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PubMedDate not supplied

Design, characteristics, and usefulness of state-based behavioral risk factor surveillance: 1981-87.

Since 1981, the Centers for Disease Control has collaborated with State health departments and the District of Columbia to conduct random digit-dialed telephone surveys of adults concerning their health practices and behaviors. This State-based surveillance system, which yields data needed in planning, initiating, and supporting health promotion and disease prevention programs, is described in this paper. Standard methods and questionnaires were used to assess the prevalence of personal health practices and behaviors related to the leading causes of death, including seatbelt use, high blood pressure control, physical activity, weight control, cigarette smoking, alcohol use, drinking and driving, and preventive health practices. Between 1981 and 1983, 29 States (includes the District of Columbia) conducted one-time telephone surveys. Beginning in 1984, most States began collecting data continuously throughout the year, completing approximately 100 interviews per month (range 50-250), with an average of 1,200 completed interviews per year (range 600-3,000). The raw data were weighted to the age, race, and sex distribution for each State from the 1980 census data. This weighting accounts for the underrepresentation of men, whites, and younger persons (18-24 years) in the telephone surveys and, for many health practices, provides prevalence estimates comparable with estimates obtained from household surveys. Nearly all (86 percent) of the States distributed selected survey results to other State agencies, local health departments, voluntary organizations, hospitals, universities, State legislators, and the press. The majority (60 percent) of States used information from the surveys to set State health objectives, prepare State health planning documents, and plan a variety of programs concerning antismoking, the prevention of chronic diseases, and health promotion. Further, nearly two-thirds (65 percent) used results to support legislation, primarily related to the use of tobacco and seatbelts. Most of the States (84 percent) reported that alternative sources for such data (prevalence of behavioral risk factors) were unavailable. Currently in 1988, over 40 State health departments are conducting telephone surveys as part of the Behavioral Risk Factor Surveillance System. This system has proved to be (a) flexible--it provides data on emerging public health problems, such as smokeless tobacco use and AIDS, (b) timely--it provides results within a few months after the data are collected, and (c) affordable--it operates at a fraction of the cost of comparable statewide in-person surveys. The system enables State public health agencies to continue to plan,initiate, and guide statewide health promotion and disease prevention programs and monitor their progress over time.

Adolescent↗
PubMed2005

[Changes in distributive equity of health insurance contribution burden].

OBJECTIVES: We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. METHODS: The study subjects were a total of 8923 employee households and a total of 7296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). RESULTS: For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased (beta = 0.232, p < 0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased (beta = 0.186, p < 0.05), although its change was smaller than that in the employee group. CONCLUSIONS: The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.

Adult↗
PubMed1992

Distribution of lifetime income allowing for varying mortality rates among women, men, blacks, and whites.

The author investigates income distribution according to gender and race differences in mortality rates in the United States. "This study merges economic and epidemiological literatures. A more extensive application of the Paglin (1975) life cycle hypothesis is proposed. Not only are adjustments made for varying ages, they are also made for varying survival probabilities from one age to the next. Finally, some consideration is also given to the implications of varying morbidity rates across race and gender for the distribution of economic well-being."

Black or African American↗
PubMed1994

Estimated numbers of one-parent families and their prevalence in Great Britain in 1991.

This article gives the final estimate of the number of one-parent families in Great Britain in 1991--1.3 million--and a provisional estimate--of 1.4 million--for 1992. It also estimates that there were 2.2 million dependent children living in one-parent families in 1991, and provides a provisional estimate for 1992 of 2.3 million. Overall, in 1992, about one in five families with dependent children was a one-parent family and about one in five of all dependent children lived in a one-parent family. The article also examines the family sizes of one-parent families; the profiles by marital status of both lone mothers and lone fathers; the ages of lone parents and of their dependent children, and the geographical variation in the prevalence of lone parenthood within Great Britain in 1991. Finally, census data on the family composition of households are examined to investigate the extent to which lone parent families live in multi-family households, and the relationship between the lone parent and the head of the other main family in the household.

Adolescent↗
PubMed2006

Household dyeing plants and traditional uses in some areas of Italy.

BACKGROUND: This paper reports the results of investigations carried out from 1977 to today in some areas of Italy (Latium, Marche, Abruzzo and to a limited extent in Sardinia) concerning traditional uses of dyeing plants in the household. RESULTS: Twenty-nine plants are described, distributed in 23 families, and for each species the vernacular name, the way it is used and the locations of traditional use are given. Other plants used in the past in the above-mentioned regions are recalled. CONCLUSION: Among the new findings--not mentioned in previous literature, see references--is Muscari neglectum (purplish). Nowadays atavistic dye uses still persist only in Nule (Sardinia).

Aged↗
PubMed1990

Experiences with Mycobacterium leprae soluble antigens in a leprosy endemic population.

Rees and Convit antigens prepared from armadillo-derived Mycobacterium leprae were used for skin testing in two leprosy endemic villages to understand their use in the epidemiology of leprosy. In all, 2602 individuals comprising 202 patients with leprosy detected in a prevalence survey, 476 household contacts and 1924 persons residing in non-case households were tested with two antigens. There was a strong and positive correlation (r = 0.85) between reactions to the Rees and Convit antigens. The distribution of reactions was bimodal and considering reactions of 12 mm or more as 'positive', the positivity rate steeply increased with the increase in age. However, the distributions of reactions to these antigens in patients with leprosy, their household contacts and persons living in non-case households were very similar. These results indicate that Rees and Convit antigens are not useful in the identification of M. leprae infection or in the confirmation of leprosy diagnosis in a leprosy endemic population with a high prevalence of nonspecific sensitivity.

Adolescent↗
PubMed1989

Family size and social utility: income distribution dominance criteria.

"This paper generalizes previous results on income distribution dominance in the case where the population of income recipients is broken down into groups with distinct utility functions. The example taken here is that of income redistribution across families of different sizes. The paper first investigates the simplest assumptions that can be made about family utility functions. A simple dominance criterion is then derived under the only assumptions that family functions are increasing and concave with income and the marginal utility of income increases with family size."

Economics↗
PubMedDate not supplied

Distribution of residence duration in owner occupied housing.

Residence duration was determined in owner occupied household by employing tax records that identify changes in ownership. Residence duration was estimated by selecting a random sample of households from Multnomah County, Oregon and using the interval between the two most recent changes in ownership. Residence duration was observed to be consistent with an exponential distribution with a mean of 13.6 years. While mean residence duration in this study was consistent with the results of other studies, the distribution of residence duration in this study was not consistent with the results of another study. The distribution of residence duration is important in establishing the distribution of exposure in a population using probabilistic risk assessment methods.

Environmental Exposure↗
PubMed2001

[Population-based health monitoring via computer-assisted telephone interviews in Bavaria].

From June 1999 until May 2000, 2051 computer-assisted telephone interviews concerning health and health related behaviours were assessed in Bavarian households. The aim of the study was the evaluation of the validity and representativity of this data by a comparison of selected variables from the Bavarian Mikrozensus-survey 1999. The distribution patterns of the marital status, the size of the households, the gainful employment, the household-netto-income, the school qualification and of the smoking status correspond well with those of the Mikrozensus 1999. As often found in questionnaire based surveys, a disproportionately high rate of participation of highly educated persons was observed. This led to an effect only in terms of a too small rate of persons with a low household-netto-income. Within the study, two different designs were compared. The commitment of the telephone numbers to a gender for an equal quotation of men and women led to an under-representation of single-households and therefore also of unmarried persons, but it had no effect on the other characteristics. The results of this study show, that the method of computer assisted-telephone interviews is a valid and cheap basis for the establishment of an exhaustive health surveillance system in Germany.

Adolescent↗
PubMed1989

Epidemiology of Rhodesian sleeping sickness in the Lambwe Valley, Kenya.

A total of 912 cases of sleeping sickness have been recorded from the Lambwe Valley from 1959 to 1984. After a period of decreasing prevalence in the 1970s an outbreak of disease occurred between 1980 and 1984. The incidence of disease for this five-year period was highest in areas adjoining the Ruma National Park, reaching 54% in Area I. Attack rates were highest in the 50+ age group (125) and children had significantly lower attack rates (8%) in this area of peridomestic transmission. Sex ratios of patients (M/F) were near 1.0 in areas in closest proximity to the thickets in the National Park, while in distant areas the ratios rose to 6.0. The distribution of the number of patients within different households was studied; fewer households than expected had 0 or one patient, and more than expected had three or more patients. No difference in attack rates were found between Nilotic and Bantu groups. Twelve different zymodemes were found in 136 stocks of Trypanosoma brucei rhodesiense. Four new zymodemes appeared in 1980 in the latest outbreak and accounted for 73% of the stocks isolated from man during this outbreak. Neutralization tests indicated that each trypanosome zymodeme may also represent a different serodeme.

Age Factors↗
PubMed1998

Migration, remittances, and inequality: estimating the net effects of migration on income distribution.

"This paper examines the net effects of migration and remittances on income distribution. Potential home earnings of migrants are imputed, as are the earnings of non-migrants in migrant households, in order to construct no-migration counterfactuals to compare with the observed income distribution including remittances. The earnings functions used to impute migrant home earnings are estimated from observations on non-migrants in a selection-corrected estimation framework which incorporates migration choice and labor-force participation decisions. For a sample of households in Bluefields, Nicaragua, migration and remittances increase income inequality when compared with the no-migration counterfactual."

Americas↗
PubMed2003

Faecal contamination of drinking water during collection and household storage: the need to extend protection to the point of use.

Paired water samples were collected and analysed for thermotolerant coliforms (TTC) from 20 sources (17 developed or rehabilitated by Oxfam and 3 others) and from the stored household water supplies of 100 households (5 from each source) in 13 towns and villages in the Kailahun District of Sierra Leone. In addition, the female head of the 85 households drawing water from Oxfam improved sources was interviewed and information recorded on demographics, hygiene instruction and practices, sanitation facilities and water collection and storage practices. At the non-improved sources, the arithmetic mean TTC load was 407/100 ml at the point of distribution, rising to a mean count of 882/100 ml at the household level. Water from the improved sources met WHO guidelines, with no faecal contamination. At the household level, however, even this safe water was subject to frequent and extensive faecal contamination; 92.9% of stored household samples contained some level of TTC, 76.5% contained more than the 10 TTC per 100 ml threshold set by the Sphere Project for emergency conditions. The arithmetic mean TTC count for all samples from the sampled households was 244 TTC per 100 ml (geometric mean was 77). These results are consistent with other studies that demonstrate substantial levels of faecal contamination of even safe water during collection, storage and access in the home. They point to the need to extend drinking water quality beyond the point of distribution to the point of consumption. The options for such extended protection, including improved collection and storage methods and household-based water treatment, are discussed.

Enterobacteriaceae↗
PubMedDate not supplied

[Distribution of Aedes aegypti and dengue in the State of Maranhão, Brazil].

Dengue and Aedes aegypti are widespread in the State of Maranhão. During 1995, 87 of the 136 of the State's counties, including 176 towns and 480,687 households, were studied, of which 30 counties (34. 4%), 118 towns (67.0%) and 10,357 households (2.1%) were positive for Aedes aegypti. The positive counties are distributed as follow: 3 on São Luís Island, 7 in the Amazonia of Maranhão, 12 in the southern zone of the cerrados or savannas, and 5 in the mixed forest/savanna/palm grove zone. One positive county for Ae. aegypti was located in each of the following: alluvial fields, forest/palm grove, and sand dune/shoals areas. The Ae. aegypti-positive household rates were higher in the Amazonia of Maranhão (3.5%) and on São Luís Island (2.5%), because they are the most heavily traveled migratory and trade routes between Maranhão and neighboring states and are also the State's main economic centers. Household infestation rates for Ae. aegypti and reported dengue case rates were higher during the rainy season, showing the importance of rain in forming prime breeding sites for Aedes and spreading dengue.

Aedes↗
PubMed2006

Moment equations and dynamics of a household SIS epidemiological model.

An SIS epidemiological model of individuals partitioned into households is studied, where infections take place either within or between households, the latter generally happening much less frequently. The model is explored using stochastic spatial simulations, as well as mathematical models which consist of an infinite system of ordinary differential equations for the moments of the distribution describing the proportions of individuals who are infectious among households. Various moment-closure approximations are used to truncate the system of ODEs to finite systems of equations. These approximations can sometimes lead to a system of ill-behaved ODEs which predict moments which become negative or unbounded. A reparametrization of the ODEs is then developed, which forces all moments to satisfy necessary constraints. Changing the proportion of contacts within and between households does not change the endemic equilibrium, but does affect the amount of time it takes to approach the fixed point; increasing the proportion of contacts within households slows the spread of the infection toward endemic equilibrium. The system of moment equations does describe this phenomenon, although less accurately in the limit as the proportion of between-household contacts approaches zero. The results indicate that although controlling the movement of individuals does not affect the long-term frequency of an infection with SIS dynamics, it can have a large effect on the time-scale of the dynamics, which may provide an opportunity for other controls such as immunizations to be applied.

Computer Simulation↗
PubMed2005

Contact inactivation of orthopoxviruses by household disinfectants.

AIMS: The aim of this study is to identify common household disinfectants that combine significant activity against the type orthopoxvirus, vaccinia virus with minimal impact in terms of potential toxicity and/or damage to household or personal items. METHODS AND RESULTS: Laboratory scale experiments assessed common disinfectants containing anionic and nonionic detergents, oxygen-based bleach, potassium peroxomonosulfate, chloroxylenol or halogenated phenols. Disinfectants were assessed for their ability to inactivate the virus on contact or after a short incubation period in the presence and absence of foetal bovine serum as a potential interferant. Significant differences were observed ranging from negligible effect of detergents to complete inactivation on contact with chloroxylenol. CONCLUSIONS: At least one chloroxylenol-based household disinfectant is available, which inactivates vaccinia virus on contact. SIGNIFICANCE AND IMPACT OF THE STUDY: In the event of a release or major outbreak of a pathogenic orthopoxvirus there is likely to be significant public demand for disinfectants with activity against these viruses. The identification of common household disinfectants with such activity obviates any requirement to stockpile or distribute laboratory/industrial disinfectants for this purpose.

Chlorine↗
PubMed2002

Spatial analysis to identify differentials in dental needs by area-based measures.

OBJECTIVES: To examine the association between tooth decay and dental treatment needs in 5-12-year-old schoolchildren in São Paulo with area-level indicators of social development. METHODS: The present study refers to a representative sample of children from the city of São Paulo, Brazil, comprising 2491 girls and boys attending public and private schools in different areas of the city. The assessment of caries and treatment needs followed the international methodological standards prescribed by the World Health Organization. We used spatial data analysis to describe epidemiological measures distributed by small areas, and to explore hypotheses of ecological association between caries indexes and indicators of social development. RESULTS: Schoolchildren in central districts were less affected by tooth decay and presented fewer dental treatment needs when compared to those in peripheral deprived areas. At the spatial level, average family income, unemployment rate, household overcrowding, and an index of inequality of income distribution were significantly correlated with variables measuring children's caries experience. CONCLUSIONS: The heterogeneous distribution of caries indexes by areas of the city indicates higher levels of dental decay in areas of social deprivation. The delimitation of areas with increased risk of caries and greater dental treatment needs should be helpful to public health services for the formulation of policies and the targeting of resources to address these problems.

Brazil↗
PubMed1988

Syrup of ipecac. The case for distribution from physicians' offices.

Data from a nationally representative sample of household interviews were analyzed to examine public preparedness for childhood poisoning episodes. Eighty-eight percent (61% to 77% in nonwhite groups) of respondents from households with children younger than 10 years had heard of poison control centers and 70% (50% to 57% in nonwhites) stated that they had the telephone number of such a center. In contrast only 25% stated they had syrup of ipecac in their home. Among blacks and Hispanics this proportion was 9%. To explore possible reasons for this we telephoned a sample of 65 physicians listed in the greater Washington, DC, telephone directory as providers of care for infants and children. Of the 45 (69%) who agreed to be interviewed, 73% informed their patients about poison control centers and 53% provided the appropriate telephone number. Although 78% believed parents should have ipecac in the house, only three (7%) of 45 actually dispensed ipecac to parents. We conclude that ipecac is not widely available in the homes of American children. By regularly dispensing it in the course of pediatric care, physicians could largely remedy this deficiency.

Attitude of Health Personnel↗