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PubMed1996

Access to care in post-economic reform rural China: results from a 1994 cross-sectional survey.

The purpose of this paper is to assess the current level of access to care in rural China based on results from a 1994 random, cross-sectional survey of three rural counties in China. A total of 722 people were interviewed. The results of the study indicate there is currently a significant gap among rural Chinese communities in terms of access to health care, particularly with regard to availability (e.g., cooperative health plan or other insurance plans) and acceptability (e.g., health care spending burden). Less developed rural communities are placed in double jeopardy: not only are residents paying a higher amount for health care, they have to do so with significantly less income.

Analysis of Variance↗
PubMed2004

An international survey of chronic obstructive pulmonary disease in young adults according to GOLD stages.

BACKGROUND: The recently published GOLD guidelines provide a new system for staging chronic obstructive pulmonary disease (COPD) from mild (stage I) to very severe (stage IV) and introduce a stage 0 (chronic cough and phlegm without airflow obstruction) that includes subjects "at risk" of developing the disease. METHODS: In order to assess the prevalence of GOLD stages of COPD in high income countries and to evaluate their association with the known risk factors for airflow obstruction, data from the European Community Respiratory Health Survey on more than 18,000 young adults (20-44 years) were analysed. RESULTS: The overall prevalence was 11.8% (95% CI 11.3 to 12.3) for stage 0, 2.5% (95% CI 2.2 to 2.7) for stage I, and 1.1% (95% CI 1.0 to 1.3) for stages II-III. Moderate to heavy smoking (> or =15 pack years) was significantly associated with both stage 0 (relative risk ratio (RRR)=4.15; 95% CI 3.55 to 4.84) and stages I+ (RRR=4.09; 95% CI 3.17 to 5.26), while subjects with stages I+ COPD had a higher likelihood of giving up smoking (RRR=1.39; 95% CI 1.04 to 1.86) than those with GOLD stage 0 (RRR=1.05; 95% CI 0.86 to 1.27). Environmental tobacco smoke had the same degree of positive association in both groups. Respiratory infections in childhood and low socioeconomic class were significantly and homogeneously associated with both groups, whereas occupational exposure was significantly associated only with stage 0. All the GOLD stages showed a significantly higher percentage of healthcare resource users than healthy subjects (p<0.001), with no difference between stage 0 and COPD. CONCLUSIONS: A considerable percentage of young adults already suffered from COPD. GOLD stage 0 was characterised by the presence of the same risk factors as COPD and by the same high demand for medical assistance.

Adult↗
PubMedDate not supplied

Depressive symptoms, unemployment, and loss of income: The CARDIA Study.

BACKGROUND: Previous studies have suggested an association between depression and low socioeconomic status, but few have empirically examined the effect of depressive symptoms on income and employment over time. OBJECTIVE: To determine whether depressive symptoms are associated with subsequent unemployment or loss of family income. METHODS: We performed a prospective cohort study of 5115 adults aged 18 to 30 years. These participants included approximately equal numbers of African Americans and whites and men and women from 4 cities in the United States who completed the 1990-1991 examination of the Coronary Artery Risk Development in Young Adults (CARDIA) study. For this analysis, we included 2334 participants who were employed full or part time and who reported an annual family income of $25 000 or more. Participants completed the Center for Epidemiologic Studies Depression Scale and were considered to have depressive symptoms if they scored 16 or higher on the 60-point scale. We evaluated self-reported unemployment and annual family income during 5 years of follow-up. RESULTS: Thirty-three percent (118/354) of participants with depressive symptoms (Center for Epidemiologic Studies Depression Scale score >/=16) in 1990-1991 and 21% (335/1581) of participants without substantial depressive symptoms (Center for Epidemiologic Studies Depression Scale score <16) reported new unemployment during the subsequent 5 years (odds ratio, 1.9; 95% confidence interval, 1.4-2.4; P<.001). This association remained strong after adjusting for potential confounding variables, including marital status, education, history of unemployment, current part-time (vs full-time) employment, and cigarette smoking (odds ratio, 1.6; 95% confidence interval, 1.2-2.0; P =.001). Seventeen percent (62/371) of participants with depressive symptoms and 7% (113/1631) of participants without substantial depressive symptoms in 1990-1991 reported that their family income had decreased below $25 000 by 1995-1996 (odds ratio, 2.7; 95% confidence interval, 1.9-3.8; P<.001). This association also remained strong after adjusting for potential confounding variables (odds ratio, 1.9; 95% confidence interval, 1.3-2.7; P<.001). CONCLUSIONS: Depressive symptoms are associated with subsequent unemployment and loss of family income among working young adults. Socioeconomic indicators, such as income and employment, should be considered in evaluating the potential benefits of treatment for patients with depressive symptoms.

Adolescent↗
PubMed2006

Suicide in India: a four year retrospective study.

Suicide is one of the ten leading causes of death in the world, accounting for more than a million deaths annually. The purpose of the study was to identify the risk groups. In the four-year period from January 2000 to December 2003, 588 suicide victims were autopsied. Information was obtained by interviewing the acquaintances of the victim, perusal of hospital records and the autopsy findings. All the cases were analyzed as to sex, age, and methods of suicide, seasonal variation, diurnal variation and other sociological aspects. The present study depicts a suicidal rate of 11.76 per 100,000 population. Males and females were almost equally the sufferers. The largest number of victims were found in the age group of 21-30 years. Hanging and poisoning constituted the two major modes of suicides (63%). Majority of the victims were mentally sound, married and were from rural background. Victims were mostly drawn from low socioeconomic status (48%). Less educated or illiterates were usually the victims. Suicidal note was detected in 5% of cases. Suicidal tendency and alcohol intake could not be encountered in most of the cases. Indoor incidence was almost double of the outdoor incidence, mostly seen in rainy season (43%) and occurred almost equally during day and night. Financial burden (37%) and marital disharmony (35%) were the principal reasons for the suicide.

Adult↗
PubMed1980

Why psychiatry is a low-paid medical specialty.

The authors examine the effect of economic forces on the income of psychiatrists and compare the economic position of psychiatry with that of the rest of medicine. Since 1970 the income of psychiatrists has been losing ground compared with that of other medical specialists, although recent data suggest a possible improvement in the economic position of psychiatry. The authors believe that psychiatrists' incomes are important as a sign of the value of psychiatric care and as one measure of the economics of practice, that is, the incentives related to the distribution of scarce technology and labor in the service delivery system.

Humans↗
PubMed2000

The effect of income inequality on the health of selected US demographic groups.

OBJECTIVES: This study assessed whether documented effects of income inequality on health are consistent across demographic subgroups of the US population. METHODS: Data from the National Health Interview Survey on White and Black non-Hispanics were used. Logistic regression models were estimated with SUDAAN software. Perceived health was the outcome variable. RESULTS: The results of the multivariate analysis, in which individual family income and county-level poverty rates were included, were not consistent with existing research. In the presence of covariates, the conditional effects of inequality were restricted to Whites aged 18-44 years in the 2 highest income inequality quartiles and middle-aged Whites in counties with the highest level of income inequality. The health of Blacks of all ages, elderly Whites, and middle-aged Whites outside of the areas of highest inequality was unaffected when controls for individual characteristics and county-level poverty were in place. CONCLUSIONS: For the United States, the independent and direct contribution of income inequality to the determination of self-perceived health net of individual income and county income levels is restricted to certain demographic groups.

Adolescent↗
PubMed2006

Associations between relative income and mortality in Norway: a register-based study.

BACKGROUND: Current research on health inequalities suggests that not only an individual's absolute level of income but also his/her relative position in the income hierarchy could have health consequences. This study examines whether relative income was associated with individuals' mortality in Norway during the 1990s. METHODS: Data were formed by linkages of Norwegian administrative registers. This study analyses 1.68 million men and women (age group: 30-66 years) with disposable income (1993) in the range 60,000-210,000 Norwegian Kroner. Relative income was calculated as deviations in per cent from the median income in the surrounding residential area. The outcome variable was deaths in 1994-1999. Effects of relative income on mortality were estimated by multiple logistic regression analyses, separately in 13 narrow brackets of absolute income. Adjustments were made for sex, education, marital status, and other individual-level mortality predictors. RESULTS: Low relative income compared with the median in residential regions with populations above 20,000 inhabitants was associated with higher mortality among those with medium and lower absolute income. The excess risk increased progressively the lower the level of absolute income. Among those with higher absolute income, however, relative income was not associated with mortality. Moreover, when relative income was considered in relation to the median in small municipalities, almost no effect on mortality was observed. CONCLUSION: In Norway during the 1990s, having low relative income constituted an additional mortality risk among individuals with middle or lower absolute incomes and when relative income was calculated in relation to the average in medium-sized or larger regions.

Adult↗
PubMed1991

[Structure of the domestic animal stock in the old jurisdictions of the Federal Republic of Germany].

After a short review of the size structure and the regional distribution of livestock holdings with cattle, pigs and poultry, the significance and distribution of those livestock holdings are presented, which according to their size and their density are excluded from certain national income compensations to German farmers because they are classified as not belonging to the farm sector proper by agricultural policy authorities. Compared to neighbouring member countries of the EC, the significance of these livestock holdings seems rather small. The introduction of the milk quota regime and the exclusion of larger livestock holdings from certain income compensations have retarded the process of structural change in livestock keeping since the middle of the 1980s. Among factors influencing the future development of the structure of livestock holdings, scientific and technical innovations in livestock breeding and husbandry as well as developments in the distribution of food will prevailingly intensify the tendencies of continuing concentration processes in livestock holdings whereas environmental legislation and agricultural price and market policies will probably counteract these tendencies.

Agriculture↗
PubMed2000

The relation of socioeconomic factors and racial/ethnic differences in US asthma mortality.

OBJECTIVES: This study described relations between socioeconomic factors and race/ethnicity as risk factors for asthma mortality. METHODS: A cross-sectional study was conducted of US mortality records from 1991 through 1996. RESULTS: Higher standardized mortality ratios were seen for Blacks vs Whites (3.34 vs 0.65), low vs high educational level (1.51 vs 0.69), and low vs high income (1.46 vs 0.71). Excess mortality for Blacks vs Whites was present in the highest and lowest quintiles of median county income and educational level. The disparity in asthma mortality rates according to median county income and education remained after control for race/ethnicity. CONCLUSIONS: Black race/ethnicity appears to be associated, independently from low income and low education, with an elevated risk for asthma mortality.

Adolescent↗
PubMed1999

Health in mid-life.

Explore the source record for details and available documents.

Activities of Daily Living↗
PubMed1983

Recent trends in Hispanic immigration to the United States.

Recent patterns of Hispanic immigration to the United States are examined using data from the U.S. Immigration and Naturalization Service. "From 1960 to 1978 Hispanic immigration increased significantly, reflecting the general acceleration in total immigration to the United States. Demographic trends reveal that Hispanic immigrants are increasingly working-age women. Their occupation composition is primarily blue collar, with operatives emerging as the predominant job category during the 1970s." The authors note that these immigrants settle primarily in a small number of urban centers of Hispanic population and culture in the United States, and thus the effects of immigration will be concentrated on the low-skill segment of particular urban labor markets that already contain large numbers of Hispanic workers.

Age Distribution↗
PubMed2003

Socioeconomic status, lifestyle factors and oral premalignant lesions.

Several studies have suggested that low socioeconomic status (SES) is associated with a higher risk of oral cancer, but the association with oral premalignant lesions has not yet been explored. The aim of this study was to examine the association of education, occupation, income and SES index with oral premalignant lesions. A case-control study was conducted with data from the baseline screening of a randomized oral cancer screening trial in Kerala, India. There were a total of 927 oral leukoplakia, 170 oral submucous fibrosis, 100 erythroplakia and 115 multiple oral premalignant lesion cases and 47,773 controls. Subjects with high SES index had protective ORs for oral premalignant lesions, ranging from 0.6 to 0.7, after adjustment for age, sex, BMI, tobacco chewing, smoking, drinking and fruit/vegetable intake. Higher education levels were also associated with decreased risk of all four oral premalignant lesions. Protective ORs for income were observed for oral leukoplakia and possibly oral submucous fibrosis and erythroplakia. SES may be associated with oral premalignant lesions because of access to medical care, health related behaviors, living environment or psychosocial factors. Though the mechanism for the association is not clear, higher SES index, education and income were associated with decreased risk of oral premalignant lesions in our study.

Adult↗
PubMed2004

Kanizsa subjective figures capture visual spatial attention: evidence from electrophysiological and behavioral data.

Figural binding and attention are two important processes that help to perceive the outside world. Binding is necessary to link together the different features of single objects which are represented in a distributed fashion in the brain. Attention serves to focus onto a small subset of incoming information. It is still not clear how exactly these two mechanisms operate and interact. We performed two experiments employing illusory Kanizsa figures (KFs) to investigate the temporal order of figural binding and spatial attention. In a visual search task, subjects had to detect the presence of a KF among distractor stimuli. We found only a slight increase of reaction times when increasing the number of distractors, indicating that KFs popped out and drew the perceiver's attention. In a further event-related potential (ERP) study, we used displays of the search task as non-informative cue for a subsequent target choice-reaction task. Enhanced contralateral negative amplitudes (starting at about 230 ms) over ventral occipital areas were found for cue displays which included a KF. For target stimuli, faster reaction times and enhanced ipsilateral N1 amplitudes over occipito-parietal areas were observed for validly (target presentation inside a KF) as compared to invalidly cued targets (target presentation outside a KF). Furthermore, enhanced contralateral N1 amplitudes were found for invalidly cued targets. It might be that interactions between perceptual closure processing of the ventral pathway and spatial target processing of the dorsal pathway contributed to the present result. We conclude that KFs automatically capture spatial attention when used as visual cues.

Adult↗
PubMed2001

Gender differences in income after substance abuse treatment.

This study asked whether men and women who enrolled in substance use treatment reported similar changes in income from work, public assistance, and crime over time. Income data were analyzed for 261 substance users (77 women, 184 men) who entered day or residential treatment, and completed Addiction Severity Index measures at treatment entry and up to 18 months later. Over time, respondents reported increases in employment income. People whose main source of income at baseline had been crime or public assistance showed significant decreases respectively in income from crime or public assistance. Men made greater gains in work income than women did. Across time, men were more likely to be employed than women were. Findings show the economic value of substance use treatment, but less improvement in employment outcomes for women than men.

Adult↗
PubMedDate not supplied

Differences in parenting stress between married and single first time mothers at six to eight weeks after birth.

Parenting stress has been shown to affect relationships between mothers and their infants. Single mothers may experience more parenting stress due to exposure to stressors that are unique to their environment. The purpose of this secondary analysis was to determine the differences between married and single first-time mothers on the Parenting Stress Index/Short Form (PSI/SF Abidin, 1995). A convenience sample of 22 single and 52 married first-time mothers were recruited from postpartum units in two large metropolitan hospitals in the southeastern United States. During hospitalization, participants completed a demographic sheet and at six weeks postpartum, were mailed the PSI/SF. T-tests were assessed for differences between mean scores. Study findings indicate significant differences between single and married first-time mothers on the Parental Distress subscale (t = -3.468, p = .001), the Difficult Child subscale (t = -2.032, p = .046), and Defensive Responding subscale (t = -3.720, p = .000), with single mothers consistently scoring higher than married mothers; however, there was not a significant statistical difference between mothers on the Parent-Child Dysfunctional Interaction subscale (t = -1.290, p = .201). Overall, single mothers scored higher on the Total Parenting Stress scores of the PSI/SF than married mothers (t = -2.858, p = .005), suggesting that single women experience more stress as a new mother than married new mothers. It is important to understand the specific stressors of new, single mothers and to develop nursing interventions that decrease parenting stress in single mothers.

Adaptation, Psychological↗