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At least 1,207 records · Page 67Linked to original sources
PubMed2004

How income and education contribute to risk factors for cardiovascular disease in the elderly in a former Communist country.

OBJECTIVES: Careful examination of the risk factors for cardiovascular disease (CVD) may enable clinicians to develop a reasonably preventive programme among the elderly. The main purpose of this paper was to examine the effects of income and education on CVD risk factors in an elderly population who had lived most of their lives in Communist times. METHODS: The CINDI (Countrywide Integrated Non-communicable Diseases Intervention) Programme questionnaire was used to collect data from an elderly (65+ years) population in Lodz, a large industrial city in Poland. The study population (n = 1,461) was selected at random, and the overall response rate was 57.1%. The following risk factors were evaluated: hypertension, obesity, elevated cholesterol, elevated blood sugar and smoking. RESULTS: Hypertension was the most frequently observed CVD risk factor (83.4% of participants) followed by hypercholesterolaemia (70.2%), obesity (30.5%), diabetes (18.4%) and smoking (8.5%). Hypertension and hypercholesterolaemia were related to age (OR=0.91, 95%CI: 0.88-0.95 and OR=0.95, 95%CI: 0.92-0.98, respectively). The younger people in the study population exhibited the highest prevalence of hypertension and hypercholesterolaemia; hypercholesterolaemia was observed more frequently among widowed respondents. Obesity and diabetes were associated with education level (OR=0.52, 95%CI: 0.34-0.79 and OR=0.60, 95%CI: 0.37-0.97, respectively). Younger single males with a lower level of education and income exhibited the highest prevalence of smoking. Multivariate analysis showed that age, education and gender were the best predictors for the cumulative risk factors of CVD. CONCLUSIONS: Education is more strongly associated with CVD risk factors than material status in the elderly. The best predictors of risk factors were age, sex and education. As we gain knowledge about CVD risk factors, we may be able to target preventive services in the elderly population more accurately and effectively, and help older adults make health decisions to reduce risk factors and increase their quality of life.

Aged↗
PubMedDate not supplied

The challenge of reducing neonatal mortality in middle-income countries: findings from three Brazilian birth cohorts in 1982, 1993, and 2004.

BACKGROUND: Middle-income countries will need to drastically reduce neonatal deaths to achieve the Millennium Development Goal for child survival. The evolution of antenatal and perinatal care indicators in the Brazilian city of Pelotas from 1982 to 2004 provides a useful case study of potential challenges. METHODS: We prospectively studied three birth cohorts representing all urban births in 1982, 1993, and from January to July, 2004. The same methods were used in all three studies. FINDINGS: Despite improvements in maternal characteristics, prevalence of preterm births increased from 6.3% (294 of 4665) in 1982 to 16.2% (342 of 2112) in 2004, corresponding to a 47 g reduction in mean birthweight. Average number of antenatal visits in 2004 was 8.3 per woman, but quality of care was still inadequate--97% of women had an ultrasound scan, but only 1830 (77%) had a vaginal examination and 559 of 1748 non-immunised women did not receive tetanus toxoid. Rate of caesarean sections increased greatly, from 28% (1632 of 5914) in 1982 to 43% (1039 of 2403) in 2004, reaching 374 of 456 (82%) of all private deliveries in 2004. The increased rate of preterm births seemed to result largely from caesarean sections or inductions. Newborn care improved, and gestational-age-specific mortality rates had fallen by about 50% since 1982. As a result, neonatal mortality rates had been stable since 1990, despite the increase in preterm deliveries. INTERPRETATION: Excessive medicalisation--including labour induction, caesarean sections, and inaccurate ultrasound scans--led by an unregulated private sector with spill-over effects to the public sector, might offset the gains resulting from improved maternal health and newborn survival. These challenges will have to be faced by middle-income countries striving to achieve the child survival Millennium Development Goal.

Adult↗
PubMed1985

Quality care, costs, market share, and income purposes of the American Academy of Dermatology Blue Ribbon Committee.

Definitions are offered for quality of health care, reasonable costs or fees, an appropriate share of the dermatologic market, and reasonable income or profit for dermatologists. Physician control of these items was almost complete in the recent past, but control is now passing rapidly to government in the form of regulations and to large health care corporations in the form of unbridled competition in the marketplace. Physicians, including dermatologists, must mobilize and unite to retain reasonable controls, especially over quality care and personal income. The Academy (as an organization of all of us) can help in this process, but individual dermatologists at local, regional, and national levels must play major roles in retention of controls.

Academies and Institutes↗
PubMed2001

Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children.

This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6-12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P = 0.03) and percent who did not have a maid (P = 0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P > 0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P = 0.003) and mean DMF-T scores (P = 0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.

Brazil↗
PubMed2003

Poverty, affluence, and income inequality: neighborhood economic structure and its implications for health.

In this paper, we attempt to verify that neighborhood economic structure influences individual health over and above other individual characteristics, and to comparatively evaluate the effects of neighborhood concentrated affluence, concentrated poverty and income inequality in relation to individual health in the USA. We also explore physical environment, health-enhancing services, social hazards (crime) and social resources as mechanisms operating at the neighborhood level that may help to explain the influence of structural economic conditions on health. We use Hierarchical Ordinal Logit Models to examine a rich multi-level data set. Results indicate that affluence exerts significant contextual effects on self-rated health while poverty and income inequality at the neighborhood level are not important structural factors. Moreover, we find that a composite measure of social resources distinguishes itself in both explaining the impact of concentrated affluence and exerting an independent contextual effect on individual health. Physical environment, or the level of physical disorder in the neighborhood, also mediates the effect of affluence on self-rated health, although to a lesser degree than social resources. Our empirical findings suggest that different dimensions of economic structure do not in fact have unique and additive contributions to individual health; the presence of affluent residents is essential to sustain neighborhood social organization which in turn positively affect health.

Adult↗
PubMed2004

A direct method for estimating the compensating income variation for severe headache and migraine.

A subjective quality of life measurement method is introduced to calculate the compensating income variation for diseases and handicaps. This approach avoids some of the limitations of existing methods. The method is based on the direct measurement of life satisfaction of individuals. We apply the method to severe headache and migraine. It is found that severe headache and migraine have a large effect on well being and that the compensating income variation for severe headache and migraine is substantial.

Adult↗
PubMed2002

Lost income and work limitations in persons with chronic respiratory disorders.

Chronic respiratory diseases are prevalent, disabling, and rank fifth in terms of cost of illness among major disease groups; however, the degree of work loss and lost income is largely unknown. Lost wages in adults with chronic respiratory conditions were calculated from the Survey of Income and Program Participation (SIPP). The National Health Interview Survey (NHIS) was used to estimate work loss and limitations in specific chronic respiratory conditions, including allergic rhinitis, asthma, chronic bronchitis, and emphysema. The SIPP indicated that adults with chronic respiratory conditions average $3,143 annual earnings loss ($5,272 for those between the ages of 25 and 64 and $1,267 for those over age 65). The NHIS indicated that 19.9% of persons with chronic respiratory conditions report being unable to work. Comparisons across respiratory diseases are made.

Adult↗
PubMed1992

Determinants of child-bearing intentions of low-income women: attitudes versus life circumstances.

Surveys of low-income women in Los Angeles County in 1985 and 1986 were used to examine the relative impact of child-bearing motivations versus life circumstances on the intention to have a(nother) child. Future child-bearing intentions are strongly related to current parity level regardless of marital status, race/ethnicity or economic status. Psychological motivating factors predict child-bearing intentions of nulliparous women, but not those of parous women. Multivariate analyses showed that motivation for parenthood and life circumstances combined predicted women's child-bearing intentions 88.6% of the time for nulliparous women, but 73.7% for parous women. These findings suggest that, in a low-income population, the onset of parenthood reduces the relationship between specific motivations for child-bearing and actual child-bearing intentions, and diminishes the ability to predict child-bearing intentions based on both attitudinal and social/structural factors.

Adolescent↗
PubMed2006

HIV/AIDS knowledge, women's education, epidemic severity and protective sexual behaviour in low- and middle-income countries.

A fundamental public health strategy to reduce the risk of HIV/AIDS is to increase levels of awareness and knowledge about the disease. Although knowledge about HIV/AIDS and protective sexual behaviour are linked theoretically, relatively little is known about their empirical relationship. Using Demographic and Health Survey data from 23 low- and middle-income countries, this study used multilevel logistic regression models: to examine cross-national variability in the relationship between HIV/AIDS knowledge and protective behaviour (condom use and restricted sex); to investigate the moderating influences of women's educational attainment on this relationship; and to test the extent to which severity of the HIV/AIDS epidemic accounts for cross-national variability in the association between HIV/AIDS knowledge and protective behaviour. There was an association between increased knowledge of HIV/AIDS and condom use that varied in strength and form cross-nationally. This cross-national variation was accounted for partially by the socioeconomic characteristics of women resident in the study countries and between-country differences in the severity of the HIV epidemic. While education modified the association between HIV/AIDS knowledge and protective behaviour--stronger associations at lower levels of education--epidemic severity exerted a stronger influence on behaviour than any other characteristic. Finally, this study indicates that protective sexual practices are disturbingly low. In eight of 23 countries, overall levels of condom use to prevent STDs and HIV/AIDS were less than 5.0%. Waiting for the spread of HIV/AIDS infection to change sexual practices in low- and middle-income countries will result in dramatic unnecessary suffering.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Dimensions of adolescent rebellion: risks for academic failure among high- and low-income youth.

The central question addressed in this study was whether upper class, suburban teenagers can engage in various problem behaviors and still maintain adequate academic grades, because of environmental safety nets, unlike their low-income, inner-city counterparts. Three problem behavior dimensions were assessed among tenth graders, that is, substance use, delinquency, and low school engagement. Academic achievement was assessed in terms of grades across four major subjects. Variable-based analyses indicated unique links with grades for self-reported delinquency and school disengagement in high- and low-income samples, but for substance use only among the former. Person-based analyses showed that in both schools, grades were clearly compromised among youth with disturbances in all three problem domains. In addition, in the suburban school only, grades were low in the cluster characterized chiefly by high substance use. Results are discussed in terms of stereotypes regarding risks (or lack thereof) stemming from families' socioeconomic status; implications for theory and interventions are also considered.

Adaptation, Psychological↗
PubMed1997

The effect of deviations from trends in national income on mortality: the Danish and USA data revisited.

The issue of whether deviations from trends in national income predict mortality in Denmark is revisited. Earlier research has yielded mixed results. The hypothesis that increases, but not decreases, in inflation-adjusted per capita income are related to decreases in age standardized mortality is tested using methods responsive to criticisms of earlier work. Results support the hypothesis. The implications of the findings for research and policy are briefly discussed.

Denmark↗
PubMed2004

The relations between contextual risk, earned income, and the school adjustment of children from economically disadvantaged families.

This longitudinal study examined the relations between multiple risk indexes representing contextual adversity, income-to-needs ratios, and the elementary school adjustment of children from economically disadvantaged families. The results provide evidence for volatility in family circumstances over 2-year intervals from preschool to 5th grade, for relations between the contextual risk indexes and change in externalizing behavior, and for relations between the income-to-needs ratios and change in academic competence. The results also show differences in the timing of the effects. Little evidence was found for persistence effects. Theoretical implications concern conceptualizations of the diverse and dynamic nature of the family circumstances experienced by disadvantaged children.

Child↗
PubMed2004

The effect of physical height on workplace success and income: preliminary test of a theoretical model.

In this article, the authors propose a theoretical model of the relationship between physical height and career success. We then test several linkages in the model based on a meta-analysis of the literature, with results indicating that physical height is significantly related to measures of social esteem (rho =.41), leader emergence (rho =.24), and performance (rho =.18). Height was somewhat more strongly related to success for men (rho =.29) than for women (rho =.21), although this difference was not significant. Finally, given that almost no research has examined the relationship between individuals' physical height and their incomes, we present four large-sample studies (total N = 8,590) showing that height is positively related to income (beta =.26) after controlling for sex, age, and weight. Overall, this article presents the most comprehensive analysis of the relationship of height to workplace success to date, and the results suggest that tall individuals have advantages in several important aspects of their careers and organizational lives.

Adult↗
PubMed2001

Income statement management in a turbulent health care environment.

This article considers the role of accounting information embedded in the income statement of health care providers in their increasingly difficult economic environment. This turbulent economic environment has resulted from the dramatic shift in power from the seller to the buyer of health care services, with a consequential shift of risks that will mandate that health care providers obtain access to better cost and utilization information. This article looks at the 2 critical components of the income statement--the revenue function and the cost structure-in terms of their importance in the management of enhanced economic performance in both the fee-for-service and the prepaid provision of health care services.

Accounting↗
PubMed2002

Non-home prepared foods: contribution to energy and nutrient intake of consumers living in two low-income areas in Nairobi.

OBJECTIVE: : To determine the nutritional importance of non-home prepared foods for men, women and schoolchildren living in two low-income residential areas of Nairobi, and the sources of these non-home prepared foods. DESIGN, SETTING AND SUBJECTS: : A survey was conducted in Korogocho, a slum area, and Dandora, a low-middle-income residential area. Some 241 men, 254 women and 146 children aged 9 to 14 years were included in the study. Food intake was measured using three 24-hour recalls per individual, with special attention on the sources of all foods consumed. RESULTS: : The median proportion of daily energy intake of consumers provided by non-home prepared foods ranged from 13% for schoolchildren in Korogocho to 36% for men in Dandora. The median contribution to fat intake was higher than to energy, but the contributions to iron and vitamin A intakes were lower than to energy intake. Men consumed more non-home prepared foods on weekdays than at the weekend. Intakes of energy and most nutrients were below Kenyan Recommended Daily Intakes in all groups, but similar for consumers and non-consumers. In Korogocho, street foods were the main source of non-home prepared foods. In Dandora, both kiosks and street foods were major sources. CONCLUSIONS: : Non-home prepared foods are an important source of energy and nutrients for men, women and schoolchildren in Nairobi. In Korogocho, street foods, and in Dandora, both kiosks and street foods are the main sources of non-home prepared foods. The adequacy of energy and nutrient intakes does not differ between consumers and non-consumers of non-home prepared foods.

Adolescent↗
PubMed2004

Globalisation and income growth promote the Mediterranean diet.

OBJECTIVE: To examine global food demand patterns and how changing diets may stimulate demand for and trade of Mediterranean diet products. DESIGN: Literature review. Trends in global and US food consumption patterns are examined and trade data are reviewed to evaluate the impact of changing diets on trade of Mediterranean diet products. Market access issues are also addressed briefly to highlight the role of policy in the trade of Mediterranean diet products. RESULTS: Diets are shifting towards higher-value products such as meats, fruits and vegetables, and a wider array of packaged food products. Trade in these products has also grown in the past two decades, with several non-traditional importers and exporters becoming increasingly active in the global market. CONCLUSIONS: Income-driven demands for quality and variety are likely to increase the demand for Mediterranean diet products globally. While the middle-income countries appear to be the best growth prospects, the USA remains a potential growth market if these products can meet the growing consumer demand for variety, quality and convenience. Although consumer trends globally indicate growth in demand for Mediterranean diet products, the additional demand may not be reflected by a corresponding growth in trade. Trade in Mediterranean diet products continues to be hampered by higher than average trade barriers and high transportation costs for perishables.

Commerce↗
PubMed1988

A comparison of unemployment, income and mortality interaction for five European countries.

The relationship between unemployment and health status is examined in a comparative study of five European countries using a time series model. "The hypothesis considered in this paper is that the secular decline in mortality rates can be attributed to the secular rise in real per capita income and that the remaining fluctuations in mortality rates can be explained by cyclical movements in income and variations in unemployment." The data concern the Federal Republic of Germany, France, Italy, Sweden, and Ireland.

Demography↗
PubMedDate not supplied

Short-term fluctuations in death by cause, temperature, and income in the United States, 1930-1985.

Disclosures that this decade has had the five hottest years ever recorded globally raise concern that extreme temperatures might be associated with higher mortality. An analysis of fluctuations in annual case-specific deaths, seasonal temperatures, and annual income per capita in Massachusetts, Michigan, Washington, Utah, North Carolina, and Mississippi, 1930 to 1985, suggests that, on the contrary, a temperature increase throughout the year was associated with fewer deaths from all causes combined, including deaths from infectious diseases, heart diseases, cerebrovascular diseases, pneumonia, and influenza. An average temperature increase of one degree Fahrenheit was associated with a more than 2 per cent decline in deaths from pneumonia and influenza. The only category of deaths showing no significant association was death from malignant neoplasms. Compared to spring, summer, and fall temperature fluctuations, unusually cold winter temperatures had the strongest fatal effects, but only in North Carolina and Mississippi. The greatest cumulative temperature effects on mortality were found in the same two states. Controlling for annual fluctuations in income per capita did not influence the relationship between temperature and mortality. There was evidence suggesting that the level of wealth ameliorated the fatal effects of extreme temperatures. In conclusion, unusually warm weather was followed by fewer deaths; unusually cold weather, by more deaths.

Cause of Death↗