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PubMed1997

The epidemiology of low back pain in the rest of the world. A review of surveys in low- and middle-income countries.

STUDY DESIGN: A criteria-based review of the literature. SUMMARY OF BACKGROUND DATA: The literature on the epidemiology of low back pain is accumulating, but for the most part studies are restricted to high-income countries, which comprise less than 15% of the world's population. Little is known about the epidemiology of low back pain in the rest of the world. OBJECTIVES: To address the imbalance in the literature and to review the relatively few studies on the epidemiology of low back pain in low- and middle-income countries. Rates from these studies are contrasted with rates from selected high-income countries. In reviewing the literature, a hypothesis is tested: low back pain rates are higher in low-income countries than in high-income countries, not only because hard physical labor is more prevalent in low-income countries, but also because, unlike high-income countries, hard physical labor for older workers in low-income countries often is unavoidable. METHODS: Among other sources, articles for the review come from a search of the MEDLINE bibliographic database, with "back pain" and individual low- and middle-income countries entered as key words. To avoid recall biases, findings specifically on point prevalence are reviewed. RESULTS: Within the categories of low-income and high-income countries, low back pain rates vary twofold or more. In comparisons between these categories of countries, rates on the whole are higher among the general populations of selected high-income countries than among rural low-income populations; specifically, rates are 2-4 times higher among Swedish, German, and Belgium general populations than among Nigerian, southern Chinese, Indonesian, and Filipino farmers. Within low income countries, rates are higher among urban populations than among rural populations and still higher among workers in particular worksites, referred to as "enclosed workshops." CONCLUSIONS: The disparity in low back pain rates within categories of countries, high-income and low-income, calls attention to the high proportion of studies on the epidemiology of low back pain that are methodologically questionable. Recommendations are offered to improve the methodologic quality of this type of study. Conclusions may be drawn from comparisons between studies, although, in the absence of set methodologic standards, they are tentative. The considerably lower rates among populations of low-income farmers compared with rates of the affluent populations of selected northern European countries indicate that, contrary to the hypothesis proposed here, hard physical labor itself is not necessarily related to low back pain. The higher rates in urban low-income populations as compared with rates in rural low-income populations and the sharply higher rates among workers in enclosed workshops of low-income countries suggest a disturbing trend: low back pain prevalence may be on the rise among vast numbers of workers as urbanization and rapid industrialization proceed.

Adolescent↗
PubMed2006

Tobacco use and low-income African Americans: policy implications.

BACKGROUND: Tobacco use has declined in the United States over the past decade, but smoking among low-income populations remains high in comparison. Although many studies have linked poverty and tobacco use, few studies have examined the prevalence and predictors of tobacco use among low-income African Americans in the South. METHODS: A total sample of 388 residents of a Housing Authority complex in the South were surveyed. This cross-sectional study examined the prevalence and predictors for current tobacco use among sampled participants. RESULTS: Results show that low-income populations in the South have high rates of smoking. Of the sample, about 43% were current tobacco users. Findings indicate that tobacco users were more likely to be older, have been exposed to secondhand smoke, have positive attitudes toward tobacco commercials, and have been arrested in the past. Results found several predictors of tobacco use in the study population including age, secondhand smoke, attitude toward tobacco media, and criminal activity. CONCLUSIONS: Housing Authority apartment complexes may be an important target for tobacco use prevention and treatment interventions. Other policy implications are recommended.

Adolescent↗
PubMed2006

Development of a child safety seat Hassles Scale in a largely low-income Latino population.

OBJECTIVE: High rates of use of child safety seats have been achieved. A remaining challenge in child passenger safety is to reach the Healthy People 2010 objective of child safety seat use to 100%. Several factors have been reported to influence child safety seat use. A child safety seat Hassles Scale was developed to explore hassles that are associated with child safety seat nonuse. METHODS: Focus groups with violators of the California Child Passenger Safety Law provided data to construct the 29-item Hassles Scale. The scale was used in an interview that was conducted with 132 parents who were cited for violation of the law and whose children were 12 to 47 months of age and weighed 20 to 40 pounds. Interviews were conducted 3 months after parents paid the fine for the citation. Each hassle was rated 0 to 3 on frequency and intensity. Parent report of child safety seat use was obtained. Factor analysis was used to construct subscales. Relationship of subscale frequency and intensity scores to reported child safety seat use was assessed with linear regression. RESULTS: The sample was 86% Latino, 45% Spanish-speaking, and 55% with income < dollar 30000. Thirty-one percent of the parents reported that the child did not now always use a child safety seat. Four subscales were identified: child, crowding/inconvenience, busy, and vehicle. Only the frequency of the child subscale items (eg, resists, gets out of seat) and the frequency and the intensity of the crowding/inconvenience subscale items (eg, child safety seat takes up too much room, too many passengers) were related to child safety seat nonuse. Sixty-nine percent agreement with parent report of child safety seat use was achieved using only the frequency scores for the 9 items in the 2 subscales child and crowding/inconvenience, compared with 65% for the 29-item scale. CONCLUSIONS: In this low-income largely Latino population of violators, self-report of "always using a child safety seat" when transporting their child was low (59%). Child safety seat nonuse was related to hassles that are associated with child behaviors and vehicle crowding/inconvenience. The child safety seat Hassles Scale documented barriers and difficulties with the use of a child safety seat in a high-risk population for nonuse. These concepts can be explored by clinicians and others who work to increase consistent child safety seat use. Additional evaluation and development of the instrument requires validation for its use as a screening or educational tool.

Child, Preschool↗
PubMedDate not supplied

The impact of income redistribution on fertility in Canada.

This paper speculates on the role of income redistribution as a means of raising fertility in Canada. It is argued that if the relationship between income and fertility is non-linear at the household level, then changes in the income distribution in a society have important consequences for changes in aggregate fertility. In order to test this hypothesis, a simple fertility model is estimated using micro-data collected in the 1981 Canadian Census. The relationship between income and fertility is found to be nonlinear with properties that indicate that transfers of income from "rich" to "poor" households will likely further depress the overall level of fertility in Canada.

Americas↗
PubMedDate not supplied

Maternal knowledge regarding breast feeding and weaning practices.

The study assessed the knowledge of mothers of the high income group of urban Baroda, related to breast feeding and weaning. Forty mothers with children aged 4 to 18 months were studied. Knowledge and practices regarding breast feeding and weaning were assessed using pretested questionnaires. Results indicated that only half the mothers breast fed their babies on the first day. Breast feeding was stopped when the child was 3-6 months; top feeding and solid supplements were initiated at 4-6 months. Mainly commercial baby foods were used for weaning. Most mothers avoided 'dals' for the child because these were believed to be difficult to digest and produced gas in the child's stomach. Fifty percent of the mothers were not in favour of feeding the sick child with small frequent meals.

Adult↗
PubMedDate not supplied

Epidemiologic characteristics of an outbreak of serogroup C meningococcal disease and the public health response.

An outbreak of serogroup C meningococcal disease occurred in six counties in the State of Washington from January 1989 through mid-1991. This report describes epidemiologic data collected from hospitals and health departments, the results of multilocus enzyme electrophoresis of isolates, and the vaccination of high-risk populations in one county. A total of 45 confirmed or probable cases (10 per 100,000 population) occurred. Infants younger than age 1, Hispanics and American Indians, and low-income populations had high attack rates. Nine (20 percent) patients died. The predominant enzyme type, ET-22, had not been detected previously in Washington. More than 22,000 persons were vaccinated in one of the counties. Major challenges to health care personnel included deciding when and where to employ vaccination, obtaining sufficient vaccine, and responding to public anxiety.

Adolescent↗
PubMed2006

Demographic factors associated with dental utilization among community dwelling elderly in the United States, 1997.

OBJECTIVES: The purpose of this study was to characterize dental service utilization in 1997 by community dwelling Medicare beneficiaries. METHODS: The Medicare Current Beneficiary Survey, or MCBS, is a continuous annual series of nationally representative surveys of Medicare beneficiaries. Univariate comparisons were made between dependent variables (dental utilization and types of dental services) by each of the independent variables (age group, gender, race, income, education, population density, marital status and U.S. Census Bureau regions using weighted proportions to test for independence between dependent and independent variables. RESULTS: Overall, an estimated 41% of the population had a dental visit. Although utilization declined with aging, 24% of those 85 and older visited a dentist. CONCLUSIONS: This descriptive study provides important information about dental utilization and services in the American elderly population. Younger, high income, white or educated elderly Americans had higher dental utilization.

Age Factors↗
PubMed1987

Variations in demographic behaviour by levels of living in Pakistan.

This paper utilizes data from the Population, Labour Force, and Migration Survey of 1979 which collected information from about 10,000 households in Pakistan. Poverty was directly related to household size and also to the average number of children under 15, which meant higher dependency ratios for the poor. Poorer ever-married women had higher fertility rates than richer women. However, the association between fertility and levels of living was not monotonically inverse. Schooling rates of 5-9 year olds varied positively with levels of living and, conversely, labor force participation rates for boys aged 10-14 were generally higher in the poorer deciles. The value of children and their utility varies across the deciles. Data from Pakistan show only broad negative associations between infant mortality and standard of living. It could be argued that relatively higher mortality is experienced by those at lower standards of living, which leads at 1st to diminished household size, but eventually to higher fertility and larger household size. Out-migration, particularly to the Middle East, seems to have occurred in reasonably well-off households, or at least has not affected the poorest strata of society. Remittances have further enhanced the standard of living of out-migrants' households. The fertility of migrant households may also be lower than that of nonmigrants and may explain smaller household size. However, internal migration to urban areas tends to increased size as rural migrants live jointly in households away from their families.

Asia↗
PubMed1983

High level manpower movements in Northwest Europe and the role of careers: an explanatory framework.

"This article works towards a theoretical explanatory framework for analyzing the geographical patterns of labor flows between the industrial countries of Western Europe. The framework proposed is based on the disaggregated nature of the modern labor market, in which specialist skills and training result in a workforce segmented into self-contained noncompeting groups. It is applied to the migration within Northwest Europe of high level manpower, especially those moving within multinational organizations."

Demography↗