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Keratoconus: maternal age and social class.

A group of patients (150) suffering from keratoconus were asked their mother's age at their birth. A statistically significant excess of older mothers as compared with the general population was found. The social class of the patients was found to have a distribution different from the general population, and it is suggested that this is related to the patient's maternal age.

Adult↗

Social class, family, and life-style factors associated with overweight and obesity among adults in Peruvian cities.

BACKGROUND: Overweight and obesity have reached epidemic proportions in Latin America. OBJECTIVE: The purpose of this study was to explore social and behavioral factors associated with obesity in Peruvian cities. DESIGN: Between 1998 and 2000 health examination surveys were conducted among adults in 1176 families identified in six cities. Stratified by social class, multistaged random sampling was used. Using body mass index (weight (kg)/height (m)(2)), men and women were classified into normal weight (BMI <25), overweight (BMI 25-29), or obese (BMI > or =30); abdominal circumference (> or =94 cm in men and > or =84 cm in women) further identified morbidity risk. Several demographic, social, and behavioral variables were collected following standardized procedures. RESULTS: Adjusting for age, 37% of women were categorized as normal weight, 40% overweight, and 23% obese; corresponding figures for men were 40, 44, and 16%. More developed cities, e.g., Lima, Arequipa, and Ica, had the largest prevalence of overweight and obesity for both men and women. Adjusted logistic models showed that BMI > or =25 was positively correlated with age; whereas, education was negatively associated, only among women. Other significant associated factors of overweight included city of residence, television viewing > or =4 h daily in women, and underestimation of body weight status. CONCLUSIONS: The study showed elevated rates of overweight across the income level spectrum. Factors such as urban development stage, income, education, and gender posed differential relationships with the risk of overweight and must be considered in designing future public health interventions. Underestimation of body weight status and sedentary behavior may also constitute specific areas of intervention.

Adult↗

Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany.

OBJECTIVE: To assess the association between socioeconomic status (SES) and childhood obesity, and which factor in particular stands out in relation to obesity. METHODS: When 2020 children attended their obligatory health exam prior to school entry in the City of Aachen, Germany, 1979 parents (97.9%) filled out a questionnaire on their child's weight development and on indicators of their family's SES in a cross-sectional survey. In addition, standardized measures of weight and height were taken. More detailed information on several different SES variables, such as parental education, occupation, income, family constellation, single parenthood, and the location and size of the family residence was obtained by personal interviews in a subsample of all native German speaking children with a BMI > or = 85th percentile, defined as cases (n = 146), and with a BMI between the 40th and 60th percentile, defined as controls (n = 221). RESULTS: The indicators of parental education were most strongly associated with children's obesity. There was a strong dose-response relationship between a composed index of social class and obesity. Children of the lowest social status had a more than three-fold risk to be obese than children of the highest social status in the screening population (OR: 3.29, CI: 1.92-5.63). CONCLUSIONS: The findings established a strong relationship between parental years of education and childhood obesity. Prevention and treatment programs should endeavor to better target undereducated parents and their young children at high risk.

Body Mass Index↗

Social class, race, and ethnicity: career interventions for women domestic violence survivors.

This story describes a community intervention study conducted with women domestic violence survivors and a research dilemma related to the complex interrelationships between women's social class, race and ethnicity, and career development needs and experiences. The author presents diversity and research dilemmas related to facilitating women's critical consciousness of power dynamics at work in their lives. The influence of community context, career intervention curricula, and research team members' values on research decisions are described. This story highlights the importance of researchers examining their values and how those values impact the communities that they serve.

Adolescent↗

An analysis of associations between social class and ambient magnetic fields in metropolitan Melbourne.

In the course of a study on residential magnetic-field exposure, some incidental data were obtained that bear on the issue of confounding of magnetic field exposure by social class. We have explored the possibility that the magnetic flux density of 50 Hz fields measured in Melbourne streets is correlated with a number of variables that index the socio-economic status of the neighborhood. We have examined also for a correlation between field-intensity levels and sums of some or all of the indicators, which were weighted to provide an overall score on socio-economic status. Although some of the indexes were weakly, but significantly, correlated with environmental levels of magnetic fields, the combined indices were not. These results indicate that socio-economic status is not likely to be a confounder in epidemiological studies of residential exposure to ELF magnetic fields in Melbourne.

Electromagnetic Fields↗

The concept of social class: the contribution of Everett Hughes.

In French Canada in Transition (1943) and a set of related essays written between 1933 and 1941, Everett Hughes, a key figure in the "Second Chicago School" of sociology developed a novel and noteworthy conceptualization of social class. This contribution, which was not recognized outside of French-language sociology in Quebec, was an integral element of Hughes's "interpretive institutional ecology" theoretical frame of reference. It combined elements of the classical ecological theory of class (human ecology, functionalism, Simmel), aspects of a Weber-inspired analysis of class, status, and political power, and elements of a proto-dependency analysis of Quebec's industrialization in the 1930s.

Canada↗

Fathers' and mothers' perceptions of temperament in Israeli neonates: effects of adoption and social class.

As part of a longitudinal follow-up study of the development of adopted and biological children in Israel, 87 couples were administered the Bates Infant Characteristics Questionnaire when their first infants were 21 to 30 days old. Middleclass adoptive parents and a middle-class biological-parent control sample constituted one group. A second group comprised a lower-class sample. Mothers in all groups saw the child as more difficult in terms of strength of cry and reactions to being dressed as compared to fathers. Mothers perceived the child as more predictable for diaper changes and sleep. Adoptive parents saw their child as easier, that is, having more stable and positive mood states. Adoptive mothers saw their neonates as more active than the biological mothers. Middle-class parents saw their children as more soothable and as less disturbing in their emotional behavior than lower-class parents. The results indicate that neonatal temperament can be studied and that parental perception is influenced by sex of parent, biological relationship to the child and environmental factors, such as social class and early intervention.

Adoption↗

Social class and psychiatric practice: a revision of the Hollingshead and Redlich model.

In 1958, Hollingshead and Redlich demonstrated that there were major differences in mental health care for lower-class patients: they primarily received low-intervention treatments from nonprofessional staff. The authors report a follow-up study initiated by F.C. Redlich that reveals new trends at the community mental health center (CMHC) serving the region studied by Hollingshead and Redlich. More than half of the lower-class patients who sought evaluation at this CMHC were discharged without a treatment assignment. Many lower-class patients, however, gained access to the CMHC's psychotherapy unit. Most of these patients were women, employed, and diagnosed as psychoneurotic. The authors conclude that the effect of social class on psychiatric care is less complete than Hollingshead and Redlich originally demonstrated.

Adult↗

Regional and social class variation in the relative risk of death from amenable causes in the city of Helsinki, 1980-1986.

BACKGROUND: Relative risk of death from causes amenable to health services' intervention was studied in a case-control design to ascertain regional and social class differences. METHODS: The data were 2091 deaths from amenable causes and 8364 randomly drawn living controls in 1980-1986 in the seven health districts in Helsinki, Finland. Logistic regression was used to adjust relative risk estimates for age, sex and marital status. RESULTS: Adjustments decreased the risk ratios. Compared with the Southern District, the Middle District had significantly higher adjusted relative risk (RR = 1.4; 95% confidence interval [CI]: 1.1-1.7). People with no address had even higher relative risk (RR = 3.1; 95% CI: 2.3-4.2). Compared with social group I, increased relative risks were found in social group II (RR = 1.3; 95% CI: 1.1-1.6), group III (RR = 2.0; 95% CI: 1.6-2.4), group IV (RR = 1.9; 95% CI: 1.5-2.5) and group VI (RR = 8.5; 95% CI: 6.9-10.6). Males had higher relative risk than females (RR = 2.4; 95% CI: 2.1-2.8). Of the dead with no address, 29% were pensioners and 41% had been registered unemployed or occupation was unknown; 48% were single and 17% divorced. CONCLUSIONS: Our results suggest that regional inequalities in health care between various districts in Helsinki are small. However, to a large extent two overlapping groups, social group VI and people with no address, seem to delineate a deprived group likely to need special help from health care.

Adolescent↗

Explanations of social class differences in alcoholism among young men.

The aim of this study was to analyse the role of differences in alcohol consumption and other risk factors for alcoholism established in late adolescence, for later differences in the distribution of alcoholism between social classes among young men. Data on risk factors in childhood and adolescence, e.g. risk use of alcohol, was collected among 49,323 men, born 1949-1951, at conscription for compulsory military training 1969/1970. Data on socio-economic group was obtained from the 1975 census and data on alcoholism diagnoses from the national in-patient care register 1976-1983. Several risk factors for alcoholism, such as risk use of alcohol, psychiatric diagnosis at conscription, parental divorce, low emotional control and contact with police and child care authorities, seemed to be more common among those who were recruited to blue-collar occupations compared to those who were recruited to non-manual occupations. In multivariate analyses, taking the background variables into consideration, the increased relative risks among manual workers for alcoholism diagnoses, found in univariate analyses, diminished considerably. Several risk factors had a stronger effect on the outcome among unskilled workers compared with non-manual employees at medium or higher degree. It is concluded that risk factors for poor health established in late adolescence could explain much of the increased relative risk of alcoholism among young unskilled and skilled male workers in this study.

Adult↗

The relationship of race/ethnicity and social class to hormone replacement therapy: results from the Third National Health and Nutrition Examination Survey 1988-1994.

OBJECTIVE: To use a nationally representative sample to examine the prevalence of hormone replacement therapy (HRT) use and its relationship to different markers of social class in American women 60 years of age and older. DESIGN: Nationally representative cross-sectional survey with an in-person interview and medical examination. Between 1988 and 1994, 3,479 women aged 60 to 90+ years were examined as part of the National Health and Nutrition Examination Survey III. Mexican Americans, non-Hispanic blacks and much older women were oversampled to produce reliable estimates for these groups. RESULTS: Overall, the number of women who reported ever having used HRT was 37% [confidence interval (CI), 33%-40%] of all women older than 60 years of age; 40% (CI, 37%-41%) of older, non-Hispanic white women; 20% (CI, 14%-25%) of non-Hispanic black women; and 24% (CI, 20%-29%) of Mexican American women. HRT was used by 43% (CI, 38%-47%) of women 60 to 70 years old, 37% (CI, 32%-41%) of those 71 to 80 years old, and 20% (CI, 13%-26%) of women older than 80. HRT use was lowest among women who did not complete high school or among those in the lowest family income categories. Among women more than 60 years old who reported having a hysterectomy, 51% (CI, 47%-55%) reported using HRT, whereas only 20% (CI, 17%-23%) of those who had a natural menopause reported using HRT. CONCLUSIONS: Although many women can benefit from HRT, the number of American women who report they have ever used it remains low. More research is needed to examine the implications of racial differences in compliance, patient and physician attitudes toward HRT, and possible environmental barriers that may prevent use.

Aged↗

Cognitive mediators between patients' social class and therapists' evaluations.

Previous research has shown that therapists are more likely to accept middle-class than lower-class persons for psychotherapy and to rate middle-class patients more favorably than lower-class patients. One explanation that has been offered is that lower-class patients may not conceptualize their experiences in a manner compatible with traditional kinds of therapy. This study investigated several cognitive variables that could theoretically serve as mediators between patients' social class and therapists' differential evaluations--specifically, verbal intelligence, psychological differentiation, and locus of control. Therapists evaluated patients after the initial therapy session. Results indicated that psychological differentiation was a mediator for therapists' judgments of both patients' desire for structure and their suitability for psychotherapy. Similarly, a locus of control orientation emphasizing the role of chance functioned as a mediator of therapists' judgments of suitability.

Attitude of Health Personnel↗

Social class and carcinoma of the prostate.

Three thousand, six hundred and four patients with carcinoma of the prostate attending the Royal Marsden Hospital, St Peter's Hospitals and all non-teaching hospitals of the South Metropolitan regions were reviewed, in addition, data from 1869 cases of prostatic carcinoma registered in the 2 South Metropolitan regions with determinable social class were compared with data collected from both teaching and non-teaching hospitals. Carcinoma of the prostate showed an increased incidence with decreasing socio-economic class.

Adolescent↗

Social class, race/ethnicity, and incidence of breast, cervix, colon, lung, and prostate cancer among Asian, Black, Hispanic, and White residents of the San Francisco Bay Area, 1988-92 (United States).

BACKGROUND: To date only eight US studies have simultaneously examined cancer incidence in relation to social class and race/ethnicity; all but one included only black and white Americans. To address gaps in knowledge we thus investigated socioeconomic gradients in cancer incidence among four mutually exclusive US racial/ethnic groups-- Asian and Pacific Islander, black, Hispanic, and white-- for five major cancer sites: breast, cervix, colon, lung, and prostate cancer. METHODS: We generated age-adjusted cancer incidence rates stratified by socioeconomic position using: (a) geocoded cancer registry records, (b) census population counts, and (c) 1990 census block-group socioeconomic measures. Cases (n = 70,899) were diagnosed between 1988 and 1992 and lived in seven counties located in California's San Francisco Bay Area. RESULTS: Incidence rates varied as much if not more by socioeconomic position than by race/ethnicity, and for each site the magnitude - and in some cases direction - of the socioeconomic gradient differed by race/ethnicity and, where applicable, by gender. Breast cancer incidence increased with affluence only among Hispanic women. Incidence of cervical cancer increased with socioeconomic deprivation among all four racial/ethnic groups, with trends strongest among white women. Lung cancer incidence increased with socioeconomic deprivation among all but Hispanics, for whom incidence increased with affluence. Colon and prostate cancer incidence were inconsistently associated with socioeconomic position. CONCLUSIONS: These complex patterns defy easy generalization and illustrate why US cancer data should be stratified by socioeconomic position, along with race/ethnicity and gender, so as to improve cancer surveillance, research, and control.

Adolescent↗

Joint effects of social class and community occupational structure on coronary mortality among black men and white men, upstate New York, 1988-92.

STUDY OBJECTIVE: Occupational structure represents the unequal geographical distribution of more desirable jobs among communities (for example, white collar jobs). This study examines joint effects of social class, race, and county occupational structure on coronary mortality rates for men, ages 35-64 years, 1988-92, in upstate New York. DESIGN: Upstate New York's 57 counties were classified into three occupational structure categories; counties with the lowest percentages of the labour force in managerial, professional, and technical occupations were classified in category I, counties with the highest percentages were in category III. Age adjusted coronary heart disease (CHD) mortality rates, 35-64 years, (from vital statistics and census data) were calculated for each occupational structure category. MAIN RESULTS: An inverse association between CHD mortality and occupational structure was observed among blue collar and white collar workers, among black men and white men, with the lowest CHD mortality observed among white collar, white men in category III (135/100,00). About two times higher mortality was observed among blue collar than white collar workers. Among blue collar workers, mortality was 1.3-1.8 times higher among black compared with white workers, and the highest rates were observed among black, blue collar workers (689/100,00). Also, high residential race segregation was shown in all areas. CONCLUSIONS: Results suggest the importance of community conditions in coronary health of local populations; however, differential impact on subpopulations was shown. Blue collar and black workers may especially lack economic and other resources to use available community services and/or may experience worse working and living conditions compared with white collar and white workers in the same communities.

Adult↗

Social class and health behaviour in Danish adults: a longitudinal study.

Health behaviours were examined in a random sample of 3,608 men and women aged 30, 40, 50 and 60 years, living in the western part of Copenhagen, Denmark. Data were collected by standardized questionnaires completed by each individual in 1982 and by 2,987 subjects who attended for follow up five years later. Smoking, leisure time inactivity and infrequent intake of vegetables were interrelated and highly influenced by social class. Between 1982 and 1987 the proportion of smokers decreased in both sexes. However, an inverse association with social status persisted in the men and increased by 8% in the women. The proportion of physically inactive subjects remained nearly constant. Infrequent intake of vegetables decreased in both sexes, but an inverse association with social status persisted in men and increased by 10% in women from 1982 to 1987. In the multivariate analysis high social status predicted quitting smoking in both sexes and increased intake of vegetables in women. It is suggested that the inequalities in health behaviours between social status groups may to some extent be attributed to the way health promotion has been carried out in Denmark. This observation provides a challenge for the future design of effective public health strategies.

Adult↗