Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health determinants”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2005

Neglected diseases of neglected populations: thinking to reshape the determinants of health in Latin America and the Caribbean.

BACKGROUND: People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation. DISCUSSION: Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations. SUMMARY: The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can contribute to the achievement of the Millennium Development Goals.

Animals↗
PubMed1992

Living arrangements, knowledge of health risks, and stress as determinants of health-risk behavior among college students.

The association of knowledge of health risks, living arrangements, and perceived stress with health-risk behaviors was examined in a sample of college students included in the Health Promotion and Disease Prevention Supplement of the National Health Interview Survey. Regressions of each health-risk behavior (dependent variable) were performed on the predicted correlates. Although knowledge was not associated with participation in physical activity or smoking, the study found that students who knew more about the harmful effects of alcohol drank less, and those with greater knowledge of health risks practiced fewer risky behaviors. Students living independently were more likely to smoke, and those living in residence halls were less like to do so. Drinking, however, was more common among students living in residence halls or independently than among those living at home. Hall residents engaged in more group physical activity than other students did, but their physical activity was unrelated to health-risk behaviors. Stress was associated with smoking but not with other health practices. The findings suggest that smoking may be less influenced by health knowledge and more associated than drinking is with a response to stress. Drinking appears to be a social activity associated with living among peers and is potentially modifiable by increased knowledge about the effects of alcohol on health.

Adolescent↗
PubMed1981

Refinements in the Measurement of health-specific locus-of-control beliefs.

A health-specific locus-of-control (HLC) questionnaire was constructed to measure beliefs about Self-Control Over Health, Provider Control Over Health, Chance Health Outcomes and General Health Threat. A factor analysis of items confirmed these dimensions, and corresponding scales were shown to be reliable. A factor analysis of HLC scales and other measures was used to evaluate construct validity. Persons believing in provider control over health outcomes tended to have strong favorable attitudes toward the quality of medical care. Chance Health Outcomes was associated with more general chance and controllability measures. General Health Threat seemed to tap susceptibility to disease and beliefs that doctors are unable to diagnose those diseases. People who believe in Self-Control Over Health tended to reject the role of chance and health threat in determining health outcomes and to believe in the efficacy of doctors, although they view them as inaccessible. Results are compared with those of previous studies, and some applications of the questionnaire are discussed.

Adolescent↗
PubMed2002

Policy requirements and performance indicators for good practice in workplace health: public health perspectives.

The author lists the main objectives, work areas and benefits of good practice in health, environment and social management in enterprises (GP HESME). History of this cross-sectoral and multidisciplinary approach to management of occupational, lifestyle, environmental and social health determinants is outlined. Health policy requirements and performance indicators are provided to facilitate GP HESME implementation at the enterprise and local levels. The role of local authorities and networking of enterprises, representing various sectors is highlighted.

Health Policy↗
PubMedDate not supplied

How can local health agencies improve health knowledge and skills of child care centre operators?

As the number of child care centres increases across Canada, local health agencies are increasingly involved in health issues within these facilities. 90% of operators of the 98 child care centres in an Ontario community responded to a mail survey distributed by the local health unit to determine health needs in these facilities. Infectious disease was reported to be the major health problem of the children. 76% of operators requested information about infectious diseases, in particular through use of written materials made available to their centre. The level of education of operators was high with 79% having completed community college courses. Over 70% of operators had attended continuing education sessions or workshops on child abuse, growth and development and nutrition; fewer operators reported attending sessions on infectious diseases, child safety, parent-child relationships and dental health. As a result of the needs assessment, a health unit multidisciplinary team has met and initiated a number of activities including meeting with child care centre operators, publication of newsletter for operators, and development of educational materials.

Child↗
PubMedDate not supplied

Prevention and treatment of osteoporosis in chronically ill children.

Osteoporosis secondary to chronic disease in children has emerged as a major health issue. As the severity of a child's illness increases, so too does the number of factors affecting their bone health. Determinants of bone health in children include level of mobility, exposure to osteotoxic medication, nutritional status, calcium and vitamin D intake, chronic inflammation and pubertal development.

Adolescent↗
PubMed1986

Preschool children's conceptions of health and health behaviors.

Conceptions of health and health related behaviors of 41 four and five year olds were explored, using a picture-interview guide. Areas of interest included feeling tone associated with health, identification of children who are healthy, health promotion behaviors, behaviors deleterious to health, and individuals who help children stay healthy. Subjects' responses to selected questions were scored; choices from groups of pictures concerned with health promotion behaviors and persons who help in maintaining health were ranked, depending on order of selection. Most subjects were able to make the correct association between feeling tone and health status, and determine health status of depicted children. Health promotion behaviors selected--in descending order of mean ranking--were eating, visiting the doctor, brushing teeth, sleeping, running, and washing hands. Most subjects could correctly identify behaviors hazardous to health. Chi-square revealed no significant differences in scores or rankings by age or sex. Subjects in the lowest of the three family income groups tended to have lower scores.

Age Factors↗
PubMedDate not supplied

Executive summary.

The Canadian health system is at a crossroads. Significant health services restructuring is occurring across the country. This restructuring process provides a unique opportunity for Public Health and others to reorient the system away from illness to a focus on health--the health of individuals and communities. The purpose of this paper is to motivate and equip Public Health workers to take leadership in the restructuring, to outline key responses and strategies for Public Health associations, to raise public awareness about restructuring, and to challenge decision makers to integrate the Public Health perspective into the restructured health system. This Issue Paper describes the unique contributions Public Health has to offer health services restructuring, outlines the Public Health response to specific restructuring issues, and identifies some successful strategies for influencing change. Two key messages are explored in the paper: 1. Restructuring will be successful if it is based on an investment in health. The health of the public can be maintained and improved through changes to the institutional sector and support for health promotion, disease prevention and health protection services. 2. Public Health must be a full partner in the restructuring of health services. The Public Health perspective includes a broad understanding of the issues that are relevant to the health of individuals and communities. The skills and knowledge base offered through Public Health provide balance and equity in decision making, by ensuring full and representative involvement of community workers and the public. The uniqueness of Public Health is manifested in three distinct ways: its approach within an organized system of practice; its historical contribution; and its purposeful combination of perspectives, skills and knowledge. In partnership with communities, other health professionals and other health-determining sectors, Public Health works to protect, maintain and improve the health of Canadians. While other sectors undertake some of the functions outlined below, what makes Public Health unique is that these contributions are offered collectively through an organized system of practitioners to create a synergistic effect. Eight contributions of Public Health are identified in this paper. Specifically Public Health: Focuses on individuals and communities in a societal and global context. Builds capacity in individuals and communities to improve health. Facilitates community mobilization through community participation. Embraces promotion, prevention, protection. Influences the orientation of the health system toward health outcomes. Provides disease surveillance and control. Builds partnerships among sectors at the local level. Advocates for the health of the public. In addition to describing these contributions, the Issue Paper addresses the major trends in health services restructuring by providing an overview of the issues and outlining the Public Health response. While there is no one single model of restructuring occurring in the provinces and territories, many common themes exist. This paper highlights four categories of restructuring issues: I. Making a Difference in Health II. Skills and Knowledge Base III. Allocation of Financial Resources IV. Governance and Management.(ABSTRACT TRUNCATED AT 400 WORDS)

Canada↗
PubMed1999

The prevalence and determinants of health care-seeking behavior for urinary incontinence in United Arab Emirates women.

The aim of this study was to determine the prevalence and sociodemographics of urinary incontinence (UI) in women in the United Arab Emirates (UAE). Women at risk, such as multiparous and climacteric women, were selected from the community (n = 200) and health-care centers (n = 200) and interviewed about inappropriate urine loss in the past 12 months, using a structured and pretested questionnaire. Of these, 81 (20.3%) admitted UI; only 25 of these (30.9%) had sought medical advice. The reasons were embarrassment (38.2%), choice of self-treatment because of low expectations from medical care (38.2%), and preferring to discuss the matter with friends, assuming that UI is normal (23.3%). Sufferers were troubled by their inability to pray (90%) and to have sexual intercourse (33.3%). Perceived causes of UI were paralysis (45%), childbirth (35.4%) and old age or menopause (33.7%). UI is common yet underreported by UAE women because of cultural attitudes and inadequate public knowledge.

Adult↗
PubMed2001

The prevalence and determinants of health care-seeking behavior for fecal incontinence in multiparous United Arab Emirates females.

PURPOSE: This study was designed to determine the prevalence and sociodemographics of fecal incontinence in United Arab Emirates females. METHODS: A representative sample of multiparous United Arab Emirates females aged 20 years or older (N = 450) were randomly selected from the community (n = 225) and health care centers (n = 225). Patients were interviewed about inappropriate stool loss in the past year using a structured and pretested questionnaire. RESULTS: Fifty-one participants (11.3 percent) admitted fecal incontinence; 26 (5.8 percent) were incontinent to liquid stool and 25 (5.5 percent) to solid stool. Thirty-eight patients (8.4 percent) had double (urinary and fecal) incontinence. Sixty-five patients (14.4 percent) were incontinent to flatus only but not to stools. The association between having fecal incontinence and chronic constipation was significant (P < 0.0001), but there was no significant association with other known risk factors such as age, parity, and previous instrumental delivery, episiotomy, perineal tears, or anorectal operations. Only 21 incontinent patients (41 percent) had sought medical advice. Patients did not seek medical advice because they were embarrassed to consult their physician (64.7 percent), they preferred to discuss the difficulty with friends, assuming that fecal incontinence would resolve spontaneously (47.1 percent) or was normal (31.3 percent), and they chose self-treatment as a result of low expectations for medical care (23.5 percent). Sufferers were bothered by the inability to pray (92.2 percent) and to have sexual intercourse (43.1 percent). Perceived causes of fecal incontinence were paralysis (90.2 percent), old age (80.4 percent), childbirth (23.5 percent), or menopause (19.6 percent). CONCLUSIONS: Fecal incontinence is common yet underreported by multiparous United Arab Emirates females because of cultural attitudes and inadequate public knowledge.

Adult↗
PubMedDate not supplied

Can life expectancies be used to determine if health promotion works?

PURPOSE: The goal of this study was to develop a method to measure the impact and cost-effectiveness of health promotion. DESIGN: Age- and sex-specific changes in life expectancy in Canada between 1970 to 1972 and 1985 to 1987, after the introduction of national health insurance (1970) and health promotion (1975), are used to assess the impact due to biological hardiness, improvements in the health care field, and the effects of health promotion. SUBJECTS: The subjects were the total male and female population of Canada between the years 1970 to 1972 and 1985 to 1987. MEASURES: Life expectancy by years of age by sex was the measurement used. RESULTS: A method is presented that allows the calculation of the differential effects of health promotion, health care, and biological hardiness on changes in life expectancy based on sequential subtraction of life expectancies for one-year age cohorts over a 15-year period. Results were obtained for each year of age for men and women, showing gender and age differences in the relative impact of the three factors. In this illustrative example using Canadian data, health promotion was found to have less impact on longevity than health care or biological hardiness. However, of the three, health promotion was the most cost-effective. CONCLUSION: This method can be used to quantify changes in life span due to health promotion, health care, and biological hardiness for men and women at each year of age and to relate this to health expenditures for the whole population. The method is limited in that it cannot determine the relative impact of other factors that can affect life expectancy such as environmental changes or social trends.

Age Factors↗
PubMed1984

The determinants of health policy, a case study: regulating safety and health at the workplace in Sweden.

This article analyzes and criticizes the " technocratic " view of occupational health and safety policies, which sees the values of the personnel in "post-industrial" regulatory agencies as the most important determinant of those policies. It takes an alternate position, which explains occupational health and safety policies as primarily resulting from the different degrees of political power of the two major classes (capital and labor), and from the set of influences exerted on the regulatory agencies by the instruments (e.g., parties, unions, trade organizations) of those classes. It shows how an analysis of the historical evolution of those classes in Sweden and their conflict in both civil and political societies explains Swedish occupational health and safety policies better than a mere analysis of the regulators' views. And it concludes that the occupational health and safety policies in Sweden are not identical to those in the U.S.--as the " technocratic " theorists assume--but rather offer more protection to the workers than U.S. policies do. This situation is a result of labor having more power in Sweden than it has in the U.S. The different class formations and class behavior in the two societies are compared, and the implications of this comparison for occupational health and safety policies are discussed.

Accidents, Occupational↗
PubMed2000

Determinants of health-promoting behavior among women ages 65 and above living in the community.

This study utilized Pender's Health Promotion Model to investigate through canonical correlation analysis the role that select cognitive-perceptual factors (health self-determinism, learned helplessness, self-esteem, and perceived health) and modifying factors (age, race, marital status, education, and income) play in understanding participation of community-living older adult women (age > or = 65) in the health-promoting behaviors of health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management. These were measured by the Health-Promoting Lifestyle Profile II in a convenience sample of 107 community-living older adult women (mean age 76.7 years). Gender-specific benefits and barriers to participating in health-promoting behaviors were also explored using open-ended questions. Two significant canonical variates were demonstrated. These indicated that age, marital status, race, education, and self-esteem and the two health-related factors of perceived health and health self-determinism made statistically significant contributions to the health-promoting behaviors of physical activity, nutrition, spiritual growth, and interpersonal relations. Benefits identified included better psychological well-being, coping with the general issues of aging, social interaction, improved function, and management of existing health problems. Internal barriers focused on perceived physical difficulties with all types of health-promoting behaviors; external barriers included aspects of the activity itself, lack of support from others and structural barriers. Study results suggest that older adult women (age > or = 65) participate in health-promoting behaviors for both health enhancement and health management reasons and that barriers may be a more important determinant of older women's health-promoting lifestyle behaviors than previously described in the model.

Aged↗
PubMed2005

Determinants of health utility in lung and heart-lung transplant recipients.

Bronchiolitis obliterans syndrome (BOS) is associated with poor health-related quality of life (HRQL) following lung and heart-lung transplantation, but few other determinants of HRQL have been described. We performed a cross-sectional study of standard gamble utility, a preference-based measure of HRQL, in 90 stable lung and heart-lung transplant recipients. We used bivariate analyses and multiple linear regression to evaluate associations between utility scores and candidate predictor variables including age, sex, indication for transplant (obstructive, interstitial, suppurative and pulmonary vascular diseases), transplant type (bilateral, single and heart-lung), time since transplant, body mass index, arterial PO(2), creatinine clearance, number of medications, presence of BOS and risk-attitude score. The median utility was 0.88 (inter-quartile range: 0.50-0.99). Multivariable analysis showed that female sex, absence of BOS, better renal function and longer time since transplantation were associated with higher utility scores, and that there were utility differences across diagnostic groups. Although BOS is a major determinant of utility following lung and heart-lung transplantation, other demographic and clinical factors are also associated with significant differences in this measure of HRQL.

Adolescent↗
PubMedDate not supplied

Achieving safe motherhood: applying a life course and multiple determinants perinatal health framework in public health.

Safe motherhood has begun to be identified as a priority for the health of American women. We argue that safe motherhood can be achieved through application of a life course and multiple determinants framework. This framework, with its focus on the preconception period, poses a dilemma in that it links together periods of life and domains of activities that have traditionally not been linked with maternal health. The interests of women and children have often been juxtaposed in the making of policy. Further, the domains of women's health, maternal and child health, and family planning have often clashed over policy priorities and funds. This framework shows that the research literature now links them inextricably to better health outcomes, albeit indirectly; there are no intervention studies that have demonstrated the empirical efficacy of this approach. Thus, although this framework creates a strong rationale for the linkages described, it also demands attention to a set of implementation strategies that will overcome existing barriers. Through a focus on one maternal factor, obesity, we discuss how a range of strategies grounded in the framework can be undertaken to address maternal morbidity and mortality. We then examine selected strategies at each level of the multiple determinants life course framework and emphasize how public policies and public and private sector professional practice can be reexamined to improve outcomes for women in all time periods and aspects of reproductive potential, which in turn might enhance outcomes for their offspring, both at birth and beyond. Our intent is to influence how policy makers, public health professionals, clinicians, and researchers approach safe motherhood.

Female↗
PubMed1999

Cognitive functioning and health as determinants of mortality in an older population.

The authors studied whether the ability of cognitive functioning to predict mortality is pervasive or specific, and they considered the role of health in the cognition-mortality association. Data were taken from a sample of 2,380 persons aged 55-85 years who took part in the Netherlands' Longitudinal Aging Study Amsterdam in 1992-1993. Five cognitive measures were distinguished: general cognitive functioning, information processing speed, fluid intelligence, learning, and proportion retained. Mortality data were obtained during an average follow-up period of 1,215 days. Cox proportional hazards regression models revealed that all cognitive functions predicted mortality independent of age, sex, education, and depressive symptoms. When health (self-rated health, medication use, physical performance, functional limitations, lung function, specific chronic diseases) was also taken into account, information processing speed, fluid intelligence, and proportion retained remained independent predictors of mortality, whereas the ability of general cognitive functioning and learning to determine mortality was lost. The authors concluded that the ability of cognitive functioning to predict mortality is pervasive to all cognitive functions that were included in the study when age, sex, education, and depressive symptoms are considered and is more specific to some functions when also controlling for health.

Activities of Daily Living↗