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PubMed1995

[The subjective evaluation of oral health in 40- to 69-year-old subjects. A representative survey of 600 persons in German- and French-speaking Switzerland].

Individual oral hygiene, professional dental care and subjective satisfaction with the oral health were investigated in 600 persons representative for the German- and French-speaking population of Switzerland. They cleaned their teeth on average 2.4 x per day, 85% had a "family dentist" whom they had last visited 14.6 months ago and who works to their full satisfaction. On average, every 13.5 month they underwent professional cleaning of their teeth which was performed in 55% by their dentist and in 45% by a dental hygienist. They were well satisfied with the condition of their teeth and gums and even better so with their reconstructions. In 1984 a gap of consumption of toothbrushes and toothpastes had been apparent in over 50-year-old people. Today this is just visible in the over 60 year old. 40 to 60 year old people care for their oral hygiene and regularly go to professional control and cleaning appointments. Only over 60 year old people are consuming slightly less dental services and buying less toothbrushes and toothpastes. Turning points are loss of teeth, retirement, isolation and sharp cuts in income.

Adult↗
PubMed2001

A method for estimating light interception by a conifer shoot.

We present an operational method for estimating the amount of PAR intercepted by a coniferous shoot. Interception of PAR by a shoot is divided into three components: the amount of radiation coming from the sky, the transmission of radiation through the surrounding vegetation, and the shoot' s silhouette area facing the direction of the incoming radiation. All three components usually vary with direction. Radiation incident from the sky consists of direct and diffuse radiation. The well-known equation of motion for the sun and Beer' s Law for atmospheric transmittance are used to simulate the directional distribution of direct sunlight for any given period of time. The diffuse component is assumed to be uniform. Meteorological field measurements are used to calibrate the absolute amounts of the direct and diffuse components. The gap fraction (proportion of visible sky) in different directions around a shoot is measured by analyzing a hemispherical fish-eye photograph, taken at the location of the shoot, with an image processing program. Similarly, the shoot silhouette area (SSA) is measured by photographing the shoot from many different directions. The measurements of SSA are interpolated by a method called trigonometric interpolation to obtain the directional distribution of SSA over the entire hemisphere. This distribution is then rotated according to the shoot' s position in the canopy. Multiplying incoming PAR, canopy gap fraction and SSA in different directions, and summing over all directions, gives an estimate of PAR intercepted by the shoot during the chosen period of time. The method is described step by step, and applied, as an example, to a shoot from a Scots pine (Pinus sylvestris L.) stand in central Finland. Differences in radiation interception properties between sun and shade shoots and their relevance to canopy-scale models are discussed.

Cycadopsida↗
PubMed1998

Educational differences in leisure-time physical inactivity: a descriptive and explanatory study.

In this study we aim to explain educational differences in leisure-time physical inactivity in terms of psychosocial and material factors. Cross-sectional data were obtained from the baseline of the Dutch GLOBE study in 1991, including 2598 men and women, aged 15-74 years. Physical inactivity during leisure time was defined as not participating in any activity, such as sports, gardening, walking or cycling. Psychosocial factors included in the study were coping resources, personality, and stressors. Material factors were financial situation, employment status, and living conditions. Logistic regression models were used to calculate educational differences in physical inactivity. Physical inactivity was more prevalent in lower educational groups. Psychosocial factors related to physical inactivity were locus of control, parochialism, neuroticism, emotional social support, active problem focussing, optimistic and palliative coping styles. Material factors associated with physical inactivity were income, employment status and financial problems. All correlates of physical inactivity were unequally distributed over educational groups, except optimistic and palliative coping. Personality and coping style were the main contributors to the observed educational differences in physical inactivity. That is to say, parochialism, locus of control, neuroticism and active problem focussing explained about half of elevated odds ratios of physical inactivity in the lower educational groups. The material factors, equivalent income and employment status explained about 40% of the elevated odds ratios. Psychosocial and material correlates together reduced the odds ratios of lower educational groups by on average 75%. These results have practical consequences for the design of more effective interventions to promote physical activity. In particular, personality and coping style of risk groups, such as lower educational groups, should be taken into consideration at the future development of these interventions, as well as inequalities in material restrictions related to engaging in physical activity. Supplementary interventions focussing on childhood conditions which, partly, influence both personality and physical inactivity may also contribute to a reduction of socio-economic differences in physical inactivity.

Adaptation, Psychological↗
PubMedDate not supplied

Income, housing, and fire injuries: a census tract analysis.

OBJECTIVES: This study investigates the social and demographic correlates of nonfatal structural fire injury rates for the civilian population for Philadelphia census tracts during 1993-2001. METHODS: The author analyzed 1,563 fire injuries by census tract using the 1990 census (STF 3) and unpublished data from the Office of the Fire Marshal of the Philadelphia Fire Department. Injury rates were calculated per 1,000 residents of a given census tract. Multiple regression was used to determine significant variables in predicting fire injuries in a given census tract over a nine-year period and interaction effects between two of these variables-age of housing and income. RESULTS: Multiple regression analysis indicates that older housing (prior to 1940), low income, the prevalence of vacant houses, and the ability to speak English have significant independent effects on fire injury rates in Philadelphia. In addition, the results show a significant interaction between older housing and low income. CONCLUSIONS: Given the finding of very high rates of fire injuries in census tracts that are both low income and have older housing, fire prevention units can take preventative measures. Fire protection devices, especially smoke alarms, should be distributed in the neighborhoods most at risk. Multiple occupancy dwellings should have sprinkler systems and fire extinguishers. Laws concerning the maintenance of older rental housing need to be strictly enforced. Vacant houses should be effectively boarded up or renovated for residential use. Fire prevention material should be distributed in a number of languages to meet local needs.

Burns↗
PubMed2001

Independent effects of income and education on the risk of obesity in the Brazilian adult population.

With a view to assess the independent effects of income and education on the risk of obesity we studied cross-sectional randomly selected samples of the adult population (20 y and over) living in 1996/97 in the less (northeastern) and the more (southeastern) developed region of Brazil (1971 and 2588 northeastern and 2289 and 2549 southeastern men and women, respectively). Independent effects of income and education on obesity (BMI > or = 30 kg/m(2)) were assessed through logistic regression analyses that controlled for age, ethnicity, household setting (urban or rural) and either education or income. The risk of obesity in men strongly increased with income in the two regions. The level of education did not influence the risk of male obesity in the less developed region but, in the more developed one, better-educated men had slightly less chance to be obese. In the less developed region obesity in women was strongly associated with both income (direct association) and education (inverse association). In the more developed region only the women's education influenced the risk of obesity, and the association between the two variables was inverse and strong as in the less developed region. Findings from this study reveal a scenario that is far from what has been generally admitted for the social distribution of obesity in the developing countries. They indicate that in transition societies income tends to be a risk factor for obesity, whereas education tends to be protective and that both gender and level of economic development are relevant modifiers of the influence exerted by these variables.

Adult↗
PubMed2006

Socioeconomic status, systolic blood pressure and intraocular pressure: the Tanjong Pagar Study.

BACKGROUND: Lower socioeconomic status (SES) is associated with higher morbidity and mortality in many countries. Present evidence suggests that glaucoma has similar risk factors to major chronic diseases such as cardiovascular disease. This study investigates the association between SES and intraocular pressure (IOP), an important risk factor for glaucoma. METHODS: The Tanjong Pagar Study was a population-based cross-sectional survey of Chinese people aged 40-79 years, who were randomly selected from the Singapore electoral register. Of the 2000 people selected, 1717 were considered eligible and 1090 were examined in clinic and included in the present study. IOP was measured using applanation tonometry. SES was assessed using a standardised questionnaire; education and income were used as the main explanatory variables. The effect of systolic blood pressure (SBP) was also examined. RESULTS: Participants with lower levels of education and income had higher mean IOP (both p<0.01). These associations remained after adjusting for age and central corneal thickness, a strong independent predictor. SBP was strongly associated with both SES and IOP (both p<0.01). Adjusting for SBP attenuated the association between SES and IOP. CONCLUSION: Participants with lower education and income have a higher mean IOP. This effect may be mediated, in part, by an association of education and income with SBP. This is the first study to suggest that there is a social gradient in the distribution of the only major modifiable risk factor for glaucoma. Increasing similarities exist between the causation models of chronic diseases and that of glaucoma.

Adult↗
PubMed1989

Projected long-term demographic trends and aggregate personal saving in the United States.

The potential effect of the changing age distribution of the U.S. population on the level of aggregate saving is examined. "The Modigliani-Brumberg life-cycle model predicts a relationship between age distribution and the aggregate saving ratio via the population growth rate, which affects the ratio of earner/savers to retiree-dissavers. Aging resulting from slower population growth will result in a decline in the aggregate saving rate. This paper utilizes empirical age-saving relations, together with projected long-run population age distributions, to estimate the age distribution effect on aggregate personal saving. Results predict a much smaller decline in the saving ratio than is generated by the basic life-cycle model."

Age Distribution↗
PubMed2004

Knowledge of aging and life satisfaction among older adults.

Four hundred young-, middle-, and old-old adults responded to a battery of quizzes dealing with life satisfaction and objective aging knowledge in the physical, psychological, and social domains. Analyses incorporated domains of aging knowledge, life satisfaction, age, gender, and demographic variables. Both means difference and regression analyses were computed. Significant age group, gender, and life satisfaction differences were found for the three aging knowledge domains. For successive age groups, knowledge of aging decreased, with females knowing less than males. The greater knowledge of aging, the higher the life satisfaction. The demographic variables education, financial status, health, living arrangement, and volunteerism were significant covariates for knowledge of aging. Results from this study indicate that knowledge of aging in specific domains varies among older adult age groups and is associated with life satisfaction.

Activities of Daily Living↗
PubMed1976

Strategies for financing national health insurance: who wins and who loses.

Two sources of funds are available to underwrite the costs of any national health-insurance plan: prepayments (premiums, payroll taxes and income taxes) and out-of-pocket payments (coinsurance and deductibles). The extent to which taxes rather than premiums are used to finance an insurance program will be the major determinant of how large a share of the costs of health care will be borne by higher-income groups. The extent to which coinsurance and deductible provisions are reduced or waived for low-income persons will have a less important, but still substantial, role in determining how the costs of a program are distributed. These financing principles, once understood, provide a basis for the design of health-insurance legislation that will achieve any pattern of income redistribution that may be desired.

Deductibles and Coinsurance↗
PubMed1985

Income of new retired workers by social security benefit levels: findings from the New Beneficiary Survey.

This article, based on New Beneficiary Survey (NBS) data, examines the sources and amounts of income available to newly retired workers by the level of their primary insurance amount (PIA). For this analysis, the PIA distribution was divided into quartiles. Retired workers with high PIA's were found to be more likely to have private pensions or asset income and thus to have the highest total income. When a spouse's income is taken into account, married retired workers at all PIA levels have higher total income than do the unmarried retirees. The difference between the income of married and unmarried retirees is greatest for those with PIA's in the lowest quartile, where the median total income of the married retirees is roughly three times as high as that of the unmarried group. New retirees with PIA's in the lowest quartile were a mixed group: Many had additional important sources of income; others did not and had income that was quite low. About 21 percent of those with PIA's in the lowest quartile had pensions and their median total income was about $19,100. An additional 55 percent were married women without pensions of their own who, together with their husbands, had a median total income of $15,900. The remaining 24 percent were married men and unmarried retirees without a pension and with much lower median income--$7,100 for the married men and their wives, and $5,000 for the unmarried men and women.

Aged↗
PubMed2005

[Changes in distributive equity of health insurance contribution burden].

OBJECTIVES: We analyzed the changes from 1996 to 2002 in distributive equity of the contribution burden in the Korean National Health Insurance. METHODS: The study subjects were a total of 8923 employee households and a total of 7296 self-employed households over the period from 1996 to 2002. Those were the households meeting the two criteria as completing each annual survey and having no change in the job of head of the household during that period from the raw data of the Household Income and Expenditure Survey annually conducted by the Korean National Statistical Office. The unit of analysis was a household, and this was the standard for assessing the contribution that is now applied on a monthly basis. Deciles Distribution Ratio, Contribution Concentration Curve and Contribution Concentration Index were estimated as the index of inequality. Multiple regression analysis was conducted to compare the annual ability-to-pay elasticity of the contribution to the reference year of 1996 for three groups (all households, the employee households, and the self-employed households). RESULTS: For the index of inequality, the distributive equity of contribution was improved in all three groups. In particular, the employee group experienced a substantial improvement. Using multiple regression analysis, the ability-to-pay elasticity of the contribution in the employee group significantly increased (beta = 0.232, p < 0.0001) in the year 2002 as compared to the reference year of 1996. The elasticity in the self-employed group also significantly increased (beta = 0.186, p < 0.05), although its change was smaller than that in the employee group. CONCLUSIONS: The employee group had a greater improvement for the distributive equity of the contribution burden than the self-employed group. Within the observation period, there were two important integration reforms: one was the integration of 227 self-employed societies in 1998 and the other was the integration of 139 employee societies in 2000. We expected that the equity of the contribution burden would be improved for the self-employed group since the integration reform of 1998. However, it was not improved for the self-employed group until the year 2000. This result suggests that capturing exactly the beneficiaries' ability-to-pay such as income is the precedent for distributive equity of the contribution burden, although a more sophisticated imposition standard of contribution is needed.

Adult↗
PubMed2003

Income differences in food consumption in the 1995 Australian National Nutrition Survey.

OBJECTIVE: To assess the relationships between an index of per capita income and the intake of a variety of individual foods as well as groups of food for men and women in different age groups. DESIGN: Cross-sectional national survey of free-living men and women. SUBJECTS: A sample of 5053 males and 5701 females aged 18 y and over who completed the Australian National Nutrition Survey 1995. METHODS: Information about the frequency of consumption of 88 food items was obtained. On the basis of scores on the Food Frequency Questionnaire, regular and irregular consumers of single foods were identified. The relationships between regularity of consumption of individual foods and per capita income were analysed via contingency tables. Food variety scores were derived by assigning individual foods to conventional food group taxonomies, and then summing up the dichotomised intake scores for individual foods within each food group. Two-way ANOVA (income x age group) were performed on the food variety scores for males and females, respectively. RESULTS: Per capita income was extensively related to the reported consumption of individual foods and to total and food group variety indices. Generally, both men and women in low income households had less varied diets than those in higher-income households. However, several traditional foods were consumed less often by young high-income respondents, especially young women. CONCLUSIONS: Major income differentials in food variety occur in Australia but they are moderated by age and gender. Younger high-income women, in particular, appear to have rejected a number of traditional foods, possibly on the basis of health beliefs. The findings also suggest that data aggregation has marked effects on income and food consumption relationships.

Adolescent↗
PubMed2006

Role of radiotherapy in cancer control in low-income and middle-income countries.

More than half the cases of cancer in the world arise in people in low-income and middle-income countries. This proportion will rise to 70% by 2020. These are regions where the annual gross national income per person is less than 9386 US dollars. Radiotherapy is an essential part of the treatment of cancer. In high-income countries, 52% of new cases of cancer should receive radiotherapy at least once and up to 25% might receive a second course. Because of the different distribution of tumour types worldwide and of the advanced stage at presentation, patients with cancer in low-income and middle-income regions could have a greater need for radiotherapy than those in high-income countries. Radiotherapy for cure or palliation has been shown to be cost effective. Many countries of low or middle income have limited access to radiotherapy, and 22 African and Asian countries have no service at all. In Africa in 2002, the actual supply of megavoltage radiotherapy machines (cobalt or linear accelerator) was only 155, 18% of the estimated need. In the Asia-Pacific region, nearly 4 million cases of cancer arose in 2002. In 12 countries with available data, 1147 megavoltage machines were available for an estimated demand of nearly 4000 megavoltage machines. Eastern Europe and Latin America showed similar shortages. Strategies for developing services need planning at a national level and substantial investment for staff training and equipment. Safe and effective development of services would benefit from: links with established facilities in other countries, particularly those within the same region; access to information, such as free online journal access; and better education of all medical staff about the roles and benefits of radiotherapy.

Cost-Benefit Analysis↗
PubMed2001

Functional ability and oral health among older people: a longitudinal study from age 75 to 80.

OBJECTIVE: To examine whether functional ability at age 75 and age 80 is associated with oral health and use of dental services cross-sectionally and whether changes in functional ability from age 75 to age 80 are associated with oral health and regular use of dental services at age 80. DESIGN: The study included a random sample of 75-year-olds at baseline and a follow-up study 5 years later. The data are treated as two cross-sectional studies at age 75 and 80, respectively, and as a longitudinal study from age 75 to 80. SETTING: The western part of Copenhagen County. PARTICIPANTS: The two cross-sectional studies of 75- and 80-year-old people included 411 and 321 persons, respectively. The longitudinal study from age 75 to 80 included the 326 persons who participated in both surveys. MEASUREMENTS: Oral health status was measured roughly by number of teeth and chewing ability. Use of dental services was measured by frequency of visits to a dentist or denturist. Functional ability was measured by two scales on mobility in relation to tiredness and need of help. Changes in mobility from age 75 to 80 is described as (1) improved or sustained good, (2) decreased, and (3) sustained poor. Gender, chronic diseases, self-rated health, socio-demographic factors, living alone, and social relations were included as possible confounders. RESULTS: The odds ratio of having no or few teeth was 1.7 (1.1-2.6) in 75-year-old individuals who felt tired in mobility, 1.7 (1.0-2.9) in 80-year-old persons who needed help with mobility, and 2.7 (0.94-7.5) in persons with sustained need of help with mobility from age 75 to 80. The odds ratio of chewing difficulties was 1.7 (1.1-2.8) in 80-year-old people in need of help, and 1.8 (1.1-3.0) in persons age 75 to 80 needing sustained help. Dentate 80-year-old persons who felt tired in mobility had an odds ratio of 2.0 (0.94-4.2) of not using dental services. CONCLUSIONS: The results indicate that oral impairment (e.g., having no or few teeth), oral functional limitations (e.g., chewing problems), and general functional limitations (e.g., mobility problems) are interrelated and that prevention of disabilities should be aimed at both functional limitations and oral health problems if the intention is to promote a good life in old age. In addition, the results point to the importance of taking problems in mobility seriously in delivering preventive services to old people because people who are tired or dependent on help seem to be at a higher risk of not using dental services regularly.

Activities of Daily Living↗
PubMed1999

Dental services: use, expenditures and sources of payment, 1987.

BACKGROUND: This article provides per capita estimates of dental care utilization, expenditures, mix of services and sources of payment for each of several socioeconomic and demographic categories. METHODS: The focus of the analyses presented here is on dental care utilization by the U.S. population during 1987. Specifically, national estimates are provided for dental visits, expenditures, sources of payment and procedure type for each of several socioeconomic and demographic categories using household data from the 1987 National Medical Expenditure Survey, or NMES. RESULTS: During 1987, less that 50 percent of Americans visited a dental office. Americans made approximately 292 million dental visits and received approximately $30 billion worth of dental care, of which $10 billion was paid by insurers, $17 billion was paid out of pocket and $1.6 billion was not reimbursed. CONCLUSIONS: These analyses establish the magnitude of the dental care market and the amounts paid by individual patients, private insurance companies and Medicaid. They also reveal that the type of care received varies among people in distinct socioeconomic and demographic groups. PRACTICE IMPLICATIONS: Although the dental care market is substantial, many Americans do not visit a dentist. By understanding these analyses, practitioners will be better positioned to meet the dental needs of all Americans.

Adolescent↗
PubMed1991

Women dentists' office apparel: dressing for success in an age of infection control.

A questionnaire on office apparel was answered by 928 of the 2000 women dentists surveyed. The most surprising aspect of this study is that only 51% of all the women surveyed feel the need to wear some type of lab coat or uniform for infection control. Women dentists who do wear a lab coat over street clothes do so primarily for the enhancement of their professional image. Women dentists reporting the highest gross incomes were more likely to wear only street clothes (P = .01) in the office. This study suggests that the dichotomy of dressing for success and dressing for infection control is an issue that needs to be addressed by the profession. Guidelines would be especially helpful for the majority of women dentists who are currently in their first years of practice.

Adult↗
PubMed2003

[Socioeconomic circumstances and health among the brazilian elderly: a study using data from a National Household Survey].

The influence of socioeconomic circumstances on senior citizens' health is still controversial. We used data from the 1998 Brazilian National Household Survey (PNAD 1998) to examine this influence. A representative sample of the Brazilian population aged > or = 65 years (n = 19,068) were included in the study. The characteristics of those in the lower quintile of per capita household income were compared with those with higher income (< 0.67 vs > or = 0.67 the Brazilian minimum wage). The lower income group presented worse health conditions (self-rated health, inability to perform routine activities due to a health problem, bedridden conditions, and a report of any disease), and worse physical functioning (level of difficulty in performing selected physical activities), and less frequent use of medical and dental services. These results do not confirm observations, in some developed countries, of a lack of association between socioeconomic status and health among the elderly. On the contrary, according to our results, in Brazil even small differences in income are sufficiently sensitive to identify older adults with worse health conditions and limited access to health services.

Age Distribution↗