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PubMedDate not supplied

Age and sex differences in physical inactivity among Ontario teenagers.

Research on physical activity and fitness indicates their importance in the prevention of disease and promotion of health. However, levels of physical activity have been shown to vary significantly by age, sex and a wide range of additional factors. This paper examines age and sex differences in physical inactivity among 13 to 19 year olds participating in the 1990 Ontario Health Survey. Findings from the bivariate analysis suggest a major increase in physical inactivity between ages 15 and 16. When logistic regression is used to examine the adjusted effects of predictor variables on physical inactivity, the effects of age remain significant. However, the odds of inactivity at one year increments are not significant. There are significant increased odds of inactivity associated with such factors as sex, friends' (activity) participation, perceived future health problems, and perceived health status. The public health implications of the findings suggest that those responsible for developing programs and policies to increase physical activity among teenagers should consider the critical years of decreased activity and the factors that might explain why this decline occurs.

Adolescent↗
PubMed1978

Development of an index of health utilizing factor analysis.

A multivariate technique, factor analysis, was used to calculate an index number for each county in Mississippi and an overall state index number for the year 1970. Data on 55 indicators of health were factor analyzed (Principal components, Varimax rotation) and eight factors were extracted. These eight factors were identified as Resource population, Economics, Geriatrics, Social problems, Preventive medicine, Nutrition, Mortality, and Disability. Sixty-two per cent of the total variance was explained by these factors. The index numbers were standardized as percentages for ease of comparison across all 82 counties. Therefore, a multivariate technique has been used to quantify the elusive multidimensional term "health" and that is something which has not previously been adequately accomplished.

Factor Analysis, Statistical↗
PubMed2005

Living quarters and unmet need for personal care assistance among adults with disabilities.

OBJECTIVES: This study used a person-environment (P-E) framework to examine individual capabilities and social and physical environmental attributes for their association with unmet assistance needs in activities of daily living (ADLs). Analyses were replicated among five ADLs (bathing, dressing, transferring, toileting, eating) and test the relative risk of apartment dwellers compared to those living in houses. METHODS: Data were obtained from the National Health Interview Survey, Supplement on Disability Followback Survey. Analyses consisted of a nationally representative sample of aged and nonaged adults with one or more ADL limitations. RESULTS: Slightly less than 1 in 5 subjects with a specific ADL limitation had unmet needs for that ADL. This was true across all ADLs. The likelihood of unmet ADL assistance increased with the number of ADL limitations and other health status indicators. It was at least 50% higher among those living in apartments than in houses and higher among Hispanics. There were no differences by age or gender. DISCUSSION: The P-E framework postulates that individuals seek settings matched to their capabilities, but findings suggest that many are at risk for adaptation at any one time. Specific risk factors are identified. Selection factors like preferences, expectations, and adaptation options available have not been directly measured.

Activities of Daily Living↗
PubMed1985

The health of clients referred to social workers in an intake team.

Though numerous reports have strongly argued that there is a need for a closer collaboration between the health and social services, studies investigating the health of clients in contact with the personal social services have been few and limited. This study collected information regarding the physical and mental health of clients referred to social workers in the local authority intake team by means of questionnaires completed by the clients, and a selected sub-sample was also given an interview. Details were also taken regarding the social worker's assessment of health, reasons for referral and their intervention. The results indicated that the proportion of patients with physical or mental illness, or both, were very high and that social workers tended to under-report or under-estimate these illnesses. While there is some suggestion that the social workers were more likely to carry out more interviews with those clients who were ill, either physically or mentally, the contacts between social workers and medical personnel were very limited indeed.

Adolescent↗
PubMed1998

Is primary care physician supply correlated with health outcomes?

Assessment of the relation between life indicators and health outcomes is a complex problem. The authors' analysis uses descriptive canonical correlation, and their solution suggests that socioeconomic factors play a major role in health outcomes. The supply of primary care physicians has a lesser but still important role: canonical correlation suggests no apparent role in enhancing health outcomes among the elderly but a larger role in improving health among the young. The authors' analysis does support the notion that specialist physician supply has no correlation with a wide range of health outcomes.

Adult↗
PubMedDate not supplied

Pulmonary function and ambient particulate matter: epidemiological evidence from NHANES I.

The relationship between pulmonary function and quarterly average levels of total suspended particulates (TSP) was examined for adults who resided in 49 of the locations where the First National Health and Nutrition Examination Survey (NHANES I) was conducted. Statistically significant relationships were observed between TSP levels and forced vital capacity (FVC) and forced expiratory volume at one second (FEV1.0). These relationships remained strong across several specifications and sample changes, e.g., exclusion of cities with two highest and two lowest TSP levels, restriction of sample to whites only. Anthropometric measurements and socioeconomic characteristics of the subjects were included in the analysis, and we restricted the sample to "never" smokers. The results indicate a 1 standard deviation increase (about 34 micrograms/m3) in TSP from the sample mean of 87 micrograms/m3 was associated with an average decrease in FVC of 2.25%. The results of this analysis also suggest that there is a threshold level (i.e., approximately 60 micrograms/m3 [quarterly average]) of TSP below which a relationship with pulmonary function ceases to exist.

Adult↗
PubMed1986

Construction of social value or utility-based health indices: the usefulness of factorial experimental design plans.

Global indices, which aggregate multiple health or function attributes into a single summary indicator, are useful measures in health research. Two key issues must be addressed in the initial stages of index construction from the universe of possible health and function attributes, which ones should be included in a new index? and how simple can the statistical model be to combine attributes into a single numeric index value? Factorial experimental designs were used in the initial stages of developing a function index for evaluating a program for the care of young handicapped children. Beginning with eight attributes judged important to the goals of the program by clinicians, social preference values for different function states were obtained from 32 parents of handicapped children and 32 members of the community. Using category rating methods each rater scored 16 written multi-attribute case descriptions which contained information about a child's status for all eight attributes. Either a good or poor level of each function attribute and age 3 or 5 years were described in each case. Thus, 2(8) = 256 different cases were rated. Two factorial design plans were selected and used to allocate case descriptions to raters. Analysis of variance determined that seven of the eight clinician selected attributes were required in a social value based index for handicapped children. Most importantly, the subsequent steps of index construction could be greatly simplified by the finding that a simple additive statistical model without complex attribute interaction terms was adequate for the index. We conclude that factorial experimental designs are an efficient, feasible and powerful tool for the initial stages of constructing a multi-attribute health index.

Activities of Daily Living↗
PubMed1985

Racial and socioeconomic disparities in childhood mortality in Boston.

We examined racial and income-related patterns of mortality from birth through adolescence in Boston, where residents have high access to tertiary medical care. Childhood mortality was significantly higher among black children (odds ratio, 1.24; P less than 0.05) and low-income children (odds ratio, 1.47; P less than 0.001). Socioeconomic effects varied for different age groups and causes of death. The largest relative disparity occurred in the neonatal and postneonatal periods, and the smallest in adolescence. Of the total racial differential in neonatal mortality (6.88 deaths per 1000 live births), 51.2 per cent occurred in premature infants, 13.4 per cent in term infants who were small for their gestational age, and 25.9 per cent in neonates who were both premature and small for their age. Black neonatal mortality was elevated at all income levels. Beyond the neonatal period, mortality from respiratory disease, fire, and homicide had strong inverse relationships with income, and mortality from injuries to the occupants of motor vehicles was directly related to income. These data suggest that despite access to tertiary medical services, substantial social differentiation in mortality may exist throughout childhood. Equity in childhood survival will probably require policies that emphasize preventive goals.

Accidents, Traffic↗
PubMed2002

[The Child and Adolescent Health Survey--a foundation for prevention, health promotion and health goals].

At the beginning of the 21st century, the German Health Interview and Examination Survey of Children and Adolescents will for the first time provide the data essential for programmes of disease prevention and health promotion as well as for the development of health targets. This it will create key information for an evidence-based health policy. The results of the study can be projected to the general population of children and adolescents in Germany. The data will be collected conjunct at the level of the individual subject. They will facilitate valid and distinct description of prevalent physical, psychological and social health problems, as well as on who has them under which circumstances and settings. Information on the impact, e.g., in terms of utilisation of the health system or impairments of quality of life, will also be available from the same subjects. In addition, indicators of risks to health in later life are included. Hence, the data will support prevention of health problems in infancy, childhood and adolescence as well as of chronic diseases in later life. Finally, the data shall be a basis for the definition of new reference values for many variables. This will improve valid and clear judgement not only in epidemiological studies but also in medical care.

Adolescent↗
PubMed1998

Differences in self reported morbidity by educational level: a comparison of 11 western European countries.

STUDY OBJECTIVE: To assess whether there are variations between 11 Western European countries with respect to the size of differences in self reported morbidity between people with high and low educational levels. DESIGN AND METHODS: National representative data on morbidity by educational level were obtained from health interview surveys, level of living surveys or other similar surveys carried out between 1985 and 1993. Four morbidity indicators were included and a considerable effort was made to maximise the comparability of these indicators. A standardised scheme of educational levels was applied to each survey. The study included men and women aged 25 to 69 years. The size of morbidity differences was measured by means of the regression based Relative Index of Inequality. MAIN RESULTS: The size of inequalities in health was found to vary between countries. In general, there was a tendency for inequalities to be relatively large in Sweden, Norway, and Denmark and to be relatively small in Spain, Switzerland, and West Germany. Intermediate positions were observed for Finland, Great Britain, France, and Italy. The position of the Netherlands strongly varied according to sex: relatively large inequalities were found for men whereas relatively small inequalities were found for women. The relative position of some countries, for example, West Germany, varied according to the morbidity indicator. CONCLUSIONS: Because of a number of unresolved problems with the precision and the international comparability of the data, the margins of uncertainty for the inequality estimates are somewhat wide. However, these problems are unlikely to explain the overall pattern. It is remarkable that health inequalities are not necessarily smaller in countries with more egalitarian policies such as the Netherlands and the Scandinavian countries. Possible explanations are discussed.

Adult↗
PubMed1997

Health impact assessments of malaria and Ross River virus infection in the Southern Highlands Province of Papua New Guinea.

Malaria at an elevation of 1050 metres is common and highly endemic in the Tagari Valley in the Southern Highlands of Papua New Guinea. Health impact assessments showed that the risks of malaria and epidemic polyarthritis at a gasfield development project in this area were high. Baseline malariometric surveys were conducted in four villages in June and August 1990 and two follow-up surveys (May and December 1991) were made in the village of Nogolitogo near the gasfield pioneer base camp. A total of 941 blood smears were examined. Average malaria prevalence rates decreased with altitude from 56% (at 1050 m) to 9% (at 1700 m) for children 1-9 years of age and from 45% (at 1050 m) to 8% (at 1550 m) for those aged 10 years or more. The spleen rate for children less than 10 years old did not vary significantly with altitude, but average enlarged spleen for all ages decreased with altitude. Mean packed cell volume increased with altitude. Plasmodium falciparum was the most common malaria parasite found and Anopheles punctulatus the predominant vector. Ross River arbovirus (RRV) antibody prevalence was 59%. These results indicate frequent or constant transmission of malaria and pathogenic arboviruses. Entomological and epidemiological data suggested that the vulnerability of the valley community, the receptivity of the environment and the health hazards from malaria and RRV were high. Nonimmune Papua New Guineans and expatriate employees face high health hazards; therefore effective preventive measures are required to mitigate epidemics and avoid the likely heightened transmission of malaria and arboviruses caused by the development project.

Adolescent↗
PubMed1995

A subjective health indicator for follow-up. A randomised trial after treatment of displaced intracapsular hip fractures.

We report a randomised prospective trial of the early results of three types of treatment for displaced intracapsular hip fractures. We used a questionnaire sent to patients at about six months (Nottingham Health Profile, NHP) in addition to clinical assessments. There was a 67.4% usable response to the questionnaire, similar to that in other studies using the NHP. There were more responders from younger patients, those walking independently before injury and those with higher mental test scores on admission. In the younger group (65 to 79 years) we found a trend for better scores in most NHP indices after the use of a bipolar prosthesis rather than a unipolar prosthesis or internal fixation, particularly for social function, pain and physical mobility. Postal assessment using the NHP gave a satisfactory response rate even in the elderly, and can provide an extra assessment to complement or replace hospital follow-up in some circumstances.

Activities of Daily Living↗
PubMed1992

Marginal nutritional status among institutionalized elderly women as compared to those living more independently (Dutch Nutrition Surveillance System).

The nutritional status (assessed by anthropometric indices, and biochemical and hematological variables in blood) of three groups of elderly women (aged > or = 65 years) was evaluated within the framework of the Dutch Nutrition Surveillance System. The groups were composed of women living in a nursing home (n = 51), women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and women living independently (n = 52). Mean blood levels of folate, pyridoxal 5'-phosphate, 25-hydroxyvitamin D, alpha-tocopherol, vitamin C, albumin, selenium and total cholesterol were significantly (p < 0.05) lower among nursing home women. Among these women a biochemical deficiency was frequently found for 25-hydroxyvitamin D (73%), pyridoxal 5'-phosphate (57%), vitamin C (38%), selenium (30%) and folate (28%). These nutritional risks were largely independent of each other. Since folate and pyridoxal 5'-phosphate were associated with several clinicochemical indicators, health status may be an important determining factor for this unfavorable situation. Low 25-hydroxyvitamin D concentrations were associated with limited exposure to ultraviolet radiation and nonusage of vitamin D supplements. We conclude that dietary intake variables are not the only determinants of a marginal nutritional status among nursing home women. Use of foods with a high nutrient density should be encouraged, whereas other preventive measures are needed to improve vitamin D status.

Aged↗
PubMed1998

State differences in reported healthy days among adults--United States, 1993-1996.

Traditional population health measures, such as infant mortality rates, vaccination rates, and average life expectancy, have emphasized morbidity and mortality. During the past decade, weighted indices of population health (e.g., years of healthy life and disability-adjusted life-years), which combine life expectancy with aspects of health-related quality of life (HRQOL), have provided more comprehensive summary measures. To meet the need for a less complex measure that is more sensitive to local variations in population health, CDC developed the "healthy days" index. This HRQOL index tracks the number of healthy days (i.e., days when persons' physical and mental health were both good) during the preceding 30 days for a specific population. This report describes state differences for 1993-1996 in the mean number of healthy days reported by adults, including large differences within each state by level of formal education.

Adult↗
PubMed2004

[Spondyloarthropathies--clinical evaluation and physical therapy].

Spondyloarthropathy is a group of chronic autoimmune disorders including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, acute anterior uveitis and undifferentiated spondyloarthropathies. The spondyloarthropathies share common clinical, radiological, and genetic features that are clearly distinct from other inflammatory rheumatic diseases. The major goal in the management of patients with rheumatic disorders is to control or cure the disease and to preserve and control function and health status. To measure treatments' efficacy standardized assessment of organ morphology, function, and of health status are required. The instruments for measuring health status or quality of life cover a variety of dimensions of health, including physical, social, and emotional functioning. Measurements used to evaluate the efficacy of treatments in ankylosing spondylitis include spinal and chest movement, duration and severity of morning stiffness, and quality of sleep. Health status indices such as the HAQ or AIMS are not readily applicable to spondyloarthropaties. It is reason to use some others: 1. Functional status measure S-HAQ for patients with spondylitis by adding five items to the HAQ, to cover the activities identified as most problematic; 2. Functional index for the assessment of ankylosing spondylitis (Dougados Functional Index - DFI) - it is valid and reliable and shows sufficient responsiveness; S-HAQ appears at least as sensitive to change as the Dougados Index; 3. The Leeds Disability Questionnaire assesses disability in ankylosing spondylitis, inquiring about four areas of function: mobility, bending down, reaching up and neck movements, and postures; 4. The Bath Ankylosing Spondylitis Functional Index (BASFI) 10 item self-administered questionnaire to assess function and activities of daily living in patients with ankylosing spondylitis. Physical therapy is one of the most important way to restore function and health status in patients with spondyloarthropathies, esspecially individual kinesitherapy. We use and many other procedures combine them with kinesitherapy (ultrasound, cryotherapy, electrotherapy, laser ...).

Activities of Daily Living↗
PubMed2006

Religious influences on preventive health care use in a nationally representative sample of middle-age women.

Despite the many benefits of preventive services, they are often underutilized. Social factors, such as religion, can figure prominently in these discrepancies by either creating barriers or facilitating use. Using data from the Health and Retirement Survey (HRS, 1992-1996), the current study examines the relationship between religious attendance, religious salience, and denomination and three types of female preventive services in a sample of middle-age women (N = 4253). Findings indicate that women who attend religious services more frequently use more mammograms, Pap smears, and self-breast exams. In addition, women belonging to Mainline Protestant or Jewish denominations use certain preventive services more than Evangelical Protestants. Finally, women with higher levels of religious salience are more likely to conduct self-breast exams. These findings add important information to the public health literature concerning factors that influence preventive service use. They also add to the growing field of religion and health research where preventive health care use is emerging as a possible mechanism linking religion to a wide variety of physical health outcomes.

Aged↗
PubMed1988

Vasectomy and health: cardiovascular and other diseases following vasectomy in Sichuan province, People's Republic of China.

The long-term sequelae of vasectomy were studied in a retrospective cohort study of 4596 vasectomized and 4340 nonvasectomized farmers from eight rural communes in Sichuan, People's Republic of China. The mean duration since the operation was 14.5 years with a range of 10 to 25 years. At the time of evaluation the vasectomized men were generally healthier than the non-vasectomized for a wide range of health indicators including clinical signs of cardiovascular disease, resting ECG changes, positive ECG changes following a maximal stress test, or fundus abnormalities. The lack of association between vasectomy and cardiovascular disease noted in Europe and the USA is supported by the present study conducted in a population with a low prevalence of cardiovascular disease and risk factors.

Adult↗
PubMed1986

Rehabilitation indicators: a complement to traditional approaches to patient assessment.

Rehabilitation Indicators (RI) form a multipart system for assessing the macrofunctioning of patients in medical rehabilitation. The RI system was designed to provide a holistic view of the patient as a means of integrating the diverse data sets that are obtained at present. The computerization of the RI system creates an easily accessible database to optimize intrateam communication and the sharing of information with patients and families, as well as to optimize the service provider's response to increasing demands for accountability.

Activities of Daily Living↗