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PubMed2005

A socio-economic perspective on periodontal diseases: a systematic review.

OBJECTIVE: The aim of this systematic review was to ascertain whether socio-economic conditions increase the risk of periodontal diseases. METHODS: A MEDLINE search was conducted for the period 1965-April 2004. Only original articles were included; 47 studies remained for the final assessment. The studies were analysed regarding the outcome of the association between socio-economic variables and periodontal disease, depending on the study design (cross-sectional survey or longitudinal case-control) and whether smoking was included or not. RESULTS: Twenty-nine out of 36 studies with a cross-sectional design were in favour of the association between socio-economic factors and periodontal diseases. In the studies with a longitudinal or case-control design, there were five in favour of the association, and also six against. When smoking was included in the analysis of cross-sectional studies, a significant association between socio-economic variables and periodontal disease was found in 11 studies and no significance in another five studies. The corresponding figures for case-control studies showed four studies being significant, but also four studies showing no significance. CONCLUSION: Based on relevant study designs and including smoking in the analysis, the socio-economic variables associated with periodontal diseases appear to be of less importance than smoking.

Body Weight↗
PubMed2004

Socio-economic differentials in mental disorders and suicide attempts in Australia.

BACKGROUND: Responses to mental disorders usually focus on treatment; socio-economic conditions are less likely to be considered. AIMS: To examine social determinants of mental disorders and attempted suicide in Australia. METHOD: Data from the 1997 Australian National Survey of Mental Health and Wellbeing (n=10 641) were used to estimate associations between socio-economic status, mental disorders and attempted suicide. Logistic regression was used to adjust for age, urban/rural residence and country of birth. Socio-economic status differentials in suicide attempts were also adjusted for mental disorders. RESULTS: Significant increasing gradients from high to low levels of education and occupational status (employed) were evident for affective disorders and anxiety disorders in both men and women and for substance use disorders in men. Similar gradients were found for suicide attempts, which decreased after adjusting for mental disorders, but remained significant in the working-age employed. CONCLUSIONS: These findings suggest social causation of mental disorders and suicide attempts, and the need for social and economic responses beyond provision of mental health services.

Adult↗
PubMed2005

Social-economic context of parent care: explaining Chinese caregivers' psychological and emotional well-being.

This paper explores Chinese familial caregivers' depression and subjective burdens among the current caregivers. Data were collected in 1997-1999 with 110 caregivers who were then taking care of physically dependent parents or parents-in-law. Regression analyses were conducted to assess the factors that influence caregivers depression and subjective burden. Findings suggest that family and individual economic conditions are related to caregivers' depression. Caregivers' involvement in caregiving tasks is associated with caregivers' subjective burden. Poorer self-perceived health is related to higher report of caregivers' depression. The author argues that poorer health and unemployment at the time of drastic social and economic changes in China may have created psychological and emotional anxieties and depression for caregivers. The lack of financial and social stability may have deleterious effect for current caregivers in the future when they grow older and have to be cared for by their one-child generation children.

Adaptation, Psychological↗
PubMed1987

A geographical analysis of the relationship between early childhood death and socio-economic environment in an English city.

The relationship between early childhood death and socio-economic conditions was studied by obtaining the home address, at the time of death, of 254 infants and children between the ages of 0 to 5 years who died within the City of Southampton, England, between 1977 and 1982. The addresses were grouped into 142 'super-enumeration' districts formed by combining enumeration districts with similar socio-economic characteristics. These 'super-enumeration' districts were then categorised into 15 cluster types which highlighted the major social characteristics of the areas within Southampton. The number of deaths for each cluster type was then ascertained. A strong relationship was found to exist between high rates of early childhood death and cluster types displaying adverse social conditions--in particular, high levels of unemployment, single-parent families and poor housing amenities. It is suggested that the approach taken by this study might be one way of pinpointing areas of cities where a disproportionately large number of babies and young children die. It might then be possible by a combined and concerted effort on the part of the medical profession, nurses, health visitors, social workers and local authority to save at least some very young babies and children who might otherwise die.

Child, Preschool↗
PubMed2006

Inequalities in health: a comparative study between ethnic Norwegians and Pakistanis in Oslo, Norway.

BACKGROUND: The objective of the study was to observe the inequality in health from the perspective of socio-economic factors in relation to ethnic Pakistanis and ethnic Norwegians in Oslo, Norway. METHOD: Data was collected by using an open and structured questionnaire, as a part of the Oslo Health Study 2000-2001. Accordingly 13581 ethnic Norwegians (45% of the eligible) participated as against 339 ethnic Pakistanis (38% of the eligible). RESULTS: The ethnic Pakistanis reported a higher prevalence of poor self-rated health 54.7% as opposed to 22.1% (p < 0.001) in ethnic Norwegians, 14% vs. 2.6% (p < 0.001) in diabetes, and 22.0% vs. 9.9% (p < 0.001) in psychological distress. The socio-economic conditions were inversely related to self-rated health, diabetes and distress for the ethnic Norwegians. However, this was surprisingly not the case for the ethnic Pakistanis. Odd ratios did not interfere with the occurrence of diabetes, even after adjusting all the markers of socio-economic status in the multivariate model, while self-reported health and distress showed moderate reduction in the risk estimation. CONCLUSION: There is a large diversity of self-rated health, prevalence of diabetes and distress among the ethnic Pakistanis and Norwegians. Socio-economic status may partly explain the observed inequalities in health. Uncontrolled variables like genetics, lifestyle factors and psychosocial factors related to migration such as social support, community participation, discrimination, and integration may have contributed to the observed phenomenon. This may underline the importance of a multidisciplinary approach in future studies.

Journal Article↗
PubMed1990

Oral findings in elderly nursing home residents in selected countries. 1.

In order to determine the influence of culture, individual idiosyncrasy, social and economic conditions as well as the importance of past and current dental care on oral health, the oral conditions of 610 patients in seven old age homes were evaluated in four countries: USA, Peru, Argentina and Israel. The patients included in this study were examined by clinicians who had undergone training and calibration sessions. The seven institutions surveyed have a large range of physical facilities, economic levels, and a variety of quantity and quality among medical, dental and ancillary staff. There were marked differences as to philosophy of treatment and scope for the dental care of the residents. A subjective impression by the examiners is that old age home administrators do not regard the dental needs of the residents to be among their higher priorities. Dental care is considered expensive and requires special equipment and exclusive physical space on the institutional premises. Of the 610 residents 419 were women and 191 men, with an average age of 80 years. The mean number of years of schooling was six. Sixty-two percent of the examinees were widowed, 21% were married, 1% single, 2% divorced, and 5% of unknown or undeclared status. The main orodontal characteristic of the population surveyed was partial or full eduentulousness. Of the total population (610 examinees) only three patients possessed a full complement of natural, unrestored teeth. Twelve examinees had 28 unit dentition, partly natural teeth and partly restored with plastic fillings, fixed prostheses, crowns or pontics. Three hundred and one patients (49%) of the examined population were totally edentulous, 249 (41%) wore sets of complete dentures and 52 (8%) did not wear any prosthetic restoration or replacement.

Aged↗
PubMed1981

Economic antecedents of child abuse and neglect.

Previous cross-sectional studies of economic influences on child maltreatment reveal that higher rates of child abuse are associated with undesirable economic conditions. The cross-sectional approach, however, is inherently unable to reveal causal direction and leaves open the possibility that the relationship between the economy and child maltreatment is due to some third variable. The present study employs an aggregate longitudinal approach to test the hypothesis that undesirable economic change leads to increased child maltreatment. Cross-correlational analyses of data over a 30-month period reveal that increases in child abuse are preceded by periods of high job loss. This finding is replicated in 2 distinct metropolitan communities under very conservative criteria which rule out most "third-variable" explanations. The loss of jobs in a community may endanger the well-being of children.

California↗
PubMed1998

Child mortality patterns in rural areas of Anhui and Henan provinces in China, 1990.

County-based IMR and U5MR in Anhui and Henan provinces in China were estimated and analyzed by using the 1990 Census Data. Census was conducted on July 1, 1990, the number of deaths only occurred in the first half year of 1990 was collected. In order to obtain the total population and total number of deaths in the same year, the total number of deaths in each age-sex group for the whole 1990 was then estimated by taking the death number in the first half of 1990 as the base and multiplying a coefficient, which varied in different age-sex-region groups. Two major adjustments for some possible under-reporting cases in female birth and infant death were made. If the sex ratio at age 0 in some counties was beyond 1.2, then it was taken as 1.15 for rural counties and 1.10 for urban cities, which were the estimates of sex ratios for the children at age 5 in the national 1% Population Sampling Survey in 1995. The adjustment for IMR were made by comparing the segment of the county lift table from age 15 through 59 with that from the same age groups in the international and Chinese Model Life Tables. The IMR in the county life table would be substituted by the one in the closest Model Life Talbe, if it was less than in the latter. The findings of the analysis may be summarized as follows: (i) Total county-based IMR and U5MR were 33.4 per 1,000 and 41.4 per 1,000 respectively, with great variations between urban cities (25.4 per 1,000 for IMR and 31.4 per 1,000 for U5MR) and rural counties (35.1 per 1,000 for IMR and 43.6 per 1,000 for U5MR). There were also significant differences in child mortality between nationally identified poor counties and other counties in rural areas. In the poor counties the total IMR was 40.7 per 1,000 living births in average while in non-poor counties it was only 33.2 per 1,000 in average (P < 0.05). The U5MR in poor counties was 25 percent higher than in non-poor counties (51.5 vs 40.9 per 1,000 living births). (ii) Statistically significant correlation between child mortality and socio-economic variables was revealed from the data set, among which gross social economic products per capita was found to have the strongest relationship with child mortality. The negative correlation was found between child mortality and a set of so-called 'rich' variables including the gross social products, gross agricultural products, gross industrial products and the proportions of high-educated population at county level, whereas the positive correlation was found between child mortality and a set of 'poor' variables, such as proportions of residents with lower level of education and illiteracy rate. (iii) Differences in child mortality between these two provinces were found, which were identical to the trends of differences in socio-economic indicators between them. Lower child mortality proved to be associated with better socio-economic conditions (higher per capita products, higher proportions of residents with higher level of education, lower proportion of less educated people and illiteracy) in province Henan. (iv) A simple linear regression model was developed separately for Henan and Anhui to predict the IMR and U5MRs in each stage of economic development, where the dependent variables were the logarithm of IMR and U5MR, and the independent variables were the quintiles of the output value of gross products (GOP). It was found that at the first quintile, which was equivalent to 800 yuan of GOP in average, the predicted IMR and U5MR would reach 40 per 1,000 and 51 per 1,000 respectively. It would decline to 38 per 1,000 for IMR and 47 per 1,000 for U5MR in the second lowest quintile. Dramatic drop of child mortality was found between the second quintile and the third quintile, where 6 per 1,000 decline would occur for both IMR and U5MR. The decline would continue subsequently, but slower. The prediction of child mortality in rural counties could be used as a reference to assess counties at different stages of socio-

Adolescent↗
PubMed2005

Cancer survival in the elderly: effects of socio-economic factors and health care system features (ELDCARE project).

The purpose of the ELDCARE project is to study differences in cancer survival for elderly patients by country, taking into account the socio-economic conditions and the characteristics of health care systems at the ecological level. Fifty-three European cancer registries, from 19 countries, participating in the EUROCARE 3 programme, collected information to compute relative survival on patients aged 65-84 years, diagnosed over the period 1990-1994. National statistics offices provided the macro-economic and labour force indicators (gross domestic product, total health expenditure, and proportion of people employed in the agriculture sector) as well as the features of national health care systems. Survival for several of the cancer sites had high positive Pearson's correlations (r) with the affluence indicators (usually r>0.7), but survival for the poor prognosis cancers (lung, ovary, stomach) and for cervix uteri was not so well correlated. Among the medical resources considered, the number of computed tomography scanners was the variable most related to survival in the elderly; the number of total health practitioners in the country did not show any relationship. Survival was related to the marital status of elderly women more strongly than for men and younger people. The highest correlations of survival with the percentage of married elderly women in the population were for cancers of the rectum (r=0.79) and breast (r=0.66), while survival correlated negatively with the proportion of widows for most cancers. Being married or widowed is for elderly people, in particular elderly women, an important factor influencing psychological status, life habits and social relationships. Social conditions could play a major role in determining health outcomes, particularly in the elderly, by affecting access to health care and delay in diagnosis.

Aged↗
PubMed1997

[Changes in surgical cases].

The shift of age distribution within the population of industrialized societies has led to an increased need of treating diseases in elderly patients and at the same time bearing an increased operative risk. Today, the development of surgical techniques and intensive care treatment enables us to carry out numerous procedures in geriatric patients. Innovative surgical techniques like minimal invasive surgery with minor trauma due to the surgical approach changed patient's categories, also. Taken together with other procedures causing less operative stress indications for patients who were not operable previously have changed. New developments such as organ transplantation and immunosuppression also generated totally new groups of patients with very distinct conditions for the operative procedure. Vanishing indications or selection of patients as in peptic ulcer disease changed the surgical approach completely: Negative selection has shifted elective operative interventions in ulcer disease to emergency procedures. Contrasting experiences made in most other countries and especially in the third world, in Germany economic restrictions have not been encountered as of yet. Economical conditions, an increase in surgical procedures in elderly patients and advances in medical science will continue to change the surgical patient's characteristics profoundly. From the physicians viewpoint we have actively participate in this development by personal interaction with the patient, by interdisciplinary cooperation and prompt social and political action.

Age Factors↗
PubMed1996

A biocultural perspective on health and household economy in southern Peru.

This article presents a biocultural approach to human health that integrates perspectives from anthropological political economy, ecology, and human adaptability. This approach frames local conditions in relation to macrohistorical forces, and focuses on the social relations that underlie health and responses to illness. It examines the coping responses of human agents operating with a "conditional rationality," and the multiple consequences to these responses. The approach is illustrated with results from a study on the relationship between health and household economy among small-scale farmers of the Nuñoa District in the southern Peruvian Andes. Poor health and nutritional status reflect historical and current economic conditions in the district. Households in illness plant half as many fields at twice the labor cost as healthy households. Among poor households the effects of illness on farming production are exacerbated by their inability to adequately supplement family labor with nonhousehold workers. The consequences of illness can force changes in access to resources and production strategies, thus shaping household health and economy in the future.

Absenteeism↗
PubMed2003

Community-based river management in Southeast Sulawesi, Indonesia: a case study of the Bau-Bau River.

In this paper we explain the current condition of the Bau-Bau River, examine community participation for management of the river system, and consider options for improving the institutional capacity for a community-based approach. This assessment is based on a research project with the following objectives: (1) analyse the biophysical and socio-economic condition of the river as a basis for future planning; (2) identify current activities which contribute waste or pollution to the river; (3) assess the status and level of pollution in the river; (4) analyse community participation related to all stages of river management; and (5) identify future river management needs and opportunities. Due to the increasing population in Bau-Bau city, considerable new land is required for housing, roads, agriculture, social facilities, etc. Development in the city and elsewhere has increased run-off and erosion, as well as sedimentation in the river. In addition, household activities are generating more solid and domestic waste that causes organic pollution in the river. The research results show that the water quality in the upper river system is still good, whilst the quality of water in the vicinity of Bau-Bau city, from the mid-point of the watershed to the estuary, is not good, being contaminated with heavy metals (Cd and Pb) and organic pollutants. However, the levels of those pollutants are still below regulatory standards. The main reasons for pollution in the river are mainly lack of management for both liquid and solid wastes, as well as lack of community participation in river management. The government of Bau-Bau city and the community are developing a participatory approach for planning to restore and conserve the Bau-Bau River as well as the entire catchment. The activities of this project are: (1) forming institutional arrangements to support river conservation; (2) implementing extension initiatives to empower the community; (3) identifying a specific location to establish an urban forest; (4) implementing demonstration projects for liquid system management; (5) promoting coordination amongst the different organisations and agencies in the catchment; (6) improving domestic waste transportation; and (7) recycling waste to create compost material to become an income source for the community.

Agriculture↗
PubMed1983

Age discrimination in retirement: in search of an alternative.

American employers have traditionally relied on age as the criterion for mandatory retirement. Yet advances in medicine indicate the inadequacy of age as a measure of job competence and suggest the potential for a more reliable measure. With current social and economic conditions pressing many employees to seek to work beyond mandatory retirement ages set by their employers, transition to more reliable measures has become a vital matter. This Note explores the potential for implementing medically-based alternatives to the age proxy. It initially addresses problems of medical feasibility and economic practicality, and considers how the divergent interests of employees and employers can be accommodated. The balance of the Note examines the present roles of Congress, agencies, and courts in facilitating age-blind mandatory retirement policy. It suggests the need for reform of the federal Age Discrimination in Employment Act and recommends a more effective distribution of roles among governmental institutions.

Age Factors↗
PubMed1976

Length of residence, social ties, and economic opportunities,.

This study examines length of residence for movers--that subsection of the population which accounts for the high mobility rates in the United States. The propensity for repeated migration is studied in relation to economic opportunities and previous familial and personal contacts. The results indicate no influence of economic opportunities on duration of residence. This finding is consistent with recent research that indicates economic conditions are not a general stimulus for out-migration, although they are for inmigration. On the other hand, length of residence is found to be longer where previous familial and personal contacts existed. Overall, the results provide additional evidence of the importance of social, as opposed to strictly economic variables in the migration process.

Family↗
PubMed1981

International trends in disability program growth.

The steep growth in the number of beneficiaries under the U.S. Social security Disability Insurance program during 1966-77 has aroused interest in learning whether programs abroad experienced similar expansion. This article presents the gross rate of disability incidence in five European programs and explores termination rates (for recovery and death) in three of those programs. Factors underlying growth patterns are also discussed. Findings show that the gross disability incidence rate increased in the Belgian and Finnish programs from the late 1960's and in the programs of the Federal Republic of Germany, the Netherlands, and France From the early 1970's, tapering off in all five countries studied by the mid-1970's. Gross recovery- and death-termination rates declined continuously in the Dutch and the Finnish programs. For all countries in this study, changes in the definition of statutory disability and changes in other program provisions, economic conditions, demographic patterns, and public awareness and attitudes were the major causes of expansion. Adequate explanations to account for the recent slackening off in program growth, however, are lacking.

Belgium↗
PubMed1979

Geropsychiatry in Indian culture.

Geriatric psychiatry will be increasingly important in years to come as the care of the elderly becomes a health problem in India. Those aged 60 and over contribute to 6% of the country's population at present. The life expectancy of an average Indian has increased from 24 years in 1900 to 53 in 1971. Improved health care promises longevity, but social and economic conditions like poverty, breakup of the joint family system and poor services, specifically for the aged, pose a psychiatric threat to them. Organic diseases and effective disorders form the bulk of psychiatric illness in the aged. Suggestions for research in areas such as social, cultural and changing attitudes, and national economics, have been suggested as a promising field for preventive geriatric services. Adding life to years is more important than adding years to life. The paper offers some references to the studies on geriatric psychiatry in India and discusses cultural factors affecting the aged.

Aged↗