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PubMed1991

Assessment of low attendance at primary health care centre.

The study was conducted at 11 (eleven) randomly selected villages of Rupganj Upazila in order to find out the way to promote Primary Health Care. 1186 household heads and 11 physicians interviewed for the purpose. The study revealed that more than 54.14 percent of the study population were suffering from various diseases and only 4 percent of the patients attended Primary Health Care Centre/Complex. 52% of the patients were not satisfied by the service of Primary Health Care Centre/Complex. Want of medicine, lack of good physicians and doctors, carelessness about the patients constituted the principal causes of unsatisfactory treatment. The comparative distribution of opinion of household heads and physicians about non-attendance to Primary Health Care Centres by patients is statistically insignificant (P less than 0.05) which implies that the opinions are more or less the same. Both household heads and physicians opined that supply of sufficient medicine, equipment, improvement of health education and more budget allocations are essential to make the Primary Health Care service effective.

Bangladesh↗
PubMed2002

Does race matter? Children's height in Brazil and South Africa.

I examine racial differences in child stunting in mid-1990s South Africa and Brazil, two multiracial societies with different histories of legal support for racial discrimination. Using data from nationally representative household samples linked to community-level measures, the analysis shows that racial inequality in the distribution of socioeconomic resources across households and communities explains much of the racial difference in stunting in both countries. Even after these factors are controlled, however, the results indicate that in South Africa, nonwhite children are still at greater risk of growth faltering than are white children. The nature of socioeconomic and racial differences in children's growth is examined, and major determinants are discussed. These findings suggest that although state-sanctioned racism may help to explain the greater racial inequality in stunting in South Africa than in Brazil, the eradication of a disadvantage for nonwhites will depend on changes in the same fundamental socioeconomic inequalities that characterize both nations.

Black or African American↗
PubMed2003

Community based program to improve firearm storage practices in rural Alaska.

OBJECTIVE: To develop and evaluate a pilot program to reduce unauthorized access to firearms by youth by distributing gun safes and trigger locks to households. DESIGN: Pilot intervention with pre/post-evaluation design. SETTING: Two Alaska Native villages in the Bristol Bay Health Corporation region of southwest Alaska. SUBJECTS: Forty randomly selected households with two or more guns in the home. INTERVENTION: Initially, a focus group of community members who owned guns was convened to receive input regarding the acceptability of the distribution procedure for the gun storage devices. One gun safe and one trigger lock were distributed to each of the selected households during December 2000. Village public safety officers assisted with the distribution of the safes and provided gun storage education to participants. MAIN OUTCOME MEASURES: Baseline data were collected regarding household gun storage conditions at the time of device distribution. Three months after distribution, unannounced onsite home visits were conducted to identify if residents were using the gun safes and/or trigger locks. RESULTS: All selected households had at least two guns and 28 (70%) of the 40 households owned more than two guns. At baseline, 85% of homes were found to have unlocked guns in the home and were most often found in the breezeway, bedroom, storage room, or throughout the residence. During the follow up visits, 32 (86%) of the 37 gun safes were found locked with guns inside. In contrast, only 11 (30%) of the 37 trigger locks were found to be in use. CONCLUSIONS: This community based program demonstrated that Alaska Native gun owners accepted and used gun safes when they were installed in their homes, leading to substantial improvements in gun storage practices. Trigger locks were much less likely to be used.

Adolescent↗
PubMed1993

The status of elderly women in families viewed from the rate of their heading the household.

The author assesses the socioeconomic status of elderly women in China, with a focus on marital status, educational level, and employment. "In family and population studies, the methodology for research on household head rate is held as superior to household size and generation distribution indexes in understanding the change of family structures. This paper attempts to apply this methodology to the study of elderly women's familial status."

Adult↗
PubMed2005

Distribution of pesticide residues within homes in central New York State.

Residues for 17 pesticides were analyzed in 41 households in central New York State that represented farm, rural, and urban houses. Samples were taken in both summer and winter of 2000-2001 from the same households from four locations; family room carpet; adjacent smooth floor; flat tabletop surface; and settled dust collected in a Petri dish on a tabletop. Pesticide residues were analyzed to identity factors that influence both the transport into and the redistribution of pesticides in the indoor environment. Differences were observed between the various pesticides and pesticide classifications relative to location within and between households as well as by season. Variations in the pesticide residues were related to a number of factors. Higher residues were observed in the farm households, particularly in summer, with the highest amount observed for chloropyrifos in carpet (33 microg/m2). For many pesticides, the frequency of detection and the amount of residues were higher in summer, which relates to usage patterns in agriculture and horticulture; however, larger amounts of insecticides such as mecoprop, resmethrin, and tetramethrin were found on flat surfaces in winter, indicating household use and possible redistribution within the home. Distribution patterns suggest that routines within a household may cause high variation in residues; these practices include indoor pets and treatment for fleas and ticks, use of termiticides, and fastidiousness of occupants. Frequency of pesticide detection was highest in carpet for both summer and winter for all households, indicating that carpets hold pesticides over time. Adsorbent fibrous materials such as textiles hold pesticides by macro- and micro-occlusion in their complex structures. Amounts of pesticide residue were higher in carpets than on smooth floors, particularly for rural farm households where the farmer was a certified pesticide applicator. The maximum amount of pesticide residue on a smooth floor surface was 13.6 microg/m2 malathion while the maxima on wiped surfaces and in settled dust were 1.8 microg/m2 2, 4 D and 3 microg/m2 pendimethalin, respectively. Physical properties of individual pesticides such as vapor pressure influenced the distribution of the pesticide within the households. Evidence of volatilization of pesticides and redeposition on surfaces was observed, indicating that this is a mechanism for contamination of surfaces in addition to adsorption on airborne particles and tracking. High residues in winter are evidence that closure of households in winter that reduces ventilation results in redistribution of pesticides within households.

Dust↗
PubMedDate not supplied

Antibiotic consumption patterns and drug leftovers in 6000 Brazilian households.

Worldwide data indicate that antibiotics are frequently used indiscriminately. The present study used a questionnaire in an attempt to quantify and qualify outpatient antibiotic consumption habits, including when the drug was used, who recommended it, and to what extent treatment was completed, and to question householders on the presence of antibiotics in their homes, including leftovers from previous treatments. The questionnaire was distributed to residents of 6000 households that made up a representative sample of the Brazilian population and was completed by designated respondents from 4932 residences (82.2%) with or without field interviewer supervision. Each household reported an average of 3.7 treatments in the previous year, with amoxicillin the most frequently used antibiotic in this survey (18%), regardless of socioeconomic class. Most treatments were recommended through medical prescription, and this source of antibiotic was associated with the highest rate of completed therapy (80.4%). Azithromycin and ciprofloxacin produced the highest rates of completed treatment and the lowest rates of antibiotic leftovers. Storing antibiotics at home increases the cost of each treatment event, reduces efficacy, and may encourage the emergence of resistant organisms in the community. Educational efforts must be redoubled to promote the rational and effective use of drugs, especially antibiotics.

Adult↗
PubMed2002

The influence of work, household structure, and social, personal and material resources on gender differences in health: an analysis of the 1994 Canadian National Population Health Survey.

Data from the 1994 Canadian National Population Health Survey (NPHS) do not confirm the widespread assumption that women experience considerably more ill health than men. The patterns vary by condition and age and at many ages, the health of women and men is more similar than is often assumed. However, we should not minimize the gender differences that do exist and in this paper we focus on three health problems which are more common among women: distress, migraine and arthritis/rheumatism. We consider to what extent work, household structure and social, personal and material resources explain these gender differences in health. Analysis of the distributions of paid work conditions, household circumstances and resources reveal mostly minor differences by gender and differences in exposure to these circumstances contribute little to understanding gender differences in health. There is also little evidence that greater vulnerability is a generalized health response of women to paid and household circumstances. We find limited evidence that social, personal and material resources are involved in pathways linking work and home circumstances to health in ways that differ between the sexes. In conclusion, we consider some reasons for the lack of support for our explanatory model: the measures available in the NPHS data set which contains little information on the household itself; the difficulty of separating 'gender' from the social and material conditions of men's and women's lives; and changes in women's and men's roles which may have led to a narrowing of differences in health.

Adolescent↗
PubMed2004

DEET mosquito repellent provides personal protection against malaria: a household randomized trial in an Afghan refugee camp in Pakistan.

Synthetic repellents based on di-ethyl 3-methyl benzamide (DEET) are a popular method of obtaining protection from mosquitoes and yet clear evidence for a protective effect against malaria has hitherto never been convincingly demonstrated. A household randomized trial was undertaken among a study population of 127 families (25%) in an Afghan refugee village in Pakistan to compare the efficacy of repellent soap (Mosbar containing 20% DEET and 0.5% permethrin) vs. a placebo lotion. Cases of falciparum and vivax malaria were detected by passive case detection at the camp's clinic. At the end of the 6 month trial 3.7% (23 of 618) of individuals in the Mosbar group had presented with one or more episodes of falciparum malaria compared with 8.9% (47 of 530) of the placebo group (odds ratio 0.44, 95% CI 0.25-0.76). 16.7% of the Mosbar group (103 of 618) presented with vivax malaria compared with 11.7% (62 of 530) of the placebo group, and thus no effect was shown against vivax malaria (odds ratio 1.29, 95% CI 0.86-1.94). A considerable proportion of individuals (22%) had presented with vivax malaria during the 7 months leading up to the trial and thus any intervention effect would be partially masked by relapsed infections. The distribution of mosquitoes among households was broadly similar between Mosbar and placebo groups. The repellent was popularly received and very few side-effects were reported. There is a case for giving repellents more prominence in public health as a preventive measure in regions where vectors bite in the early evening or in emergency situations such as epidemics or newly established refugee camps.

Adolescent↗
PubMed1990

[Changes in economic well-being of families with children in Canada and Quebec over the last 15 years].

"This study analyses changes in the average real income of families with children [in Canada] over the 1971-1987 period. It presents the factual basis with which to evaluate changes in incomes at a variety of positions along the income distribution, focusing on poverty and income inequality. The study presents the sources of family income changes by emphasizing: the contributions of wives' earnings which affect total family income, the incidence of poverty as well as time available for leisure and child care; the role of government's cash transfers and personal income taxes." (SUMMARY IN ENG AND SPA)

Americas↗
PubMed1997

Demographic change and income inequality in the United States, 1976-1989.

"The U.S. economy experienced significant increases in the degree of income inequality over the past two decades.... In this paper we consider the effects of race, age, female headship, and college education on the distribution of family income by developing a multivariate methodology that allows us to gauge the influence of one factor while holding other determinants of family incomes constant. Over the period studied we find that race had only a minor effect on the overall size distribution of income. Age had a somewhat greater effect than race. In contrast, the impact of female heads and college education were quite substantial. The multivariate estimates reveal that the effects of female heads and college education both increase the Gini to a much greater extent than the progressivity of federal income taxes decreases it. The effects of college education and female headed families on inequality have grown larger across time, while the influence of age has declined. We find that the effects of race on inequality have changed little over the 1976 to 1989 period."

Age Factors↗
PubMed2002

Social risk management options for medical care in Indonesia.

This paper investigates the extent to which price subsidies for medical care are a suitable instrument to reduce household's exposure to catastrophic financial risks associated with ill-health in Indonesia. Using the 1995 SUSENAS household survey, the observed distribution of user fees and health expenditures is used to derive a distribution of 'needed' medical expenditures. The trade-off between the tax burden and effectiveness in reducing the exposure to catastrophic risk is analyzed for two existing price regimes along with a number of hypothetical regimes. We find that the existing regimes significantly reduce the exposure to catastrophic shocks but do not eliminate them. Simulations suggest that further reductions could be achieved if a larger proportion of government subsidies were directed to inpatient care. Subsidizing outpatient treatment is a cost effective policy to reduce exposure to catastrophic risks only for the very poor.

Adult↗
PubMed2000

Food security among preschool children.

A cross-sectional study of preschool children from 450 families from a residential colony of 'D' class hospital employees was undertaken to study food security & associated variables. Food security was established from (a) 24 hours recall method with 1 day weighment and (b) monthly food purchase inventory for cereals and pulses. Relationship between food secure status and variables of interest was studied from Chi-square value and odds ratio. Only 42.6% households and 54% preschool children from these households were calorically secure. Insecurity was the highest in 48-59 months age group. Per capital income, increasing birth order, family size, household size, less years of schooling of the mother, less than 4 meals per day and pulse insufficiency at home were associated with food insecurity. Per capita income ensures food availability at home. Family size and household size probably ensure distribution. Mother's education, frequent feeds more than four, ensure that it reaches the preschool children.

Child, Preschool↗
PubMed2005

Comparing the welfare effects of public and private health care subsidies in the United Kingdom.

We use a calibrated analytical model to compare the welfare costs (gross of externalities) of increasing subsidies for public and private health care in the UK. The model incorporates wait costs for rationed public care, burdens that subsidies impose on the tax system, and distributional weights for different households. Welfare costs are significantly higher for expanding public health care over a range of parameter scenarios. Both policies reduce average wait times, but for public health care this is offset by new waiting costs incurred on extra treatments. And the burden on the tax system is much larger for expanding public health care.

Delivery of Health Care↗
PubMed2001

Onchocerciasis control in Nigeria: will households be able to afford community-directed treatment with ivermectin?

OBJECTIVES: To determine the level of affordability of community-directed treatment with ivermectin (CDTI) to households living in two onchocerciasis endemic Nigerian communities namely Toro in the north and Nike in the south. METHODS: The proportion of the cost of treating people with ivermectin will deplete in average monthly/projected annual household expenditure on food and health care, and on average monthly and projected annual household income were respectively calculated and used to determine the level of affordability of CDTI. Questionnaires administered to heads of households or their representatives were used to collect information on the household expenditures and income. The suggested unit CDTI cost of $0.20 was used. However, as a test of sensitivity, we also used the unit cost of $0.056 which some community based distributors are charging per treatment. RESULT: Using $0.20 as the unit treatment cost, this will consume less than 0.05% of average annual household income in both communities. It will equally deplete 0.05% of combined annual household expenditures on food and health care in both communities. However, using $0.056 as the unit treatment cost, then 0.02% of average annual household expenditure on health care, 0.01% average annual expenditure on combined health care and food, and 0.01% of average annual household income will be depleted. CONCLUSION: The households living in both communities may be able to afford CDTI schemes. However, the final decision on levels of affordability lies with the households. They will decide whether they can afford to trade-off some household income for ivermectin distribution.

Adult↗
PubMed1995

Water sources and environmental transmission of multiply resistant enteric bacteria in rural Bangladesh.

The role of different water sources in the spread of multiply resistant enteric bacteria was investigated in rural Bangladesh. The prevalence of resistance to commonly used antimicrobial agents in the faecal flora of village children and the water quality and prevalence of resistance in village water sources were studied. Most of the children studied (81%) had multiply resistant faecal coliform bacteria, i.e. bacteria resistant to at least three antimicrobials. Although tubewells provided water with low faecal coliform counts, 62% of household storage pots contained water with moderate to high counts. Most of the storage pots (76%) and each of the river and pond sites tested contained multiply resistant isolates. Contamination of water within the household, and the widespread distribution of resistant coliforms in the environment, contribute to the high prevalence of multiply resistant enteric flora in the community. These findings are of importance in understanding the spread of multiply resistant enteric pathogens.

Ampicillin Resistance↗
PubMed1983

Headship rates and the household formation process in Great Britain.

"This paper looks at the changes in headship rates in Great Britain over the period 1960-1979, and attempts to explain them in terms of economic variables, such as real income and the real cost of housing. Such variables are found to be significant for some household types, but not for others. Notably, young single person household formation appears to be more supply constrained and to respond to appropriate supply variables." Furthermore, "some comparisons are made with similar studies done on similar data from the USA and France. These studies reveal a number of features in common, but also some differences, and these are commented upon."

Americas↗