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PubMed1999

Self-reported health status and mortality in a multiethnic US cohort.

The authors examined the relation between self-reported health status and mortality among the following racial/ethnic groups: Native Americans, Asian/Pacific Islanders, blacks, whites, and Hispanics. They pooled 1986-1994 data from the National Health Interview Survey to obtain information on more than 700,000 cohort participants. Although fewer than 5,000 Native Americans are included in this cohort, the data provide information previously unavailable for this group. Also included are almost 17,000 Asian/Pacific Islanders, over 90,000 blacks, and over 50,000 Hispanics. The authors found strong associations between self-reported health status and both socioeconomic status and subsequent mortality. A self-report of fair or poor health was associated with at least a twofold increased risk of mortality for all racial/ethnic groups. Even after adjustment for socioeconomic status and measures of comorbidity, a significant relation was found between self-reported health status and subsequent mortality. The authors found that self-reported health status is a strong prognostic indicator for subsequent mortality for both genders and all racial/ethnic groups examined. These results emphasize the utility of using simple filter questions in population research.

Adult↗
PubMed1987

Measurement of outcomes of general practice: comparison of three health status measures.

The broad range of medical problems seen in general practice means that the assessment of health outcomes shares much with the assessment of health status in the general community. The last two decades have seen considerable progress in health status measurement for this purpose. This paper reports the use of three such measures in a general practice setting. The 'Rand health insurance study battery', the 'sickness impact profile' and the 'general health questionnaire' were tested in two general practices in Sydney, Australia, to determine patient compliance, to assess the range of scores and discriminative ability of the instruments, and to compare the different instruments. There was a high degree of acceptance of the questionnaires, showing that patients visiting their general practitioners are prepared to complete such questionnaires. The range of scores obtained was less skewed for the Rand measures than for the sickness impact profile or the general health questionnaire, suggesting that the Rand measures should be the preferred general health status measure.

Australia↗
PubMed1996

The hubris of health status measurement: a clarification of its role in the assessment of medical care.

Numerous advances in health status measurement have occurred in the past several years. Of the many challenges, one, in particular, is important for any health reform proposal to succeed. That is, while many researchers point to health status measures as a means of evaluating outcomes of competing health plans, this paper outlines difficulties with such a proposal. The paper then provides different suggestions for dealing with this important issue. Most notably, a community based health status assessment is recommended.

Competitive Medical Plans↗
PubMed2001

[Self-perception of oral health status by the elderly].

OBJECTIVE: To assess the self-perception of oral health status of the elderly and to analize the clinics, subjectives and sociodemographic factors that interfer in this perception. METHODS: Results are based on interviews and clinical assessment of 201 subjects aged 60 years and over, who were dentate, functionally independents and used to go to a health care center in the town of Araraquara, SP, Brazil. A questionnaire with questions about social characteristics of the sampled population, their oral health status self-perception and the Geriatric Oral Health Assessment Index (GOHAI) was applied. All subject underwent a clinical examination to determine the prevalence of the main oral diseases. Statistical analyses were performed to determine the association between social and clinic variables, and the GOHAI index with their oral health self-perceptions. In addition, analyses were made to identify self-assessment predictors. RESULTS: The clinical examination revealed that dental caries and periodontal disease had a significant prevalence, though 42.7% of the sample assessed their oral health status as regular. Social class, the GOHAI index, and the decayed and missing teeth were all associated with the self-assessment. The multivariate analysis showed that the self-assessment predictors were the GOHAI index, missing teeth and Community Periodontal Index and Treatment Needs index. These predictors accounted for 30% of the self-assessment variability. CONCLUSIONS: As the oral health self-perception had minor influence on the clinical conditions, developing educational and preventive actions for the elderly population are recommended.

Aged↗
PubMed1975

The influence of cultural heritage on the health status of Puerto Ricans.

The problems of poor health among Puerto Ricans today are compounded by their cultural traditions. Many Puerto Ricans still rely on folk medicine to cure their ills. One study by Suchman found that compared with persons of other ethnic groups in New York City, the Puerto Ricans are more suspicious of scientific medical care, tend to use general health services less, have more limited health horizons than any other ethnic group. Aside from the unsophisticated health practices stemming from a knowledge of Puerto Rican folk medicine, the cultural phenomena of spiritualism plays a significant role in retarding the health status of the Puerto Rican. Puerto Ricans who view illness as possession by evil spirits will consult a medium or curandero(a) for treatment instead a physician. The hot and cold theory of disease has a profound influence on the Puerto Ricans' health status. In the attempt to achieve equilibrium of the four body humors, Puerto Ricans will often disregard a physician's advice which does not conform to this theory. Also, machismo, the concept of male dominance and superiority leads to sexual promiscuity, over-population, venereal disease, family breakdown, early marriage, and a variety of health related problems.

Adolescent↗
PubMed1997

Epidemiological studies of pig diseases: 1. Use of French protocols for risk factor assessment to predict the health status of Australian herds.

OBJECTIVE: To determine in Australian pig herds the accuracy of French protocols for risk factor assessment. PROCEDURE: Data on health indicators and risk factors were collected for three syndromes, 'pre-weaning diarrhoea', 'post-weaning diarrhoea' and 'respiratory problems', using the French protocols. The protocols were used on 118 occasions in 32 Western Australian pig herds during 3 years (1988 to 1991). RESULTS: There was a wide variation in pre-weaning performance, for example growth rate was 107 to 273 g/day (< 200 g/day in 33% of herds). Respiratory lesions at weaning were associated with poor pre-weaning performance. Post-weaning (21 days after weaning) growth rate was 114 to 408 g/day (< 250 g/day in 54% of herds). In the grower herds, 91% of herds had pneumonia, and growth rate was 439 to 625 g/day (< 550 g/day in 54% of herds). Pleurisy as well as pneumonia was associated with reduced growth rate. The risk factor most closely associated with respiratory health status was air volume per pig. CONCLUSION: Risk factors were most accurate at predicting the health status in post-weaning problems. A weaning weight of at least 7.9 kg and weaning age of 30 days optimised weaner performance. Stocking densities and shed designs providing at least 3 m3 air volume and 0.6 m2 floor space per pig throughout the growing phase should be considered for an improved respiratory health status. Australian pig sheds often do not provide a satisfactory environment for optimum health. The technique of risk factor assessment as an aid to the maintenance of health in pig herds is applicable in Australia, but further research is necessary to determine the most important Australian risk factors.

Animals↗
PubMed2005

Health status of the Slovakia population at its entry to the European Union.

The health status of the Slovak Republic (SR) population on the eve of its entry to the European Union (EU) was generally worse than the EU average. Life expectancy at birth was in SR for males 70 years, in EU 75.5 years and for females 78 in SR and 82 in EU. Premature mortality for the age interval 0-64 years (standardized death rates--SDR per 100,000) was mostly higher in SR; male mortality being almost twice as high as in EU. The reason was a significantly higher mortality caused by cardiovascular diseases, malignant neoplasms and mortality from external causes. Also mortality caused by diseases of respiratory and digestive system, by cirrhosis and diabetes is higher in SR both in male and female populations. However, there were some positive aspects in SR. Mortality caused by infectious and parasitic diseases was lower in SR for both males and females. The prevalence of HIV/AIDS in EU was five times higher than in SR. SR has one of the lowest concentrations of newly registered AIDS cases in all Europe. Immunization coverage in SR is higher than in many EU countries. The health status of children population in SR is not significantly worse than in EU. However, the global health status image seems worse due to values of the Gypsy minority. Trends of premature mortality are favourable in SR. Mortality from cardiovascular diseases, external causes of injury and poison and from diseases of respiratory system is falling. Infant mortality is falling while the average life expectancy of both men and women is rising. However, with health care improving constantly in EU countries in all these areas, it will not be easy for SR to catch up with EU. We estimate that this process might possibly take up to 20 years. (Tab. 5, Fig. 11, Ref. 26.)

Adult↗
PubMed2003

Depression, anxiety, and associated health status in low-income Chinese patients.

BACKGROUND: Little is known about the prevalence of mental disorders and the associated impact on health status in low-income immigrant Chinese Americans. METHODS: This cross-sectional study surveyed low-income Chinese patients attending a community health center in Chinatown (New York City) from July through November 2001 to determine the prevalence of depressive and anxiety disorders. Selected modules translated into Chinese from the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire (PHQ), a self-administered measure designed to diagnose mental health disorders in primary care, were used. To assess the relationship between mental disorders and health status and to examine convergent validity, mean scores on the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were examined according to PHQ diagnoses and calculated severity of depression. RESULTS: A total of 856 patients were approached and data were obtained from 523 (61%) eligible participants. Thirty-two (6.1%) patients met the established criteria for major depressive disorder; 26 (5.0%) patients met the criteria for other depressive disorder; and 24 (4.6%) patients met the criteria for other anxiety disorder. Compared to patients without depression or anxiety, patients with major depressive and other anxiety disorder had significantly lower mean scores on all eight SF-36 subscales, while patients with other depressive disorder had lower mean scores on all subscales except for physical functioning. SF-36 subscale scores tended to decrease with increasing depression severity. CONCLUSIONS: Depression and anxiety were prevalent and demonstrated an adverse impact on health status, as measured by the SF-36. Strategies for screening for mental disorders may vary depending on the needs of the primary care setting and may be accomplished using a general health status measure or a disease-specific approach.

Adult↗
PubMed2003

Mixed signals from Kerala's improving health status.

It can be said that health policy is about creating the conditions to free a population from disease and impairment, and so prolong the quality of life for all. If this is its purpose, then the practice of public health policy in the Indian state of Kerala presents a conundrum for health promotion analysts. On the one hand, Kerala has had remarkable success in reducing its infant mortality rates to around one-third of the Indian average, but on the other, its morbidity rates have risen to impose an economic cost more than three times the national level. This paper sets out to explain this apparent contradiction in outcomes, serving both to provide a review of Kerala's health status and as an illustrative guide for the interpretation of the effects of health policy in some other developing areas. While the essential health data for Kerala might imply an unsatisfactory future, the authors argue that the rapid improvements that have occurred simultaneously in public education are more likely to explain an increase in the effective reporting of disease conditions, thus suggesting a more optimistic scenario for future practice that can lead to a sustained improvement in health care.

Health Promotion↗
PubMed1999

Cross-cultural adaptation of a health status classification system in children with cancer. First results of the French adaptation of the Health Utilities Index Marks 2 and 3.

Our objective was to adapt and validate the Health Utilities Index Mark 2 (HUI 2) and HUI 3 health status classification systems self-report questionnaire in a population of children with cancer, a group of 42 children already included in a multi-centre database designed by the Group on Brain Tumors in Children of the French Society for Pediatric Oncology. Children were recruited during a routine consultation. Most of them had completed treatment. The version of the questionnaire for French adults was adapted linguistically for children. Open-ended queries by children about the comprehensiveness of the questions and very low non-response rates showed a good acceptability of the questionnaire. The main psychometric properties of the HUI 2 and HUI 3 classification systems were assessed in 3 groups of raters (child, parent, physician): construct validity was tested against the rating of the child's health state on a Likert scale and through comparison with clinical data, and internal consistency was determined through multi-trait analysis. Weighted and unweighted kappa values were used to measure the inter-rater agreement between the child's, parent's and physician's assessment of the child's health state. The convergent validity was satisfactory, with better results when the physician's assessment was used. The most affected attributes were the expected ones (i.e., cognition, pain and emotion). Disagreement was observed between the 3 raters, more often in the same direction: taking the child's assessment as the reference, the parents tended to under-estimate the health status while physicians tended to over-estimate it.

Adolescent↗
PubMedDate not supplied

Implementing breast cancer screening guidelines: results of the Ontario Health Status Survey.

INTRODUCTION: The Ontario Health Status Survey (OHS) was undertaken by the Ontario Ministry of Health in 1990 to provide data on factors related to health and health service use in a province of 10 million inhabitants. OHS analyses for this report focused on patterns of breast screening behaviors in relation to physician contact and various sociodemographic and psychological variables. METHODS: The OHS was a probability sample survey using a multistage stratified cluster design to gather household-level data. SUDAAN was used to obtain population estimates for study variables. Data analyses were restricted to women 40 years of age and older. RESULTS: Although over 85% of respondents reported contact with their physicians in the previous 12 months, most women did not adhere to recommended breast screening guidelines. Educational achievement, income adequacy, and smoking status were important factors explaining differences in screening behaviors. CONCLUSIONS: Physicians should not overlook opportunities to recommend mammography screening, where appropriate, and include breast examinations as part of regular physical exams. The involvement of educationally or economically disadvantaged women in the design of appropriate recruitment strategies for breast cancer screening would be informative.

Adult↗
PubMed2000

Impact of lower respiratory tract infections on health status.

Acute exacerbations of COPD have a broad range of effects on the patients in addition to cough and sputum production. These include malaise, increased dyspnea, diminished tolerance and social restriction. No single clinical or physiological measure captures this multiplicity of effects adequately. Health status measurement using instruments erroneously termed ;quality of life' questionnaires can provide this integrative function. Validation studies have shown that these scores reflect exercise capacity, respiratory symptoms, disability in daily life, and impaired mood. Furthermore they relate to levels of arterial hypoxaemia in COPD and blood leucocyte count in patients with bronchiectasis. Health status scores have been shown to predict hospital readmission or death in patients with COPD. Recent studies have shown that whilst sputum color and volume recover within a week of starting treatment, full recovery of health status may take over three months. This is consistent with the observation that exacerbation frequency is strongly related to health status and a recent report that the rate of decline in health status over time is related to the frequency of exacerbations. Health status instruments were developed originally to measure treatment efficacy, but they also provide insights into acute exacerbations of COPD and their clinical importance.

Journal Article↗
PubMed2002

The influence of daily hassles and role balance on health status: a study of mothers of grade school children.

The purpose of this study was to investigate the influence of daily hassles and role balance on health status. Participants (146 mothers) completed a self-administered survey that included assessments of daily hassles, role balance, and health status. Based on hierarchal regression analyses with interaction terms, daily hassles and role balance directly influenced the mothers' health status. The results also indicated that role balance had a buffering effect on the relationship between daily hassles and health status. These findings lend empirical support to the theory of role balance.

Adaptation, Psychological↗
PubMed1991

Formaldehyde exposure and health status in households.

This report describes a case study concerned with acute and subacute health effects of formaldehyde in the indoor air, which is based on a large group of control houses and houses retroinsulated 4 to 5 years earlier with urea formaldehyde foam insulation (UFFI). Both groups underwent an environmental and health assessment on two occasions separated by an interval of 12 months, during which about one-half of the UFFI group performed remedial work on their houses. The results show that in the first survey of the study population, before remedial work, there was a moderate excess of many adverse health status indicators among the UFFI subset relative to the controls. This was associated with the presence of direct exposure-response relationships between formaldehyde levels in the UFFI houses and the prevalence of a number of symptoms. No comparable relationships were seen among the controls. At the second survey, performed following the removal of the UFFI, there was an appreciable reduction in the excess of most adverse health status indicators among the UFFI subjects. This improvement in health status among the UFFI removal subset was not associated with any significant diminution of formaldehyde exposures, although the previously observed exposure-response relationships had vanished. These observations imply that the findings obtained in the preremedial stage of the study cannot be explained by formaldehyde exposure alone.

Adult↗
PubMed2003

The anomalous health status of Texas border counties.

The health status of Texas border counties is anomalous in that the combination of poor health care services, low socioeconomic status, and low education rate does not result in the expected increase in age-adjusted mortality rate and shortened life expectancy. The anomaly appears to be due largely to the combination of a high Hispanic population density in this region, specifically Mexican-Americans, and to the phenomenon of Hispanic longevity. The latter is considered to be based on a variety of possible cultural factors. In the face of continuing escalations in the cost of health care, further definition of what those factors are and how they could be incorporated into the delivery of health care in our state should be a priority for state health policy.

Age Factors↗
PubMed2002

Relations of intrinsic spirituality with health status and symptom interference.

The purpose of this study was to examine the relationships between spiritual experience and current health status and between spiritual experience and subjective experience of symptom interference. Symptom interference is the extent to which symptoms of physical or psychological illness limited participants' activities of daily living. Participants were 49 volunteers who were enrolled in a spiritual fitness class at a variety of denominational Christian churches in Plano, Texas. The sample ranged in age from 22 to 65 years, and 84% were women. The Index of Core Spiritual Experiences and the Medical Symptoms Checklist were administered. Current health status and symptom interference were utilized from the self-report checklist. It was predicted that Index scores would be significantly different based on participants' health status and that Index scores would correlate significantly with participants' ratings of symptom interference. Analysis indicated that Index scores were significantly higher (p = .02) for participants with no current medical diagnosis than for those currently experiencing either a life-threatening or a chronic medical or psychological disorder. Also, the percentage-bend correlation between Index scores and scores for interference of symptoms in daily life was significant ((r)Pb = -.33, p = .02). These results suggest that the report of core spiritual experiences may be related to better current health status. These findings have implications for understanding the role of spirituality in the prevention of illness and in an individual's ability to cope with illness.

Adaptation, Psychological↗
PubMed1997

Three-year changes in self-perceived oral health status in an older Canadian population.

Although change is a central goal of oral health care interventions, little attention has yet been paid to change in self-perceptions of oral health status. This is an important omission, given the current emphasis on assessing health outcomes. This paper reports the results of a study which examined changes over a period of three years in self-perceived oral health among 611 community-dwelling Canadians aged 50 years and over. Change in self-perceptions was measured by means of a global transition item and change scores derived from repeat administrations of four subjective oral health status indicators. Overall, 20.5% reported that their oral health had deteriorated over the three-year observation period, 68.5% that it had remained the same, and 10.5% that it had improved. There was a significant association between these global change categories and change scores for the four subjective indicators. Because of the small number of edentulous subjects, the analysis of baseline characteristics predicting change was confined to dentate subjects. Bivariate and logistic regression analyses were used to compare the two groups reporting change with those whose oral health status remained stable over the observation period. The results suggest that, when compared with this reference group, those who deteriorated and those who improved were similar in some respects but distinct in others. Those who improved appeared to have specific oral conditions at baseline causing pain. Those who deteriorated had poor oral health in general and came from more disadvantaged backgrounds. However, the explanatory power of logistic regression models predicting change in self-perceived oral health was poor when judged in terms of model sensitivities. This was to be expected, given that the models did not include variables documenting the incidence of disease, receipt of dental care, or changes in social and personal circumstances over the observation period.

Aged↗