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PubMed2006

Nondaily smokers should be asked and advised to quit.

BACKGROUND: Nondaily smokers are a growing subpopulation of smokers. Current cessation guidelines were developed for daily smokers, and how clinicians might help nondaily smokers is not clear. METHODS: Analyzing the 2000 National Health Interview Survey in 2004, we compared characteristics of nondaily smokers with never smokers and daily smokers. We used multivariate logistic regression to compare predictors of wanting to quit in 6 months between nondaily and daily smokers. RESULTS: About one in five current smokers was a nondaily smoker. Nondaily smokers reported better health than daily smokers, but had some health status indicators suggesting worse health than never smokers. Nondaily smokers were more likely to want to quit (odds ratio [OR]=1.31, 95% confidence interval [CI]=1.10-1.56) than daily smokers, but were less likely to report a physician having asked about tobacco use (41% vs 50%, p<0.0001) or advised quitting (31% vs 41%, p<0.0001). In both nondaily and daily smokers, physician advice (nondaily OR=1.50, 95% CI=1.03-2.2; daily OR=1.58, 95% CI=1.32-1.89), and the belief that secondhand smoke harms others (nondaily OR=1.48, 95% CI=1.04-2.1; daily OR=1.80, 95% CI=1.56-2.1), predicted wanting to quit. Higher-educated nondaily smokers were less likely to want to quit (OR=0.54, 95% CI=0.32-0.91), unlike in daily smokers (OR=1.48, 95% CI=1.15-1.89). Latino nondaily smokers were less likely (OR=0.43, 95% CI=0.30-0.64) than whites, and African-American daily smokers were more likely (OR=1.27, 95% CI=1.04-1.55) than whites, to want to quit. CONCLUSIONS: While daily smokers may seem a higher cessation priority, nondaily smokers may be more likely to quit with brief interventions. Cessation messages should address health risks of any smoking, ethnic differences, smoke-free messages, and situational triggers.

Adolescent↗
PubMed1989

Community-health needs assessment: use of the Nottingham health profile in an Australian study.

This article reports on the use of the Nottingham health profile (which was developed in the United Kingdom as a valid and reliable indicator of perceived health status) in a community-health survey in Noarlunga, an outer suburban area of Adelaide. The instrument appears valid for use with an Australian population. It was used in Noarlunga to demonstrate a correlation between health status and a range of social and economic variables. The uses of the Nottingham health profile in health-services planning are discussed.

Adolescent↗
PubMed1990

[Mortality and mean life span as an indicator of population health status].

The main source of data for the evaluation of the health status of the population are mortality statistics. The paper contains data on the standardized mortality and mean life span from the Annual World Health Report. The graphic presentation of data makes it possible to compare 15 selected European countries. In addition to the general mortality the cardiovascular mortality and the mortality from neoplasm is given. In the conclusion the author points out that the adverse health status of the Czechoslovak population must be improved not only by ensuring healthy living conditions but also by creating prerequisites for a change of the present lifestyle.

Czechoslovakia↗
PubMed1993

An overview of health care systems: Canada and selected OECD countries.

This article presents an overview of health care systems in Canada and selected OECD countries (Australia, France, Finland, Germany, Sweden, the United States and the United Kingdom). The article discusses the organization of health care systems, health care expenditure, the availability and utilization of health services, and the health status of the population. In addition, it highlights and compares key health care indicators that are common to all health care systems. The article focuses on the relationship between health expenditure and health status in terms of life expectancy and infant mortality and shows that the United States had the highest infant mortality and second lowest life expectancy for females at birth in 1990 while it spent the most on health care as percentage of GDP. The article also shows that the overall health status indicators in some countries such as Finland and Sweden are comparable to that of Canada despite spending considerably less on health care.

Adult↗
PubMed2006

[Indicators of health status and psychomotor abilities in pyrotechnists].

AIM: The aim of the study was to assess the relationship of age, psychomotor (oculomotor) functions and parameters indicating overall neuroticism with clinical findings and level of gamma-glutamyltransferase (GGT). SUBJECTS AND METHODS: The study included 100 male subjects, mean age 37 (range 25-62) years, pyrotechnists by occupation. Results recorded on their pre-employment visit and four subsequent regular annual visits are presented. The algorithm of examinations fully complied with current regulations (Official Gazette, 26/96). The following parameters were observed: age, membership/affiliation (Croatian Army, Mungos or other companiess engaged in mine clearing); psychological testing: overall neuroticism (EPQ scale N, Cornell Index), the results accomplished by computerized Bonnardel sinusoid; levels of GGT, and the results of clinical examination. The relationship between group variables and differences in the parameters of between-group variables were tested using a STATISTICA software package (Statsoft, version 5.5). RESULTS: The results accomplished by computerized Bonnardel sinusoid in the follow-up period revealed a statistically significant decrease in number of mistakes (p<0.001), time-to-perform (p<0.001), and time-to-correct a mistake (p<0.001). At the same time, GGT value raised significantly (p<0.001). Positive relationship between age and psychomotor abilities was statistically significant (p<0.05). Psychomotor abilities showed correlation with age. GGT values were unrelated to either performing characteristics revealed on psychomotor abilities testing, or to the results obtained on overall neuroticism testing. CONCLUSION: The results of the study suggested that meaningful monitoring of health competence of pyrotechnicsts should comprise all of the above parameters.

Adult↗
PubMed1982

[Health statistics and health index in developing countries].

Having briefly criticized those health indexes which are currently used, the author suggests that the LDC'S should exploit the information contained in routine statistical reports of health services activities: utilization rate (number of patients divided by population served) and intensity of service rate (number of visits per patient). She shows that these rate depend not only on morbidity, but also on the characteristics of the supply of health services (distance . . .) and on the characteristics of the demand for those services (behavioral attitudes of the patients . . .). The author uses multiple regression techniques to isolate the influence of these factors on utilization rate and on service's intensity. She concludes that the residual may be considered as a health status indicator. The application of this method to data for the forty administrative areas of Cameroon (1970 and 1975), shows that the resulting health index is correlated with infant mortality rates and with sanitary conditions.

Cameroon↗
PubMedDate not supplied

Embedding child health within a framework of regional health: population health status and sociodemographic indicators.

OBJECTIVE: The description of regional variation in children's health requires regional population-based context. But what is the best way to measure the health of a region's population? METHODS: The use of two indicators is described--one a health status measure and the other a measure of socioeconomic wellbeing. It is well known that the population's premature mortality rate (PMR), the age/sex-adjusted rate of death before age 75 years, is highly related to overall health status of an area's residents. Socioeconomic characteristics of an area's residents are also indicative (and likely causative) of health status differences. RESULTS: The Socioeconomic Factor Index (SEFI) was developed at the Manitoba Centre for Health Policy, using a Principal Components Analysis of census data. PMR and SEFI are highly correlated (Spearman's correlation coefficient r = 0.85, p < 0.0001). CONCLUSION: PMR can be used as a surrogate measure for both the health status and socioeconomic well-being of regional populations in Manitoba.

Adolescent↗
PubMed2005

Dyspnoea with activities of daily living versus peak dyspnoea during exercise in male patients with COPD.

Dyspnoea measurements in chronic obstructive pulmonary disease (COPD) can be broadly divided into two categories: those that assess breathlessness during exercise, and those that assess breathlessness during daily activities. We investigated the relationships between dyspnoea at the end of exercise and during daily activities with clinical measurements and mortality in COPD patients. We examined 143 male outpatients with moderate to very severe COPD. The peak Borg score at the end of progressive cycle ergometry was used for the assessment of peak dyspnoea rating during exercise, and the Baseline Dyspnea Index (BDI) score was used for dyspnoea with activities of daily living. Relationships between these dyspnoea ratings with other clinical measurements of pulmonary function, exercise indices, health status and psychological status were then investigated. In addition, their relationship with the 5-year mortality of COPD patients was also analyzed to examine their predictive ability. Although the BDI score was significantly correlated with airflow limitation, diffusing capacity, exercise indices, health status and psychological status, the Borg score at the end of exercise had non-existent or only weak correlations with them. The BDI score was strongly significantly correlated with mortality, whereas the Borg score was not. Dyspnoea during daily activities was more significantly correlated with objective and subjective measurements of COPD than dyspnoea at the end of exercise. In addition, the former was more predictive of mortality. Dyspnoea with activities of daily living is considered to be a better measurement for evaluating the disease severity of COPD than peak dyspnoea during exercise.

Activities of Daily Living↗
PubMedDate not supplied

Sentinel human health indicators: to evaluate the health status of vulnerable communities.

The presence of toxic substances in the Great Lakes (GL) basin continues to be a significant concern. In the United States, some 70,000 commercial and industrial compounds are now in use. More than 30,000 are produced or used in the Great Lakes ecosystem. These substances include organochlorines (e.g., polychlorinated biphenyls (PCBs), dioxins, furans, dieldrin, etc.), heavy metals such as methylmercury, and alkylated lead, and polycyclic aromatic hydrocarbons (e.g., benzo[a]pyrene). The IJC has identified 42 locations in the GL basin of the United States and Canada as Areas of Concern (AOCs) because of high concentrations of these toxic substances. In 1990 the U.S. Congress amended the Great Lakes Critical Programs Act to create The Agency for Toxic Substances and Disease Registry (ATSDR) Great Lakes Human Health Effects Research Program (GLHHERP) to begin to address these issues. This program characterizes exposures to contaminants via consumption of GL fish and investigates the potential for short- and long-term adverse health effects. This paper reviews the GLHHERP program and indicators established to monitor and address the risks posed by these substances to vulnerable populations in the Great Lakes ecosystem.

Ecosystem↗
PubMed2006

[The individual's status in the labor market and health inequity in Brazil].

OBJECTIVE: To investigate inequalities in personal health conditions and in the utilization of healthcare services according in relation to the individual's status in the labor market. METHODS: This study was based on 39,925 males aged 15 to 64 years living in 10 Brazilian metropolitan regions, who took part in the 1998 National Household Survey. They were classified as formal labor, informal labor, unemployed or outside of the labor market. Each category was compared with formal labor regarding sociodemographic characteristics, health status indicators and healthcare utilization. This analysis was by means of Pearson's Chi-square test. Multinomial logistic regression was used to investigate independent associations between labor market status, health status indicators and healthcare utilization. RESULTS: The classification of the participants' status was that 52.2% were formal labor, 27.7% informal labor, 10% unemployed and 10.2% were outside of the labor market. There were significant differences between these categories with respect to age, schooling, household income, household status and region of residence. Independent of the sociodemographic characteristics, unemployment, informal labor status and, especially, exclusion from the labor market remained associated with poor health status. CONCLUSIONS: The individual's status in the labor market is expressed through a gradient of inequality in health conditions. These findings reinforce the need to also consider the individual's status in the labor market in studies on healthcare inequalities.

Adolescent↗
PubMed2006

Assessment of the health status and risk factors of Kham Tibetan pastoralists in the alpine grasslands of the Tibetan plateau.

The health status of Tibetan herders in the Sanjiangyuan region of the Tibetan Plateau, in southwest Qinghai Province, is assessed in this paper. The field study was conducted in 2002 in the context of a broader community development and research framework, the ultimate goal of which is to achieve an effective region-specific programme of preventative health care and training for Tibetan pastoralists. Specifically, the authors analysed the impact of a number of potentially health-related environmental and lifestyle risk factors on self-reported health indicators, with a special emphasis on mother and child health. Several health status indicators were used, including a general morbidity index and a measurement of functional incapacity due to illness in the sample households. Maternal and child health findings were alarming with high rates of miscarriage and infant loss, with no traditional midwives to assist in pregnancy and delivery. Preventable childhood illnesses were also common. Other debilitating diseases included hepatitis, tuberculosis, arthritis (gout), gall bladder disease, peptic ulcers and back pain. Finally, binary logistic regression analysis showed a significant link between general morbidity and the time it takes to obtain water. The survey findings, validated by the focus groups, indicate a real need for increased accessibility and quality of health service provision to women and men and effective preventative health strategies.

Adolescent↗
PubMed2002

Rural health care in Malaysia.

Malaysia has a population of 21.2 million of which 44% resides in rural areas. A major priority of healthcare providers has been the enhancement of health of 'disadvantaged' rural communities particularly the rural poor, women, infants, children and the disabled. The Ministry of Health is the main healthcare provider for rural communities with general practitioners playing a complimentary role. With an extensive network of rural health clinics, rural residents today have access to modern healthcare with adequate referral facilities. Mobile teams, the flying doctor service and village health promoters provide healthcare to remote areas. The improvement in health status of the rural population using universal health status indicators has been remarkable. However, differentials in health status continue to exist between urban and rural populations. Malaysia's telemedicine project is seen as a means of achieving health for all rural people.

Humans↗
PubMed1991

Selected measures of health status for Mexican-American, mainland Puerto Rican, and Cuban-American children.

The 1987 National Vital Statistics System and the Hispanic Health and Nutrition Examination Survey (1982 through 1984) were used to assess the health status of Mexican-American, mainland Puerto Rican, and Cuban-American children by examining the prevalences of pregnancy outcomes and chronic medical conditions. The low-birth-weight rate among Hispanics (7.0%) compared favorably with that of non-Hispanic whites (7.1%) despite the greater poverty and lower levels of education among Hispanics. When examined by Hispanic subgroup, however, significant differences were present, with mainland Puerto Ricans having the highest prevalences of low-birth-weight infants. Premature births were more common among all three Hispanic subgroups than among non-Hispanic whites. Mexican-American and Cuban-American children had a similar prevalence of (3.9% and 2.5%, respectively) chronic medical conditions compared with non-Hispanic white children; Puerto Rican children had a higher prevalence of chronic medical conditions (6.2%). When assessed by these health status indicators, Hispanic children seem to have a health status similar to non-Hispanic white children. However, mainland Puerto Rican children seem at greater risk for poor health, reflecting the US Hispanic population's heterogeneity. Health programs targeted at US Hispanics should appropriately consider these group differences.

Adolescent↗
PubMedDate not supplied

Health indicators for mothers and children in rural Herat Province, Afghanistan.

INTRODUCTION: Following years of conflict and neglect, major efforts now are underway to develop health policy and rehabilitate the health facilities in Afghanistan. As part of these efforts, there is a need to better understand the health status and health-seeking behaviors. As part of an effort to assist local non-governmental organizations (NGOs), a household survey of mothers with children under the age of five years was conducted in two rural districts of Herat Province, Karokh and Chesht-e-Sharif. METHODS: A two-stage, 30-cluster approach was used for each district. This included 622 mothers of 926 children under the age of five years living in the two districts. Outcome measures included demographic characteristics, antenatal services, immunization coverage, hemoglobin levels of the mothers, nutritional status and practices, environmental health indicators, recent illness, and health seeking behaviors. RESULTS: The mean value of ages of the mothers was 27 years with an average parity of 6.1. Less than 5% of mothers ever had attended school. Half of women had lost at least one child before the child reached the age of five years. Under-five-year mortality was estimated at 325. Only 29% of the women had attended an antenatal clinic during their last pregnancy. Virtually all deliveries occurred at home. Only 7.6% of women had received three doses of tetanus toxoid. Less than 9% of the children 12-59 months of age were fully immunized. According to the measurements of mid-upper-arm circumference (MUAC), 11% of children were malnourished. Although breastfeeding almost was universal, greater than one-third of the women did not start breastfeeding until the second day after delivery. Protected water sources and appropriate control of feces were lacking in both districts. In the previous two weeks, 45.7% of children had experienced diarrhea, and dysentery had occurred in 10%. Fever had been present in one-quarter of the children. CONCLUSIONS: Household health indicators indicate serious maternal and child health concerns in these two districts. Of particular concern is the poor immunization coverage, lack of reproductive health service, and the prevalence of common childhood illness in these populations. The feeding practices for children and the anemia among mothers also raised concerns. Poor environmental health contributes substantially to childhood illness. Without special emphasis, efforts to rebuild the health sector are likely to reach the household level only late in the process. An aggressive program to integrate community development and promotion of sound health practices is needed to improve the health of the Afghanistan people.

Adult↗
PubMed1990

The advantage of multiple measures of quality of life.

The concept of "quality of life" is rich and multi-faceted. In the present paper, we argue that the very richness of the concept requires that we (a) evaluate multiple dimensions of quality of life in our studies and (b) include multi-item assessments of each dimension selected for study. Conceptual and psychometric advantages which accrue by using multiple measures are delineated. We discuss the way in which the use of multiple measures affects the selection of instruments, the source of information, and the mode of data collection. In addition, the application of multi-item assessments to the construction of health status indices is considered along with their use in health policy and cost-benefit analyses.

Data Collection↗