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PubMed2006

Health status, activity limitations, and disability in work and housework among Latinos and non-Latinos with arthritis: an analysis of national data.

OBJECTIVE: To document disparities in health status, activity limitations, and disability in work and housework between Latinos and non-Latino whites with arthritis. We examined whether sociodemographic factors (age, income, and education) account for the disparities between the ethnic groups, and whether comorbid conditions, disease duration, health care utilization, and functional abilities predict health status, activity limitations, and work and housework disability after controlling for sociodemographic variables. METHODS: We analyzed data from the Condition file of the 1994 National Health Interview Survey on Disability, Phase I. RESULTS: The risk of worse health, activity limitations, and work and housework disability was >2 times greater among Latinos compared with non-Latino whites. In the regression models accounting for potential confounders, Latino ethnicity remained significantly associated with poorer health status, but not activity limitations or disability in work or housekeeping. Of the socioeconomic status variables, education had a significant protective effect on work disability and health status. Comorbid conditions and health care utilization increased the likelihood of worse health, activity limitations, and work disability. Limitations in physical function were associated with poorer health and disability in work and homemaking. CONCLUSION: Social status differences between Latinos and non-Latinos may account for disparities in activity limitations and disability in work and housework. Education may provide various health benefits, including access to a range of occupations that do not require physical demands. The findings help to address the great gap in knowledge concerning factors related to the health and disability status of Latinos with arthritis.

Activities of Daily Living↗
PubMed1990

A review of the health status of Southeast Asian refugee women.

Six substantive areas that contribute to knowledge of the health status of Southeast Asian (SEA) refugee women were identified in the current literature. The six areas are general information, childbearing issues, health beliefs and practices, health-illness focus, stress and adaptation, and miscellaneous issues. The majority of the articles focused on the women's childbearing role, emphasizing their unique cultural beliefs and the implications of those for health care delivery. The remaining substantive areas provided more limited information about this group's health status, including incidence and prevalence of disease, the women's role in resettlement, and the presence of mental health problems. Future research with this group could be conducted from a feminist perspective by studying the multitude of roles of SEA refugee women and their effects on health status.

Asia, Southeastern↗
PubMed2000

[Health status of gypsy and non-gypsy children in a health district in Granada].

AIM: To evaluate the health status of gypsy and non-gypsy children and to determine how far stereotypes need to be eradicated in order to improve decision-making. The aim of this investigation originated in the observation of different behaviors in the population of a health district in Granada, Spain, and in the apparent concentration of certain diseases in the pediatric population of the gypsy minority. MATERIALS AND METHODS: Data from the clinical histories and variables of the mother and child health program of the Iznalloz Health Center were analyzed and compared. Of these clinical histories 149 (38.40%) belonged to gypsy children and 239 (61.59%) belonged to non-gypsy children. RESULTS: Outstanding variables were:a) the start of breastfeeding and its continuation until the third month were the same for both groups; b) gypsy children were up to 3.53 times more likely to be admitted to the neonatal unit than non-gypsy children; c) metabolic illness or degenerative illness accounted for 1.4%, and d) incomplete follow-up was up to 3.24 times more likely in gypsy children than in non-gypsy children.

Adolescent↗
PubMed2006

Health status of workers in small and medium-sized companies as compared to large companies in Japan.

The health status of workers in small companies has been noted to be relatively poor, but no actual comparisons of groups of variously sized companies within the same region based on the same methodology have ever been conducted. We undertook this study to clarify differences in health status according to company size. The subjects comprised workers of a Japanese steel company and various subcontractors who received health checkups in 2003. We obtained answers from 83 companies employing 11,844 workers and analyzed the data for 6,480 men aged 40 yr or more, comparing results of the health checkups, health management practices, and number of occupational health personnel according to company size (number of employees). Mean worker age in the various groups ranged from 49.7 to 54.0 yr. Drinking and smoking habits did not differ between them. There was a significant trend to higher prevalences of diabetes and hypertension, and lower prevalences of renal disease and hypercholesterolemia in smaller companies. Mean body mass index and diastolic blood pressure were significantly higher in companies with 1,000-2,999 workers. Health management practices satisfied the legal requirements of the respective company size. Occupational physicians devoted more time per worker in companies with 1,000-2,999 and 50-299 workers. No consistent differences were apparent between small and large companies in worker health status. Inter-company activities for occupational safety and health were undertaken and labor regulations almost equally adhered to. Endeavors to maintain a certain level of hygiene and health management play an important role in maintaining worker health in small companies.

Adult↗
PubMed2006

Perceived health status and use of healthcare services among children and adolescents.

BACKGROUND: The aim of the present study was to analyse the use of healthcare services according to health status in a population of children and adolescents, taking into account family socio-demographic characteristics and characteristics of the proxy respondent. METHODS: A total of 836 interviews of proxy respondents for children aged 5-14 years from the Barcelona Health Interview Survey carried out in 2000 were included. Dependent variables were visits to a healthcare professional, visits to the emergency room, and hospitalization. Independent variables were: report of medical conditions, health status of the child measured by the Child Health and Illness Profile-Child Edition, Parent Report Form (CHIP-CE/PRF), the educational level of the head of household, social class, child's healthcare coverage, and proxy-related variables [mental health status by means of the General Health Questionnaire-12 items version (GHQ-12), and other]. Logistic regression analysis was used to estimate prevalence ratio (PR) to compare the use of healthcare services among different categories of independent variables. RESULTS: Children having worse health status were more likely to have visited a healthcare professional [PR = 1.68; 95% confidence interval (95% CI) = 1.09-3.83], whereas children with a reported medical condition were more likely to have made a visit to the emergency service (PR = 1.47; 95% CI = 1.27-2.55) and were hospitalized more frequently (PR = 2.50; 95% CI = 1.12-5.57). Higher likelihood of visits to the emergency room was associated with children having both public and private coverage and a proxy respondent scoring 3 or higher on the GHQ-12. CONCLUSIONS: Use of healthcare services differed by health needs but not by social class. Double healthcare coverage and mental distress of the proxy respondent influenced the use of emergency services.

Adolescent↗
PubMed1994

[A comparison on health status between Paiwan and Min-Nan elderly].

The study investigated the Taiwanese elderly in two different ethnic groups (Paiwan and Min-Nan) regarding their multifunctional status. The purpose was to make known and compare the subjective and objective health status of these two groups. The results for the objective measurements indicated that an elderly Paiwanese had 2.74 kinds of diseases on average. The most prevalent diseases among the Paiwan elderly were arthritis (rheumatism), circulation troubles in arms or legs, high blood pressure, stomach or intestinal disorders or gall bladder problems, cataract, heart trouble, emphysema (chronic bronchitis), skin disorder (leg ulcers or severe burns), asthma, and digestive system ulcers. Of all disease, five (arthritis, circulation trouble, emphysema, skin disorder, and tuberculosis) were statistically more prevalent among the Paiwan elderly than among the Min-Nan elderly. In terms of health scoring, the two groups were comparable except in the following two aspects: (1) more Paiwan elderly were unable to take medicine by themselves, and (2) the Paiwan elderly had lower cognitive ability ratings. In the subjective arena, the Paiwan elderly had a lower score in self-rating health status. Condensed, the health status of the Paiwan was worse than that of the Min-Nan elderly both in objective and subjective measurements.

Aged↗
PubMed1993

A causal model of health status and satisfaction with medical care.

Patients with better health status have often been shown to be more satisfied with their medical care, but the causal factors in this relation have not been determined. In this study, a longitudinal assessment of these two constructs was undertaken in which older patients in a health maintenance organization were interviewed at baseline (N = 590) and again 1 year later (N = 526) about their health status and satisfaction with their medical care. Structural equation modeling using LISREL procedures revealed that the predominant direction of causation went from earlier self-perceived overall health and functional ability to later levels of satisfaction. There was no evidence for causal paths going from satisfaction to later health. In addition, a test of spuriousness indicated that for self-perceived overall health, the significant longitudinal path was unlikely to be explained by unmeasured confounding variables.

Activities of Daily Living↗
PubMedDate not supplied

Health status of newcomers.

This article presents and discusses findings on the health status of newcomers residing in Windsor, Ontario. The data are part of a larger study, which was based on the Ontario Health Survey's questionnaire. Data were collected from 548 newcomers through home visits, focus groups, mail surveys, and telephone interviews. Descriptive multivariate analyses focused on main areas in newcomers' physical and mental health status and their access to health services. The findings identified that most newcomers do not have acute, life-threatening physical problems or chronic illness. They do not experience major problems with access to health care or activity limitations. Men are happier, more satisfied with their health, and less stressed than women. This study has implications for adoption of sensitive transcultural approaches to promote newcomers' health. Special challenges lie in women's health and mental health.

Adolescent↗
PubMed1998

Knee pain and disability in the Nottingham community: association with poor health status and psychological distress.

OBJECTIVE: To assess the prevalence of knee pain, disability and health status in the community, and to examine the association of pain with psychological distress. METHODS: A postal survey was sent to 4057 men and women aged 40-79 yr in Nottingham. Health status was assessed using the SF-36 instrument, with the specific dimensions of physical function and mental health used to measure disability and psychological distress. RESULTS: The overall response rate was 81.9%. The prevalence of knee pain was 28.7%, rising with age. Disability was more common in those with knee pain compared to those without pain (P < 0.001). Subjects with knee pain had lower scores for all dimensions of health. When adjusted for potential confounders, low mental health scores associated with increased odds for pain and disability (2.1, 95% CI 1.7-2.6; and 4.7, 95% CI 3.7-6.1). CONCLUSIONS: Knee pain is common in this population and is associated with poor perceived health and significant disability. Psychological distress strongly associates with both pain and disability.

Adult↗
PubMed2002

Perceived quality of life and mental health status of Irish female prisoners.

Mental health status and quality of life of female prisoners, the majority of whom are drug-users, was examined as part of a larger, cross-sectional, general healthcare study of the Irish prisoner population. Comparisons were made with drug using and non-drug using male prisoners and females from the general population. Instruments include the GHQ-12 and the WHOQOL-BREF. While their quality of life profile was closer to drug-using male prisoners than other comparison groups, female prisoners still had significantly poorer physical and psychological Quality of Life scores. While poorer quality of life scores may be associated with the more severe drug use patterns of female prisoners it is likely that other factors also contribute. Before resorting to drugs/crime women may have already experienced adversity. There may also be gender differences in response to the combined dimensions of environmental distress. If women are to be imprisoned appropriate comprehensive mental health promotion approaches must address their specific needs.

Adult↗
PubMed1998

Course of health status among chronically ill persons: differentials according to level of education.

This article describes socioeconomic differences in the time course of several health indicators, encompassing perceived health and disabilities, among a population sample of persons reporting one or more chronic conditions. Data covering the period 1991-1993, were obtained from a Dutch follow-up study. Educational differences in the course of health status were estimated by ordinary least squares regression. The course of almost all health status measures was statistically significantly less favorable (p<0.05) for those with a low educational level compared to those with higher vocational training or a university degree, adjusting for age, sex, and marital status. After additional adjustment for health status in 1991, significant differences remained for perceived general health, long-term disabilities, and two subscales of the Nottingham Health Profile. These findings imply that socioeconomic differences in prevalence of health problems are not only attributable to differences in incidence of diseases by socioeconomic status, but also to a differential course of existing health problems. Implications for health care delivery are discussed.

Activities of Daily Living↗
PubMed1996

Functional health status and instrumental activities of daily living performance in noninstitutionalized elderly people.

The purpose of this descriptive correlational study was to examine the relationship between functional health status and the performance of instrumental activities of daily living (IADL) in a group of noninstitutionalized elderly people. A convenience sample of 47 subjects who were 70 years of age or older participated by completing three questionnaires: the Health Status Questionnaire, the Multidimensional Functional Assessment IADL Scale and a demographic questionnaire. Lawton's (1985) theoretical model of person-environment interaction provided the conceptual framework for the study. Three functional status variables reached statistical significance (0.001) with IADL performance: social functioning (r = -0.6045); health perception (r = -0.6984); and physical functioning (r = -0.6635) suggesting that these are important indicators of overall health status, and that a decline in each could contribute to increased IADL dependency. The IADLs of housekeeping, shopping, and transportation correlated significantly (0.001) with functional health status, implying that, as health declines in elderly people, they may require more assistance with IADLs, in order to remain more independent in the community. The results have implications for nursing administrators and nursing educators with regard to developing health promotion strategies related to independence of elderly people, community health and social policy.

Activities of Daily Living↗
PubMed2003

Serum androgen levels in men: impact of health status and age.

OBJECTIVES: To investigate the impact of health status on androgen levels in men and to assess the age-related changes in androgen levels. METHODS: Sera were obtained from 526 men (age 20 to 89 years) participating in a health screening project and 35 men selected according to the SENIEUR protocol, which excludes those with underlying disease. The health screening project participants were divided into two groups: healthy men (n = 133; group 1) and the remainder (n = 393; group 2). The total testosterone and sex hormone-binding globulin levels were quantified, and the amount of free testosterone (cfT) was calculated. RESULTS: The lowest annual declines in androgen level were observed in group 3 (testosterone 0.2%; cfT 0.4%), followed by group 1 (testosterone 0.4%; cfT 0.8%) and group 2 (testosterone 0.8%; cfT 0.9%). Body mass index and levels of cholesterol, triglycerides, and glucose correlated negatively (P <0.01) with testosterone and cfT. Decade-adjusted reference values (mean +/- 2 standard deviations) for testosterone and cfT were defined. The proposed lower testosterone reference value declined gradually from 3.1 ng/mL (20 to 29 years) to 1.7 ng/mL (70 years or older). CONCLUSIONS: In this cross-sectional study, serum androgens declined in aging men, and the extent of this decrease correlated with health status. A fixed, non-age-adjusted reference value does not adequately reflect this and might lead to a false diagnosis of androgen deficiency, particularly in elderly men. The clinical value of age-related reference values, however, needs to be determined in prospective studies.

Adult↗
PubMed1996

Reliability and validity of a comprehensive health status measure in a heterogeneous population of children admitted to intensive care.

This study assesses psychometric and empirical characteristics of the Multi-Attribute Health Status Classification (MAHSC) in a heterogeneous population of children admitted to intensive care. The MAHSC encompasses six health domains (sensation, mobility, emotion, cognition, self-care, and pain), each with four or five hierarchic levels of dysfunction. The health status of 254 consecutively admitted children was determined independently by 3 different observers (parents, attending clinicians, and investigators). The proportion of children with health impairment varied between 13% (in sensation) and 58.7% (in mobility). Interrater reliability of domain scores, as analyzed by Spearman's rank, Pearson product moment, and intraclass correlations, was high, generally exceeding 0.80 for all pairs of observers. Intraclass correlation appeared to be highest in nonsurgical patients (range, 0.89-0.98) and lowest in cardiovascular surgery patients (range, 0.50-0.84). The validity of the classification was supported by (1) the presence of expected specific health status impairment in patient suffering from diseases with an acknowledged impact on specific domains and (2) the presence of a relation between health impairment and medical consumption. The absence of a relation between the average (chronic) health status preceding admission and the acute risk of mortality precipitating the admission confirmed their independent prominence in outcome assessment. We conclude that the MAHSC is a feasible, reliable, and valid measure for outcome assessment in a heterogeneous population of children within a demanding clinical situation. Excellent interrater reliability allows the use of various raters, adjusted to practical requirements.

Adolescent↗
PubMed1998

The self-reported health status of lone parents.

A number of studies have shown that lone parents have poorer health status than the general population. However, what is missing from the existing literature is any systematic assessment of the contribution that lone parents' relatively poor socioeconomic circumstances make to their relative health disadvantage. This paper aims to fill this gap. It employs a large national dataset based on three consecutive years of the British General Household Survey (1992/1993 to 1994/1995) to assess the relative health status of lone parents in comparison to couple parents, and to evaluate the importance of different explanations for their health differences. The results confirm that lone parents, particularly lone mothers, have poor health status relative to parents living as couples. The observed health differences mirror variations in socioeconomic circumstances. However, even when a wide range of demographic and socioeconomic circumstances are included in multivariate models, lone mothers still have significantly poorer health than couple mothers for four out of five health variables. The paper concludes by discussing alternative explanations for the health differences between lone and couple parents--such as the absence of an intimate/confiding relationship, the stress and stigma associated with becoming a lone parent and health selection--and by highlighting future options for policy and research in this area.

Fathers↗
PubMedDate not supplied

The health status of adults with epilepsy compared with that of people without chronic conditions.

STUDY OBJECTIVES: To examine the feasibility of administering and the psychometric properties of a general health status questionnaire in adults with epilepsy, and to assess the health status of these patients. DESIGN: Prospective, cross-sectional, observational study. SETTING: Neurology clinic of a tertiary care medical center. PATIENTS: One hundred forty-eight ambulatory adults with epilepsy. INTERVENTIONS: Patients completed the SF-36, a general health status questionnaire. Respondent burden and data quality as well as psychometric characteristics were evaluated. Patients' SF-36 scale scores, adjusted for comorbidities, were compared with those of 641 people without chronic conditions with the same sociodemographic characteristics. MEASUREMENTS AND MAIN RESULTS: Administering the SF-36 to adult outpatients with epilepsy is feasible and results are psychometrically sound. Compared with those who were not ill, patients had significantly (p < 0.001) lower (0 = worst, 100 = best) scores in six of the eight SF-36 domains: general health perceptions (57.7 vs 82.1), mental health (61.3 vs 79.6), vitality (53.5 vs 67.8), role limitations owing to physical (69.6 vs 95.0) and emotional problems (67.2 vs 88.4), and social functioning (75.2 vs 89.9). CONCLUSIONS: Lower SF-36 scores may reflect patients' assessments of the balance among epilepsy, seizures, and antiepileptic drug therapy-related effects. Incorporating health status information into therapeutic decision making may help to attain the ultimate goal of improving patients' health.

Adult↗
PubMed2006

Quality-adjusted health status in veterans with posttraumatic stress disorder.

This study evaluated the quality-adjusted health status in veterans with posttraumatic stress disorder (PTSD). In a cross-sectional study veterans diagnosed with PTSD completed a quality-adjusted health status measure (Quality of Well-Being Self-Administered [QWB-SA] scale), PTSD symptom severity measures (Mississippi Scale for Combat-Related PTSD and Clinician-Administered PTSD Scale), and a depression severity measure (Beck Depression Inventory). Significant inverse relationships were identified between the QWB-SA and PTSD severity measures as well as between the QWB-SA and depression severity measures in this sample. Demonstration of these relationships suggests that greater symptom severity is associated with lower quality-adjusted health status in veterans with PTSD. More importantly, the QWB-SA was designed for use in cost-effectiveness analyses and may be useful in assessing the relative value of PTSD interventions compared with other mental and physical health interventions.

Combat Disorders↗
PubMed2003

Previous consultation and self reported health status as predictors of future demand for primary care.

STUDY OBJECTIVE: There has been little prospective investigation of what predicts general practice consultation. The objective of this study was to investigate the extent to which previous primary care consultation and self reported health status are predictors of future primary care consultation. DESIGN: Population based cohort study in two phases. Firstly, a baseline survey (1995/96) to identify the cohort and to obtain self reported health status using the UK census limiting long term illness (LLI) question and the Short Form-36 (SF-36) health profile. Secondly, analysis of general practice medical records for two years (1994/1995) before the survey and for two years (1997/1998) after the survey. Analysis was performed on: (a) all contacts coded by the GP, (b) the subgroup of contacts given a diagnostic morbidity code by the GP. SETTING: One general practice in North Staffordshire, UK. PARTICIPANTS: 738 survey respondents who had consented to viewing of medical records including all those who reported LLI together with an age-gender matched control group of those who reported no LLI. MAIN RESULTS: High frequency consulters in 1994/95 were more likely than non-consulters or average consulters in that year to be high consulters in 1997/98 (odds ratio 5.6, 95% confidence interval 3.82 to 8.25, for all contacts; 4.4 for diagnostic coded consultations). Self reported role disability and physical limitation from the SF-36 at baseline increased the probability of being a future high consulter but the effects were weaker than for previous consultation. Previous consultation within a diagnostic group was the main predictor for future consultation within that group with weaker but significant prediction by self reported health status. CONCLUSIONS: Reliable morbidity coding in general practice provides the best available basis for predicting future demand in primary care. Self reported health status survey instruments add to this information but on their own are weaker predictors of future consultation.

Adult↗