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PubMed1997

Factors influencing perceived treatment need and the dental attendance patterns of older adults.

AIM: To identify variables influencing perceived treatment need of older individuals and to identify predictive variables for reported dental attendance. DESIGN: Cross-sectional study using a self-report, posted questionnaire. SETTING: Two electoral wards, one deprived and one affluent, in the city of Liverpool in 1994. SUBJECTS AND MATERIALS: Samples of older individuals (aged 60-65) were selected at random using the FHSA register as a sampling frame. A total of 500 questionnaires were distributed, 250 to each ward. The measuring instrument included the Subjective Oral Health Status Indicators (SOHSI). RESULTS: 342 questionnaires (68.4%) were returned. There was a highly significant (P < 0.001) association between living in a deprived area and reported poor dental attendance. Recent pain experience and concern about oral health and appearance were significant predictors for perceived treatment need. The main factor predicting subjective need for treatment was a reported history of regular, asymptomatic visiting. Such individuals were nearly six times more likely to have a perceived treatment need than poor attenders. CONCLUSIONS: Identification and quantification of these variables is necessary in order to promote regular, asymptomatic dental attendance and for the future planning of dental services for older individuals.

Aged↗
PubMed1978

Uniform basic data sets for health statistical systems.

The United States approach to coordinating health statistics involves introduction of multipurpose basic data sets describing health status and the health care system. Standard reporting procedures have been used for many years for vital statistics. Recently designated data sets cover health manpower, inpatient facilities, short-stay hospital discharges, and use of ambulatory care services. A data set for long-term health care is in the design stage. Advantages of this approach in the United States and internationally are: basic comparisons can be made between health care settings are geographic areas while maintaining the variety and flexibility of existing public and private information systems; shared local, regional, and national data systems can be set up; and better coordination can be achieved between government-sponsored general-purpose and administrative data systems. Problem areas are: avoiding undue proliferation, e.g. of disease-specific data sets; adhering to the principle of minimal requirements; linking data sets and coordinating them with census and other social indicators; promoting widespread use; assuring data quality; establishing mechanisms for review and revision; and extending the concept internationally.

Data Display↗
PubMed1982

Correlates of life expectancy in less developed countries.

Analyses were performed to investigate several hypotheses concerning the multiple determinants of levels of life expectancy in developing countries in recent decades and some possible explanation for the observed variations in amount of gain in life expectancy from the 1950's to the 1970's. The findings were significant. For level of life expectancy the results of this present work conform by and large to results of other scholars in this area, although the present work is unique in that only developing countries were included. From the 1960's to the 1970's there has been a shift in the relative importance of economic indicators and general social indicators in favor of the social indicators. In the period 1960-65 some 70% of the variation in levels of life expectancy was associated with per capita income and literacy rates in a ratio of about three to two in favor of the economic variable. By 1970-75 the ratio has become six to one in favor of literacy. In addition, the multivariate model showed that the sanitation variables began to appear as significant correlates of levels of life expectancy in the more recent time period, playing a larger role than level of income per capita. Work pursued as part of a separate but concurrent project explored explicitly this three-way interaction between literacy, life expectancy and sanitation.

Developing Countries↗
PubMed2000

The stress process in neighborhood context.

The positive relation between socio-economic status (SES) and health, both mental and physical, is examined within a stress-process framework. Telephone survey data of adults age 45-74 are analyzed to test the roles of stressors and resources as mediators of the SES-health relation. Next, the stress process is tested in neighborhood context by splitting the sample in half according to residence in lower- or higher-SES neighborhoods. The relative impact of stressors on mental and physical health, and effectiveness of resources in protecting mental and physical health, are tested separately for both types of neighborhoods. The results indicate that social support is only protective of mental and physical health among residents of higher-SES neighborhoods. The implications of the results for future research are discussed.

Aged↗
PubMed2004

[Financing healthcare in low-income countries: recurring questions, new challenges].

Healthcare financing policies in low-income countries have gone through three successive phases. In the first phase the dominant approach was based on free access to healthcare and focused first on development of vertical programs and then on the necessity of providing primary care to all. While maintaining the emphasis on accessibility to primary care, the second policy phase introduced user fees and attempted to integrate healthcare programs into district-based healthcare structures. The third phase has been strongly influenced by the relationship between healthcare and development and the Millenium Objectives and places strong emphasis on necessity of developing insurance schemes. Recent studies on the relationship between healthcare spending and health status indicate that the efficiency and effectiveness of healthcare spending plays a more determinant role than the amount. At the same time an effort is being made to develop synergy between the different players in the health care systems and to clarify the role of each player by hinging financing decisions on operating criteria such as "public welfare", externalities, catastrophic costs, and equity. Although many countries have made significant progress, there are still several lagging areas, i.e., coverage for the poorest segment of the population (despite the rhetoric), follow-up of financing, and governance. Increasing external aid already initiated by several states may have a non-negligible impact on the macroeconomic balance. Since these changes could lead to adverse effects on health, there is a need to implement careful non-dogmatic policies.

Decision Making↗
PubMedDate not supplied

Harmonization of regional health data requirements in the South Pacific.

The South Pacific has 22 diverse countries and territories that receive various levels of assistance, training, and financial support from International, regional, and national agencies. To support various aspects of these activities, the agencies currently request health data from the Pacific Island countries and territories on systematic bases in two major fields: health program monitoring and disease surveillance. There currently is little consultation or integration between the agencies. Communication exists mostly in terms of the exchange of various types of processed information such as reports, circulars, and other publications. The Interagency Meeting on Health Information Requirements in the South Pacific took place in December 1995 in Noumea, New Caledonia, to discuss the potential for more integration and cooperation in order to ease the pressure on the data providers (the countries) and to improve the relevance, quality, and timeliness of regional health information in the Pacific. As part of the effort to deal with the problems of both the pressure on data providers and the low quality and availability of good health information, we have developed methodological tools for evaluating both health indicators and diseases subject to surveillance in order to ascertain those most suitable for public health surveillance.

Health Care Surveys↗
PubMedDate not supplied

The Beaver Dam Health Outcomes Study: initial catalog of health-state quality factors.

The Beaver Dam Health Outcomes Study (BDHOS) is an ongoing longitudinal cohort study of health status and health-related quality of life for a random sample of adults (age range at interview was 45 to 89 years; mean = 64.1, SD = 10.8) in a community population. In a face-to-face interview lasting approximately an hour, each participant responds to several batteries of questions. Included are a history of chronic medical conditions, current medications, and past surgeries; the SF-36 (a general health-status questionnaire); the Quality of Well-being index; self-rated health status on a five-point scale from "excellent" to "poor"; and evaluation of current health using the method of time tradeoffs. The authors present results from 1,356 interviews on these four principal measures, reporting mean scores by sex, by age, and for persons reporting being affected by various medical conditions. They believe data from the BDHOS will provide researchers and policy makers a reference collection of vital statistics for health-related quality of life. Additionally, the data provide a way to compare results from studies that utilize different indices from among the four principal measures of the BDHOS.

Adult↗
PubMed1992

[Objective and subjective health status of selected population groups in the former district of Halle].

In recent years the scientific work of the Institute of Social Medicine of the University Martin Luther Halle-Wittenberg, concentrated on investigating the complete registration of the state of health of selected groups of the population in interaction with the corresponding living conditions. The main indicators consisted of the opinion of the physician (physician's appraisal of health) and of the people/patient (self-appraisal of health). These reflect two main aspects of the state of health. During the study period 1986-1989 a total of 3,794 probationers (working population of selected firms, apprentices, students) were examined. Additionally, in connection with other targets (study of hypertension, study of the family doctor, study of the pulmonary function), further groups of the population were consulted to evaluate its state of health confirming the trends of the main examination. The results show specific characteristics of groups and also regionally and possible environmentally influenced differences of the state of health. They supply starting points for improving medical care and for on-target improvement advancement of health.

Adult↗
PubMed1982

Health and inequality. Some applications of uncertainty theory.

This paper applies to the Field of Health results of Stochastic Dominance Theory and expressions originally devised for the measurement of Income Inequality. In particular, use is made of Atkinson's inequality measure to compare health levels in England and Wales in the past century. It appears that the 'inequality before death' is less important today than it was in the past, this improvement being parallel to the increase in the average number of years lived (life expectancy). The analysis indicates also that both improvements were greater for women than for men during the period considered.

Actuarial Analysis↗
PubMed1998

Black-white differences in health perceptions among the indigent.

Two studies were conducted that assessed health perceptions and functional health status among an urban, low-income population in the southeastern region of the United States. The first study was conducted with 176 hospitalized indigent patients prior to discharge from a county hospital. Patients were administered the Short Form-36 (SF-36) health status questionnaire and two additional questions regarding perceptions of health. The second study was conducted in the same geographic region with a nonhospitalized, low-income population. The SF-36 was administered by telephone to 546 randomly selected interview respondents. The results demonstrated consistent differences between black and white respondents in referents for self-perceived health. It is suggested that health expectations and perceptions may be indicative of the cultural, contextual, and social-political factors that affect the lives of this urban, low income population. The validity of global single-item health indicators for use among low-income populations is questioned. Further research is needed to develop patient-based measures that accurately reflect the meanings and values of low-income patient groups.

Adolescent↗
PubMed1994

Health concepts, issues, and experience in the Abakaliki area, Nigeria.

Environmental health problems are increasingly receiving global attention. The health of entire nations may not only be affected by adverse environmental conditions, but by nutritional deficiencies that lead to morbidity and mortality. The type and extent of adverse health effects in a population depend on the potential for exposure to some environmental factors and pathogens as well as other environmental variables like industrialization, sanitation conditions, and urbanization. National and international comparisons between health status indicators can reveal the extent of any differences that exist, including dynamic changes in prevailing environmental conditions which may be helpful in characterizing the role of specific risk factors. Improvements in collection of environmental data related to health can help to identify, control, and eliminate many of the factors that are associated with environmental risk in the Abakaliki area of eastern Nigeria.

Delivery of Health Care↗