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PubMed2005

Increasing awareness of health care resources for the uninsured and underinsured:a pilot study.

Programs are available to provide assistance to the uninsured, but information about how to access those programs is not readily available to the average uninsured citizen. A pilot study involving the University of Kentucky Family and Consumer Science Agents and Homemaker groups in two rural counties significantly increased the number of people who accessed one of the programs, Health Kentucky. Findings from the study could be validated in other Kentucky counties and with other types of health-related messages.

Adolescent↗
PubMed1997

Comparison of survey and physician claims data for detecting hypertension.

Using linked data from the Manitoba (Canada) Heart Health Survey (MHHS) and physician service claims files we assessed the degree to which self-reported hypertension and clinically measured hypetension agreed with physician claims hypertension, and examined the likely sources of disagreement. The overall agreement between survey and claims data for hypertension detection was moderate to high: 82% (kappa = 0.56) for self-reported and physician claims hypertension, and 85% (kappa = 0.60) for clinically measured and physician claims hypertension. In the comparison between self-report and physician claims, those who were classified as obese, diabetic, or a homemaker were significantly more likely to have a hypertension measure not confirmed by the other. Disagreement between clinically measured and physician claims was also more common among the obese and homemakers, as well as those on medication for heart diseases, elevated cholesterol levels (LDL), and 35 years of age and older. The high overall level of agreement among these three measures suggest that each may be used with confidence as an indication of hypertension; however, the agreement appears lower among individuals presenting a more complicated clinical profile.

Adult↗
PubMedDate not supplied

Women in the labor force.

Unlike the rate for men, the labor force participation rate for women has increased significantly over the past three decades or so. This trend is expected to continue at least through 2005. Among the reasons for the growing role of women in the labor market are higher levels of educational attainment, improved employment opportunities, changing values in society, and economic pressures and aspirations that require women to assume dual careers as homemakers and family income producers. By the year 2005, it is estimated that women workers will number about 72 million, with more than 63 percent of all women age 16 and over either working or actively looking for work. While traditional occupations such as secretarial and clerical administrative support and professions such as nursing and teaching still predominate, about 4 million women are now in executive, administrative and managerial positions in the private sectors of the economy. As for the types of industry in which women are employed, service industries clearly predominate. Projections suggest that women workers of the future will be older on average, with the fastest growth occurring in the 45-64 age cohort. They will also be a more diverse group as the number of black, Asian and Hispanic women workers grows more rapidly than the number of white non-Hispanic labor force participants.

Adult↗
PubMed1997

Psychopathology and the development of disability.

The objective was to determine the effect of preexisting psychopathology on days missed from work or usual activities ("disability days") in a large community sample (N = 3481). Logistic regression analyses were performed with the presence or absence of disability days (wave 2) as the dependent variable. The effects of sociodemographic variables, six psychiatric disorders, a high distress score, and chronic physical conditions (wave 1) were studied. Separate analyses were conducted for the total sample and four subgroups (labor force participants, homemakers, men, and women). The adjusted odds ratios and 95% confidence intervals (95% CI) for subjects with onset of panic disorder were 7.3 (95% CI = 1.8, 28.7); for those with chronic major depressive disorder, 7.2 (95% CI = 0.3, 160.6); and for those with chronic high distress, 5.0 (95% CI = 2.6, 9.9). The relative odds for developing a disability were greater for those with either type of psychiatric disorder or high distress than for those with any prior physical illness or those with a prior disability day. Disability days experienced by persons with psychopathology result in diminished quality of life, economic losses, and increased need for health services. Improved health services and educational and work adjustments for emotionally disabled persons are recommended.

Absenteeism↗
PubMed1999

Communicating at life's end.

With more and more people choosing to die at home, palliative care is an increasingly important field. The challenge for those of us working in the field is to develop a comprehensive system of care that will provide high quality, in-home support. Such support involves a large network of formal and informal caregivers--family members, caregiving friends, homemakers and a variety of health care providers--who collaborate together and with the individual to provide holistic care. Thus, co-ordination, collaboration and communication are essential if this network is to meet the physical, psychological, social and spiritual needs of the dying and their families.

Aged↗
PubMed2001

Lithium revisited: savings brought about by the use of lithium, 1970-1991.

BACKGROUND: Recent estimates of the cost of manic-depressive illness totaled roughly $45 billion in 1991. Using data from the Epidemiological Catchment Area (ECA) study, this study estimates the savings brought about by the use of lithium between 1970 and 1991. METHODS: Total savings are the difference between estimated actual costs and projected costs had lithium never been introduced. Actual yearly costs were interpolated from data for 1970 and 1991, and projected costs were obtained by adjusting 1970 costs with Consumer Price Index (CPI) and population inflaters. All costs for 1970 were obtained using methods almost identical to those used to calculate the 1991 costs of manic-depressive illness, presented in a previous publication. All savings are presented in 1991 dollars. RESULTS: Between 1970 and 1991, lithium saved over $170 billion, or roughly over $8 billion per year. Approximately $15 billion in direct costs, which included inpatient and outpatient care as well as research, was saved between 1970 and 1991. The savings are more dramatic for indirect costs, which include the lost productivity of wage-earners, homemakers, family caregivers, and individuals who are in institutions or who committed suicide; these totaled roughly $155 billion. CONCLUSIONS: Our results suggest that, although manic-depressive illness is still costly, lithium has been tremendously successful in treating the illness, and has provided enormous financial savings in the process.

Antimanic Agents↗
PubMed1986

Disability, utilization, and costs associated with musculoskeletal conditions.

In this report, data from the 1980 National Medical Care Utilization and Expenditure Survey are used to present health characteristics, types and quantities of services used, and the charges for these services for persons with musculoskeletal diseases. Slightly more than 44 million people, or 19.8 percent of the U.S. civilian noninstitutionalized population, were reported in the survey to have at least one musculoskeletal disorder. These data are generally consistent with those from other health surveys, which show that the prevalence of musculoskeletal disorders increases for successive age categories, that such disorders are more common among women than among men, and that they are less prevalent among black persons than among persons of other races. In terms of both functional limitation and perceived health status, persons with musculoskeletal conditions are, with some notable exceptions, in relatively poor health. Persons having back problems in addition to problems with peripheral joints (such as the knee, hip, or shoulder) were more likely to rate their health as "fair" or "poor" compared with persons having only back problems or compared with persons in the civilian noninstitutionalized population as a whole. Musculoskeletal disorders accounted for a considerable proportion of all disability days reported by the total civilian noninstitutionalized population: 13 percent of restricted-activity days, 8.8 percent of bed-disability days, and 11.2 percent of all work-loss days were directly attributable to musculoskeletal conditions. The disabling effects of musculoskeletal problems pose a significant economic burden; they accounted for a total of $3.9 billion in lost productivity costs during 1980 for employed persons in the work force and for homemakers. For persons with musculoskeletal problems, the mean number of ambulatory visits per year was nearly twice the rate of 5.2 for the general civilian noninstitutionalized population. Of ambulatory visits made to all health care providers by persons with these conditions, 35.6 percent were related in some way to the treatment of their musculoskeletal problems. Musculoskeletal conditions are somewhat different from many other illnesses because their treatment is within the professional domain of several types of health care providers. Approximately 13 percent of persons with any type of musculoskeletal disorder received care from chiropractors during the year and this figure rose to nearly 30 percent for back problems only. However, nearly 33 percent of persons with musculoskeletal problems made no visits for treatment of their condition.(ABSTRACT TRUNCATED AT 400 WORDS)

Absenteeism↗
PubMed1990

Comparison of rehabilitation in patients undergoing home dialysis. Continuous ambulatory or cyclic peritoneal dialysis vs home hemodialysis.

Rehabilitation was assessed in 70 patients undergoing continuous ambulatory (CAPD; n = 67) or cyclic (CCPD; n = 3) peritoneal dialysis and 76 patients undergoing home hemodialysis (HHD). In the CAPD/CCPD group, there were more blacks (83% vs 53%) and diabetics (24% vs 8%). If patients too infirm to work were excluded, no statistically significant differences were found between those working for gain and in school (19% for CAPD/CCPD vs 32% for HHD); homemakers (16% for CAPD/CCPD vs 28% for HHD); and those not working (66% for CAPD/CCPD vs 41% for HHD). Although the CAPD/CCPD group had less formal education (8.9 +/- 3.7 years vs 10.9 +/- 2.2 years for HHD), illiteracy rates were similar (CAPD/CCPD, 16%; HHD, 7%). If unemployable (elderly and debilitated) patients were excluded, full rehabilitation was excellent in both groups (57% for CAPD/CCPD vs 65% for HHD), despite the greater number of blacks and diabetics in the CAPD group.

Adolescent↗
PubMed2002

Job stress and job dissatisfaction of home care workers in the context of health care restructuring.

Changes in the social organization of home care work due to health care restructuring have affected the job stress and job dissatisfaction of home care workers. This article reports the results of a survey of 892 employees from three nonprofit home care agencies in a medium-sized city in Ontario, Canada. Survey results are complemented by data from 16 focus groups with 99 employees. For the purposes of this study, home care workers include both office workers (managers, supervisors, coordinators, office support staff, and case managers) and visiting workers (nurses, therapists, and visiting homemakers). Focus group participants indicated that health care restructuring has resulted in organizational change, budget cuts, heavier workloads, job insecurity, loss of organizational support, loss of peer support, and loss of time to provide emotional laboring, or the "caring" aspects of home care work. Analyses of survey data show that organizational change, fear of job loss, heavy workloads, and lack of organizational and peer support lead to increased job stress and decreased levels of job satisfaction.

Administrative Personnel↗
PubMed2001

Access to prenatal, delivery, and newborn care among undocumented Hispanics in the Memphis area.

The purpose of this study was to examine the prenatal, delivery, and newborn care received by undocumented Hispanics in the Memphis area. The focus was to sketch a demographic profile of this population, identify barriers encountered in obtaining prenatal, delivery and newborn care, and present a five-year projection of the demand for prenatal care for this population. Participants included 97 undocumented Hispanic women, who either were pregnant or had a baby within the past 12 months, and health care providers. Most women came from Mexico (90.7%). They tended to be young, to have low educational attainment, to be homemakers, to have a high number of members in their households, to be financially supported by their spouses, and to live at or below the poverty line. The average length of time that they had been in the United States and Memphis were 42 and 21 months respectively. With regard to access to health care, undocumented Hispanics who migrated to the Memphis area lacked adequate prenatal and delivery care, and we estimated that the demand for prenatal care in this population will increase over 60% in the next five years.

Adolescent↗
PubMed1975

Nutritional status of black preschool children in Mississippi. Influence of income, mother's education, and food programs.

The nutritional status of 247 black preschoolers in two counties of Mississippi was studied by relating caloric and nutrient intakes and anthropometric measurements to homemaker's education, family income, and participation in Food Stamp and donated food programs..23AUTHOR Low intakes of calories, iron, calcium, vitamin A, and ascorbic acid were found in many of the children, regardless of the variable considered. These findings--in comparison with similar studies--imply that, as time passes, low education and income are having less impact on child nutrition. This ameliorating effect may be due to programs designed to educate parents and extend purchasing power of food dollars. Thus, it seems advisable to continue these programs.?23AUTHOR

Black or African American↗
PubMedDate not supplied

Cancer coverage in mass-circulating Canadian women's magazines.

Mass media can inform health beliefs and shape cancer control behaviours. This study surveyed cancer coverage in 309 issues of Canadian women's magazines for the period 1991-1997. Magazines were selected if 1996 revenue > $10 million and circulation > 500,000; Canadian Living, Chatelaine, Flare and Homemaker's met these criteria. The volume of cancer coverage varied significantly by year and by magazine. However, coverage of specific cancers did not reflect their contribution as a cause of cancer death in Canadian women. The percentage of articles on lung cancer was lower and on breast cancer was higher than the percentage of deaths due to these cancers. All magazines had decreased coverage of lung cancer in 1997 compared to 1991. National cancer resource agencies and research initiatives on breast cancer were infrequently mentioned. These results argue for greater partnerships between the media and health educators to enhance balanced dissemination of cancer control information to Canadian women.

Canada↗
PubMed1977

Nutrition survey of schoolchildren in greater Winnipeg. I. Descriptive and anthropometric data.

By sequential random numbering 10 schools in greater Winnipeg were selected for a nutrition survey. Interviews were conducted with 201 grade 3 children and 182 grade 6 children for whom parental consent was obtained. Of these, 48 in grade 3 and 51 in grade 6 were studied in further detail. There were no differences in descriptive data between the general and detailed groups or among the 10 schools. Most fathers were skilled or unskilled labourers and about 50% of the mothers were homemakers without outside employment; parental occupation did not influence eating patterns. Breakfast was the meal most often missed; 8% of the 383 children had come to school without breakfast. Since many children in grade 3 had prepared their own breakfast and since there was a relative lack of physical activity, school health programs should incorporate more than nutritional supplements and nutrition education. On the basis of body weight and height the nutritional status of the 99 children studied in detail was judged to be generally satisfactory; according to the Boston standards the boys were heavy and tall, and the girls were normal in weight but short.

Body Height↗
PubMed2006

Enhancing patient education about medicines: factors influencing reading and seeking of written medicine information.

OBJECTIVE: To investigate the influence of patient factors on patients' reading and seeking of written medicine information (WMI). DESIGN: A cross-sectional questionnaire study. Main variables studied Patient's health locus of control, coping style, health literacy, demographics and disease state (independent variables) and patient's interest and likelihood in reading and seeking WMI (dependent variables). MAIN OUTCOME MEASURES: Patient factors predicting interest in reading and seeking WMI. SETTING AND PARTICIPANTS: Patients (total n = 479) from three Rheumatology/Pain clinics in teaching hospitals (n = 217) and 40 community pharmacies (n = 262) in metropolitan Sydney, Australia. RESULTS: The majority of patients were interested and likely to read WMI about their prescription medicines. However, not many were likely to seek WMI and not many frequently sought WMI. Using logistic regression, patients' interest in reading WMI was predicted by their coping style [monitor vs. blunter, odds ratio (OR) = 2.19, confidence interval (CI) = 1.17-4.10], health literacy levels (adequate vs. inadequate/marginal, OR = 2.86, CI = 1.16-7.05) and occupation (blue-collar vs. homemaker, OR = 3.42, CI = 0.09-0.88) whilst patients' interest in seeking WMI was predicted by their disease state (pain/rheumatology condition vs. hypertension, OR = 1.84, CI = 1.11-3.05), health locus of control (powerful other, OR = 0.95, CI = 0.90-0.99) and health literacy levels (adequate vs. inadequate/marginal, OR = 2.7, CI = 1.17-6.39). CONCLUSIONS: Patients' interest in reading and seeking WMI were influenced by several patient factors including disease state, health locus of control, coping style, health literacy levels and occupation. Furthermore, the results highlighted that reading and seeking WMI were regarded as distinct activities influenced by different factors. These findings may guide health professionals in assessing the utility of WMI for different patient groups and more broadly in the tailoring of patient education to meet patient needs.

Aged↗
PubMed1999

Physician contact with older community patients: is there an association with physical fitness?

BACKGROUND: Contact with family physicians by older adults may be linked to their physical fitness in addition to other health, behavioral, and sociodemographic determinants. We studied a stratified random sample of urban community-dwelling elderly patients in London, Ontario, Canada, to describe the interaction of physical fitness measures and a number of health and lifestyle behaviors and sociodemographic outcomes with family physician contact over 1 year. We hypothesized that physician contact would be associated with lower indices of physical fitness and that association would be similar to other known determinants of physician utilization. METHODS: Three hundred seventy-five noninstitutionalized elderly men (N = 185) and women (N = 190) ages 55 to 84 years were recruited from the municipal tax assessment list for the city of London (population 280,000). Four categories of independent variables were selected to reflect common determinants of health (physical fitness, self-reported and clinically measured health, lifestyle behaviors, and sociodemographics). The association between these categories of variables and self-reported contact with family physicians and a variety of health professionals was determined for the year prior to the study. RESULTS: Forty-six percent of the subjects had at least one physician contact in the month prior to the study and 79% within the previous year. None of the other health professions (including nursing, chiropractic, physiotherapy, homemaking, and dentistry) were contacted more than once in the previous year. Lifestyle and sociodemographic variables including activity habits, smoking, income, marital status, and education were not associated with physician contact, whereas poor self-reported cardiovascular health and use of cardiovascular and pulmonary medications were associated with physician contact. Interestingly, physical fitness variables including maximal aerobic capacity, grip strength, and hip flexibility were not associated with physician contact. CONCLUSIONS: The absence of an association among physical fitness, lifestyle, and sociodemographic variables and physician contact was not anticipated and may be due to the selection of individuals who were independent, active community dwellers. It may be that most of the physician contact in this relatively healthy and physically fit sample was preventive in nature, for example, monitoring common chronic disease states in the elderly including cardiovascular and pulmonary disease. This paper reports baseline data from a longitudinal study of the interaction between physical fitness and health outcomes in groups of older community-dwelling individuals. As this group ages further, it would be interesting to determine the use of the health care system in relation to their changing functional and health status. In particular, do chronic health conditions such as cardiovascular disease, which increase in prevalence with age, become modified through maintenance of physical fitness and does this impact on health service use?

Aged↗
PubMed1984

Abortion outcome as a function of sex-role identification.

The present study investigated the relationship between sex-role identification and abortion outcome in 120 women receiving 1st trimester abortions. The sex-role concept dimension was measured both ty self-attributions of sex-role traits (as measured by the Bem Sex-Role Inventory) and by lifestyle (career vs. homemaker) trait attbibutions. Psychological and physiological aspects of abortion outcome were included: slighlty more than 7% of scores were in the symptomatic range, similar to percentages found in previous studies. Both Androgyny (r = -.42, p.001) and Masculinity (r = -.23, p.05) were found to be related to positive abortion outcome. Androgyny was more strongly related, which suggests that a balance of masculine and feminine traits, at least for women in the post-abortion situation, is prefereable to high Masculinity scores alone. Congruence between one's self-image and one's image of a career woman was also found to be related to abortion outcome (r = .31, P.01). In attempting to differentiate between the upper and lower 10% of the distribution of abortion outcome, only 2 variables, Androgyny and self-career congruence, survived parameter criterion, and accounted for 32% of the variance.

Abortion, Induced↗
PubMed1995

Accessing an understudied population in behavioral HIV/AIDS research: low income African American women.

Most HIV/AIDS behavior research involving African American women has focused on traditional high risk populations, such as those in drug treatment centers, STD clinics, and hospitals. Few studies have examined the health needs and behaviors of African American women in the general population (i.e., working mothers and homemakers). The Parent Health Project examined beliefs and concepts of illness, including AIDS, of low income African American mothers of young children. We used a variety of methods of community outreach and recruitment strategies to gain access and trust from these African American women, including (1) recruitment of women who had children in a related research project, (2) subject reimbursement, and (3) culturally sensitive community based outreach. Of approximately 200 women contacted, 147 (74%) agreed to participate in a two-hour face-to-face interview about concepts of health and illness. Through our efforts, we were able to gain access to a population generally not studies in HIV/AIDS research. We were also exposed to a number of issues, concerns and behaviors faced by women not classified as high risk, yet who are at risk as a result of their own and/or their sexual partner's(s) risk behaviors.

Acquired Immunodeficiency Syndrome↗