in Austria: current self-reported data on sleep behaviour, sleep disturbances and their treatment. Acta Neurol Scand 2010; 122:398-403. [PMID: 20298492 DOI: 10.1111/j.1600-0404.2010.01325.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To acquire current information on sleep habits, disturbances and treatment options in the adult population of Austria and compare results with previously collected data. MATERIALS AND METHODS A representative sample of the Austrian population (women: n = 522, men: n = 478). RESULTS Seventy-five percent reported daily sleep-duration between 6 and 8 h. In 76%, sleep latency was <30 min, 15% described difficulties in sleep maintenance. Longer sleep on weekends was prevalent in 54%, 23% took a nap. Concerning sleep environment, 31% reported sleeping alone; the rest had a constant or occasional bed partner. Sleep disturbances such as sleep disruption or prolonged sleep latency were reported by 18%. Predominant symptoms included snoring/apneas (22%), nightmares (22%) and restless legs (21%). Daytime tiredness was reported by 17% and sleepiness by 20%. Twenty-four percent did not take treatment. Only 7% asked for medical help: 96% consulted their physician; 47% tried to change their way of living. Sleep promoting drugs were taken by 7%. Sleep improving measures were: sleep promoters (45%), general measures (20%), consultation of general practitioner (20%), psychotherapy (6%), and technical tools (3%). Comparison with a dataset of 1993 revealed only a slight increase in short sleepers and a slight decrease in long sleepers. CONCLUSIONS Subjectively reported sleep disorders proved to be relatively stable between 1993 and 2007.
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Affiliation(s)
- Josef Zeitlhofer
- Department of Neurology, Medical University of Vienna, Vienna, Austria.
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Asbridge M, Cartwright J. The Relationship of Home Smoking Bans to the Physical and Mental Health of Smokers. Nicotine Tob Res 2010; 13:70-7. [DOI: 10.1093/ntr/ntq211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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234
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Betlehem J, Horváth A, Göndöcs Z, Jeges S, Boncz I, Oláh A. Major contributing factors of self perceived health in Hungarian ambulance personnel. Orv Hetil 2010; 151:2089-98. [DOI: 10.1556/oh.2010.28976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A mentődolgozók egészségi állapota önmagában is befolyásolja a betegellátás minőségét. Magyarország egyes régióiban végzett felmérések ugyan rendelkezésre állnak a mentődolgozók egészségi állapotával összefüggő szokásaikról, azonban ezek nem az egészségi állapot dimenzióinak komplexitásával készültek. A jelenlegi tanulmány célja, hogy bemutassa a mentődolgozók észlelt egészségi állapotával összefüggő jelentősebb munkahelyi és egyéni faktorokat. Módszerek: Keresztmetszeti vizsgálat készült az Országos Mentőszolgálat dolgozói körében 2008-ban. A vizsgálatban a mentőszervezet valamennyi régiója részt vett, ezért a minta jó reprezentatív értékkel bír. A dolgozók közül 364 fő válaszai voltak értékelhetők. Adatfelvétel, -rögzítés és -kódolás után leíró adatbemutatás és Spearman-, χ2-teszt és logisztikus regressziós elemzés történt az SPSS 15.0 szoftverrel. A vizsgálat önkitöltős kérdőívvel készült, amely az észlelt egészségi állapot alábbi fő dimenzióit mérte: egészségi állapot önértékelése, fizikai fittségi állapot önértékelése, napi munkavégzésben akadályozó egészségi problémák. Eredmények: Az eredmények rámutatnak arra, hogy a mentődolgozók észlelt egészségi állapota szignifikánsan nem különbözik az ellátóegység-típusok szerint a legtöbb vizsgált paraméterben, jóllehet az általuk ellátott esetek különböző összetettségűek. Az egészségi állapotuk önértékelésében 1,9-szer (95% CI: 1,2–2,8), a fizikai fittségi állapotuk önértékelését illetően 2-szer (95% CI: 1,3–3) és a mindennapokban jelentkező munkájukat befolyásoló egészségi problémájukat illetően 1,9-szer (95% CI: 1,2–3,1) kedvezőbben élik meg azok a dolgozók, akik valamilyen sportot űznek. Általánosságban elmondható, hogy komoly stressz éri őket, alig van szabadidejük, és kevés rekreációs fizikai aktivitást végeznek. A kedvezőtlen életmódjukból következően a kóros elhízás minden ötödik dolgozónál megjelenik. Következtetések: A fizikai aktivitás képes az egészségi állapotot még akkor is pozitívan befolyásolni, ha már bizonyos panaszok jelen vannak. Rendszeres testmozgást, mely növeli a fizikai fittséget, minden mentődolgozónak végezni kellene, s ez jelentős mértékben javítaná az észlelt egészségi állapotot. Orv. Hetil., 2010, 151, 2089–2098.
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Affiliation(s)
- József Betlehem
- 1 Pécsi Tudományegyetem, Egészségtudományi Kar Sürgősségi Ellátási Tanszék Pécs Vörösmarty u. 4. 7621
| | | | | | - Sára Jeges
- 3 Pécsi Tudományegyetem, Egészségtudományi Kar Ápolástudományi Tanszék Pécs
| | - Imre Boncz
- 2 Pécsi Tudományegyetem, Egészségtudományi Kar Egészség-gazdaságtani, Egészségpolitikai és Egészségügyi Menedzsment Tanszék Pécs
| | - András Oláh
- 3 Pécsi Tudományegyetem, Egészségtudományi Kar Ápolástudományi Tanszék Pécs
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Cornman JC, Glei D, Rodríguez G, Goldman N, Hurng BS, Weinstein M. Demographic and socioeconomic status differences in perceptions of difficulty with mobility in late life. J Gerontol B Psychol Sci Soc Sci 2010; 66:237-48. [PMID: 21098041 DOI: 10.1093/geronb/gbq087] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study assesses whether socioeconomic and demographic differences in reported mobility limitations are attributable to differential perceptions of mobility difficulty that result in the differential use of response categories. METHODS Data come from the Social Environment and Biomarkers of Aging Study and its parent study, the Taiwan Longitudinal Study of Aging. Ordered probit models with person-specific cut-points are used to test whether, after controlling for underlying mobility using objective performance measures, cut-points for reporting mobility limitations vary across groups defined by demographic and socioeconomic characteristics. RESULTS Age is the only characteristic that is consistently associated with the location of the cut-points for reporting mobility difficulty: At the same level of underlying mobility difficulty, older adults are more likely than younger adults are to report difficulty with all tasks except short walks. Other variables showed differences but only for one specific activity, for example, urban residents are more likely to report difficulty running than are rural residents with the same underlying level of mobility function. DISCUSSION For most mobility activities, there are no systematic differences in the perception of difficulty by individual characteristics. Thus, for older Taiwanese adults, differences in mobility limitations associated with socioeconomic status are more likely to reflect underlying differences in function than differences in how these groups report the same capacity. The usual loss of mobility with age, however, reflects both a decrease in capacity and a lowering of the threshold for reporting difficulty.
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Affiliation(s)
- Jennifer C Cornman
- Jennifer C. Cornman Consulting, 113 Chapin Pl, Granville, OH 43023, USA.
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Wong FKY, Chan MF, Chow S, Chang K, Chung L, Lee WM, Lee R. What accounts for hospital readmission? J Clin Nurs 2010; 19:3334-46. [DOI: 10.1111/j.1365-2702.2010.03366.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Aronsson G, Blom V. Work conditions for workers with good long‐term health. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2010. [DOI: 10.1108/17538351011055041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Haseen F, Adhikari R, Soonthorndhada K. Self-assessed health among Thai elderly. BMC Geriatr 2010; 10:30. [PMID: 20507638 PMCID: PMC2893188 DOI: 10.1186/1471-2318-10-30] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2009] [Accepted: 05/28/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ageing of the population is rapidly progressing in Thailand. Self-assessed health status can provide a holistic view of the health of the elderly. This study aims to identify the determinants of self-assessed health among older Thai people. METHODS The data for this study were drawn from a national survey of older persons conducted in 2007. Stratified two-stage random sampling was used for data collection. The analysis was restricted to the population aged 60 and above. The study used univariate, bivariate, and multivariate analysis procedures to analyze the data. Bivariate analysis was used to identify the factors associated with self assessment of health status. After controlling for other variables, the variables were further examined using multivariate analysis (binary logistic regression) in order to identify the significant predictors of the likelihood of reporting poor health. RESULTS Overall, 30,427 elderly people were interviewed in this study. More than half of the sampled respondents (53%) were aged 60-69 years and about one out of seven (13%) were aged 80 years or above. About three in five respondents (56%) reported that their health was either fair or very bad/bad. Logistic regression analysis found that age, education, marital status, working status, income, functional status, number of chronic diseases, and number of psychosocial symptoms are significant predictors in determining health status. Respondents who faced more difficulty in daily life were more likely to rate their health as poor compared to those who faced less such difficulty. For instance, respondents who could not perform 3 or more activities of daily living (ADLs) were 3.3 times more likely to assess their health as poor compared to those who could perform all the ADLs. Similarly, respondents who had 1, 2, or 3 or more chronic diseases were 1.8 times, 2.4 times, and 3.7 times, respectively, more likely to report their health as poor compared to those who had no chronic disease at all. Moreover, respondents who had 1-2, 3-4, or 5 or more psychosocial symptoms in the previous months were 1.6 times, 2.2 times, and 2.7 times, respectively, more likely to report poor health compared to those who did not have any psychosocial symptoms during the same period. CONCLUSION Self-assessed poor health is not uncommon among older people in Thailand. No single factor accounts for the self-assessed poor health. The study has found that chronic disease, functional status, and psychosocial symptoms are the strongest determinants of self-assessed poor health of elderly people living in Thailand. Therefore, health-related programs should focus on all the factors identified in this paper to improve the overall well-being of the ageing population of Thailand.
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Affiliation(s)
- Fariha Haseen
- Health System and Infectious Diseases Division, ICDDR, B, GPO Box 128, Dhaka 1000, Bangladesh.
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Li CL, Lai YC, Tseng CH, Lin JD, Chang HY. A population study on the association between leisure time physical activity and self-rated health among diabetics in Taiwan. BMC Public Health 2010; 10:277. [PMID: 20500890 PMCID: PMC2889868 DOI: 10.1186/1471-2458-10-277] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Accepted: 05/26/2010] [Indexed: 11/29/2022] Open
Abstract
Background There is strong evidence for the beneficial effects of physical activity in diabetes. There has been little research demonstrating a dose-response relationship between physical activity and self-rated health in diabetics. The aim of this study was to explore the dose-response association between leisure time physical activity and self-rated health among diabetics in Taiwan. Methods Data came from the 2001 Taiwan National Health Interview Survey (NHIS). Inclusion criteria were a physician confirmed diagnosis of diabetes mellitus and age 18 years and above (n = 797). Self-rated health was assessed by the question "In general, would you say that your health is excellent, very good, good, fair, or poor?" Individuals with a self perceived health status of good, very good, or excellent were considered to have positive health status. Results In the full model, the odds ratio (OR) for positive health was 2.51(95% CI = 1.53-4.13), 1.62(95% CI = 0.93-2.84), and 1.35(95% CI = 0.77-2.37), for those with a total weekly energy expenditure of ≥ 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. Those with duration over 10 years (OR = 0.53, 95%CI = 0.30-0.94), heart disease (OR = 0.50, 95%CI = 0.30-0.85), and dyslipidemia (OR = 0.65, 95% CI = 0.43-0.98) were less likely to have positive health than their counterparts. After stratified participants by duration, those with a duration of diabetes < 6 years, the adjusted OR for positive health was 1.95(95% CI = 1.02-3.72), 1.22(95% CI = 0.59-2.52), and 1.19(95% CI = 0.58-2.41) for those with a total weekly energy expenditure of ≥ 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. In participants with a duration of diabetes ≥ 6 years, total energy expenditure showed a gradient effect on self-perceived positive health. The adjusted OR for positive health was 3.45(95% CI = 1.53-7.79), 2.77(95% CI = 1.11-6.92), and 1.90(95% CI = 0.73-4.94) for those with a total weekly energy expenditure of ≥ 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. Conclusions Our results highlight that regular leisure activity with an energy expenditure ≧ 500 kcal per week is associated with better self-rated health for those with longstanding diabetes.
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Affiliation(s)
- Chia-Lin Li
- Department of Health Care Management, Chang Gung University, Tao-Yuan, Taiwan
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de Castro AB, Voss JG, Ruppin A, Dominguez CF, Seixas NS. Stressors among Latino Day Laborers. ACTA ACUST UNITED AC 2010. [DOI: 10.1177/216507991005800503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This pilot study evaluated the feasibility of conducting a research project focused on stressors and allostatic load (AL) among day laborers. A total of 30 Latino men were recruited from CASA Latina, a worker center in Seattle. Participants completed an interview and researchers measured six indicators of AL (body mass index, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, C-reactive protein, and cortisol). Percentages and mean scores were calculated for several self-reported stressors in work, economic, and social contexts and were compared between low and high AL groups. Overall, participants with high AL reported experiencing more stressors than those with low AL. Additionally, those with high AL generally reported being less healthy both physically and mentally. Findings suggest that Latino day laborers experience stressors that place them at risk for high AL. Also, a study of this nature is possible, but must be conducted with trust and collaboration between researchers and community partners.
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de Castro AB, Voss JG, Ruppin A, Dominguez CF, Seixas NS. Stressors among Latino day laborers. A pilot study examining allostatic load. AAOHN JOURNAL : OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES 2010; 58:185-96. [PMID: 20507008 PMCID: PMC2964275 DOI: 10.3928/08910162-20100428-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This pilot study evaluated the feasibility of conducting a research project focused on stressors and allostatic load (AL) among day laborers. A total of 30 Latino men were recruited from CASA Latina, a worker center in Seattle. Participants completed an interview and researchers measured six indicators of AL (body mass index, waist-to-hip ratio, systolic blood pressure, diastolic blood pressure, C-reactive protein, and cortisol). Percentages and mean scores were calculated for several self-reported stressors in work, economic, and social contexts and were compared between low and high AL groups. Overall, participants with high AL reported experiencing more stressors than those with low AL. Additionally, those with high AL generally reported being less healthy both physically and mentally. Findings suggest that Latino day laborers experience stressors that place them at risk for high AL. Also, a study of this nature is possible, but must be conducted with trust and collaboration between researchers and community partners.
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Affiliation(s)
- A B de Castro
- University of Washington School of Nursing, Seattle, WA, USA.
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Wolff LS, Subramanian SV, Acevedo-Garcia D, Weber D, Kawachi I. Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample. Soc Sci Med 2010; 70:2019-2028. [PMID: 20381225 DOI: 10.1016/j.socscimed.2010.02.033] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2009] [Revised: 12/24/2009] [Accepted: 02/28/2010] [Indexed: 11/29/2022]
Abstract
Emerging research has revealed that subjective social status (SSS), or how people perceive their position in the social hierarchy, is significantly associated with multiple health outcomes. Yet few studies have examined how this association is affected by the person or group to whom respondents are comparing themselves. While previous studies have used distal referent groups when assessing SSS, scholars have suggested that individuals may prefer to make comparisons to those who share similar characteristics to themselves. Overall, there has been little empirical analysis assessing the health impact of comparing oneself to one referent group over another. Using a diverse, national US sample (n=3644), this study explores whether the relationship between SSS and self-rated health is sensitive to the referent used for social comparison. Data are from respondents who completed the ConsumerStyles and HealthStyles mail surveys and who have assessed their SSS against four referents: others in American society, others of the same race or ethnicity, neighbors, and parents at the same age. Self-rated health was the dependent variable, while we controlled for household income, education, home ownership, race/ethnicity, and other covariates. In logistic regression models, SSS using each of the four referents was significantly associated with self-rated health, but the model using the referent of others in American society had the strongest association with self-rated health and was the most parsimonious. Findings validate previous studies which typically have used a more distal referent such as others in American society in exploring the SSS-health relationship. However, future work should explore whether this referent is salient to diverse population groups when making social comparisons. Researchers may also want to consider using SSS as an additional status measure since it may capture more subtle differences in the status hierarchy than traditional economic measures.
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Affiliation(s)
- Lisa S Wolff
- Health Resources in Action, Research and Evaluation Department, Boston, MA, United States.
| | - S V Subramanian
- Harvard School of Public Health, Department of Society, Human Development, and Health, Boston, MA, United States
| | | | - Deanne Weber
- Porter Novelli, Strategic Planning and Research, Washington, DC, United States
| | - Ichiro Kawachi
- Harvard School of Public Health, Department of Society, Human Development, and Health, Boston, MA, United States
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Korpela KM, Ylén M, Tyrväinen L, Silvennoinen H. Favorite green, waterside and urban environments, restorative experiences and perceived health in Finland. Health Promot Int 2010; 25:200-9. [PMID: 20176589 DOI: 10.1093/heapro/daq007] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The study investigated restorative experiences in relation to respondents' everyday favorite places and analysed the associations between the use of favorite places, restorative experiences, their determinants and aspects of self-rated health. A simple random sample of 1273 inhabitants, aged between 15 and 75 years, of two major cities in Finland (Helsinki and Tampere) completed a postal questionnaire. A subsample of the answers from inhabitants with a self-reported distance from home to a favorite place of 15 km or less (n = 1089) was analysed. Restorative experiences in favorite exercise and activity outdoor areas, waterside environments and extensively managed natural settings (mainly urban woodlands) were stronger than in favorite places in built urban settings or green spaces in urban settings (mostly parks). The results revealed a link between the need for restoration (worries and stress), the use of environmental self-regulation strategies (favorite places) and restorative outcomes. The more worries about money and work (during the last month) a person had, the more stressed a person had felt during the last year, the less energetic s/he had felt, the lower was the number of visits to the favorite place (during the last 6 months) and the lower the typical level of restorative experiences. Inconsistently, the direct path suggested that the more worries about money and work, the higher the typical level of restorative experiences. The findings increase knowledge of health-enhancing environments and have implications for stress and work recovery research.
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Affiliation(s)
- Kalevi M Korpela
- Department of Psychology, FIN-33014 University of Tampere, Tampere, Finland.
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244
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Self-rated health and mortality: gender- and age-specific contributions of explanatory factors in South Korea. Int J Public Health 2010; 55:279-89. [DOI: 10.1007/s00038-010-0121-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 06/01/2009] [Accepted: 01/12/2010] [Indexed: 10/19/2022] Open
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Abstract
This cross-sectional study examines the relationship between poor employee well-being (PEWB) and work-related mental ill-health and substance consumption (MIH). It is proposed as a unification model that links both work-related negative consequences on the basis of the experiences of threat, loss, and frustration at work. PEWB contains the following elements: emotional discomfort, bodily uneasiness, organizational distance, task impairment, and dragging workday; and MIH includes work-related anxiety, depression, irritability, cigarette smoking, alcohol and drug consumption, and physical illness. Six hundred ninety-seven participants, working in a wide range of jobs and occupations, completed the survey. Results indicated that PEWB and MIH are significantly associated, after controlling for demographic and personal factors. Sense sharing between PEWB-MIH and PEWB element combination explained the relationships between both constructs. These findings could be helpful for organizations interested in preserving and improving worker mental health.
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Salavecz G, Chandola T, Pikhart H, Dragano N, Siegrist J, Jöckel KH, Erbel R, Pajak A, Malyutina S, Kubinova R, Marmot M, Bobak M, Kopp M. Work stress and health in Western European and post-communist countries: an East-West comparison study. J Epidemiol Community Health 2010; 64:57-62. [PMID: 19692735 PMCID: PMC3986036 DOI: 10.1136/jech.2008.075978] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is evidence that psychosocial factors at work influence the risk of poor health in Western societies, but little is known about the effect of work stress in the former communist countries. The aim of this paper is to compare the association of work stress with self-rated health in Western European and post-communist countries. METHODS Data from four epidemiological studies were used: the HAPIEE study (Poland, Russia and the Czech Republic), the Hungarian Epidemiological Panel (Hungary), the Heinz Nixdorf Recall study (Germany) and the Whitehall II study (UK). The overall sample consisted of 18 494 male and female workers aged 35-65 years. RESULTS High effort-reward imbalance at work was associated with poor self-rated health. The adjusted odds ratios for the highest versus lowest quartile of the effort-reward ratio were 3.8 (95% CI 1.9 to 7.7) in Hungary, 3.6 (95% CI 2.3 to 5.7) in the Czech Republic, 2.5 (95% CI 1.5 to 4.1) in the UK, 2.3 (95% CI 1.6 to 3.5) in Germany, 1.5 (95% CI 1.0 to 2.1) in Poland and 1.4 (95% CI 1.1 to 1.8) in Russia. The differences in odds ratios between countries were statistically significant (p<0.05). A similar pattern was observed for the effect of overcommitment on poor health. CONCLUSION The association of effort-reward imbalance at work and of a high degree of work-related overcommitment with poor self-rated health was seen in all countries, but the size of the effects differed considerably. It does not appear that the effects in Eastern Europe are systematically stronger than in the West.
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Affiliation(s)
- G Salavecz
- Institute of Behavioral Sciences, Semmelweis University, Nagyvarad ter 4, Budapest, Hungary H-1089.
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Self-rated health in different social classes of Slovenian adult population: nationwide cross-sectional study. Int J Public Health 2009; 56:45-54. [PMID: 20033254 DOI: 10.1007/s00038-009-0103-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Revised: 11/09/2009] [Accepted: 11/09/2009] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES Self-rated health can be influenced by several characteristics of the social environment. The aim of this study was to evaluate the relationship between self-rated health and self-assessed social class in Slovenian adult population. METHODS The study was based on the Countrywide Integrated Non-communicable Diseases Intervention Health Monitor database. During 2004, 8,741/15,297 (57.1%) participants aged 25-64 years returned posted self-administered questionnaire. Logistic regression was used to determine unadjusted and adjusted estimates of association between poor self-rated health and self-assessed social class. RESULTS Poor self-rated health was reported by 9.6% of participants with a decrease from lower to upper-middle/upper self-assessed social class (35.9 vs. 3.7%). Logistic regression showed significant association between self-rated health and all self-assessed social classes. In an adjusted model, poor self-rated health remained associated with self-assessed social class (odds ratio for lower vs. upper-middle/upper self-assessed social class 4.23, 95% confidence interval 2.46-7.25; P < 0.001). CONCLUSIONS Our study confirmed differences in the prevalence of poor self-rated health across self-assessed social classes. Participants from lower self-assessed social class reported poor self-rated health most often and should comprise the focus of multisectoral interventions.
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The predictors of self-rated health and the relationship between self-rated health and health service needs are similar across socioeconomic groups in Canada. J Clin Epidemiol 2009; 63:412-21. [PMID: 19926448 DOI: 10.1016/j.jclinepi.2009.08.015] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Revised: 08/12/2009] [Accepted: 08/18/2009] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine if there are systematic differences in the predictors of self-rated health (SRH) and to examine the relationship between SRH and health care utilization across socioeconomic groups. STUDY DESIGN AND SETTING We used cross-sectional data from the Canadian Community Health Survey linked to the Ontario Health Insurance Plan (N=17,109). We examined relative differences in the factors associated with different levels of SRH across socioeconomic groups (as assessed by education and household income) using probit models separately for men and women. We then examined differences in expected health care costs, as assessed by adjusted clinical group weights using administrative health care records, between socioeconomic groups within the same level of SRH. RESULTS We found limited differences across the predictive ability of a broad range of physical, mental, health service/care utilization, and health behavior variables on SRH across socioeconomic groups. In addition, no differences were found in the expected health care utilization costs across socioeconomic groups within the same level of SRH. CONCLUSIONS The results of this study suggest that SRH assesses a broad variety of factors, including physical health status, mental health status, health service/care utilization, and health behaviors, relatively equally across socioeconomic groups, measured as either education or income.
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Barron JS, Tan EJ, Yu Q, Song M, McGill S, Fried LP. Potential for intensive volunteering to promote the health of older adults in fair health. J Urban Health 2009; 86:641-53. [PMID: 19488860 PMCID: PMC2704275 DOI: 10.1007/s11524-009-9353-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2008] [Accepted: 04/06/2009] [Indexed: 10/20/2022]
Abstract
Volunteer service opportunities for older adults may soon be expanded. Although volunteering is thought to provide health benefits for healthier older adults, it is not known whether older adults in less than very good health are suitable candidates for high-intensity volunteering and can derive health benefits. This manuscript presents a prospective analysis of 174 older adult volunteers serving in Experience Corps Baltimore, a high-intensity senior volunteer program in Baltimore, Maryland. Volunteers served > or =15 h per week, for a full school year, in elementary schools helping children with reading and other skills between 1999 and 2002. Volunteers were assessed with standardized questionnaires and performance-based testing including grip strength, walking speed, chair stand speed, and stair-climbing speed prior to school volunteering and at the end of the school year. Results were stratified by health status. Among 174 volunteers, 55% initially reported "good" and 12% "fair" or "poor" health status. At baseline, those in fair health reported higher frequencies of disease and disability than volunteers in excellent or very good health. After volunteering, a majority of volunteers in every baseline health status category described increased strength and energy. Those in fair health were significantly more likely to display improved stair-climbing speed than those in good or excellent/very good health (100.0% vs. 53.4% vs. 37.5%, p = 0.05), and many showed clinically significant increases in walking speed of >0.5 m/s. Satisfaction and retention rates were high for all health status groups. Clinicians should consider whether their patients in fair or good health, as well as those in better health, might benefit from high-intensity volunteer programs. Productive activity such as volunteering may be an effective community-based approach to health promotion for older adults.
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Affiliation(s)
- Jeremy S Barron
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, 5505 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
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What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 2009; 69:307-16. [PMID: 19520474 DOI: 10.1016/j.socscimed.2009.05.013] [Citation(s) in RCA: 1425] [Impact Index Per Article: 95.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Indexed: 11/21/2022]
Abstract
The association of self-rated health with mortality is well established but poorly understood. This paper provides new insights into self-rated health that help integrate information from different disciplines, both social and biological, into one unified conceptual framework. It proposes, first, a model describing the health assessment process to show how self-rated health can reflect the states of the human body and mind. Here, an analytic distinction is made between the different types of information on which people base their health assessments and the contextual frameworks in which this information is evaluated and summarized. The model helps us understand why self-ratings of health may be modified by age or culture, but still be a valid measure of health status. Second, based on the proposed model, the paper examines the association of self-rated health with mortality. The key question is, what do people know and how do they know what they know that makes self-rated health such an inclusive and universal predictor of the most absolute biological event, death. The focus is on the social and biological pathways that mediate information from the human organism to individual consciousness, thus incorporating that information into self-ratings of health. A unique source of information is provided by the bodily sensations that are directly available only to the individual him- or herself. According to recent findings in human biology, these sensations may reflect important physiological dysregulations, such as inflammatory processes. Third, the paper discusses the advantages and limitations of self-rated health as a measure of health in research and clinical practice. Future research should investigate both the logics that govern people's reasoning about their health and the physiological processes that underlie bodily feelings and sensations. Self-rated health lies at the cross-roads of culture and biology, therefore a collaborative effort between different disciplines can only improve our understanding of this key measure of health status.
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