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Biomedical subjects

S L Syme

Publications and source records attributed to S L Syme.

At least 55 records · Page 3Linked to original sources
PubMed1987

Social determinants of disease.

The primary purpose for identifying psychosocial risk factors is to prevent disease and disease complications. For 30 years, we have been doing research in this field and have been successful in identifying such risk factors as Type A behavior, social isolation, stressful life events, and various psychological patterns. However, our success in using this information to help prevent disease has been much more limited. One reason for this limited success is that we have focused virtually all of our attention on the study of individuals and almost no attention on the social environment within which people live. There are two major limitations of such a one-to-one approach: it is difficult for people to change their behavior and their life situation and even if some people do change, others enter the "at risk" population because no action has been taken to change those forces in society that stimulated the problem in the first place. In discussing the social determinants of disease, it is important that we develop a new approach that permits us to study not only individuals but also the social environment. An example of this approach is provided by researchers who were successful in preventing infectious diseases. The work of these researchers focused not on clinical entities or on individuals but on the environment. This resulted in a disease classification system that included concepts such as air-borne, food-borne, water-borne, and vector-borne diseases. We have no such system for the study of non-infectious diseases. Considerable data already are available to help us to think about such a new classification system.(ABSTRACT TRUNCATED AT 250 WORDS)

Educational Status↗
PubMed1986

Strategies for health promotion.

A key element in most efforts to prevent disease and promote health is behavioral change to lower risk. One-to-one programs to help people change their behavior are seriously limited because of the difficulty people have in making behavioral changes and because one-to-one programs do little to modify those forces in the community that continually produce new people at risk. In addition to one-to-one programs, therefore, environmental strategies for disease prevention are needed. Several clues regarding environmental interventions can be gleaned from the study of patterns of disease distributions. Not only are environmental approaches to prevention more efficient and practical than one-to-one programs, they also may shed new light on our understanding of disease etiology.

Behavior↗
PubMed1982

Acculturation and coronary heart disease among Japanese men in Hawaii.

A cohort of 4653 men of Japanese ancestry living in Hawaii, with traditional Japanese social and cultural lifestyles, were studied for the association of the prevalence and incidence of coronary heart disease (Honolulu Heart Program, 1971-1979). Two of four scales of acculturation were significantly associated with coronary heart disease prevalence independently of 11 other risk factors, but none of the acculturation scales were associated with incidence appeared to be mostly due to the inclusion of fatal cases in the incidence data, although other explanations are possible. Measures of acculturation were also significantly associated wih many of the other coronary heart disease risk factors in such a way that the more traditional Japanese men had lower serum cholesterol and uric acid, were less obese, more physically active, and smoked fewer cigarettes than the more westernized men. A comparison of bivariate and multivariate analyses indicated that some of acculturation scales were indirectly associated with coronary heart disease because of the confounding association with the other risk factors.

Acculturation↗
PubMed1979

Cultural context of type A behavior and risk for CHD: a study of Japanese American males.

A total of 2437 Japanese American men living in Hawaii were given the Jenkins Activity Survey (JAS) and classified as either type A or type B. Only 18% of the sample scored in the type A direction, a much lower percentage than usually found among white American males. There was a slightly higher prevalence of CHD among type A Japanese Americans than among their type B counterparts (5.7% vs. 3.6%, respectively). A factor analysis of JAS data produced three new factors for this population: HS (hard-driving and impatient), JH (ability to function successfully in job setting), and HW (hard-working). Those men who were more Westernized had a higher prevalence of CHD, expecially if they were also type A, in terms of both geographical mobility and intergenerational change. The results are discussed in light of the dual role of sociocultural influences and behavioral characteristics (type A/B) which predispose an individual to CHD.

Aged↗
PubMed1979

Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents.

The relationship between social and community ties and mortality was assessed using the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, California and a subsequent nine-year mortality follow-up. The findings show that people who lacked social and community ties were more likely to die in the follow-up period than those with more extensive contacts. The age-adjusted relative risks for those most isolated when compared to those with the most social contacts were 2.3 for men and 2.8 for women. The association between social ties and mortality was found to be independent of self-reported physical health status at the time of the 1965 survey, year of death, socioeconomic status, and health practices such as smoking, alcoholic beverage consumption, obesity, physical activity, and utilization of preventive health services as well as a cumulative index of health practices.

Adult↗
PubMed1978

Epidemiologic research in hypertension: a critical appraisal.

Epidemiologic studies of blood pressure have been conducted for over twenty-five years, but the results of this research can only be described as modest. The basic epidemiologic and demographic description of blood pressure distributions in human populations remains problematic and psychosocial studies have not yielded clear and solid hypotheses pointing the way to future research. There is no doubt that blood pressures vary among and between population groups, and there seems little doubt that variations in life-style are associated with these differences. It is puzzling that we have failed to discern systematic and patterned relationships among these variables. It is suggested that a more useful approach to research in this field would be to distinguish factors that affect general susceptibility to becoming ill from those that initiate or maintain particular disease states.

Disease Susceptibility↗
PubMed1977

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California. Incidence of myocardial infarction and death from coronary heart disease.

The incidence of myocardial infarction and death from coronary heart disease was studied in defined samples of 45 to 68 year old Japanese men in Japan, Hawaii and California. The incidence rate was lowest in Japan where it was half that observed in Hawaii (P less than 0.01). The youngest men in the sample in Japan were at particularly low risk. The incidence among Japanese men in California was nearly 50 percent greater than that of Japanese in Hawaii (P less than 0.05). A striking increase in the incidence of myocardial infarction appears to have occurred in the Japanese who migrated to the United States; this increase is more pronounced in California than in Hawaii.

Age Factors↗
PubMed1976

Acculturation and coronary heart disease in Japanese-Americans.

Among men of Japanese ancestry, there is a gradient in the occurrence of coronary heart disease (CHD). It is lowest in Japan, intermediate in Hawaii, and highest in California. This gradient appears not to be completely explained by differences in dietary intake, serum cholesterol, blood pressure or smoking. To test the hypothesis that social and cultural differences may account for the CHD differences between Japan and the United States, 3809 Japanese-Americans in California were classified according to the degree to which they retained a traditional Japanese culture. The most traditional group of Japanese-Americans had a CHD prevalence as low as that observed in Japan. The group that was most acculturated to Western culture had a three- to five-fold excess in CHD prevalence. This difference in CHD rate between most and least acculturated groups could not be accounted for by differences in the major coronary risk factors.

Acculturation↗
PubMed1975

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: introduction.

It has been observed that among men of Japanese ancestry, there is a gradient in CHD mortality increasing from Japan to Hawaii to California. A study of 11,900 Japanese men in Hiroshima and Nagasaki, Japan, Honolulu, Hawaii, and the San Francisco Bay Area of California has been conducted to investigate this disease difference. This paper describes the selection of the study populations and their age distributions, and outlines the study methods. This paper also introduces and briefly summarizes four papers that give the results for mortality comparisons, biochemical and blood pressure distributions and results for heart disease prevalence among the three cohorts.

Aged↗
PubMed1975

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: mortality.

Stroke, coronary heart disease (CHD) and total mortality are evaluated from death certificates in enumerated cohorts of 45-64-year old Japanese men in Hiroshima and Nagasaki (1965-1970), in Homolulu (1966-1970), and in the San Francisco area (1968-1972). Total mortality is highest in Japan with no consistent differences between Japanese Americans in Homolulu and San Francisco. Age-specific CHD death rates are markedly lower in all three Japanese groups than in American whites. The CHD rates are consistently and significantly lower in Japan that in American Japanese. Stroke death rates for American Japanese men appear equivalent to figures for US white men of the same age, but are significantly lower than in the Japan cohort for the 60-64-year-old group. The number of stroke deaths below that age are too few as yet for analysis. Validation of mortality ascertainment and of the accuracy of death certification has been carried out in Japan and in Hawaii. The international differences in mortaltiy do not appear to be due to certification or other methodologic artifact.

Age Factors↗
PubMed1975

Epidemiologic studies of coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: distribution of biochemical risk factors.

Distributions of serum cholesterol, glucose, uric acid and triglycerides are examined among Japanese men living in Japan, Hawaii and California. Laboratory methods are described in detail and efforts to assure comparability of these methods. In every age group studied, the mean, median and percentile for each of the biochemical variables are lower for men in Japan than in Hawaii and California.

Aged↗