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PubMed2003

Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents.

OBJECTIVE: To examine family meal patterns and associations with sociodemographic characteristics and dietary intake in adolescents. DESIGN: A population-based cross-sectional study design was employed. Adolescents completed the Project EAT (Eating Among Teens) survey and the Youth and Adolescent Food Frequency Questionnaire within their schools. Subjects/setting The study population included 4,746 middle and high school students from Minneapolis/St. Paul public schools with diverse racial and socioeconomic backgrounds. Statistical analyses Associations were examined using cross tabulations, log-linear modeling, and linear regressions. RESULTS: There was a wide distribution in the frequency of family meals during the previous week: never (14.0%), 1 or 2 times (19.1%), 3 to 6 times (40.1%), and 7 or more times (24.8%). Sociodemographic characteristics associated with more frequent family meals included gender (boys), school level (middle school), race (Asian American), mother's employment status (not employed), and socioeconomic status (high). Frequency of family meals was positively associated with intake of fruits, vegetables, grains, and calcium-rich foods and negatively associated with soft drink consumption. Positive associations were also seen between frequency of family meals and energy; protein (percentage of total calories); calcium; iron; folate; fiber; and vitamins A, C, E, and B-6. CONCLUSIONS: Family meals appear to play an important role in promoting positive dietary intake among adolescents. Feasible ways to increase the frequency of family meals should be explored with adolescents and their families.

Adolescent↗
PubMed1994

[Factors associated with utilization of hospital emergency services by alcoholic patients in a follow-up study of 18 months].

BACKGROUND: This paper assesses the use of hospital emergency services by alcoholics in clinical treatment for a period of 18 months and looks for possible sociodemographic and clinical explanatory variables associated with use of those services. METHODS: A prospective study of a cohort of male alcoholics (n = 137) which began medical treatment because their alcoholism in outpatient or inpatient facilities. Information was assembled by means of a structured interview on sociodemographic and clinical variables, including the Michigan Alcoholism Screening Test (MAST) and the General Health Questionnaire (GHQ-60). RESULTS: Sixty-five percent of alcoholics (n = 88) attended the emergency services at least once during the 18 months of follow-up, and 25% (n = 34) did use them more than three times. The politomous logistic regression models point to the age (OR = 0.95; 95% CI = 0.92-0.98); MAST score (OR = 1.1; 95% CI = 1.0-1.2); and employment status (unemployed vs. employed, OR = 2.1; 95% CI = 1.0-4.4) as the main predictors for heavy attendance of emergency service. CONCLUSIONS: The relevance in this study of age, employment status, and alcohol-related problems experienced (MAST), as well as taking into account that 36% of attended emergencies were because drunkenness or demanding disintoxication treatment, point to the non-sanitary problems which emergency services might be looking after, at least for some alcoholics whom do not seem to adhere to regular treatment programs.

Adult↗
PubMed1997

Sociodemographic predictors of response to antidepressant treatment.

OBJECTIVE: Our goal was to assess whether sociodemographic variables such as gender, marital status, level of education, and employment status are related to the changes in social functioning that have been reported after drug treatment in outpatients with major depressive disorder. METHOD: Eligible subjects were 166 depressed outpatients participating in a study involving open treatment with fluoxetine 20 mg/day for eight weeks. Diagnosis of major depressive disorder was made with the use of the Structured Clinical Interview for DSM-III-R-Patient Edition (SCID-P), and patients were required to have a seventeen-item Hamilton Rating Scale for Depression (HAM-D-17) score > or = at study entry. All subjects were administered the HAM-d-17 and the Social Adjustment Scale-Self-Report (SAS-SR) before and after treatment with fluoxetine. RESULTS: We found that SAS-SR scores decreased significantly following treatment with fluoxetine from a mean score at baseline of 2.6 +/- 0.7 to a mean score at endpoint of 2.3 +/- 0.6. After adjusting for the degree of change in HAM-D-17 scores, we found a significant relationship between degree of change in SAS-SR and level of education. No statistically significant relationships were observed between SAS-SR change and age, gender, marital status, and employment status. CONCLUSION: The degree of improvement in psychosocial functioning observed in depressed outpatients following antidepressant treatment appears to be related to the level of education at study entry, but not to other sociodemographic variables. Further studies need to investigate the nature of this relationship.

Adult↗
PubMed1978

Employment patterns of male methadone maintenance patients.

The employment patterns of 342 male methadone maintenance patients who remained in treatment for at least 1 year are examined. Four periods in the patients' lives are considered: (1) the period before addiction, (2) the period of addiction, (3) the time of entry into the treatment program, and (4) the first treatment year. Although more than three-quarters of the patients were employed regularly during the period before addiction, only about one-quarter were employed while addicted. At entry into the program 15% were employed, and 25% worked regularly during the first treatment year. An examination of some semographic, social, and work-related correlates of employment status during each period revealed that factors such as ethnicity, educational attainment, marital status, alcohol use, previous employment, and attitudes toward work were all important in relation to patients' employment status at one or more of the four periods. The treatment program had only a moderate impact on patients' attitudes toward work and employment behavior.

Adolescent↗
PubMed1987

Population dynamics and consumer demand.

The authors analyze the effects on consumption in the United States of 11 demographic variables, including "regional location and the urban/rural base of the household, its age, size, race, sex and marital characteristics, and the education and the employment status of the household head and the spouse." Data are from the 1972-1973 Consumer Expenditure Survey. The expenditure functions are first specified, followed by descriptions of the data sources and the empirical estimates of expenditure functions for various items of consumption spending.

Age Factors↗
PubMedDate not supplied

Are veterans seeking Veterans Affairs' primary care as healthy as those seeking Department of Defense primary care? A look at Gulf War veterans' symptoms and functional status.

OBJECTIVE: This study compared Gulf War veterans seeking VA primary care with Gulf War veterans seeking treatment from a Department of Defense primary care clinic on measures of physical symptoms, psychiatric complaints, and functional status. Additionally, the association between employment status and health was examined. METHODS: Analysis was based on the responses of consecutive patients attending the Gulf War Primary Care clinics at either the VA Puget Sound Health Care System in Seattle, WA (N= 223), or the Walter Reed Army Medical Center in Washington, DC (N= 153), between March 1998 and September 1999. RESULTS: After controlling for demographic variables, Gulf War veterans who sought VA care reported significantly more anxiety and PTSD symptoms than active duty military personnel. The groups did not differ on somatic complaints or summary scores from the SF-36. Employment status was significantly, independently, and consistently associated with greater psychiatric symptoms, physical symptoms, and decreased functional status. CONCLUSIONS: Our findings reveal important differences in health status between veterans seeking primary care at a VA and a Department of Defense facility, differences that are in part related to employment status. Both groups report symptoms of psychiatric distress and decreased functional status, though VA patients are more impaired. Research findings based on clinical samples of veterans at VA sites may not generalize to Gulf War veterans still on active duty (and vice versa).

Adult↗
PubMed1996

Negative bias in exposure-response trends in occupational studies: modeling the healthy workers survivor effect.

Many occupational studies analyze trends between cumulative exposure and mortality. The authors show that such trends are, in general, negatively confounded by employment status. Mortality rates for workers who leave work ("inactive" workers) are higher than for active workers because some workers leave because they are ill. The percentage of inactive relative to active person-time is higher in low categories of cumulative exposure, causing employment status to act as a negative confounder of exposure-response trends (the opposite occurs for time-since-hire). We illustrate these phenomena using 10 "negative" mortality studies, in which adjustment for employment status removes false trends. However, adjustment for employment status will lead to biased estimates when it acts as an intermediate variable between cumulative exposure and death, as occurs directly when exposure causes a disabling disease that, in turn, causes death or indirectly when exposure causes workers to leave work. The authors illustrate this problem using simulated follow-up data for leaving, disease incidence, and mortality. In the null case in which cumulative exposure affects neither disease incidence (or mortality) nor leaving rates, employment status indeed acts as a negative confounder of exposure-response trends, and traditional adjustment eliminates this confounding. However, when cumulative exposure affects disease incidence or rates of leaving, adjustment for employment status will not be adequate. Employment status falls under the general rubric of variables that are simultaneously confounders and intermediate variables.

Bias↗
PubMed1991

An epidemiologic study on differences in health status between employed men and women in Hawaii.

Differences in health status between employed men and employed women were examined. 56,203 participants in a stratified random sample of Hawaii's adult population were interviewed during 1981-1986 in the Hawaii Health Surveillance Program. Multiple regression analysis controlling for sociodemographic and occupational variables showed that although the differences were small, employed women reported more health problems than employed men, especially acute conditions and those requiring more hospital services. The findings of this study indicate a need for further study to understand the nature of the observed differences and to develop relevant preventive programs.

Adolescent↗
PubMed2006

Mental health functioning (SF-36) and intentions to retire early among ageing municipal employees: the Helsinki Health Study.

AIMS: To examine the associations of mental health functioning with intentions to retire early among ageing municipal employees. METHODS: Cross-sectional survey data (n = 7,765) from the Helsinki Health Study in 2000, 2001, and 2002 were used. Intentions to retire early were sought with a question: "Have you considered retiring before normal retirement age?" The dependent variable was divided into three categories: 1 = no intentions to retire early; 2 = weak intentions; 3 = strong intentions. Mental health functioning was measured by the Short Form 36 (SF-36) mental component summary (MCS). Other variables included age, sex, physical health functioning (SF-36), limiting longstanding illness, socioeconomic status, and spouse's employment status. Multinomial regression analysis was used to examine the association of mental health functioning with intentions to retire early. RESULTS: Employees with the poorest mental health functioning were much more likely to report strong intentions to retire early (OR 6.09, 95% CI 4.97-7.47) than those with the best mental health functioning. Adjustments for physical health, socioeconomic status, and spouse's employment status did not substantially affect this association. CONCLUSIONS: The findings highlight the importance of mental health for intentions to retire early. Strategies aimed at keeping people at work for longer should emphasize the importance of mental well-being and the prevention of poor mental health. More evidence is needed on why mental problems among ageing baby-boomer employees are giving rise to increasing social consequences, although the overall prevalence of mental problems has not increased.

Adult↗
PubMed1985

Employment, marital status and alcohol consumption of young Canadian men.

This article focuses on heavy alcohol consumption among young Canadian men drinkers aged 15-29 and examines how employment status and marital status interact with age. The study found that the highest percentages of heavy drinkers occurred in men over the age of 18 who are single (divorced, separated or never married) and in the labor force, whether employed or unemployed. This study, based on cohort data, generated hypotheses that need to be tested with longitudinal data in order to better understand developmental differences and other factors that affect drinking practices.

Adolescent↗
PubMed2002

Which aspects of socioeconomic status are related to obesity among men and women?

OBJECTIVE: This study aimed to investigate the relationships between body weight and fat distribution, and four empirically derived domains of socioeconomic status: employment, housing, migration status and family unit. DESIGN: A population-based study was used. PARTICIPANTS: A total of 8667 randomly-selected adults (4167 men; 4500 women) who participated in the 1995 Australian National Health and Nutrition Surveys provided data on a range of health factors including objective height, weight and body fat distribution, and a range of sociodemographic indicators. RESULTS: Results demonstrated associations for women, after controlling for age, between the employment domain, and body mass index and waist-to-hip ratio. Low status employed women were 1.4 times as likely to be overweight as high status employed women. There were less consistent relationships observed among these factors for men. Relationships between family unit and indicators of body weight and body fat distribution were observed for both men and women, with those who were married, particularly men (OR = 1.6, 95% CI 1.4-2.0), at higher risk of overweight. The migration and housing socioeconomic status domains were not consistently associated with body mass index or waist-to-hip ratio. CONCLUSIONS: These findings indicate that different components of socioeconomic status may be important in predicting obesity, and thus should be examined separately. Future research would benefit from investigating the underlying mechanisms governing the relationships between socioeconomic status domains further, particularly those related to employment and family unit and obesity.

Adipose Tissue↗
PubMed2003

Using the SF-36 measure to compare the health impact of multiple sclerosis and Parkinson's disease with normal population health profiles.

OBJECTIVE: To examine the relative impact of two chronic neurological disorders, multiple sclerosis and Parkinson's disease, by comparing patients' scores on the medical outcomes study 36-item short form health survey (SF-36) with the health profile of the United Kingdom population norms. METHODS: 638 people representing the full spectrum of multiple sclerosis and 227 patients with Parkinson's disease were studied. Health status was measured by the SF-36. Scores for the eight health domains were compared after controlling for age, sex, disease duration, mobility, social class, ethnicity, education, marital status, and employment status. RESULTS: People with multiple sclerosis and those with Parkinson's disease had significantly worse health than the general population on all eight domains measured by the SF-36. The relative impact of multiple sclerosis and Parkinson's disease were similar, but multiple sclerosis resulted in poorer scores on physical functioning and better scores in mental health. People with mild multiple sclerosis who walked without an aid also had significantly worse scores in all dimensions than the general UK population. CONCLUSIONS: The results highlight the need for further research into aspects of health measured by the SF-36. Nevertheless, generic measures that are applicable across multiple diseases may fail to address clinically important aspects of the impact of specific disorders.

Adult↗
PubMed1998

Demographic and socioeconomic predictors of dental care utilization.

The authors analyzed a comprehensive, nationally representative data set from the 1989 National Health Interview Survey to determine what factors are related to dental care utilization. The authors estimated the percentage of low-income and minority adults who reported visiting a dentist in the past year by race, income, employment status, dental insurance coverage status, sex, health status, education, marital status, age and major activity. Data analyses focused on 49,687 18- to 64-year-old dentate respondents, who were black, Hispanic or white. The authors found large differences in dental care utilization between blacks, Hispanics and whites, when controlling for education, income, age and other variables.

Adolescent↗
PubMed2001

Changing health inequalities in a changing society? Sweden in the mid-1980s and mid-1990s.

Whereas the end of the 1980s was characterized by an economic boom, the early 1990s saw the worst recession since the 1930s. In Sweden, the crisis that started in the fall of 1991 and culminated in 1995 meant dramatically increased unemployment rates followed by cutbacks in welfare state programs. In addition, other major changes in economic and political conditions have taken place during this period, including tax reforms and EU membership. Although public health as well as health inequalities are likely to be linked with these kinds of macro changes, it is unclear what types of changes in health and health inequalities one would expect. In this paper analyses of Swedish data on health inequalities in the periods 1986-87 and 1994-95 are undertaken on the basis of the Swedish Surveys of Living Conditions. The main finding is that overall health levels as well as differences in health between men and women, different age groups, educational groups, social classes, and employment status groups have remained constant.

Adult↗
PubMed2000

Social issues in the rehabilitation of younger stroke patients.

OBJECTIVES: To study social factors and outcomes in stroke rehabilitation patients under the age of 50. STUDY DESIGN: Retrospective chart review examining (1) martial status and employment status on admission and at 3 months post discharge, (2) discharge destination, (3) the presence of absence of children under the age of 16, and (4) psychosocial difficulties as recorded by staff during hospitalization. SUBJECTS AND SETTING: Eighty-three consecutive stroke patients under the age of 50 admitted to a Canadian tertiary-care hospital rehabilitation unit. MAIN OUTCOME MEASURES: Discharge destination and primary caregiver at discharge, and return to work and marital separation 3 months after rehabilitation discharge. RESULTS: Of the 55 patients with spouses, 8 (14.5%) separated within 3 months of hospital discharge. Fifteen of the 83 patients (18.1%) were not able to return to their premorbid place of residence; 4 (4.8%) required institutionalization. Of the 64 patients employed outside the home or studying at the time of their stroke, only 13 (20.3%) were able to return to work within 3 months of their discharge to home. Only 9.4% of those working full-time were able to return to full-time employment. CONCLUSIONS: Rehabilitation of young stroke patients is associated with a variety of social problems, including marital breakup, child care responsibilities, and return to employment, which are uniquely important in this age group.

Adolescent↗
PubMed2005

Employment outcomes of men treated for prostate cancer.

BACKGROUND: Some organizations recommend prostate cancer screening for men younger than age 65 years, many of whom will be employed when they are diagnosed and treated for prostate cancer. Yet little is known about how prostate cancer and its treatment affect men's employment status. Consequently, we explored employment outcomes 6 and 12 months after the diagnosis of prostate cancer. METHODS: We collected data from a prospective, population-based, longitudinal cohort of 267 men aged 30-65 years who had been diagnosed with prostate cancer and compared their likelihood of employment to that of men in two population-based control groups of 283 and 256 men without prostate cancer. The study outcomes were, among all participants, employment status and, among patients with prostate cancer, reasons why they remained employed, reasons why their weekly hours worked changed, and work-related disabilities. We predicted employment using probit regression models. In addition, we tested differences between the samples with two-sample Wilcoxon rank sum tests and chi-square tests. All statistical tests were two-sided. RESULTS: Patients with prostate cancer were 10 percentage points (95% confidence interval [CI] = 2.50 to 17.51 percentage points; P = .009) less likely to be working 6 months after their diagnosis than men without prostate cancer. However, at 12 months after diagnosis, the likelihood of employment for prostate cancer patients and control subjects was not statistically significantly different (P = .771). Some patients reported that cancer and its treatment interfered with their ability to perform physical and cognitive tasks at work 12 months after diagnosis. For example, 26% (95% CI = 18.51% to 33.87%) of men (33 patients) reported that cancer interfered with their ability to perform tasks that involved physical effort. CONCLUSIONS: Prostate cancer and its treatment appear to have an impact on employment.

Adult↗
PubMed2006

Smoking, not smoking: how important is where you live?

ISSUE ADDRESSED: To explore and describe the social-environmental influence upon the likelihood of smoking tobacco for the Australian experience, in particular, Victoria. METHODS: A multilevel (hierarchically structured regression) method was used. The micro-level units (characteristics of individuals) came from the annual surveys conducted by the Cancer Council of Victoria from 1990-97. The dependent variable was smoking status. The socio-demographic variables of age, marital status, education, employment status and ethnicity of individuals were used. The macro-level units (partitioned by postcode) came from the Australian Bureau of Statistics' Socioeconomic Index for Areas, split into quartiles. RESULTS: Residential neighbourhood had a unique but modest influence in the likelihood of smoking for both men and women. Also as the level of disadvantage increased within the residential area so did the odds of smoking for both men and women; however, the effect was not consistent. The odds of smoking were highest in the most disadvantaged areas for men, contrasting with women for whom the highest odds were in areas of more but not most disadvantage. CONCLUSIONS: The level of disadvantage of the residential neighbourhood has a unique, statistically significant influence, but not to the same degree as previously published Australian research. The effect is consistent across individual characteristics such as age and level of education for men. The effect is small and less consistent for women. Indeed, area of residence seems less important for women as a whole, suggesting differential influences according to gender.

Adolescent↗
PubMed2000

Multiple chronic health problems are negatively associated with health related quality of life (HRQoL) irrespective of age.

PURPOSE: To examine HRQoL measured by EORTC QLQ-C30 with respect to an increasing number of self-reported chronic health problems in the general Swedish population and to study the association between HRQoL, chronic health problems and age, gender, income, marital status and employment status. METHOD: A postal survey among a large random sample of 4000 adults aged 18-79 years. The study material contained EORTC QLQ-C30 core questionnaire supplemented by a sociodemographic questionnaire including questions about 13 chronic health problems of which four categories, 'No', 'Few', 'Some' or 'A lot of chronic health problems were constructed. RESULTS: Multiple chronic health problems were significantly associated with reduced HRQoL. The increased number of chronic health problems was also associated with age. When the number of chronic health problems was accounted for, the influence of age diminished. Low income and unemployment were associated with greater decline in HRQoL with respect to increasing number of problems among the respondents in working age. CONCLUSION: The impact of increased number of chronic health problems had varying consequences in different age groups. Moreover, sociodemographic and economic factors showed to interact differently with chronic health problems and HRQoL in various age groups. It appears from our results that an assessment and a careful consideration of these factors will be valuable in order to facilitate the interpretation of the effects of cancer and treatment on long-term HRQoL of cancer patients.

Adolescent↗