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PubMed2006

A multilevel study of socio-economic inequalities in food choice behaviour and dietary intake among the Dutch population: the GLOBE study.

OBJECTIVE: To examine the influence of individual- and area-level socio-economic characteristics on food choice behaviour and dietary intake. SETTING: The city of Eindhoven in the south-east Netherlands. DESIGN: A total of 1339 men and women aged 25-79 years were sampled from 85 areas (mean number of participants per area = 18.4, range 2-49). Information on socio-economic position (SEP) and diet was collected by structured face-to-face interviews (response rate 80.9%). Individual-level SEP was measured by education and household income, and area-level deprivation was measured using a composite index that included residents' education, occupation and employment status. Diet was measured on the basis of (1) a grocery food index that captured compliance with dietary guidelines, (2) breakfast consumption and (3) intakes of fruit, total fat and saturated fat. Multilevel analyses were performed to examine the independent effects of individual- and area-level socio-economic characteristics on the dietary outcome variables. RESULTS: After adjusting for individual-level SEP, few trends or significant effects of area deprivation were found for the dietary outcomes. Significant associations were found between individual-level SEP and food choice, breakfast consumption and fruit intake, with participants from disadvantaged backgrounds being less likely to report food behaviours or nutrient intakes consistent with dietary recommendations. CONCLUSIONS: The findings suggest that an individual's socio-economic characteristics play a more important role in shaping diet than the socio-economic characteristics of the area in which they live. In this Dutch study, no independent influence of area-level socio-economic characteristics on diet was detected, which contrasts with findings from the USA, the UK and Finland.

Adult↗
PubMed1997

Expectations of nursing home use in the Health and Retirement Study: the role of gender, health, and family characteristics.

Economic models of life cycle behavior suggest that expectations about future events may affect savings, insurance, and retirement planning. This article uses data from the first wave of the Health and Retirement Survey (HRS) to examine how personal characteristics and health conditions influence expectations of nursing home use. Subjective expectations of nursing home use are quite close to known probabilities of lifetime use. There are marked differences in the determinants of expectations for women and men that also conform to actual behavior. There is strong evidence that women and men incorporate what is known about nursing home risk into their own expectations, even many years prior to the time when they are most likely to need long-term care.

Black or African American↗
PubMed2000

Job insecurity in a sample of Canadian civil servants as a function of personality and perceived job characteristics.

Economic downturns and organisational changes have stimulated studies on the importance of job security for public employees; however, there has been some disagreement as to whether job insecurity should be defined using a single- or a two-factor model, on how to measure it and which antecedents and consequences are linked to it. Questionnaires measuring job insecurity as well as personality traits and job characteristics as possible antecedent variables, and job performance and job satisfaction as possible consequences were completed by a sample of 71 federal government employees during recent important government downsizing. A multiple regression analysis indicated that job insecurity, defined as a combination of organisational or personal vulnerability, was significantly related to only two antecedent variables, i.e., Neuroticism and job characteristics. Further regression analyses indicated that job insecurity was a statistically significant moderator but only between one consequence, i.e., intention to quit, and the job characteristics variable. These results along with methodological issues and further research, are discussed.

Adult↗
PubMed2006

Environmental risk perception, environmental concern and propensity to participate in organic farming programmes.

This paper aims to identify the factors underlying farmers' propensity to participate in organic farming programmes in a Romanian rural region that confronts non-point source pollution. For this, we employ structural equation modelling with latent variables using a specific data set collected through an agri-environmental farm survey in 2001. The model includes one 'behavioural intention' latent variable ('propensity to participate in organic farming programmes') and five 'attitude' and 'socio-economic' latent variables ('socio-demographic characteristics', 'economic characteristics', 'agri-environmental information access', 'environmental risk perception' and 'general environmental concern'). The results indicate that, overall, the model has an adequate fit to the data. All loadings are statistically significant, supporting the theoretical basis for assignment of indicators for each latent variable. The significance tests for the structural model parameters show 'environmental risk perception' as the strongest determinant of farmers' propensity to participate in organic farming programmes.

Agriculture↗
PubMed2004

Clinical characteristics and economic costs of patients with painful neuropathic disorders.

UNLABELLED: Using a large US health insurance claims database, we identified all persons aged 18 years or older with 2 or more medical encounters in calendar year 2000 for painful neuropathic disorders (PNDs). We also identified an age- and gender-matched group of patients without PNDs (matched control subjects). We then compared the clinical characteristics and economic costs of PND patients with those of matched control subjects. There were a total of 55,686 patients with PNDs in the study database. The most frequently noted PNDs were back and neck pain with neuropathic involvement (62.3% of PND patients), causalgia (12.1%), and diabetic neuropathy (10.8%). In comparison with matched control subjects, PND patients were more likely to have other pain-related conditions, including fibromyalgia (6.0% vs 0.6% for control subjects), osteoarthritis (13.6% vs 3.6%), and other chronic comorbidities, such as coronary heart disease (13.6% vs 6.5%) and depression (6.4% vs 2.3%). Total calendar year 2000 health care charges were 3-fold higher for PND patients than matched control subjects ($17,355 vs $5,715, respectively). Our results suggest that patients with PNDs are generally in poorer health and have higher health care costs than their peers without these conditions. PERSPECTIVE: Use of nonsteroidal anti-inflammatory agents and opioids was widespread in patients with PNDs, while relatively few received antiepileptic drugs and tricyclic antidepressants, both of which are often more effective against neuropathic pain. Our study raises questions about the optimality of PND treatment in clinical practice.

Adolescent↗
PubMedDate not supplied

[Changes in socioeconomic differences in the utilization of and accessibility to health services in Spain between 1987 and 1995/97].

BACKGROUND: The objective of this study is to evaluate the trend in the use and accessibility of health services in Spain between 1987 and 1995-1997 in groups with different socio-economic characteristics. METHODS: The data used are taken from National Health Surveys carried out on the adult population in 1987 and 1995-97 by the Ministry of Health and Consumer Affairs. The information for 1995 and 1997 has been combined due to the different sample size, in such a way that the estimates so obtained are the mean from both years. Population analysed has been people aged 24 years and older. The following have been studied: visits to the doctor, hospitalization, visits to the dentist and the gynecologist, the time taken to reach the visits to the doctor, and the waiting time in both the visits to the doctor and ordinary hospital admission. The socio-economic characteristics used are the level of education and the socio-economic group of the respondents. The measure of the association calculated between use of services and the socio-economic characteristics was the percentage ratio estimated by binomial regression. In addition, the relative index of inequality was estimated as a global measure of inequality. RESULTS: Visits to the doctor were the most frequent factor in people without academic qualifications and the lower socio-economic group in the two periods, while visits to the dentist and the gynecologist were more frequent in the higher socio-economic groups in both periods. Statistically significant differences in the frequency of hospitalization in the two periods were not found. Neither in 1987 nor 1995/1997 were statistically significant differences found between the different socio-economic groups as regards the time taken to visits to the doctor (p > 0.05), although there were in waiting time in visits to the doctor (p < 0.05). In the second period the socio-economic differences observed in the first period in waiting time for ordinary hospital admission disappeared. CONCLUSIONS: In the second half of the 1990s the same socio-economic profile was observed in the use of health services and the time spent waiting to receive them, as in the second half of the 1980s, with the exception of waiting time for ordinary hospital admission in the second period.

Adult↗
PubMed2000

Social determinants of health in Canada's immigrant population: results from the National Population Health Survey.

As part of the Metropolis project--a large-scale investigation of immigration and integration, including well-being of immigrants in a number of areas of social life--in this paper we investigate the social determinants of health in Canada's immigrant population using Canada's National Population Health Survey (NPHS). Specifically, we examine differences in health status and health care utilization between immigrants and non-immigrants, immigrants of European and non-European origin, and immigrants of < 10 years and > 10 years' residence in Canada. We also examine social determinants of health care utilization and health status in immigrants and non-immigrants, and evaluate the utility of large-scale, national databases for these purposes. Our conceptual approach draws upon a 'population health' perspective, which suggests that the most important antecedents of human health status are not medical care inputs and health behaviours (smoking, diet, exercise, etc.), but rather social and economic characteristics of individuals and populations. We find no obvious, consistent pattern of association between socio-economic characteristics and immigration characteristics on the one hand, and health status on the other, in the NPHS data. This does not mean that socio-economic factors in Canada are not influential in shaping immigrants' health status. In fact, the results of the logistic regression models calculated for immigrants and non-immigrants on four outcome variables in this study suggest that socio-economic factors are more important for immigrants than non-immigrants, although in ways that defy a simple explanation. The complexity of immigrants' experiences, combined with the inherent limitations of cross-sectional survey data are discussed as major limitations to this kind of research.

Adult↗
PubMed1996

Economic opportunity in Mexico and return migration from the United States.

I analyze the influence of the economic characteristics of origin area on trip duration for Mexican migrants in the United States. I argue that migrants from economically dynamic areas in Mexico with favorable opportunities for employment and small capital investment have a larger incentive to stay in the United States longer and to withstand the psychic costs of separation from family and friends than do migrants from economically stagnant areas in Mexico, where the productive uses of savings are severely limited. In line with this argument we should expect investment opportunities in migrants' origin areas to be associated positively with migrants' trip duration in the United States. To test this hypothesis I use individual- and household-level data on U.S. migration experience collected in 13 Mexican communities. Evidence from parametric hazards models supports the idea that economic characteristics of origin areas influence the motivations and strategies of Mexican migrants in the United States.

Adolescent↗
PubMed1991

Characteristics and economic implications of migration.

Factors affecting rural-urban migration in India are explored. "The study, based on the sample of 205 migrant households, conducted in the hill region of Uttar Pradesh, attempts to highlight the characteristics of migration and its effects on the pattern of income distribution among the households....[It is found that] migration...is primarily motivated by...socioeconomic condition of households, development of road transport and communication sources, level of education...and various geographical and physical conditions."

Asia↗
PubMed1993

Measuring social inequality in dental health services research: individual, household and area-based measures.

The literature on inequalities in health is extensive and provides convincing evidence that lower socio-economic groups have poorer general and dental health than higher socio-economic groups. In this literature, socio-economic status has been measured in terms of occupation, income or education. These conventional measures have a number of methodological and theoretical weaknesses which limit their ability to fully describe and explain differences in health between population sub-groups. In this paper, these measures are reviewed and alternatives, in the form of area-based indicators, are considered. The evidence suggests that measures of the socio-economic characteristics of neighbourhoods are better predictors of the health status of population subgroups than measures of the socio-economic characteristics of individuals or households. Moreover, they add additional explanatory power to models of health inequalities. Area-based measures can be readily applied to survey data or information derived from health records or routinely collected sources. Since they identify where deprived groups with relatively poor health live, they may prove useful in terms of the planning and targeting of health services. These alternative indicators should be explored in the context of dentistry to determine their ability to predict differences in dental health and risk factors for dental disorders among different segments of the population.

Aged↗
PubMed1986

Central American and Mexican immigrant characteristics and economic incorporation in California.

"Data compiled from the 1980 U.S. Census and other sources are used in this article to demonstrate the distinctiveness of Central American immigration.... Comparisons between Central American and Mexican immigrants in California reveal substantial differences between the two groups in their age structure, sex ratio, and human capital characteristics." The emphasis of the study is on the differences concerning incorporation of these migrant groups into the Californian economy.

Acculturation↗
PubMed2000

Self-rated health, life satisfaction and personal characteristics of post-menopausal women under estrogen replacement therapy.

OBJECTIVES: To describe the prevalence of oestrogen replacement therapy (ERT)-use among post-menopausal women in relation with personal and socio-economic characteristics and to examine the association of ERT-use with self-rated health and selected aspects of life satisfaction. METHODS: Population survey data were derived from a cohort study of 511 Bernese women, aged 55-65 years. Data were collected by means of telephone interviews. Overall prevalence of ERT-use, and selected associations with personal and socio-economic characteristics were investigated using descriptive statistical methods and logistic regression. The relations of ERT-use with five self-reported health measures were explored using Spearman's correlation coefficients. The associations of ERT-use with six dichotomous variables on satisfaction with various aspects of life were tested with chi-square tests in cross tabulations. RESULTS: The overall prevalence of self reported ERT-use was 17.6%. ERT was more prevalent women younger than 61 years than in women in the older age group. Women with a body mass index (BMI) under 25 reported ERT-use significantly more frequently than women with higher BMI (OR=3.16, CI 1.87-5.34). ERT-use was more prevalent in women with relatively high education: OR=2.01, CI 1.18-4.00. The self-reported health measures and the satisfaction items were not significantly associated with ERT-use. CONCLUSIONS: ERT-use among post-menopausal women was found to be associated with higher educational level and lower BMI. ERT-users did not report better health or life-satisfaction.

Aged↗
PubMed2006

Health disparities between racial groups in South Africa: a decomposition analysis.

This article explores the sources of self-rated health status inequalities among South Africans. We propose a decomposition of observed health disparities between racial groups using a procedure based on an extended version of Oaxaca-Blinder decomposition methods which addresses explicitly the specificities associated with the analysis of subjective measures. This method allows for a decompositions of differences in self-rated health status between races and isolates what may be due to observed socioeconomic inequality between racial groups, i.e. an "indirect racial effect" (Whites and Africans with different socio-economical characteristics have different health), from what could be due to unexplained racial differences, i.e. a "direct racial effect" (Whites and Africans with similar socio-economical characteristics have different health). Unsurprisingly, we find a strong indirect racial effect in favor of Whites. However, our analysis tends to show that the issue of direct racial discrimination on health is more complex and closely linked with that of economical inequality and discrimination. Our results thus stress the necessity not only to open access for Africans to the more sophisticated sector of health care but also to provide them with the economical opportunity to use it.

Adult↗