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PubMed2001

Socio-economic differences in patterns of health and oral health behaviour in 25 year old Norwegians.

The purpose of this study was to test the hypothesis of multidimensionality of oral and general health behaviour. To evaluate the proposed behavioural dimensions, relationships with individual beliefs and socio-economic factors were explored. A simple random sample of 1190 residents born in 1972 was drawn from the populations of three counties in western Norway in February 1997. A questionnaire was mailed to the eligible sample. After one reminder, 735 subjects (58% women) replied. Principal component analysis (PCA) provided two factors, which accounted for 32.5% of the variance among the behavioural variables. One-way analysis of variance revealed significant, inverse relationships between two sum scores of health enhancing and health detrimental behaviour derived from the factors; socioeconomic variables and perceived vulnerability. Controlling for gender, multiple logistic regression analyses revealed significant relationships between health enhancing behaviour and occupational status (non-manual versus student, OR=0.6, 95% CI 0.4-0.8) and perceived vulnerability (OR=2.2, 95% CI 1.5-3.0). Occupational status (manual versus student OR=1.8 95% CI 1.2-2.6 and non-manual versus student OR=1.4 95% CI 1.0-2.1) turned out to be the strongest predictor of health detrimental behaviour. The present results indicate that oral and general health behaviour reflects two distinct behavioural domains. This appears to imply that oral and general health behaviour should be approached jointly in health promotion lifestyle programmes and that the lower socio-economic status groups should be targeted.

Adult↗
PubMedDate not supplied

Why did they lie? Socio-economic bias in reporting menarcheal age.

PRIMARY OBJECTIVE: To show that socio-economically dependent cultural bias distorts results of the status quo method of estimating age at first menstruation. METHODS: Questionnaires asking for menstrual status and the recalled age at menarche were distributed to approximately 1000 Javanese girls who attended junior and senior high schools in Malang. Age of participants ranged from 11.98 to 18.89 years. Probit analysis was applied to the status quo data while average menarcheal age recalled by girls > or =16 year old was also calculated. t-test, F-test, ANOVA and chi2 tests were applied to test significance of differences between groups. MAIN OUTCOMES AND RESULTS: Girls of low occupational status fathers (Group 1) had a probit average menarcheal age of 13.99 years (SD = 1.33, n = 524). Girls of medium occupational status fathers (Group 2), had a lower probit average menarcheal age (13.06 SD = 1.38, n = 315). Girls of fathers with the highest occupational score (Group 3) rarely reported premenarcheal status (less than 10% in all age groups studied) and the probit analysis of their reports yielded an unbelievable average of 9.61 (SD = 3.41, n = 157) years. Group 3 girls tend to report their menarcheal status incorrectly, probably due to a 'fashion' of appearing mature or to 'contagion' during filling out of a questionnaire. The recalled average menarcheal age of Group 3 females questioned when they were aged 16 years and above, yields an average that seems to be more reliable (12.74 years, SD = 1.41, n = 7), because at a fully postmenarcheal age there is no need to enhance one's status by falsely claiming maturity.

Adolescent↗
PubMed1997

Socioeconomic differences in hysterectomy: the Wisconsin Longitudinal Study.

OBJECTIVES: This study evaluated the relative gross and net predictive value of multiple socioeconomic status indicators for the likelihood of undergoing hysterectomy. METHODS: Data from a sample of Wisconsin Longitudinal Study women respondents (n = 3326) followed for 35 years were analyzed by means of multivariate logistic regression. RESULTS: Women's own higher occupational status and greater family net worth were significant net predictors of a lower likelihood of hysterectomy. Women's own education was a significant bivariate predictor. Mental ability did not account for the education effect. CONCLUSIONS: Higher education's association with a lower rate of hysterectomy is not due to ability, but to the opportunities that more-educated women have for higher-status employment and its health-related benefits. Measures of women's own occupational status should be included in future health surveys.

Educational Status↗
PubMed1997

[New methodological approaches to the study and assessment of health status in occupational medicine].

The authors present materials on work conditions and workers' health state, that necessitate urgent measures to increase living standards, to meet sanitary and hygienic demands, to preserve health through alternative methods (time-related defence, early rehabilitation), to set strict economic penalties for employers' higher concern for better work conditions. The topics discussed include consideration of complex hazards (effects of chemicals coming from various media, influence of occupational and household physical factors) in setting an Allowable Daily Dose. Regional peculiarities should be taken into account in hygienic standardization.

Absenteeism↗
PubMed1998

Mood disorders following traumatic brain injury: identifying the extent of the problem and the people at risk.

The extent of mood disorders following traumatic brain injury (TBI), and the possible risk factors, are investigated. New data are presented from a prospective study of consecutive hospital admissions. Six months post-TBI, 99 adults completed a standardized assessment of emotional state, the Wimbledon Self-Report Scale. Cognitive performance and the impact of the injury on everyday functioning were also assessed. The rate of clinically significant mood disorders (caseness) was 38%. Of the demographic or injury characteristics, only pre-injury occupational status predicted post-injury caseness. Those unoccupied pre-injury were more likely to report mood disturbance post-injury. In contrast, post-injury occupational status was not related to caseness either for the whole group or the subgroup of those previously occupied, despite the adverse effects on occupational functioning for a significant proportion of subjects. Associations were found between emotional state and cognitive and everyday functioning 6 months post-injury. Psychosocial disabilities appeared more strongly associated to mood disorders than did physical disabilities. A significant level of unmet need has been highlighted, and possible risk factors identified, which may inform the purchase and provision of TBI rehabilitation services. Follow-up data on these subjects are available and will be reported separately.

Activities of Daily Living↗
PubMed2006

Advances in medical technology and creation of disparities: the case of Down syndrome.

OBJECTIVES: We assessed socioeconomic differences in probabilities of prenatal diagnoses of Down syndrome and continuation of pregnancies after such diagnoses, along with the effects of these differences on disparities in live-birth prevalences of Down syndrome. METHODS: Using population-based data derived from 1433 cases of Down syndrome and 3731 control births, we assessed age-adjusted effects of maternal occupation and geographic origin on prenatal diagnoses, as well as overall and live-birth odds, of Down syndrome. RESULTS: Maternal occupation and geographic origin had significant effects on the probability of a prenatal diagnosis of Down syndrome and on continuation of pregnancy after such a diagnosis. Women in lower-status occupational categories had higher odds of delivering a live-born infant with Down syndrome. In comparison with women in the highest-status occupational category, the age-adjusted odds ratio for a Down syndrome live birth among women without an occupation was 2.4 (95% confidence interval [CI] = 1.7, 3.3). By contrast, there were no disparities in age-adjusted overall likelihood of Down syndrome. CONCLUSIONS: Socioeconomic differences in use of prenatal testing have created disparities in the live-birth prevalence of Down syndrome. Overall Down syndrome risk does not vary according to socioeconomic status.

Abortion, Eugenic↗
PubMed1991

The importance of employment status in occupational cohort mortality studies.

Person-years at risk in occupational cohort mortality studies may be defined as "active" (when a person is working) or "inactive" (after a person has left employment at the plant under study). To investigate the effects of employment status (active/inactive) both across studies and within them, we have analyzed ten large cohort studies conducted by the National Institute for Occupational Safety and Health in which no occupational risk had been observed. These ten data sets included 89,376 workers, 1,984,505 person-years, and 18,840 deaths. In these ten studies, the SMR for all causes was positively correlated with the percentage of inactive person-years in the study (r = 0.57, p = 0.08). Considering only inactive person-years, the all-causes SMR was 1.12 (approximately 1.25 before age 65, dropping to 1.00 after age 65). Stratification of inactive person-years by time-since-last-employment showed markedly increased mortality during the first year following employment. The all-causes SMR during active person-years was 0.40 and was fairly constant across age categories. With active and inactive person-years combined, a strong negative trend in SMRs with duration of employment was observed for all causes and for heart disease. These trends were not apparent when person-years were stratified by employment status. These results indicate that investigators should evaluate the effects of employment status when comparing SMRs between multiple cohorts or when interpreting trends in rate ratios within cohorts.

Cohort Studies↗
PubMed2001

Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the Third National Health and Nutrition Examination Survey.

OBJECTIVES: This study examined the associations of poverty income ratio (PIR), education, and occupational status with type 2 diabetes prevalence among African American and non-Hispanic White (White) women and men aged 40 to 74 years. METHODS: We analyzed cross-sectional data from the Third National Health and Nutrition Examination Survey, controlling for age and examination-related variables. RESULTS: Among African American women, there was a strong, graded association between PIR and diabetes, which remained significant after other risk factors were adjusted for. All 3 variables were significantly associated with diabetes among White women. Among White men, only PIR was significantly associated with diabetes. Controlling for risk factors substantially attenuated these associations among White women. There were no significant associations for African American men. CONCLUSIONS: Socioeconomic status is associated with type 2 diabetes prevalence among women, but not consistently among men. Diabetes prevalence is more strongly associated with PIR than with education or occupational status. These associations are largely independent of other risk factors, especially among African American women. Economic resources should be addressed in efforts to explain and reverse the increasing prevalence of diabetes in the United States.

Adult↗
PubMed1998

Ethnic stratification in northwest China: occupational differences between Han Chinese and national minorities in Xinjiang, 1982-1990.

The debate on market reforms and social stratification in China has paid very little attention to China's ethnic minorities. We explored rising occupational stratification by ethnicity in the Xinjiang Uygur Autonomous Region. Analyses of census data from 1982 and 1990 pointed to educational disadvantages faced by ethinic minorities as the most plausible explanation for the change. Multivariate analysis revealed a significant increase in the effect of education on high-status occupational attainment but no change in the effect of ethnicity. Net of education, ethnic differences in high-status occupational attainment were negligible. In contrast, large ethnic differences in manufacturing and agricultural occupations persisted after education and geography were statistically controlled.

Adult↗
PubMed2002

Prediction of employment status following traumatic brain injury using a behavioural measure of frontal lobe functioning.

OBJECTIVE: To examine whether a behavioural measure of frontal lobe functioning, the Brock Adaptive Functioning Questionnaire (BAFQ), could predict employment status following traumatic brain injury (TBI). DESIGN: A discriminant function analysis was conducted to determine the ability of the BAFQ, along with other factors, to predict occupational status post-injury. METHODS: Sixty-one TBI survivors completed a background information questionnaire, the BAFQ, and an employment status rating scale. RESULTS: A factor analysis of the BAFQ sub-scales revealed two factors, one related to functioning in the orbitofrontal area, and one related to dorsolateral frontal lobe functioning. These two factors, along with background information, were entered into a discriminant function analysis, revealing a 77.4% accuracy rate in predicting occupational status post-injury. CONCLUSIONS: Demographic variables were found to differentiate employed from unemployed survivors. The BAFQ appeared useful in differentiating survivors who may return to their pre-injury employment level from those who may require modified employment.

Adolescent↗
PubMed2001

Plasma and RBCs antioxidant status in occupational male pesticide sprayers.

A total of forty-one (n=41) male, healthy agricultural sprayers, exposed to pesticides for 5 years, were compared with twenty one (n=21) controls matched for age and economic status with respect to free radical generation, lipid peroxidation, antioxidant status and concentration of cellular enzymes were determined. Significantly increased TBARS (thiobarbituric acid reactive substances) were observed (P<0.001) in sprayer populations when compared to controls. The concentration of antioxidants such as glutathione (GSH), alpha-tocopherol, ascorbic acid and ceruloplasmin were significantly altered when compared to controls, and the activities of antioxidant enzymes were remarkably elevated (P<0.001) in sprayer populations, when compared to controls.

Adult↗
PubMed2005

Father's occupational group and daily smoking during adolescence: patterns and predictors.

OBJECTIVES: We investigated the relationship among father's occupational group, daily smoking, and smoking determinants in a cohort of New Zealand adolescents. METHODS: The longitudinal Multidisciplinary Health and Development Study provided information on adolescents' self-reported smoking behavior and potential predictors of smoking, such as social and material factors, personality characteristics, educational achievement, and individual attitudes and beliefs regarding smoking. Longitudinal logistic generalized estimating equation analyses were used. RESULTS: Adolescents whose fathers were classified in the lowest-status occupational group were twice as likely as those whose fathers occupied the highest-status occupational group to be daily smokers. This high risk of daily smoking among the adolescents from the lowest occupational group was largely predicted by their lower intelligence scores and by the higher prevalence of smoking among fathers and friends. CONCLUSIONS: To prevent socioeconomic differences in smoking, school-based interventions should seek to prevent smoking uptake among adolescents, particularly those of lower socioeconomic status. Programs need to provide positive, nonsmoking role models consonant with the culture and norms of lower-socioeconomic-status groups. Adolescents need to acquire resistance skills and protective behaviors against social pressure and influences.

Adolescent↗
PubMed1995

Socioeconomic differences in sexually transmitted disease rates among black and white adolescents, San Francisco, 1990 to 1992.

This paper examines the effect of socioeconomic position on the differences in the 3-year rates (1990 to 1992) of reported cases of gonorrhea and chlamydia between Black and White adolescents, aged 12 to 20 years, residing in San Francisco. The crude relative risks for Blacks were 23.4 (95% confidence interval [CI] = 20.4, 27.8) for gonorrhea and 9.3 (95% CI = 8.3, 10.3) for chlamydia. Adjusting for poverty and occupational status, the relative risks were 28.7 (95% CI = 22.5, 36.1) for gonorrhea and 8.9 (95% CI = 7.4, 10.6) for chlamydia. This study demonstrates that factors other than poverty and occupational status account for the racial/ethnic differences in the rates of gonorrhea and chlamydia among adolescents in San Francisco.

Adolescent↗
PubMed2000

Leisure-time, occupational, and household physical activity among professional, skilled, and less-skilled workers and homemakers.

BACKGROUND: Adults in lower status occupations are at higher risk of premature cardiovascular disease, for which physical inactivity is a major risk factor. While lower rates of leisure-time physical activity have been found to be associated consistently with lower income and education levels, the association between occupational and home-based physical activity with membership of different occupational categories is not well understood. METHODS: An urban-representative population data set derived from a self-completion questionnaire was used to examine both self-reported leisure-time physical activity and a combined measure of occupational/home-based physical activity of adult less-skilled, skilled, and professional workers and homemakers (3795 males; 4140 females). chi(2) analyses, ANOVA, and logistic regressions were used to examine the associations between occupational group membership and physical activity. RESULTS: After adjustment for age, body mass index, education, country of birth, marital status, and smoking, less-skilled workers were less likely to report any form of leisure-time physical activity. However, occupational category was not a strong predictor of participation in combined vigorous occupational/home physical activity. Homemakers and those in lower status occupations were less likely to report participation in vigorous leisure-time physical activity sufficient for cardiorespiratory fitness. With the inclusion of time spent in combined vigorous occupational/home physical activity, there was no longer an association of activity with occupational status for males. However, for females the association remained. CONCLUSIONS: The assessment of occupational and household physical activity in addition to leisure-time activity may be important for understanding associations between occupational categories, physical activity, and increased levels of health risk and for the development of physical activity promotion strategies.

Adult↗
PubMed1986

Urinary excretion of benzidine in relation to the acetylator status of occupationally exposed subjects.

Twenty-four male workers engaged in the manufacture of benzidine dihydrochloride for 1-4 years were included in this study. Urinary levels of free benzidine were estimated by high-pressure liquid chromatography in all the workers. Acetylator status of the workers was determined with sulphamethazine. There was substantial absorption of benzidine over an 8-h work shift. A significant correlation was observed between the rate of sulphamethazine acetylation and urinary excretion of free benzidine.

Acetylation↗