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Cardiovascular risk factors of young adults in relation to parental socioeconomic status: the Cardiovascular Risk in Young Finns Study.

The socioeconomic status (SES) of the family influences the cardiovascular risk status of children and adolescents; however, it is not as well known whether parental SES has any effect on the risk factor profile of young adults. The aim of the present study was to investigate the relations of different aspects of parental SES, namely occupation, education, income and living area, to the common cardiovascular risk factors of their offspring (n = 919) aged 18, 21 and 24 years as a part of the Cardiovascular Risk in Young Finns Study in 1986. Subjects from farming families and rural areas had the highest serum total and low-density lipoprotein cholesterol values, and the lowest diastolic blood pressure compared with subjects from other occupational groups and subjects from urban regions. The diet of young adults from farming families and from rural areas contained more saturated fatty acids and less monounsaturated and polyunsaturated fatty acids. In addition, the body mass index was lower in subjects from urban regions compared with rural regions, and physical inactivity was less common in the urban group. Subjects with the highest parental occupational status smoked less compared with those with the lowest status. Parental education related inversely to physical inactivity and directly to dietary polyunsaturated fatty acids. The income level of the family associated positively with frequent inebriation by alcoholic beverages and inversely with the percentage of dietary energy from fat. In conclusion, there were modest inverse associations between different indicators of the SES of parents and some of the traditional risk factors of their offspring in young adulthood, which may contribute to the future risk of cardiovascular diseases.

Adolescent↗

Low status control, high effort at work and ischemic heart disease: prospective evidence from blue-collar men.

An inverse relation between socio-economic class and occurrence of ischemic heart disease (IHD) in advanced societies is an often replicated finding from empirical studies. Yet, the processes which produce these effects remain an open question. One promising explanation concerns the prevalence of stressful working life, especially of distinct 'job strain' occupations. Based on these considerations, we develop a refined concept of work-related socio-emotional distress which considers a mismatch between high workload and low control over occupational status (e.g. job insecurity, poor promotion prospects, status inconsistency) as crucial distress-provoking conditions. Moreover, we assume that the effect of this condition on IHD risk is substantially increased by the presence of a distinct individual pattern of coping with work demand ('need for control'). Based on data from a 6.5 years prospective study on IHD incidence (n = 21) in a cohort of 416 middle-aged blue-collar men this concept is tested using logistic regression analysis. Results indicate that status inconsistency [multivariate odds ratio (o.r.): 4.4], job insecurity (o.r. 3.4), work pressure (o.r. 3,4) and 'need for control' (o.r. 4,5) independently predict IHD occurrence after adjusting for major confounding somatic and behavioral coronary risk factors. In conclusion, a refined model of work-related socio-emotional distress substantially contributes to the explanation of high IHD incidence among blue-collar men.

Adaptation, Psychological↗

Educational attainment, continued learning experience, and cognitive function among older men.

OBJECTIVES: This article assesses the effects of educational attainment, posteducational training experience, and occupational status on cognitive function among older men, controlling for demographic and health factors. Conditional relationships between educational attainment and factors that importantly influence cognitive function are also investigated. METHODS: Data from a nationally representative sample of 1,839 older men are used to explore life-course effects of occupational and training experiences during the 1960s, 1970s, and 1980s. RESULTS: A positive relationship is found between formal educational attainment and cognitive function, but this association is conditional on subsequent training experience, ethnicity, and symptoms of depression. Training experiences are also positively associated with cognitive function. DISCUSSION: Continued pursuit of education and training may offer opportunities to promote cognitive function throughout the life course, especially among those with low educational attainment early in life.

Cognition↗

The effect of total hip replacement on the employment status of patients under the age of 60 years.

INTRODUCTION: A retrospective study was undertaken of a consecutive cohort of 86 patients (101 hips) under the age of 60 years operated on by a single orthopaedic team between 1993 and 2003 at a district general hospital. PATIENTS AND METHODS: Demographic and diagnostic data were collected from patients' hospital records, and a detailed questionnaire regarding occupational status was used at follow-up. RESULTS: Nearly all of the patients working prior to surgery returned to employment following surgery. Nearly half of those not working pre-operatively regained employment postoperatively; among those that did not return to work, this was for reasons unrelated to their hip. Those patients who had been out of work prior to their surgery took significantly longer to return to work. CONCLUSIONS: Our study demonstrates that total hip replacement is effective in keeping patients under the age of 60 years employed. It is also effective in allowing those already off work due to hip pain to return to work, although there is a much greater delay.

Adult↗

'Reprofessionalization' or 'occupational imperialism'?: some reflections on pharmacy in Britain.

Drawing upon preliminary research findings, this paper considers whether pharmacists in Britain face a crisis in their occupational status and identity as a result of changes in their work and market situations. It further examines some of the ways in which they are responding to the challenges and opportunities presented. The paper also comments on the utility of the concepts of 'reprofessionalization' and 'occupational imperialism' in the study of British pharmacy.

Economic Competition↗

Occupational differences in ischemic heart disease mortality and risk factors in Australia.

Mortality rates from ischemic heart disease in Australia declined by about 25% over the period 1969-1978. The greatest declines were experienced by the professional occupations, while lower socioeconomic groups had higher mortality rates at the beginning of the period and experienced smaller declines. From a national survey in 1980, significantly and consistently lower risk levels of blood pressure, triglyceride, cigarette smoking, body mass and exercise were found among higher status occupation groups. This suggests that there is a pattern of coronary prevention behavior spanning multiple risk factors that is associated with a reduction in ischemic heart disease.

Adult↗

[Occupational handicaps as risk factors for the readmission of psychiatric patients hospitalized for the first time--results of a prospective longitudinal study].

In dealing with the issue of readmission of psychiatric patients into in-patient care, the focus had in the past primarily been on clinical variables such as diagnosis, or severity of the clinical picture. The present study, however, had centered on occupational variables, such as vocational training, occupational status, periods of gainful employment, and unemployment. This complex was studied in a sample of psychiatric patients, with analyses directed at: percentage of the initial sample readmitted after a catamnestic period of 1 and 2 1/2 yrs. resp., diagnostic groups with increased readmission incidence, and occupational variables associated with the need for readmission. Summing up, it may be stated that occupational handicaps arose in particular in the diagnostic groups of endogenous psychoses, whereas in other groups (such as neuroses, alcoholism) the issue of "social handicaps", in particular, had been in the foreground.

Germany, West↗

The relation of social factors to physical and psychiatric illness.

A study in social factors associated with illness status was conducted in an Australian suburban community. Forty six per cent of adults reported a chronic physical condition and twenty four per cent were psychiatrically impaired. Life event stress, adverse childhood experience and poor social support were related to both physical psychiatric illness. Low occupation status was associated with poor physical health and a poor coping style was associated with psychiatric illness. Twenty per cent of the physical illness and thirty seven per cent of the psychiatric impairment could be attributed to the presence of social factors.

Adult↗

Cigarette smoking in Connecticut: home and workplace exposure.

Estimates of smoking prevalence, environmental tobacco smoke exposure patterns, and the effect of sociodemographic variables were obtained from a telephone survey of 596 randomly selected adults in Connecticut, aged 18 or older. Results of this study indicate that 21.5% of respondents smoked cigarettes, and the smoking prevalence of men was almost twice the rate of women. Smokers were disproportionately represented in lower education, income, and occupational status categories. Approximately 60% of respondents stated they do not allow smoking in their homes. Environmental tobacco smoke exposure in the home was inversely related to age, (OR = .12, P < .01) and education (OR = .23, P < .05). Persons employed in crafts, trades, or general labor occupations were three times (P = .01) more likely to work in places which allowed smoking. Although Connecticut ranks among the top 10 states with the lowest cigarette smoking prevalence rates, continued antismoking efforts targeting lower socioeconomic groups will likely further reduce smoking and environmental tobacco smoke among adults and children.

Adolescent↗

[Health status during the occupation years--morbidity].

We refer to several studies on different aspects of the health status of the Norwegian population during World War II. The failure of the food supply led to various symptoms caused by deficient diet which reduced the resistance to infection. Hygienic problems increased, access to medical services deteriorated, and resources in terms of hospital beds, economic appropriations and number of health personnel were reduced, in particular during the final years. A network of factors contributed to deterioration in the health of the population. After the occupation the health status improved very quickly, evidently due to rapid access to the medical resources organized by the Norwegian public authorities in exile.

Disease Outbreaks↗

Socio-economic conditions, health status and employment among persons living with HIV/AIDS in France in 2001.

To investigate employment levels and identify barriers to work among persons living with HIV/AIDS in France in 2001, we conducted a cross-sectional study among HIV-infected patients seen in the hospital outpatient clinics of the two French regions most affected: Ile-de-France (IDF) and Provence-Alpes-Côte-d'Azur (PACA). Of the 840 outpatients included in the study, 58.8% in IDF and 46.8% in PACA were currently employed, and 28.1 and 47.8%, respectively, were receiving disability benefits. Among unemployed patients, 32.1% in IDF and 29.6% in PACA reported that they planned to (re)enter the workforce. Current and planned employment status were associated with characteristics indicative of the patients' social and demographic situation before the HIV diagnosis (region of residence, educational level, HIV transmission group, age, nationality) and with their health status at the interview (HIV progression, HCV co-infection). Receiving disability benefits was negatively associated with plans to return to work. HIV-related discrimination at work was reported by 11.9% of the patients in IDF and 9.2% in PACA, and was not associated with occupational status. Thus, social interventions should seek to prevent patients, particularly the most socially vulnerable, from leaving their jobs at acute stages of their illness and should promote (re)entry into the workforce among unemployed patients.

Acquired Immunodeficiency Syndrome↗

Story of benzene and leukemia: epidemiologic approach of Muzaffer Aksoy.

In 1974, Professor Muzaffer Aksoy established a link to leukemia in humans as a result of occupational exposure to benzene. The aim of this study is to evaluate his epidemiological approach for his investigation on the effects of benzene and to bring attention to the benzene problem in Turkey. Dr. Aksoy observed that a large group of leukemic patients were shoemakers, or they worked in leather manufacturing. In the 1960s, benzene was a popular solvent in the leather industry. Dr. Aksoy conducted a field investigation in Gedikpasa- Istanbul, where the shoemakers worked so that he could draw his key observations from actual environmental conditions. With a gas detector, he found the concentration of benzene in these work places to be 150-210 ppm and up to 650 ppm on rare occasions. He performed an epidemiological study and health education among 28,500 shoe, slipper and handbag workers during the period from 1967 to 1974. He published these data, establishing an association between benzene and leukemia. The incidence of leukemia among the shoe workers was decreased by screening, health education, and legislative actions in Turkey, but it began to increase again because of lack of an occupational health policy and underestimation of the problem. These results suggest the importance of primary prevention of occupational cancers. Dr. Aksoy's epidemiologic approach may highlight the necessity for detailed investigations of the occupational status of patients who need medical aid in order to diagnose the real underlying factor.

Benzene↗

A comparative study of black South African children from three different contexts.

This study compares family characteristics and developmental outcomes of black children (N = 300) from 3 rural contexts in South Africa: the homeland, the resettlement, and the white-owned farms. Parents in the homeland were more likely to be married and had more education, less household crowding, and lower mobility than parents in the other 2 areas, and higher occupational status than parents from the farms. Child outcomes paralleled these differences in material resources and family stability. Children from the homeland scored higher than children from the resettlement or farms on head circumference, vocabulary, quantitative skill, and self-concept, with no significant differences between the latter 2 areas on these outcome variables. Children from the homeland also scored higher than resettlement children on weight, copying skill, and height, with children from the farms measuring lowest on height. Child outcomes were highly intercorrelated in all 3 residence areas, but correlations among family variables, and between family and child variables, showed different patterns across areas. Parent education, occupation, and crowding were the most consistent predictors of physical development, cognitive development, and self-concept. Family mobility and marital status, however, showed different relationships to other family variables and to child outcomes across the 3 environments. These results highlight the importance of studying children in multiple environmental contexts, because family characteristics are not associated uniformly across residence areas.

Achievement↗

Family average income and diagnosed Type 2 diabetes in urban and rural residents in regional mainland China.

AIMS: To explore the relationship between family average income (FAI; an index of socio-economic status) and Type 2 diabetes in a region of mainland China. METHODS: Population-based cross-sectional study, conducted between October 2000 and March 2001 in administrative villages (n = 45) randomly selected from three urban districts and two rural counties of NanJing municipality, mainland China, with a regional population of 5.6 million. Participants were all local residents aged > or = 35 years old (n = 29 340); 67.7% from urban areas, 32.3% from rural areas, 49.8% male and 50.2% female. RESULTS: The response rate of eligible participants was 90.1%. The overall prevalence of self-reported Type 2 diabetes was 1.9%. After adjustment for possible confounding variables (age, gender, area of residence, body mass index, educational level, smoking status, occupational and leisure-time physical activity), participants in the higher and middle FAI categories were more than twice as likely to have Type 2 diabetes as those in the lower FAI category. CONCLUSIONS: The prevalence of Type 2 diabetes is positively related to socio-economic status (indexed by FAI) in Chinese at the population level. After controlling for potential confounding factors, people in higher socio-economic status groups are more likely to have Type 2 diabetes. These associations are consistent with other effects of epidemiological transition and identify a need for preventive initiatives.

Adult↗

Risk factors for depression and anxiety in abstainers, moderate drinkers and heavy drinkers.

AIMS: To identify risk factors for depression and anxiety that are more prevalent in abstainers than in moderate drinkers and to estimate their contribution to U-shaped relationships of depression and anxiety with alcohol consumption. DESIGN: Cross-sectional general population sample. SETTING: Canberra, Australia. PARTICIPANTS: 2725 subjects completed questionnaires, including 1128 men and 1258 women aged 18-59 years. MEASUREMENTS: Consumption categories from AUDIT quantity/frequency items: (1) non-drinkers (no alcohol in the past year), (2) occasional drinkers (monthly or less), (3) lower-level drinkers (up to 14 standard drinks per week for men and seven for women), (4) higher-level drinkers (up to 28 and 14 standard drinks per week, respectively), and (5) those drinking at hazardous or harmful levels (over 28 and 14 standard drinks per week, respectively). Goldberg and DSSI/sAD depression and anxiety scales. A range of demographic, socio-economic, socio-environmental and personality factors. FINDINGS: Non-drinkers were more likely than lower-level drinkers to have low status occupations, poor education, current financial hardship, poor social support and recent stressful life events, and scored lower on extraversion, fun-seeking and drive. Many of these characteristics also applied to hazardous/harmful drinkers. In multivariate models, these risk factors accounted for a substantial part of the higher depression and anxiety scores of non-drinkers and occasional drinkers relative to lower-level drinkers. CONCLUSIONS: Abstainers have a range of characteristics known to be associated with anxiety, depression and other facets of ill health, and these factors may contribute significantly to their elevated levels of depression and anxiety.

Adolescent↗

Practice-based buprenorphine maintenance treatment (BMT): how do French healthcare providers manage the opiate-addicted patients?

UNLABELLED: France was the first country to promote the extensive use of buprenorphine for the treatment of drug-addicted subjects through the primary care system. To assess both professional commitment and patients' characteristics, all the physicians and pharmacists of a French area having prescribed/dispensed buprenorphine from 2/12/96 (the official release date) to 1/31/98 were identified from data files of the Health Insurance and then interviewed. During the first 61 weeks of buprenorphine maintenance treatment (BMT), 27.5% of physicians and 51.2% of pharmacists of that area were involved; 142 patient records were documented. Features of the clinical routines spontaneously implemented for practice-based BMT were: a high level of on-site supervised dispensation by the pharmacist (71% at treatment induction and 23% thereafter); the absence of objective measurement of illicit drug use; and a low buprenorphine dosage. These features are consistent with the lack of physicians' experience and training, and also the relatively good status of the population treated (no HIV-positives, heroin use duration averaging 4.2 +/- 3.1 years, and 81.7% with stable accommodations). Despite liberal regulations guiding BMT, a negligible proportion of cases had a "nomadic" attitude (multiple buprenorphine prescribers/deliverers). The treatment outcomes (no deaths, three drug overdoses, improvement in occupational status) are encouraging. CONCLUSION: Practice-based BMT appears to be a safe and acceptable response to moderate heroin addiction, but further training of the professionals involved and longitudinal investigations of individual outcomes are needed.

Adult↗

[Management of the adult population in ten psychiatric sectors. A new active file from a single year].

In 1983, a study was conducted during one year on the active file of patients of ten public psychiatric sectors. In the first part of this study, the social characteristics of the patients were compared to those of their population of reference. This comparison defined a profile of the psychiatric patients. It also showed that males had a socio-demographic profile differing significantly from the general population by age, marital and occupational status. For females, differences were found by age, marital status and nationality. Considering professional status, a remarkable similarity exists between the females and the general population.

Adult↗

Aboriginal socio-economic characteristics: issues affecting the interpretation of statistics.

Statistical data on aborigines in Australia are examined, and it is recognized that internationally accepted census definitions and criteria may not be appropriate for analyzing the situation of aboriginal groups. In particular, the author "uses 1981 census-based comparisons of some Aboriginal and non-Aboriginal socio-economic characteristics and discusses how these assessments are affected by Aboriginal attributes. Attention is confined to three commonly used socio-economic indicators: labour force status, occupational category and income (on an individual and per capita basis)--all examined on an Australia-wide basis and specifically for the Northern Territory."

Australia↗