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PubMed1998

Predicting the admission into medical school of African American college students who have participated in summer academic enrichment programs.

PURPOSE: To identify cognitive and noncognitive variables as predictors of the admission into medical school of African American college students who have participated in summer academic enrichment programs (SAEPs). METHOD: The study sample comprised 309 African American college students who participated in SAEPs at the Medical College of Georgia School of Medicine from 1980 to 1989 and whose educational and occupational statuses were determined by follow-up tracking. A three-step logistic regression was used to analyze the data (with alpha = .05); the criterion variable was admission to medical school. The 17 predictor variables studied were one of two types, cognitive and noncognitive. The cognitive variables were (1) Scholastic Aptitude Test mathematics (SAT-M) score, (2) SAT verbal score, (3) college grade-point average (GPA), (4) college science GPA, (5) SAEP GPA, and (6) SAEP basic science GPA (BSGPA). The noncognitive variables were (1) gender, (2) highest college level at the time of the last SAEP application, (3) type of college attended (historically African American or predominately white), (4) number of SAEPs attended, (5) career aspiration (physician or another health science option) (6) parents who were professionals, (7) parents who were health care role models, (8) evidence of leadership, (9) evidence of community service, (10) evidence of special motivation, and (11) strength of letter of recommendation in the SAEP application. For each student the rating scores for the last four noncognitive variables were determined by averaging the ratings of two judges who reviewed relevant information in each student's file. RESULTS: In step 1, which explained 20% of the admission decision variance, SAT-M score, SAEP BSGPA, and college GPA were the three significant cognitive predictors identified. In step 2, which explained 31% of the variance, the three cognitive predictors identified in step 1 were joined by three noncognitive predictors: career aspiration, type of college, and number of SAEPs attended. In step 3, which explained 29% of the variance, two cognitive variables (SAT-M score and SAEP BSGPA) and two noncognitive variables (career aspiration and strength of recommendation letter) were identified. CONCLUSION: The results support the concept of using both cognitive and noncognitive variables when selecting African American students for pre-medical school SAEPs.

Black or African American↗
PubMed1994

Associations between social and environmental factors and perinatal mortality in Jamaica.

Social and environmental factors in Jamaica were compared between 9919 mothers delivering in a 2-month period a singleton who survived the early neonatal period and 1847 mothers who were delivered of a singleton perinatal death in a contiguous 12-month period. Logistic regression showed independent positive statistically significant increased odds of having a perinatal death among mothers who lived in rural parishes, older mothers (aged 30 +), single parents, no other children in the household, large number of adults in the household, mother unemployed, the major wage earner of the household not being in a managerial, professional or skilled non-manual occupation, the household not having sole use of toilet facilities, smaller mothers and those classified as obese or undernourished. Variations were found for different categories of death. Intrapartum asphyxia deaths were not related to union (marital) status, occupation of major wage earner, number of adults nor to the use of the toilet. Antepartum fetal deaths did not vary significantly with occupation of major wage earner or maternal height, but did show a relationship with maternal education, mothers with lowest levels having reduced risk. Deaths from immaturity were significantly related only to occupation of major wage earner, number of children in the household, number of social amenities available (negative relationships) and maternal age (< 17 at highest risk). In conclusion there was little to indicate that social deprivation per se was related to perinatal death, although specific features of the environment showed strong relationships.

Adolescent↗
PubMed1999

Relation of occupation to presence or absence of coronary artery disease: an angiographic study.

To determine the relation of occupation to the presence or absence of coronary artery disease (CAD) and cardiovascular risk factors, the authors compared the occupations of a series of 116 consecutive patients who underwent coronary angiography and were found to have normal or near-normal coronary arteries (< 30% stenosis of all major coronary arteries) with those of a series of 116 patients with moderate to severe CAD (> or = 60% stenosis of one or more major coronary artery). The usual lifetime occupational status of each study participant was classified as sedentary, intermediate, or strenuous. The presence of the usual cardiovascular risk factors in the patients was also recorded. There was no significant difference in the frequency of the three occupational categories between the two groups (those with or without CAD) when subjects of all ages were considered or when subjects less than 40 years or more than 60 years old were considered. However, the results indicate that among 40-60-year-old individuals CAD occurred significantly more frequently in those engaged in strenuous occupations than in those engaged in sedentary occupations. Cardiovascular risk factors occurred significantly more frequently in patients with CAD than in those with normal coronary arteries and in those engaged in strenuous occupations compared with those in sedentary occupations.

Adult↗
PubMed2006

Neighbourhood non-employment and daily smoking: a population-based study of women and men in Sweden.

BACKGROUND: To examine whether neighbourhood non-employment is associated with daily smoking after adjustment for individual characteristics, such as employment status. METHODS: Cross-sectional study of a simple, random sample of 31,164 women and men aged 25-64, representative of the entire population in Sweden. Data were collected from the years 1993-2000. The individual variables included age, sex, employment status, occupation and housing tenure. Logistic regression was used in the analysis with neighbourhood non-employment rates measured at small area market statistics level. RESULTS: There was a significant association between neighbourhood non-employment rates and daily smoking for both women and men. After adjustment for employment status and housing tenure the odds ratios of daily smoking were 1.39 (95% CI = 1.22-1.58) for women and 1.41 (95% CI = 1.23-1.61) for men living in neighbourhoods with the highest non-employment rates. The individual variables of unemployment, low occupational level and renting were associated with daily smoking. CONCLUSION: Neighbourhood non-employment is associated with daily smoking. Smoking prevention in primary health care should address both individuals and neighbourhoods.

Adult↗
PubMed2002

[Social inequality and health of the elderly--classical or alternative status indicators?].

This article is focussed on the following two questions: first, whether socio-economic status (SES) differentials in health among the aged vary by the indicators of health and SES applied. Secondly it is investigated how SES differentials in health vary by age. The analyses are based on a telephone survey of 821 older people (> or = 60 years) living in a private household in Germany. In addition to the traditional indicators of SES (education, income and occupational status) two alternative indicators (assets and home ownership) are used in the study. Self-rated health, depression (CES-D) and functional status according to Advanced Activities of Daily Living are introduced as health indicators. Results of multiple regression analyses show that associations between income and the health indicators were comparably strongest. Education, occupational prestige, assets and home ownership were not consistently related to health, especially after controlling for the remainder of the SES indicators. Thus, home ownership and assets do not predict health significantly beyond the effect of the traditional indicators of SES. With regard to age-related variations of the social gradient results were not consistent: In terms of self-rated health associations do not differ between the age groups (60-65, 66-74, 75+), while associations between traditional SES indicators and depression tend to become stronger among those aged 75 years and older. With regard to functional status there were no significant associations with socio-economic status in the multivariate model among those aged 75 years and older. The present study shows that the magnitude of the association between social inequality and health among the aged as well as age related changes in the social gradient depend on the indicators of SES and health applied. Because the analyses are based on cross-sectional data it is not possible to identify causal relationships or to separate age effects from cohort effects. Therefore longitudinal studies are needed in which traditional as well as alternative indicators of SES are used that are appropriate for older adults in general and important for an explanation of differentials in health among the aged in particular.

Activities of Daily Living↗
PubMed1990

Occupational outcomes of truancy.

This paper presents some findings of a study into early adult outcomes of truancy, which was based on the National Child Development Study, a longitudinal survey of all people in Great Britain born in the week 3rd-9th March 1958. It was found that truancy is associated with lower status occupations, less stable career patterns and more unemployment. Among those who were working, former truants' incomes were not lower, but they were considerably less well off once their family situation was taken into account. Differences remained after controlling for the effects of social background, educational ability, poor attendance due to other reasons, and end-of-school qualifications. The authors conclude that truancy is a predictor of employment problems, and of a more severe kind than will be experienced by others who share the disadvantaged background and low attainment which typify the truant.

Absenteeism↗
PubMed1993

Prevalence and associated features of depression and psychological distress in polio survivors.

This cross-sectional study examines the prevalence of psychological distress and depression among 116 polio survivors. It investigates demographic, medical, and coping differences between subjects with (n = 17) and without (n = 99) these symptoms. Subjects were administered the Brief Symptom Inventory (BSI), the Coping with Disability Inventory (CDI), and a questionnaire about their polio histories. The BSI provided measures of psychological distress and depression that defined the subgroups. The CDI assessed coping behaviors. BSI scores for the overall sample were within the normal range indicating no major distress, depression, nor elevated somatic complaints. Several significant differences were found between the two subgroups. On average, depressed/distressed subjects reported an increase in pain (p < .01) and further deterioration of their medical status since the time of their physical best subsequent to the onset of polio (p < .01). They consistently rated their health as poorer than did nondepressed/nondistressed subjects (p < .001). They also reported less satisfaction with life and their occupational status (p < .001) and displayed poorer coping behaviors combined (p < .001). Selected variables such as life satisfaction, pain, decrease in activity, and current living situation accounted for 51% of the variance when predicting distress and depression among this group of polio survivors.

Adaptation, Psychological↗
PubMed2002

The health of the Australian workforce: 1998-2001.

OBJECTIVE: To describe the health of the Australian workforce in relation to occupational status. METHODS: Data on 9,167 workers, collected between 1998 and 2001, were obtained from the Campbell National Health Monitor, a cross-sectional national, health survey. Professional, white-collar and blue-collar workers were compared on five health outcomes: self-rated health, long-and short-term conditions, reduced activity days and work absences. RESULTS: One in 10 workers (M:11%; F:10%) rated their health as poor. Two-thirds (M: 60%; F: 64%) reported long-term conditions with four in five (M:77%; F: 83%) reporting short-term conditions. Smaller proportions took health-related actions, with 21% of men and 28% of women reducing their activity, and 17% of men and 20% of women taking time off work in a given month. Occupational inequalities in self-rated health were evident for both men and women, with professionals reporting the best health and blue-collar workers the worst (p < 0.001). Male, but not female, white- and blue-collar workers also had higher rates of short-term conditions (OR 1.25, 1.06-1.50 and 1.25, 1.07-1.46, respectively) and reduced activity days due to health (OR 1.43, 1.20-1.71 and 1.25, 1.07-1.47, respectively) compared with professionals. However, blue-collar workers reporting health problems were the least likely to take time off work (poor health: p = 0.043; short-term conditions: p = 0.001; long-term conditions: p = 0.003). CONCLUSIONS AND IMPLICATIONS: Blue-collar workers are the least healthy occupational grouping. They are also the most likely to present to work unwell. With employment conditions rapidly changing, better understanding of the impact of these changes on workers' health is vital.

Adolescent↗
PubMed1990

[Integration possibilities of graduates of the Vocational Retraining Center Heidelberg with mental handicaps].

Persons with chronic mental illness face particular difficulties in finding employment, a fact which is substantiated by the studies referred to in the present article. Placement outlook however is considerably improved by qualified vocational training. Of the 1984-87 programme participants with chronic mental illness of the BFW Heidelberg, the Heidelberg vocational retraining centre, some 60% were occupationally integrated 18 to 30 months after having completed their training. The majority of them had found employment appropriate to their training and disablement, felt neither under- nor over-strained, and were satisfied with their work. The share of occupationally integrated persons was lower when compared with programme participants with other disablements, yet hardly any differences were found relative to placement quality. The share of limited duration employment, however, was greater for those with chronic mental illness. Programme participation had entailed improvements in occupational status, income and/or life situation for about two thirds. Integration and rehabilitation outcomes above all are determined by the baseline situation present as well as by severity and chronicity of the condition. The diagnosis has hardly any influence on occupational course, but is highly relevant in respect of the expectations held and the opinions on what has been achieved. The value of vocational rehabilitation is indicated by the improvements attained vis-à-vis the initial situation, as well as by keeping in mind that great numbers of persons with chronic mental illness retire prematurely within but a few years if no rehabilitation intervention is provided.

Adolescent↗
PubMed2004

[Work-related stress and resources of psychosomatic patients compared to the general population].

Work-related stress is an important determinant of the development of psychosomatic complaints and of the success of psychosomatic treatments. In order to specify work-related stress and resources in relation to the general population, 461 consecutive inpatients in psychosomatic rehabilitation were compared to matched pairs (age, sex, occupational status) from a representative community survey, the German Socio-economic Panel (GSOEP). Psychosomatic inpatients reported overall higher work stress than their matched pairs of the general population, the rank order of the stress factors as well as sociodemographic and occupational determinants were comparable. Patients also rated resources lower than their matched pairs. They reported much higher strains due to conflicts with supervisors and found less support among their colleagues. The items studied are useful to describe work stress profiles of psychosomatic rehabilitation patients and serve as a basis for therapeutic work.

Adult↗
PubMed1987

Relationship of smoking to lifestyle factors in women.

The purposes of this research were to examine the relationship of female smoking and lifestyle factors and to assess the applicability of an index of "emancipation" to smoking status in women who live in the Province of Ontario. The index of "emancipation," developed by Eide, was based on distinguishing women who are not following traditional roles as housewives from those who are. While reports in the literature confirm that occupational status, marital status and educational achievement are related to female smoking, little is known about the relationship of smoking to other lifestyle factors (e.g., sexual activity, use of cosmetic agents). Some of these relationships were examined through the secondary analysis of two data sets--one from a population survey design to assess relationships between socio-economic status, sexual behavior, and the occurrence of antibodies to herpes simplex virus type 2, and the other from a case-control study designed to test the hypothesis that oxidative hair dyes were carcinogenic. Five hundred and sixty-six women participated in the former study and 1,155 in the latter. Analyses revealed that smokers are more active sexually than "never" and "ex-smokers" for all groups of women. In addition, a curvilinear relationship with "emancipation" was found in two of the three groups of women. A higher level of smoking was found in women who were in the middle ranges of "emancipation," a finding very similar to that of Eide (1984, 1985). The possibility that increased levels of stress and/or personality characteristics underlie these relationships is discussed.

Adult↗
PubMed1981

A survey of opinion among different occupational groups toward selection of medical students.

A survey was conducted by postal questionnaire among 1200 residents of metropolitan Adelaide, South Australia, to determine public opinion on various policies and procedures concerned with the selection of medical students. There were 712 respondents, reflecting closely the metropolitan population in age and sex distribution but having a significant bias toward higher status occupational groups. Responses were examined separately for three broad occupational groups and were found to be quite consistent across each group. A clear majority preference was indicated for selecting medical students not only from those completing secondary school but including others with different educational and occupational backgrounds, and for using a variety of selection procedures in addition to examination results.

Australia↗
PubMed2000

Patients' satisfaction with physicians' services in primary healthcare centres in Kuwait City, Kuwait.

Enhancing patient satisfaction offers a way of optimising health status and helps in the reduction of wastage of medical resources. The direct measurement of patient satisfaction is new in Kuwait. This study aimed to assess patient satisfaction with respect to physicians' services in primary health care (PHC) and to determine the association of patients sociodemographic variables on their satisfaction level. The sample consisted of 301 patients selected systematically from five primary healthcare centres (PHCC) to represent various geographic areas in Kuwait. The data were collected by personal interview using a structured questionnaire. The overall mean satisfaction with physician services was 2.21 points out of a maximum of five points. The results from multiple regression analysis indicated that gender, marital status, occupation and income are the most important predictors, with females, married, labourers and higher income levels having the highest mean satisfaction score. The principal component analysis indicated that the most important aspect is 'communication' which accounted for 54% of the total variance. The results suggested a need for an educational programme to inform patients of the objectives and limits of primary health services.

Adolescent↗
PubMed2005

Organisational downsizing as a predictor of disability pension: the 10-town prospective cohort study.

OBJECTIVE: To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased risk of disability retirement among employees who kept their jobs. DESIGN: Prospective cohort study. Based on reductions of personnel in participants' occupation and workplace, employees were grouped into exposure categories of no downsizing (less than 8% reduction), minor downsizing (reduction between 8% and 18%), and major downsizing (more than 18% reduction). They were followed up for a five year period after downsizing. SETTING: Four towns in Finland. PARTICIPANTS: 19 273 municipal employees, aged 21-54 years. MAIN OUTCOME MEASURES: All permanent full disability pensions granted because of medical reasons below 55 years of age between 1 January 1994 and 31 December 1998 from the national registers. RESULTS: In all, 223 employees were granted a permanent disability pension. The overall rate for disability pensions per 1000 employees was 7.7 after no downsizing, 13.1 after minor downsizing, and 14.9 after major downsizing. Cox proportional hazard models adjusted for age, sex, occupational status, type of employment contract, and town showed 1.81 (95% confidence intervals 1.22 to 2.70) times higher risk of disability retirement after major downsizing than after no downsizing. CONCLUSIONS: The immediate financial advantages of downsizing need to be considered in relation to increased occupational disability and the resulting extra costs to employers and society.

Adult↗
PubMed1993

Social inequality in health--the role of the healthy worker effect.

Current occupational status is frequently used as an indicator of position in the socioeconomic structure in analyses of health inequalities. People outside the work-force are thereby ignored. One may hypothesize that due to a 'healthy worker effect' economically active people are a positively selected health group and that health-related exits from the labour marked are concentrated among low socioeconomic groups. One may therefore expect that this system of classification will show artificially small differences in health between socioeconomic groups. Analyses of material from a nation-wide representative survey and a complete set of mortality statistics confirm these expectations. When previously employed are included among currently employed, the differentials in health between the extreme groups in the occupational hierarchy widen. The system of classification has only a moderate impact on the main conclusion regarding men. For women, however, the conclusion depends more heavily on how they are classified. If one relies only on current occupation, small or inconsistent patterns emerge. Inclusion of previously employed has the effect of showing that low status women suffer from poorer health than high status women. This applies to several measures of health, i.e. morbidity, restricted activity and mortality.

Adult↗
PubMed1984

Occupational mortality.

Mortality statistics have been formally collected in the United Kingdom since the time of John Graunt in 1692. The advent of birth and death registration in 1839 established a reliable system of mortality rate calculations. Occupation was added to the sixth decennial census in 1851, and supplementary occupational mortality reports have been published since that date. The usefulness of these decennial supplements as hypothesis-generating exercises is reviewed. Particular emphasis is placed on the validity of the standardized mortality ratio as an index of comparative mortality. Flaws in the collection and recording of causes of death and occupational status at death and during life are noted, and the ways in which standard reporting of these events could be improved are outlined.

Humans↗
PubMed2001

Effect of socioeconomic status on aphasia severity and recovery.

Low levels of educational attainment and low socioeconomic status have been significantly linked to poor health and increased incidence of disease, including Alzheimer's disease and diseases of the cardiovascular, pulmonary, renal, and gastrointestinal systems. Our goal in the present study was to determine the degree to which educational level and socioeconomic status influence initial severity of aphasia and subsequent recovery. We evaluated the records of 39 persons with aphasia twice: at about 4 months and 103 months postonset. We found early severity of aphasia to be significantly greater for subjects in the lower educational and occupational groups. However, rate of recovery (the slope of the recovery curve) was the same regardless of educational or occupational status.

Aphasia↗
PubMed1992

Does equal socioeconomic status in black and white men mean equal risk of mortality?

Although concerns have been expressed that mortality from coronary disease and all other causes is greater among Blacks than Whites, we hypothesized that, when socioeconomic status is adequately considered, mortality inequalities between Blacks and Whites are insignificant. The study population was a random sampling of Black and White men who were 35 years of age or older when recruited into the Charleston Heart Study in 1960. Education level and occupational status at baseline were used to compare mortality over the ensuing 28 years between Black and White men, who were classified as low or high socioeconomic status. In no instance were Black-White differences in all-cause or coronary disease mortality rates significantly different when socioeconomic status was controlled. We conclude that socioeconomic status is an important predictor of mortality and that, when socioeconomic status is considered, differences in Black-White mortality rates may be small.

Adult↗