[Health status in population groups. Indicators for health and disease].
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Health Planning↗
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[Utilization of health status indicators in relation to occupational health qualifications and surveillance studies].
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Germany, East↗
The relationship between housing conditions and health status of rooming house residents in Toronto.
BACKGROUND: Rooming houses are an important source of housing for low-income Canadians. Little information is available on the relationship between housing conditions and health status in this vulnerable population. METHODS: Interviews were conducted with a representative sample of 295 residents in 171 rooming houses in Toronto. Health status was assessed using the SF-36. The physical attractiveness of each rooming house was rated using the Multiphasic Environmental Assessment Procedure. Associations between the health status of residents and the physical attractiveness and organizational characteristics of rooming houses were examined. RESULTS: Rooming house residents aged 35 years and older had significantly poorer health status than their counterparts in the Canadian general population. Eight of the ten dimensions of individual health status assessed by the SF-36 were significantly correlated with the physical attractiveness of the rooming house in which the individual lived. However, there was no significant association between residents' health status and the rooming house's non-profit status, provision of meals, or the presence of an on-site landlord. CONCLUSIONS: Rooming house residents suffer from a high prevalence of ill health. Residents reporting worst health are concentrated in rooming houses in the poorest physical condition. This relationship may be mediated by selection processes that place the sickest individuals in the lowest-quality rooming houses, and/or by a direct effect of adverse housing conditions on health status. Further research is needed to elucidate these processes and to improve the health of this vulnerable population.
Adult↗
The health status of HOPE VI public housing residents.
The purpose of this study is to provide new data on the relationship between housing quality and health status for people in five HOPE VI public housing developments around the country. HOPE VI is a federal program to replace or redevelop some of the poorest quality public housing in the country. A special survey of residents of these developments was conducted while they lived in HOPE VI housing before its redevelopment. Data for these individuals provides a profile of the quality of housing and the health status of people in HOPE VI housing before its renovation, of residents of publicly assisted housing across the nation, of other people living below the federal poverty level, and of non-poor people. Previously, the lack of data sets that included both housing quality and health status measures has prevented such an analysis. We examined two indicators of health status-perceived overall health status and medically diagnosed asthma. The health status of HOPE VI residents is decidedly worse than that of others in assisted housing and other poor people, despite their similarity in terms of economic deprivation. The difference in the level of asthma prevalence, a condition that has been tied to various measures of housing quality, is especially pronounced. Our analysis indicates that one major benefit of improving housing quality may be improved health status.
Adolescent↗
Understanding needs is important for assessing the impact of food assistance program participation on nutritional and health status in U.S. elderly persons.
This study aimed to assess the impact of food assistance programs on nutritional and health status of nutritionally needy elderly persons. Two cross-sectional and one longitudinal data sets were used: Third National Health and Nutrition Examination Survey (1988-94), Nutrition Survey of the Elderly in New York State (1994) and Longitudinal Study of Aging (1984-1990). Multiple logistic and linear regression analyses were used to examine whether food assistance participants among food insecure elderly (i.e., those whose needs for food assistance programs are met) have better nutrient intake, skinfold thickness and self-reported health status and less nutritional risk, hospitalization and mortality than nonparticipants (i.e., those whose needs are unmet) and whether the benefit is larger than that among food secure elderly persons. Across three data sets, food insecure elderly persons had poorer nutritional and health status than food secure elderly persons. Contrary to the hypotheses, among food insecure elderly persons, food assistance participants had similar or poorer nutrient intakes, skinfold thickness, nutritional risk, self-reported health status, hospitalization and mortality than nonparticipants. Food secure participants had similar nutritional and health status as food secure nonparticipants. Lack of information on the dynamic nature and changes in needs with program participation in the three data sets likely did not allow accurate estimation of the impact of food assistance participation. Different study designs, as well as theory and knowledge of needs that clarifies need status and its change within each older individual across an appropriate time interval, are necessary to accurately assess impacts of food assistance programs.
Aged↗
Preventive dental behaviors and their association with oral health status in older white men.
While prevention practices are widely encouraged, the link between the performance of preventive behaviors and oral health status has rarely been examined. This study investigates the association between preventive dental behaviors (recent and long-term) and oral health status and compares the strength of such associations. Longitudinal data over six time points on 649 dentate white men were obtained from the VA Dental Longitudinal Study (DLS). Participants' oral health was measured through dental examinations, and preventive dental behaviors--i.e., toothbrushing, flossing, using interdental devices, seeking dental prophylaxis, and undergoing dental treatment-were assessed by self-report. Oral health status was measured in terms of (1) functioning teeth, (2) sound-equivalent teeth, (3) decayed, missing, and filled teeth, and (4) decayed and filled root surfaces. Pearson correlation and linear regression analysis revealed significant positive associations between most preventive behaviors and measures of oral health status. Dental prophylaxis emerged as the strongest predictor of oral health status. Long-term preventive dental behavior measures explained more variance in oral health status than short-term preventive behaviors measured cross-sectionally.
Aged↗
Testing relationships among determinants of health, health policy, and self-assessed health status in Quebec.
By removing financial barriers, the Canada Health Act (1984) equalized access to health care services in Canada. Yet class, educational, and geographical disparities in individual and population health status persist. Recent health reform policies in Quebec assert that health and well-being are a function of income, educational level, housing conditions, employment, and other socioeconomic factors. They suggest that health policy should encompass social policies that influence individual and community socioeconomic factors which in turn affect health. Against the backdrop of these reforms, this study tests the importance of socioeconomic factors as a determinant of health--while controlling for other known determinants through a logistic regression model--with data from the Santé Quebec health surveys 1987 and 1992-93. The results confirm the importance of economic security as a determinant of individual health. This effect appears to operate through an individual income variable and through the community-level variable of regional unemployment. The importance of the income effect declined between 1987 and 1992-93. This may indicate that an increased focus on the socioeconomic determinants of health has reduced inequalities in health. It may also mean that health inequalities appear inevitable until health care policy merges completely with broader health and social policies. But such integration may well conflict with economic (and political) imperatives of the post-Fordist capitalist system.
Adolescent↗
Health status in chronic disease: a comparative study of rheumatoid arthritis.
A self-administered questionnaire has been used to measure and compare health status in rheumatoid arthritis (RA) and 5 other chronic diseases. Subjects with RA, hypertension, cancer, diabetes, cardiac disease, or pulmonary disease were assessed along 11 aspects of health status. Results showed significant differences in health status across the 6 diseases, particularly for physical function and pain. The psychological status measures were similar. A summary estimate indicated that RA and pulmonary diseases produced poorer health status than the others. This study confirms the severe negative health status associated with chronic RA.
Activities of Daily Living↗
A comparison of two simple measures to evaluate the health status of asthmatics: the Asthma Bother Profile and the Airways Questionnaire 20.
Simple and concise measures for health status are desirable in clinical practice. The Asthma Bother Profile (ABP), which consists of 23 items, has been developed to assess how much asthma bothers patients. The Airways Questionnaire 20 (AQ20) is a simple instrument which consists of 20 items. The purpose of this study was to investigate how the ABP and AQ20 evaluate the health status of patients with asthma. A total of 166 patients with chronic asthma (age: 48 +/- 16 yr, 77 males) completed pulmonary function testing, measurement of airway hyperresponsiveness, dyspnea rating, assessments of their anxiety and depression (HADS; Hospital Anxiety and Depression Scale), and assessments of their health status. The health status was assessed using the ABP, AQ20, the short-form 36 health survey questionnaire (SF-36), the Living With Asthma Questionnaire (LWAQ) and the Asthma Quality of Life Questionnaire (AQLQ). The Japanese version of the ABP included only 15 'bother' items out of the original 23 items due to cultural differences. The scores on the ABP were widely distributed, whereas the scores on the AQ20 were skewed towards the milder end of the scale. The ABP had a strong correlation with the Avoidance and Distress constructs on the LWAQ, and Anxiety and Depression on the HADS (Rs = 0.56 to approximately 0.79), and its strongest correlation with the General Health (Rs = -0.64) scale among the 8 subscales on the SF-36. The AQ20 had a less significant correlation with the LWAQ, AQLQ, and SF-36 than the ABP. The ABP and AQ20 were short and simple to complete, and both measures could easily be used in clinical practice. The ABP can evaluate patients more specifically with respect to distress and bother than the AQ20.
Adult↗
Evaluation of two health status measures in adults with growth hormone deficiency.
OBJECTIVE: To evaluate the psychometric properties of two health status measures for adults with growth hormone deficiency (GHD): Nottingham Health Profile (NHP) and Short-Form Health Survey (SF-36). DESIGN: (1) A cross-sectional survey of adults with treated or untreated GHD to assess reliability and validity of the questionnaires. (2) A randomized, placebo-controlled study of 3 months' GH withdrawal from GH-treated adults to assess the sensitivity of the questionnaires to change. PATIENTS: (1) A cross-sectional survey of 157 patients with severe GHD (peak GH < 10 mU/l on provocative testing), mean age 48.9 years (range 23-70 years), who had either received GH replacement therapy for at least 6 months immediately prior to the study or had not received GH treatment in the previous 6 months. (2) GH treatment was withdrawn from 12 of 21 GH-treated adults, all with severe GHD (peak GH < 7.7 mU/l on provocative testing), mean age 44.9 years (range 25-68 years). MEASUREMENTS: The NHP and SF-36 were used once in the cross-sectional survey, but twice in the GH-withdrawal study, at baseline and end-point (after 3 months). RESULTS: (1) Cross-sectional survey. Both questionnaires had high internal consistency reliability with subscale Cronbach's alphas of > 0.73 (NHP) and > 0.78 (SF-36). Calculation of an NHP Total Score, occasionally reported in the literature, was shown to be inadvisable. Overall, patients with GHD were found to have significantly worse perceived functioning than the UK general population in SF-36 subscales of General Health, Bodily Pain, Social Functioning, Physical Functioning, Role-Emotional, Role-Physical, and Vitality. Although neither questionnaire found significant differences between GH-treated and non-GH-treated patients, there were correlations with duration of GH treatment (P < 0.01) for GH-treated patients in SF-36 Mental Health (r = 0.29, N = 87) and SF-36 Vitality (r = 0.33, N = 88), indicating improvement with increasing treatment duration. The SF-36 was also more sensitive than the NHP to sex differences: men had significantly better health status compared with women (P < 0.05) in all SF-36 subscales but Mental Health, but only in one NHP subscale (Physical Mobility). (2) GH-withdrawal study. Significant between-group differences in change were found in SF-36 General Health [t(17) = 2.76, P = 0.013, two-tailed] and SF-36 Mental Health [t(17) = 2.41, P = 0.027, two-tailed]: patients withdrawn from GH reported reduced general health and mental health at end-point. The NHP found no significant change. CONCLUSIONS: The SF-36 is a better measure than the NHP of health status of people with GH deficiency because of its greater discriminatory power, with ability to detect lesser degrees of disability. It also has superior sensitivity to some subgroup differences and superior sensitivity to change compared with the NHP. The SF-36 is highly acceptable to respondents, and has very good internal consistency reliability. The SF-36 is recommended to measure the health status of adults with GH deficiency.
Adult↗
Health status of homeless and marginally housed users of mental health self-help agencies.
The study discussed in this article investigated the health status of 310 homeless and marginally housed people to determine the usefulness of mental health self-help agencies (SHAs) in addressing their physical health needs. The study compared self-reported health problems among SHA users with similar reports and clinical assessments of other homeless or marginally housed populations. Findings indicate that frequencies of health problems among respondents were similar to those of other homeless or marginally housed groups and that the study group had a higher prevalence of HIV infection and tuberculosis than the general population. Because this hard-to-reach group actively seeks SHAs, these organizations may be uniquely suited to health outreach, education, testing, and treatment.
Adult↗
[International classification of daily living function, disability and health status].
The World Health Organisation issued the international classification of impairments, disabilities and handicap in 1980. As no Hungarian translation appeared, it was mainly utilised in Hungary in education, with good results. Based on practical application in foreign countries and on positive and negative experiences, as a result of an almost ten years development process a new version was published, entitled the International classification of functioning, disability and health. The new classification, employing qualifiers, enables the description of both the nature and the magnitude of the problems, thus it may be applied in rehabilitation medicine practice. It may also support the establishment of still missing disability data bases. Applying together with quality of life assessments, it may serve obtaining better knowledge of the persons in need of rehabilitation.
Activities of Daily Living↗
The health status of Cuba: recommendations for epidemiologic investigation and public health policy.
The health status of Cuba is described in comparison with Costa Rica and, in some instances, the United States. Recommendations are made for epidemiologic studies and for specific health policies to lower death rates from diarrhea and enteritis, cardiovascular disease, cancer, and injuries. Rapid expansion of training and research in epidemiology and biostatistics is emphasized, and specific goals for health outcomes for the year 2000 are suggested.
Adolescent↗
A comparative study of oral health status in a migrant/Japanese sample.
OBJECTIVES: The aim of this study was to compare the oral health status of migrants to Japan with that of Japanese using the questionnaire and the Oral Health Status Index (OHSI). METHODS: The questionnaire for collecting demographic and behavioral variables and the OHSI were applied in a mixed migrant/Japanese sample of patients from a dental clinic in Yokohama. A sample of 224 subjects, 52% of whom were migrants, was selected from new patients. RESULTS: The mean OHSI scores were 78.56 for migrants and 83.16 for Japanese (p<0.01). Multiple regression analysis of OHSI showed that the statistically significant contributors were: age, status (migrants / Japanese), reason for initial visit, perceived oral health, and flossing behavior. CONCLUSION: The oral health status of migrants was worse than that of Japanese even though they were younger than Japanese. The present public support system for foreign patients and their self-care behavior were considered to be the factors for the inequity in oral health status.
Adolescent↗
Measurement of the global and functional dimensions of health status in the elderly.
Data from a two-stage random sample of 401 noninstitutionalized elderly individuals residing in 18 census tracts in south-central metropolitan St. Louis were used to examine the relationships among seven measures of health status. Factor analyses revealed two pristine dimensions: (a) a global health status dimension, on which perceived health status, nutritional risk, perceived sensory functions, and mental health all load significantly; and, (b) a functional dimension on which the Activities of Daily Living, Instrumental Activities of Daily Living, and mental orientation measures all load significantly. These two factors explain 56% of the variance in the seven health status measures, and, using an oblique rotational procedure, they were found to be correlated only modestly (r = .37). The implications for the measurement of health status of elderly adults as well as the use of such measures in predicting health services utilization are discussed, and recommendations for the inclusion of items tapping both dimensions in future studies are presented.
Activities of Daily Living↗
Quality of life and health status in interstitial lung diseases.
PURPOSE OF REVIEW: The aim of this review is to provide information on the influence of interstitial lung disease on patients' health status and quality of life, with an emphasis on which aspects might be affected by interstitial lung disease. RECENT FINDINGS: The quality of life of sarcoidosis patients with current symptoms and patients with idiopathic pulmonary fibrosis is mainly impaired in the domains of physical health and level of independence. Concerning health status, sarcoidosis patients report reduced physical functioning, especially when they have current symptoms. The health status of idiopathic pulmonary fibrosis patients is impaired in almost all aspects. Subjectively assessed dyspnea is related to health status. A relationship between treatment and health status has not been found. SUMMARY: Results from the existing studies show that both illnesses have a substantial impact on patients' life. Studies aiming at measuring quality of life or health status in other interstitial lung diseases are scarce or nonexistent.
Health Status↗
Bronchoalveolar lavage cytology and hematology: a comparison between high and low health status pigs at three different ages.
Bronchoalveolar lavages (BALs) were performed with a bronchoscope on 5- and 7.5-week-old, anesthetized, high health status pigs (n = 14). At 10 weeks of age, pigs (n = 28) were necropsied, lungs were removed, and BAL samples were collected from the right diaphragmatic lobe with a modified 12-Fr (4-mm) Foley catheter. Peripheral blood was sampled from all pigs (n = 28) before each BAL procedure. Peripheral blood and BAL samples were collected according to a similar study design at 5, 7.5, and 10 weeks of age from 12 low health status pigs, which were raised according to standard farm procedures (n = 6) or as segregated early weaned pigs (n = 6). Bronchoalveolar lavage cytology and hematologic 95% confidence intervals were determined for 5-, 7.5-, and 10-week-old high (group A) and low health status pigs (groups B and C). The results were compared between the different groups. Repeated BALs were easily performed in all pigs, making this an additional tool for evaluation of respiratory health. Total numbers of cells and neutrophils in peripheral blood and BAL samples were greater in low health status pigs than in high health status pigs. Hematologic results paralleled the findings in BAL fluid. Segregated early weaning of low health status pigs in a less challenging environment mainly reduced the number of neutrophils in BAL samples and peripheral blood.
Age Factors↗
Impact of dyspnea and physiologic function on general health status in patients with chronic obstructive pulmonary disease.
STUDY OBJECTIVE: To examine the relationship among clinical dyspnea ratings, physiologic pulmonary function, and general health status in symptomatic patients with chronic obstructive pulmonary disease (COPD). DESIGN: Observational data collected at a baseline state. SETTING: Outpatient pulmonary disease clinics at a university hospital and two VA medical centers. PATIENTS: One hundred ten male patients with COPD with no significant comorbidity were recruited. MEASUREMENTS AND RESULTS: Clinical ratings of dyspnea were measured by the multidimensional baseline dyspnea index (BDI). Pulmonary function tests included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and maximal inspiratory mouth pressure (PImax). General health status was assessed with the Medical Outcomes Study short-form survey, which consists of 20 questions that cover six health components. The mean age of the patients was 67 +/- 8 yr (+/- SD). The mean value for FVC was 2.84 +/- 0.84 L (68 +/- 18 percent of predicted), for FEV1 was 1.28 +/- 0.59 L (44 +/- 17 percent of predicted), and for PImax was 59.0 +/- 25.0 cm H2O. The BDI score and PImax were significantly correlated with five of the six components of general health status. Only three of the six components of general health were significantly correlated with FEV1 as percent predicted (rs value range, 0.30 to 0.44) and with FVC as percent predicted (rs value range, 0.25 to 0.33). Statistical comparisons showed that the BDI score had significantly higher correlations than FVC (percent predicted), FEV1 (percent predicted), and PImax values with physical functioning and role functioning. Multiple linear regression analysis showed that the BDI score was the only statistically significant predictor of role functioning, mental health, and health perceptions for general health status, whereas both the BDI score and FEV1 (percent predicted) were independent predictors of physical functioning and social functioning. CONCLUSION: Dyspnea ratings influence and predict general health status to a greater extent than do physiologic measurements in symptomatic patients with COPD. A shift in focus from the pathophysiology of disease to assessment and relief of symptoms may provide more meaningful benefits for the individual patient in terms of quality of life. This consideration requires that health-care providers use available measuring tools in clinical practice to quantify symptoms, as well as overall health status.
Adult↗