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PubMed1997

Regional and rural-urban differences in obesity in Canada. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To describe regional and rural-urban differences in weight and weight loss patterns in Canadian adults. DESIGN: Population-based, cross-sectional surveys. SETTING: Nine Canadian provinces (excluding Nova Scotia) from 1986 to 1992. PARTICIPANTS: A probability sample of 27,120 men and women aged 18 to 74 years was selected using the health insurance registration files in each province. Anthropometry was performed on 18,043 participants (67%). OUTCOME MEASURES: Region of Canada (Atlantic, central, western); rural or urban residence (rural if participant resided in a community whose population was < 10,000, urban if population > or = 10,000); body mass index (BMI, kg/m2); percentage of participants trying to lose weight; reasons for trying to lose weight; level of leisure-time physical activity. RESULTS: Overall, mean BMI values in rural men (26.1 kg/m2) and women (25.3 kg/m2) were not significantly different from urban counterparts (25.7 kg/m2 and 24.8 kg/m2, respectively). Similarly, obesity (BMI > or = 27 kg/m2) was as prevalent in rural men (37%) and women (30%) as in urban participants (34% and 28%, respectively). However, a difference was observed in western Canada where 41% of rural and 34% of urban men were obese (odds ratio [OR], adjusted for age and education = 1.29; 95% confidence interval [CI] 1.06, 1.57), as were 35% of rural and 25% of urban women (OR, adjusted for age and education = 1.47; 95% CI 1.17, 1.84). Among men in western Canada, the rural-urban differences were greatest in the 25-64 year age group, whereas in women the differences were present at all ages. Overall, in Canada, urban men (26%) are more likely than rural men (23%) to be trying to lose weight; the reverse was true for women (39% and 42%, respectively). CONCLUSION: Considerable regional and rural-urban differences are seen in the patterns of weight and weight loss in Canada. A fuller understanding of the underlying behavioural determinants of these differences is needed. On the basis of such an understanding, effective programs to promote healthy weights for individuals and communities in these areas might be developed.

Adult↗
PubMed1990

Spells without health insurance: distributions of durations and their link to point-in-time estimates of the uninsured.

To be able to design effective policies that will provide financial access to medical care to the uninsured, we need to know how many people experience long versus short spells without health insurance. Previous studies of the characteristics of the uninsured have relied almost exclusively on data from a point in time. Using the Survey of Income and Program Participation (SIPP), this paper provides a link between the distributions of four characteristics of the uninsured at a point in time and the expected uninsured spell lengths of people in specific subgroups of each characteristic. Our findings indicate that half of all uninsured spells end within 4 months while only 15% last longer than 24 months. Also, people who are employed (either full-time or part-time) in the first month of an uninsured spell are highly likely to have short uninsured spells, while people who are unemployed or out of the labor force are more likely to have long uninsured spells. This implies that efforts to increase health insurance coverage via employer mandates should proceed cautiously until we know how many people with long uninsured spells are employed.

Adult↗
PubMed2004

Intra-household clustering of hepatitis C virus infection in Karachi, Pakistan.

Transmission rates of hepatitis C virus (HCV) infection through non-sexual household contacts have been considered to be very low. This study evaluated intra-household clustering of cases of HCV infection in a low socio-economic community in Karachi, Pakistan. Serum samples from 341 household contacts of 86 thalassaemic HCV-seropositive children were evaluated for antibodies to HCV using an ELISA. Spatial analysis of data was carried out to test for intra-household clustering. Seventy of 341 (20.5%) household contacts were HCV-seropositive. Of the households studied, 44.2% (38/86) had one or more contacts who tested HCV-seropositive. Ecological analysis of variables at household level showed that in households where HCV-seropositive index thalassaemic children were male HCV tended to be transmitted to one or more familial contacts. Spatial analysis with an asymptotic score test of the null hypothesis of no extra within-family infectivity revealed that there was a significant tendency of HCV infection to cluster within a household (score statistic = 19.44, P=0.032). The results showed that non-sexual household exposure may play a role in efficient HCV spread to household contacts of HCV-infected persons and needs further evaluation.

Adolescent↗
PubMed1981

Fertility decline and differences in less-developed countries: an anthropological microstudy of some communities of West Bengal, India and Upper Khumbu, Nepal.

The role of socioeconomic and other cultural factors as determinants of fertility change has been widely discussed, with some scholars emphasising an inverse relation between socioeconomic development and fertility, others suggesting that no such relation necessarily exists, and yet others indicating that by using data from various sources it is possible to "prove" that a given country's crude birth rate has declined, remained unchanged or increased. Demographic data are presented on age-sex structure, completed and total fertility rates, and age specific fertility rates by age cohorts of women, from several small, anthropological population units of West Bengal, India and Upper Khumbu, Nepal, exposed to various physical and cultural environmental stresses. The data show that fertility has declined in most of the populations/subpopulations studied and that the decline may, deductively, be attributed to economic development via greater family planning practices.

Adolescent↗
PubMedDate not supplied

A look at income and wealth in America.

Diverse forces in the U.S. economy have led to a tendency for increased concentration of income and wealth in the upper income brackets. Some mobility within classes helps to mitigate the problem, but sluggish growth of real incomes has heightened awareness of this trend. Even though the vast majority of Americans continue to identify themselves as "middle class," this slowed growth contributes to the concerns about the shrinking size of this group. Between 1975 and 1995 the highest quintile of households was the only one to experience a growing share of money income, with virtually all of the increase occurring within the top 5 percent. Education and training in our high-technology society are two key elements in improving income. Demographic forces may also change income and wealth dynamics in the future particularly as the population ages and the ratio of workers to the elderly retired affects the supply demand forces in the labor markets.

Age Distribution↗
PubMed1994

Baby boomers in retirement: what are their prospects?

This Issue Brief examines the baby boomers' retirement income prospects by analyzing trends in the elderly's income and pension participation among workers; examining saving behavior and critically evaluating studies of the adequacy of the boomers' saving; and looking at tenure trends, lump-sum distribution preservation, and changes in Social Security benefits. Since the mid 1970s, the real median income of individuals aged 65 and over has increased 18 percent. Sources of income have shifted, with employment-based pensions increasing and earnings and asset income decreasing as a proportion of income. The boomers' prospects are partly dependent on participation in employment-based retirement plans. After decreases in the sponsorship rates, participation rates, and vesting rates of workers during the 1980s, all three percentages increased during the early 1990s. Data do not support the perception that the U.S. work force is becoming increasingly mobile. Tenure levels for prime age workers in the 1980s and beginning of the 1990s were higher than those of previous decades. Still, in response to competitive pressures, employers may not offer the security of paternalistic benefit packages as in the past. Various studies have reached different conclusions regarding the adequacy of the boomers' financial preparation for retirement. Evidence indicates that boomers, in general, will enjoy a retirement standard of living exceeding that of their parents. It is less clear whether they will maintain a standard of living in retirement comparable to that of their working years. To the extent they are willing to tap housing wealth, they would appear at this early stage to be in good shape. Federal fiscal policy decisions will impact boomers by affecting their disposable income today, and thus their ability to save, as well as the benefits they will receive in retirement through Social Security and Medicare. The boomers are 17 to 35 years away from age 65. Given heterogeneity of the boomers, research is needed to identify what specific groups within the generation are at risk and the magnitude of that risk. Groups that would now appear to be at risk to some degree include non-homeowners, the less educated, the single, and the youngest boomers.

Aged↗
PubMed1990

[Regional differences in mortality from ischemic heart disease].

The geographical distribution of mortality from ischaemic heart disease in the Netherlands has changed dramatically since 1950. In 1950-1954 mortality was highest in high-income, urbanized areas, in 1980-1984 the reverse was true. This development resembles the one observed in the United States of America. The changes in geographical distribution cannot be attributed to differences in cause-of-death certification. The change in the association with income and the association between mortality and a number of ischaemic heart disease risk factors found in 1970-1974, suggest that at least part of the explanation is a change in the geographical distribution of risk factors.

Adult↗
PubMed2004

Preferences for receipt of care among community-dwelling adults.

Preferences for long-term care alternatives include both place of care and persons to provide care. In this analysis, these elements are separated for mature adults (N-1503, ages 40-70) regarding future care needs. Most adults preferred care in home/community settings by kin or non-kin, with few deeming nursing homes acceptable. Demographics and personal knowledge, experience, and expectations were marginally likely to influence preferences; males were more likely to prefer care in paid/professional settings. Women, who more often expressed preference for kin/home care, face demographic trends reducing available female kin who might be caregivers.

Adult↗
PubMedDate not supplied

Contraceptive social marketing and community-based distribution systems in Colombia.

Three operations research experiments were carried out in three provinces of Colombia to improve the cost-effectiveness of Profamilia's nonclinic-based programs. The experiments tested: (a) whether a contraceptive social marketing (CSM) strategy can replace a community-based distribution (CBD) program in a high contraceptive use area; (b) if wage incentives for salaried CBD instructors will increase contraceptive sales; and (c) whether a specially equipped information, education, and communication (IEC) team can replace a cadre of rural promoters to expand family planning coverage. All three strategies proved to be effective, but only the CSM system yielded a profit. Despite this, Profamilia discontinued its CSM program soon after the experiment was completed. Unexpected government controls regulating the price and sale of contraceptives in Colombia made the program unprofitable. As a result, family planning agencies are cautioned against replacing CBD programs with CSM. Instead, CBD programs might adopt a more commercial approach to become more efficient.

Colombia↗
PubMed1993

The projections of intracellularly labeled auditory nerve fibers to the dorsal cochlear nucleus of cats.

The cochlear nucleus receives incoming auditory nerve discharges, preserves or transforms the signals, and distributes outgoing activity to higher centers. The organization of auditory nerve input to the cochlear nucleus will heavily influence the mechanisms by which acoustic information is processed. In order to study structure-function relationships between auditory nerve and cochlear nucleus, the axonal arborizations of type I spiral ganglion cells were labeled with intracellular injections of horseradish peroxidase after first being electrophysiologically characterized by recording with a micropipette inserted into the axon. For each auditory nerve fiber, spontaneous discharge rate (SR) and a frequency tuning curve were determined. The tuning curve yielded the characteristic frequency (CF, that frequency to which the fiber is most sensitive) and CF threshold in dB SPL. Individual axonal arborizations including all terminal swellings were reconstructed through serial sections with the aid of a light microscope and drawing tube. On average, 13.4 +/- 8.1% of the terminal swellings were found in the dorsal cochlear nucleus (DCN) and the remaining terminal swellings were located in the ventral cochlear nucleus. In the DCN, the terminal fields of auditory nerve fibers were restricted to layer III, contributed to cytoarchitectonic striations, and exhibited a systematic relationship between fiber CF and position along the strial (or long) axis of the nucleus. Computer-aided rotations revealed that the terminal fields were anisotropic, being flattened within the trans-strial axis. The maximal width of the terminal fields along the strial axis ranged from 31-321 microns and was inversely related to fiber CF and SR. Variation in the number of terminals or depth of the terminal field within layer III was not related to SR grouping or CF of the fiber.

Animals↗
PubMed2006

Self-reported health: reliability and consequences for health inequality measurement.

Self-reported health (SRH) is one of the most frequently employed measures for assessing income-related health inequalities between counties. A previous study has shown that 28% of respondents changed their assessment of their health status when asked a SRH question on two occasions in the same survey (first as part of self-completed questionnaire and then in a personal interview). This study re-examines this issue using another survey where SRH was again asked twice of respondents, but this time the personal interview was first and self-completion second. We find the same variation in responses, but the predominant direction is away from the 'extreme' categories 'Excellent' and 'Poor' which is the opposite direction to the previous study. We therefore conclude that the most likely explanation is a mode of administration effect that makes people less likely to choose the extreme categories in a self-completion questionnaire, but not a personal interview. However, this effect has a relatively minor impact on measures of inequality. This is due to a large proportion of the movement (i.e. movement to the middle) not being related to income and hence does not systematically impact on the cumulative distribution of health across this measure of socio-economic status.

Health Status↗
PubMed1994

A case-control study of reproductive risk factors associated with cervical cancer.

Using the logistic-regression technique, a hospital-based case-control study of 177 married women with invasive squamous-cell cervical cancer and 149 hospital-visiting controls enabled evaluation of selected reproductive factors as risks. Early age at marriage was found to be the single best predictor of the disease status. However, those who married late but gave birth to a large number of children were generally found to be suffering from cervical cancer. The results support the hypothesis that it is not so much parity per se that enhances the risk, but the rapidity of multiple pregnancies that matters. Logistic analysis also revealed the independent influence of birth interval on the risk of cervical cancer. These findings warrant serious consideration in future studies, given the obvious implications for prevention. Other implications for the prevention of cervical cancer are briefly discussed.

Adult↗
PubMed2006

Gender differences in diagnostic radiologists' annual incomes.

RATIONALE AND OBJECTIVES: Specialty, work effort, and gender have been shown to be associated with physicians' annual incomes; however, careful examination of the association between provider gender and physician incomes after correcting for other factors likely to influence income has not been conducted at the subspecialty level. We sought to determine the association between provider gender and diagnostic radiologists' annual incomes after controlling for work effort, provider characteristics, and practice characteristics. MATERIALS AND METHODS: Using survey responses that were collected throughout the 1990s from 491 actively practicing white diagnostic radiologists, we generated a linear regression model to determine the association between provider gender and radiologists' annual incomes after controlling for work effort, provider characteristics, and practice characteristics. RESULTS: White female radiologists reported working 2% fewer annual hours than their white male counterparts. Female radiologists had practiced medicine for fewer years than males, were more likely to be employees, as opposed to having an ownership interest in the practice, and were equally likely to be board certified. After adjustment for work effort, provider characteristics, and practice characteristics, female radiologists' mean annual income was $273,907, or $80,090 (23%) lower than that for white males (95% CI: $113,930 lower to $46,250 lower, P < .001). CONCLUSIONS: During the 1990s, female gender was associated with lower annual incomes among diagnostic radiologists. Researchers should further explore the relationship between physician gender and incomes to determine what factors might cause the differences that we found.

Income↗