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PubMed2001

Health status, life habits, and social background among the JPHC study participants at baseline survey. Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases.

A self-reported questionnaire on the health status, life habits, and social background was conducted at baseline in the Japan Public Health Center-based Prospective Study on Cancer and Cardiovascular Diseases (JPHC study). This report presents the outcome of the study regarding past or family history of various diseases, medical treatment, life habits such as physical labor or sports, and social background among study participants. In both cohorts I and II, prevalent past and family history included hypertension, stroke, and cancer, whereas the prevalence of coronary heart diseases was historically low. The prevalence of a past history of hypertension and stroke was higher in the northern part of Japan, Ninohe, and Yokote, and lower in Okinawa, compared to the other districts. The prevalence of participants with a history of stomach cancer and liver cancer was higher in Arikawa than in other districts. The frequency of participants who took medication from doctors ranged from 20% to 30%, higher in the Tohoku areas, and lower in Okinawa compared to the other districts. All districts showed a high rate of over 70% for the participation rate for basic health examination conducted by the local government, The rate was particularly high in the Tohoku area where a high prevalence of a history of hypertension was found. The frequency of persons who had a chance to participate in sports or physical exercise was high in Okinawa and Suita subcohort 2, although the mean total physical activity (both at work and for leisure time) was lowest in the latter subcohort. No substantial differences were found in compositions of personality among districts. The frequency of more active and positive persons, however, was relatively higher in urban areas and lower in Okinawa compared to the other districts. The association between the differences of health status, life habits, and social background and the occurrence of various lifestyle-related diseases will be clarified in a follow-up study within the JPHC study.

Adult↗
PubMed1990

Effects of antepartal stress on health status during early motherhood.

A group of high-risk women who were hospitalized for a pregnancy-risk complication, and a group of low-risk women experiencing normal pregnancy were compared for differences in health status and the effects of antepartal stress on their health status from pregnancy through early motherhood. High-risk women reported a statistically significant poorer health status during pregnancy, early postpartal hospitalization, and at eight months following birth. High-risk women reported greater stress from negative life events in addition to their greater pregnancy risk. Among both groups of women, negative life events' stress had indirect effects on health status over time through either self-esteem, family functioning, mate relationships or perceived support. The effects of a high-risk pregnancy on health status were evident at eight months following birth; high-risk women's feelings about their pregnancy and the extent of stress from hospitalization had direct effects on their health status, while negative life events had indirect effects.

Adult↗
PubMed1990

Minority health status in New Jersey.

The health status of minorities in New Jersey, like that of the nation, continues to lag far behind that of whites. In an effort to address this problem, UMDNJ has established a Minority Health Institute to focus the resources of the state's academic health science center on the problem.

Health Status↗
PubMed2002

[Relationship between cigarette smoking and oral health status].

The purpose of the study was to examine the relationship between the smoking habit and oral health status, while adjusting for age and some aspects of dental health behavior. The data used were based on a cross-sectional study on dental checkup in the worksite, which included a self-reported questionnaire and oral examination by a dentist. The oral health status variables were CPITN scores, missing teeth/filled teeth/decayed teeth, and self-reported gum bleeding. In addition, the subjects reported in a questionnaire concerning their smoking habit and dental health behavior. Of a total of 7,713 of workers, 5,232 (67.8%) participated in the dental checkup of the worksite. From the population, only the data for 3,303 men were analyzed. We used multiple logistic regression to calculate the odds ratio (OR) for each oral health status according to the smoking habit. Current smokers, compared to subjects who had never smoked, had a higher risk of periodontal disease (OR = 2.3; 95% CI: 1.9-2.7), missing teeth (OR = 1.6; 95% CI: 1.3-1.9) and decayed teeth (OR = 1.5; 95% CI: 1.3-1.8), but they had a reduced risk of gum bleeding (OR = 0.7; 95% CI: 0.6-0.8). Dose response relationships between smoking and these variables were also observed. The results indicated that cigarette smoking was associated with oral health status independent of some aspects of dental health behavior.

Adult↗
PubMed2005

Evaluation of health status in epilepsy using the EQ-5D questionnaire: a prospective, observational, 6-month study of adjunctive therapy with anti-epileptic drugs.

AIMS: The aims of this project were to evaluate the impact of adjunctive treatment with an anti-epileptic drug (AED) on the health status of people with epilepsy and to investigate how seizure frequency affects their health status. METHODS: Adult epilepsy patients, refractory to current treatment, were included in this prospective observational study. Patients commencing adjunctive therapy with one of five AEDs (topiramate, lamotrigine, gabapentin, clobazam, vigabatrin) were eligible for inclusion. The study took place at the outpatient clinics of the National Hospital for Neurology and Neurosurgery, Queen Square, London. Patients completed the EQ-5D, a generic health status measure, at baseline and again after 3 and 6 months. Information was also collected on medications and seizure frequency. RESULTS: In total, 125 patients entered the study and were followed up for 6 months. Patients treated with topiramate had a significant increase (p < 0.05) in EQ-5D score from baseline, indicating an improvement in their health status whereas scores for lamotrigine, clobazam and gabapentin all showed a non-significant decline. When the data were analysed according to seizure frequency, only patients who became seizure-free on adjunctive treatment had a significant increase in their health status. The group who had a 50% reduction in seizure frequency did not have increased health status. CONCLUSIONS: In summary, adjunctive treatment with topiramate significantly increased health status as measured by the EQ-5D. These data also suggest that achievement of seizure-freedom is the key to improving health status in this patient group.

Adult↗
PubMed2001

Health status of African Americans.

The health status of African Americans identifies a higher prevalence of cardiovascular diseases, cancer, hypertension, diabetes, obesity, and sexually transmitted infections when compared with Whites. However, more research is needed to identify socioeconomic variables and to establish needed health programs. The vestiges of early 20th century traditions of substandard housing and inadequate nutrition for African Americans are still apparent in many communities today. Most health care professionals are not educated and trained to be culturally sensitive. The struggle against the prevalence of diseases in African Americans must incorporate cultural sensitivity, community organization and empowerment. The need for a universal system of health insurance coverage is of utmost importance. The elimination of health disparities among African Americans requires a national effort, the involvement of public and private sectors, individuals and communities.

Black or African American↗
PubMed2001

Health status measurement in chronic obstructive pulmonary disease.

Health status measurement is a common feature of studies in chronic obstructive pulmonary disease (COPD). This review assesses recent evidence for the validity of these measurements and their role as measures of the overall impact of the disease on the patient's daily life and wellbeing. It reviews the mostly widely used COPD specific questionnaires and examines the contribution that they make to an assessment of the overall effect of treatment. Finally, it addresses the question of how symptomatic benefit may be assessed in individual patients in routine practice.

Controlled Clinical Trials as Topic↗
PubMed2002

The Department of Defense's Persian Gulf War registry year 2000: an examination of veterans' health status.

This study examined the health status of 46,633 Persian Gulf War theater veterans who received full clinical evaluations in the Department of Defense's Gulf War Comprehensive Clinical Evaluation Program (CCEP) as of spring 2000. Clinical data analyzed included demographic information, 15 health symptoms, 19 wartime exposures, and primary and secondary physician-determined medical diagnoses based on International Classification of Diseases, 9th Revision, Clinical Modification, criteria. Findings and discussions are arrayed, by gender, with comparative 1996 data from the Department of Veterans Affairs Health Examination Registry Program. Many veterans reported fewer physical symptoms now than during the time of the Gulf War. Many endorsed symptoms of joint pain, fatigue, weight change, and sleep disturbances. Most reported exposure to diesel fuel and the nerve agent antidote pyridostigmine bromide; far fewer female veterans reported combat involvement. The most frequent primary or secondary diagnosed medical conditions were musculoskeletal/connective tissue diseases, ill-defined conditions, and mental disorders. Female veterans were diagnosed more frequently with mental disorders. Symptom endorsement and diagnosis rates between the CCEP and the Department of Veterans Affairs registry were not dissimilar. Overall, the self-reported general health of veterans with symptoms was much poorer (females had higher rates of "fair to poor" health than males) than that of veterans with no reported symptoms.

Adult↗
PubMed2003

Do GOLD stages of COPD severity really correspond to differences in health status?

The purpose of this study was to assess whether different stages of chronic obstructive pulmonary disease (COPD) severity defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria correlate with meaningful differences in health status. A total of 381 COPD patients, aged 73+/-6 yrs, were classified in the five GOLD stages. Disease-specific (St George Respiratory Questionnaire (SGRQ)) and generic indexes of health status were measured in all patients. Multivariate analysis of covariance or Kruskal Wallis tests were used to compare health status indexes across the spectrum of GOLD stages of COPD severity. GOLD stages of COPD severity significantly differed in SGRQ components and Barthel's index, but not in the indexes assessing cognitive and affective status and quality of sleep. The largest variation in health status was observed at the transition from stage IIa to stage IIb, while there were no other significant differences between consecutive stages. Both female sex and comorbidity were associated with a greater impact of COPD on the health status. In conclusion, the upper limit of stage IIb (forced expiratory volume in one second of 49%) marks a threshold for dramatic worsening of health status. Progression of chronic obstructive pulmonary disease severity from stage 0 to stage IIa does not correspond to any meaningful difference in health status.

Aged↗
PubMed1996

Is health status related to residence in medically underserved areas? Evidence and implications for policy.

This study sought to compare the health status of adult residents of medically underserved areas (MUAs) with adult residents of nonshortage areas (non-MUAs). A random digit dialing telephone survey was used. Respondents were subsequently classified by their county of residence as residing in an MUA or non-MUA. A sample of 421 adults (aged 18 years or older) residing in Kentucky during 1993 were included in the analysis. Health status was measured by the Medical Outcomes Study 20-item Short-Form Health Survey's (SF-20) six subscales. After controlling in the multiple regression for demographic variables there were no significant differences between residents of MUAs and non-MUAs for the physical functioning, role functioning, general mental health, self-perception of health, or pain subscales. The social functioning subscale was significantly related to the residence in an MUA. The demographic variable "education" was a consistent predictor of each of the health status subscales. Excepting the social functioning subscale, residents of MUAs do not have significant differences in health status when compared to residents of non-MUAs. Future policy may need to focus on other health services shortage area designators that are more highly associated with the health status of residents. Consideration should be given to including the education demographics of areas or populations in health services shortage designation criteria.

Adult↗
PubMed1995

[Effects of lifestyle on health status].

We followed up 2,148 male and female workers for 6 years and assessed the relationship between lifestyle and physical health status. The physical health status was significantly higher in the group with a good lifestyle than in the group with a poor lifestyle. When we analyzed the effects of lifestyle on chronic diseases using multiple logistic regression, the incidence of gastric and duodenal ulcers and cardiovascular diseases was several times higher in the group with a poor lifestyle than in the group with a good lifestyle. We also introduced several biological markers, including natural killer (NK) cell activity and chromosome alterations such as sister chromatid exchanges, chromosome aberrations and micronucleus formation, to predict the participants' future health status. All these markers were significantly correlated with lifestyle. Our findings indicate that lifestyle is the most important environmental factor which quantitatively affects the development of adult diseases and the changes of biological markers.

Adult↗
PubMed1998

Use of the Short Form-36 to detect the influence of upper gastrointestinal disease on self-reported health status.

Patient-centred outcome measures such as the Short Form-36 (SF-36) have been developed to assess the impact of ill health and medical interventions on self-reported health status. The objective of the study was to assess the impact of gastrointestinal disease upon health status as measured by the SF-36 physical and mental health component scores (PCS and MCS) and to assess whether these component scores might be an appropriate outcome measure for use in clinical research in gastroenterology. The subjects were 364 patients aged between 18 and 64 years who had been prescribed proton pump inhibitors (PPIs) by general practitioners in Oxfordshire. The general practices participating identified patients who had been prescribed PPIs. The data were abstracted from the general practice medical records of these patients concerning gastrointestinal diagnoses and other prescribed medications. The patients were sent the SF-36 questionnaire by post and the PCS and MCS scores were derived, which were adjusted for age and sex and compared with the scores of the general population of the Oxford region. Co-morbidity was assessed by the extent to which non-gastric medications were also used. The commonest diagnoses were oesophagitis/gastro-oesophageal reflux and indigestion. People with these diagnoses had significantly lower health status than the general population. Differences persisted when the results were controlled for the possible effects of co-morbidity. It was concluded that the SF-36 is sensitive to the impact of gastrointestinal disease on health status.

Adolescent↗
PubMed2004

A health outcomes framework for assessing health status and quality of life: enhanced data for decision making.

BACKGROUND: Currently, information to improve health status and quality of life is derived from independently designed data systems that range from population-based health surveys to health records used in managing individual patient care. But there is no coherent strategy for using these data sources in concert across diverse applications. Thus, it is frequently difficult to compare or combine results across studies to provide population-level inferences based on findings from specific subpopulations. OBJECTIVE: The Health Outcomes Framework is an analytic structure to provide more comprehensive information about the health status and quality-of-life impact of disease and its treatment. This framework consists of three components: (1) a core set of health, lifestyle, and economic questionnaires that collect data from an individual's perspective; (2) applications that range from population to patient care levels; and (3) time. Although health is the outcome of interest, lifestyle behaviors and economic and political factors are important determinants of health, which also need to be studied using standardized procedures; thus, they are included in the core. This article focuses on the nature and application of a core health status and quality-of-life instrument. To be useful across a range of applications, such a core instrument needs to have three conceptual characteristics: (1) a theoretical model that regards health as a continuum of states; (2) domains that represent policy-relevant aspects of impairment, disability, and handicap; and (3) a set of societal preferences for these domains. In addition, the core needs to address three practical concerns: (1) brevity, (2) methods of administration that are suitable for respondents with diverse capabilities, and (3) documentation that is publicly available. These features are discussed using examples from currently available, multi-domain generic instruments, each of which has some, but not all, of the necessary features of the core instrument. CONCLUSION: The Health Outcomes Framework is intended to be a cooperative effort. It is proposed that the National Cancer Institute and the Centers for Disease Control and Prevention take leadership roles not only by adopting a core health status and quality-of-life instrument for use in current and future cancer data collection activities but also in encouraging industry and academic investigators to implement this core instrument in their cancer studies. Having a vertically integrated core instrument can lead to more representative data for informing decision making and ultimately for obtaining a more equitable distribution of health.

Decision Making↗
PubMed2005

Health status and the challenges for prevention in The Netherlands.

In 2002, the third Public Health Status and Forecasts report was published, containing up-to-date information about Dutch public health and health care. A striking finding was that although life expectancy (LE) in The Netherlands increased between 1980 and 2000, the LE of men is rising less rapidly than the European Union (EU) average. The LE of Dutch women is stagnating and has now fallen below the EU average. These and many other unfavourable trends in the health status of the Dutch population were found to be largely due to unhealthy behaviour. One of the policy recommendations therefore was to strengthen the investments in prevention in order to reverse the stagnation in health status. In response to the findings, the Ministry of Health, Welfare and Sport published the National Prevention Paper. This Paper states that the Ministry, within the existing prevention policy, will pay more attention to healthy behaviour, stressing the responsibility of citizens as well as the societal responsibility of other parties, such as business communities, schools, health insurers and care suppliers. The prevention of specific diseases (diabetes, psychosocial problems, heart diseases, cancer, musculosceletal disorders, asthma and chronic obstructive pulmonary disease) has been given priority status. In this article, we present the major findings regarding the health status of the Dutch population and discuss the implications for prevention policy.

Age Factors↗
PubMed2006

Patient-reported economic burden and the health status of heart failure patients.

BACKGROUND: Heart failure (HF) guidelines recommend treatment with multiple medications to improve survival, functioning, and quality of life. Yet, HF treatments can be costly, resulting in significant economic burden for some patients. To date, there are few data on the impact of patients' perceived difficulties in affording medical care on their health outcomes. METHODS AND RESULTS: Comprehensive clinical data, health status, and the perceived economic burden of 539 HF outpatients from 13 centers were assessed at baseline and 1 year later. Health status was quantified with the Kansas City Cardiomyopathy Questionnaire overall summary score. Cross-sectional and longitudinal (1-year) analyses were conducted comparing the health status of patients with and without self-reported economic burden. Patients with economic burden had significantly lower health status scores at both baseline and 1 year later. Although baseline perceptions of economic burden were associated with poorer health status, patients' perceived difficulty affording medical care at 1 year was a more important determinant of lower 1-year health status. CONCLUSION: HF patients reporting difficulty affording their medical care had lower perceived health status than those reporting little to no economic burden. More research is needed to further evaluate this association and to determine whether addressing perceived economic difficulties affording health care can improve HF patients' health status.

Aged↗
PubMed2006

Health status assessed by the SF-36 along the diabetes continuum in an Australian population.

OBJECTIVE: To examine the association of health status with stage along the diabetes continuum. DESIGN, SETTING AND PARTICIPANTS: Self-reported health status (SF-36) was assessed in the North West Adelaide Health Study, a representative population cohort (n = 4060) aged 18 years and over in metropolitan South Australia. Impaired fasting glucose (IFG), undiagnosed diabetes, diagnosed diabetes, glycaemic control and cardiovascular disease were determined from fasting blood and self-reported data. RESULTS: The prevalence of diagnosed diabetes was 5.6% (95% CI: 4.9-6.3), with an additional 1.0% (95% CI: 0.7-1.4) previously undiagnosed. When compared to those with normal glucose, those with diabetes were significantly impaired on all SF-36 dimensions except Mental Health, and those with IFG (4.3%) were significantly impaired in terms of Physical Functioning and Bodily Pain when controlling for the effects of age, sex and cardiovascular disease. Poor glycaemic control (HbA1c >or= 7.0%) was also associated with impaired health status. CONCLUSIONS: Health status is impaired not only among those with diagnosed diabetes but also those with IFG and undiagnosed diabetes.

Adolescent↗
PubMed1993

[The health status dynamics of schoolchildren and the importance of biomedical factors in its development].

The dynamics in schoolchildren's health status varies in time, as the incidence of some chronic diseases decreases and that of the others increases. As a result, the health status of schoolchildren has deteriorated due to a reduction in the number of healthy children and an increase in the number of chronic patients in the past 30 years. Nervous, immune (allergic), and blood diseases have become frequent. Chronic ENT diseases have been encountered more infrequently due to the noticeable reduction in the incidence rates of tonsillitis and otitis. The positive trend is that schoolchildren have no rheumatism, infective allergic myocarditis, chronic pneumonia and diffuse glomerulonephritis and that the prevalence of locomotor disorders, renal and metabolic (obesity) diseases is low. During school time, the health status of children slightly improves due to the lower incidence rates of chronic diseases and the higher proportion of healthy children, but it has remained still worse than it was 30 years ago. The formation of chronic diseases has been found to occur in health group II children, who have morphological and functional changes, in 50% of cases from the first to the sixth forms and in 20% of cases from the seventh to the tenth forms. The present-day children are characterized by a combination of abnormalities and functional disturbances. This all require active and timely prophylactic measures to block chronization at the premorbid stage. Lifestyle (to keep the hygienic school regime, to do exercises and to go in for sports), sociohygienic conditions and genetic factors have profound effects on the health status.

Child↗
PubMed1996

[Self-assessed quality of mastication in relation to remaining teeth and self-assessed health status in elderly persons].

To explore factors related to quality of mastication, information about teeth status and self-assessed health status were obtained by a self-administered questionnaire from participants in a dental screening program. Invitation letters for participation in the program were distributed by members of the neighborhood association to 1.275 residents of a town in Gifu prefecture aged 65 years or older. Participation rate in the dental screening program was 40.5%. A total of 513 participants (245 males and 268 females) completed the program and the questionnaire. The results were as follows. 1. Overall, 32% had 20 teeth or more and 88.4% had bridge(s) and/or denture(s). 2. The mean number of remaining teeth were 12.9 for males and 12.5 for females. There was no statistical difference in the number of remaining teeth between males and females. The mean numbers of remaining teeth among those aged 65-69 years was 15.7 and two thirds of them had lost the Lower First Molar. 3. Those who reported to be satisfied with their present mastication were 83.3% of men and 86.3% of women. The proportions were not influenced by age or sex. 4. Quality of mastication was related to self-reported "good physical condition' and "not easily tired'. 5. The proportion of those satisfied with their mastication was large in the groups with remaining teeth index 0-8 and > or = 17, and small in the group with remaining teeth index 9-16, showing a U-shaped curve for satisfaction rate against remaining teeth index. These results suggest a relationship of quality of mastication on health status. The importance of primary dental care for the elderly persons is underlined.

Aged↗