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The development of the requirement of private persons (by households) is discussed by micro-economic models, legal regulations, and cross-section-data, and is represented in stylized figures. These hypothetical longitudinal profiles are compared to those of income. The analysis supplies evidence of increasing requirement and decreasing income during retirement.
Over the past ten years, the amount and number of different types of pesticides have increased significantly, which led to a growing concern about the possible adverse effects on human health and the environment. This is particularly true for countries where regulations are not strictly implemented and farmers' knowledge of safe handling is often inadequate. This paper discusses the results of a series of spray experiments to determine drift patterns along field boundaries and the exposure of farmers during their usual spraying exercises. Moreover, farmers' pesticide usage and methods of application will be described, and the effects of income and market accessibility on pesticide use patterns will be investigated. It is based on a study conducted in four villages located at increasing distance from the national highway leading to regional markets and connecting the Cagayan Valley in Northeast Luzon with Manila. The 20 pesticides encountered in this study cover 18 different active ingredients, 9 of which are classified by the WHO as 'highly hazardous' or 'moderately hazardous'. The EPA has classified at least 6 of the encountered pesticide formulations as Restricted Use Pesticides. Nevertheless, all pesticides are freely sold in stores or on markets and applied by farmers without personal protection in an unsafe manner. The farmers living nearest to the highway have the highest income and largest farms. Yet they are most at risk, having easiest access to pesticides and spraying the largest quantities of pesticides per hectare, compared to the farmers living at greater distance from the highway. It is recommended to review the list of pesticides approved for use in the Philippines and discern between Restricted and General Use Pesticides. Several recommendations for improving the implementation of pesticide policies and the IPM program are given.
PURPOSE: The purpose of the above work is description and assessment of nutritional habits of the patient group operated because of CHD in relation to their income sources. MATERIAL AND METHODS: Among 100 patients hospitalized in The Cardiosurgery Clinic of Pomeranian Medical University in Szczecin, (72 M and 28 F) there were collected data concerning nutritional habits and income sources. To estimate the way of nutrition there was used the method of a direct interview, led individually according to the questions of an anonymous questionnaire. Quantitative biomedical data connected with body mass index (BMI), systolic (RRs) and diastolic (RRd) blood pressure and total cholesterol (CHL) came from the hospital files. RESULTS: The diet of all investigated people was not consistent with the requirements of rational nutrition in respect of quality (sort of meat, brown bread, fruit and vegetables) and daily quantity of meals. This incorrectness was particularly showed in not working group of people (pensioners, people on unemployment benefits). Almost all measured parameters (BMI, CHL, RRs), except RRd, are higher than commonly admitted referenced values. CONCLUSIONS: Our investigated category of patients proves how important is adapting to the requirements of rational nutrition, especially in lower socio-economic status societies.
In this article, the authors use data from the Survey of Income and Program Participation (SIPP) to examine the relationship between economic resources and acute health care needs among the aged. The circumstances of individuals who rely on Medicare as their only form of health insurance are considered in detail because they are potentially more vulnerable when faced with health care expenses. Particular attention is given to the amount of family income and personal contingency assets held by this group and the level of out-of-pocket liability for acute care they might have been expected to face in 1984. The authors point out that their research findings would be strengthened by linkage of a more current SIPP data set to Medicare program records and the development of Medicaid eligibility simulation capability in the SIPP context.
The authors collected data with Countrywide Integrated Noncommunicable Diseases Intervention Programme (CINDI Programme) questionnaire, in Lódź an industrial city of Poland. One of the purposes of CINDI Programme was to evaluate the impact of socioeconomic status, lifestyle and stress on health status in elderly. Obesity is a very important risk factor for cardiovascular disease (CVD), some pulmonary, neoplasmatic and motoric system diseases. The main purpose of this paper was to examine the effect of income, education, lifestyle and stress on BMI (body mass index) and WHR (waist/hip ratio) in older population of Lódź (age 65 + years). The study was conducted according to WHO standards set for CINDI Programme. The surveys were directed at random samples and sent to 1461 men and women age 65. An overall response rate was 57.1%. We have found that lower educational level and low physical activity are the predictors of obesity in our population. We have observed an inverse correlation between smoking and BMI and WHR. Stress associated with the feeling of not being able to fulfil the demands of everyday life was a strong predictor of obesity in woman. Income, family status and food habits were not associated with obesity in elderly. As we gain new knowledge about older population, we may be able to more accurately and effectively target preventive services and help older adults make health decisions to reduce diseases' risk factors and increase their quality of life.
SETTING: Although there are proven risk factors related to air pollution, the prevalent situation in low-income countries is not well known. OBJECTIVE: To quantify the health impacts associated with particulate air pollution in the city of Algiers. DESIGN: Descriptive study to evaluate a health impact assessment (HIA) approach based on a dose-response curve from the literature. A study area was defined around an air quality monitoring site in Algiers. Daily health data were obtained from a network of physicians practising in out-patient health centres. RESULTS: Over the period studied, the number of consultations for respiratory reasons attributable to PM10 exposure was 439, representing 4.5% of all health events observed. Different scenarios were examined, showing that a reduction in ambient levels of PM10 would be accompanied by important public health gains. CONCLUSION: The study allowed us to test the applicability of the HIA approach in a low-income country and to confirm the interest of the approach. Although the estimation of dose-response functions obeys a complex methodology, the HIA is an alternative that constitutes an important decision-making tool.
For 1986, 219,470 live births were reported for residents of Canada's 25 Census Metropolitan Areas (CMAs). For each of these births, street address information as shown on the birth registration was used to code the census tract where the mother lived. Data by census tract were obtained for 1,650 infant deaths in 1986, and from the 1986 census for the population of 4,727,770 women aged 10-49 in 1986. Births, infant deaths and census population data (adjusted for undercount) were then used to calculate rates of infant mortality, low birth weight (LBW), very low birth weight (VLBW), prematurity, small for gestational age (SGA), and total fertility. The results are presented by neighborhood income quintile group (based on percentage of low income), and by the mother's age, parity (number of live births), marital status and country of birth, as well as by CMA.
A sample of 665 low-income women from a predominantly rural area of north central Florida rated the value of 25 features of family planning providers and reported their perceptions of how characteristic each feature was of different types of providers. A well-trained, trustworthy and friendly staff, the presence of a doctor if you need one and a staff that is gentle with the examination were the most desirable features of family planning services. The respondents' perceptions of public health clinics suggest that the strongest qualities of such facilities are that they treat people from different backgrounds, accept Medicaid, are easy to find and teach you how to avoid pregnancy and how to take care of yourself and stay healthy. Features thought most characteristic of private physician services were a well-trained staff, privacy and the presence of a doctor if you need one. Voluntary organizations were seen as providing services for people of different backgrounds, having a friendly staff, serving as a referral agency and teaching about staying healthy and avoiding pregnancy. However, voluntary organizations were rated lower than public health clinics or private physicians on nearly all features. The total scores for public health clinics and private physicians were not significantly different from each other, but both were noticeably higher than the score for voluntary organizations. Ethnicity affected ratings dramatically, with black respondents clearly more favorable toward public health clinics and private physicians than white respondents; conversely, whites were more positive toward voluntary organizations than were blacks. For many of these low-income respondents, the high ratings of private physicians may have represented their expectations rather than their actual experience.
Analysis of physicians' work patterns and income between 1982 and 1987 provides strong evidence that the demand for physicians' services has risen at least as quickly as physician supply. Aggregate hours spent by US physicians who provide patient care rose by 21%, and aggregate real net income rose by more than 30% during a period in which the supply of physicians grew by only 16%. The aggregate number of visits rose by only 9%, indicating that the time spent per patient encounter rose sharply, presumably as a result of technological change and the increased complexity of care. Recently released data for 1988 are consistent with these trends. Our findings are inconsistent with the prediction by the Graduate Medical Education National Advisory Committee that there would be a large physician surplus by the year 1990. Moreover, if the upward trend in demand for physicians' services continues, as seems probable, a physician surplus should not develop in the foreseeable future. Only extensive rationing of beneficial services would be expected to alter this projection.
Over a 2-year period, dietary and socioeconomic data were collected from 793 food records of 90 toddlers, aged 1 to 2 years, who were predominantly U.S. Hispanics living in low-income households in Denver, CO. This study was part of a larger investigation designed to assess the efficacy of vitamin and mineral supplements in young children. The toddlers were randomly assigned to one of five treatment groups: multivitamin; multivitamin and iron; multivitamin, iron, and zinc; multivitamin and zinc; or placebo. Three-day food records that were collected from the toddlers at the beginning of the study, at 3 months, and at 6 months were used to assess the dietary and nutrient intakes. Meal patterns were devised on the basis of the frequency of food consumption and common food combinations. Nutrient values were calculated using a diet analyzer program. Nutrient analysis of the toddlers' diets indicated that iron and magnesium were consumed least frequently, whereas more than adequate amounts of protein (193% of the Recommended Dietary Allowance) and sodium (207% of minimum requirements for healthy persons) were consumed. No significant differences in nutrient intakes were observed among the treatment groups, suggesting that the vitamin and mineral supplements had no effect. A difference in energy intake was observed over time with the 6-month and 3-month intakes significantly higher than the initial intakes. There was also a high consumption of carbonated beverages. Despite the low income levels of the families, these toddlers were consuming adequate amounts of food; however, an educational component aimed at reducing the toddlers' high intakes of protein, sodium, and carbonated drinks may help improve the present feeding practices of the mothers.
A survey of active members of the American Academy of Family Physicians was conducted to determine the effect of the practice of obstetrics by family physicians on patient age distribution, physician work load, and physician income. A questionnaire was mailed to 800 randomly selected physicians; the survey response rate was 60.4%. Almost 20% of all respondents had never provided obstetrical care of any type. Another 40% had provided obstetrics previously but had discontinued this service, while the remaining 40% currently provided obstetrical care. Physicians who provided obstetrical services reported a significantly higher mean proportion of children and a significantly lower proportion of middle-aged and elderly adults in their patient panels than did physicians who do not provide obstetrics. Those physicians who had never offered obstetrics saw approximately the same number of patients and worked approximately the same number of hours as did those who provided low-risk, routine obstetrics; however, the former group reported a significantly higher average annual income than did the latter group.
Driven to retire mainly by changes in the health care delivery system, physicians nevertheless find it difficult to reduce their professional activities as they grow older. Retired physicians in a seven-county region of upstate New York were surveyed to discover how they were faring in retirement and to elicit information of possible value to doctors planning to retire. Good health and adequate income were the prime factors in successful retirement, along with active involvement in postretirement activities, especially nonmedical ones. Three quarters of respondents found annual incomes between $25,000 and $50,000 to be comfortable. All agreed that private investments must make up at least a third of this amount, supplementing Social Security, pensions, individual retirement accounts, and Keogh plan distributions. There was diversity of opinion on remaining active in medical affairs after retirement. A large majority of those who found retirement better than anticipated advised a clean break with medicine. Most of their colleagues who rated retirement about as expected or not as good as anticipated counseled continued involvement in professional activities.
The Wisconsin Department of Health and Human Services has identified breast cancer as the most common malignant neoplasm among women in Wisconsin. To determine the potential effectiveness of a program of low-cost screening mammography in reducing cancer morbidity and mortality in individuals of low socioeconomic status, the authors conducted a retrospective analysis of data from tumor registries. Using the tumor registries of two hospitals in Milwaukee, Wisconsin, the records of 323 patients with breast cancer were identified and analyzed for size of tumor at first presentation. These data were correlated with per capita income taken from census block information for the residence of each patient. The data indicate that mean income was lower for patients with more advanced disease. Other variables such as race did not influence tumor classification at initial presentation. Economically disadvantaged women present with more advanced breast cancers than affluent patients. This adverse circumstance may be the result of lack of financial resources and poor dissemination of information. Programs that recognize these problems are likely to be more successful in achieving earlier breast cancer detection.
Continuing the study of social representation of the physically handicapped, the authors of this article study the influence of income and family situation on the evaluation of a fictive handicapped person. In creating twelve portraits by crossing the modalities of these variables, they arrive at a factorial plan which allows them to prove the effect of income and family situation as well on the positive adjectives marked on a list of personality traits as on the evaluations given by means of a scale ranging from "has overcome his handicap very poorly" to "has overcome his handicap very well". Although the evaluations are in general favorable and in spite of the fact that only little information was given to the subjects, the responses are significantly different. In addition, the relation between the number of positive adjectives attributed and the values received on the scale make it evident that the notion of having well or poorly "overcome one's handicap" is socially evaluated. Finally, the interaction observed between the two studied variables shows that the fact of having a professional occupation is clearly more important if the described person is unmarried than if he is married.
The Census Bureau's Survey of Income and Program Participation (SIPP) provides data that can be used to study the characteristics of Old-Age, Survivors, and Disability Insurance (OASDI) and Supplemental Security Income (SSI) program participants. It is important that estimates of sampling errors accompany such studies because the estimates may have large sampling errors due to the small number of sample cases available for specific analyses. The generalized sampling variances provided by the Census Bureau did not identify separately either program's participants and, therefore, do not pertain directly to analyses of these groups. This article describes an approach to the direct computation of sampling variances for OASDI and SSI program participants. The approach uses the pseudo stratum and half-sample codes available in SIPP public use data files. A table of generalized standard errors is constructed for participants of both programs aged 18 or older. Generalized standard errors could not be computed for child beneficiaries under age 18 because of a wide variation of design effects across subpopulation estimates.
This study examined how family practice residents coded their patient care services, and whether feedback on coding patterns together with income projections would alter coding behavior. Current and future income projections were calculated using assumptions about the practice setting. The collected and calculated data were presented to the residents after the study period, together with a discussion of coding of patient care services and fees. The same data were collected three months and nine months later. There was no significant difference in coding patterns when comparing first- to second- to third-year residents. Six months after the information was presented to the residents, the percentage of brief visits coded decreased significantly, and the percentages of intermediate and comprehensive visits coded increased significantly. Twelve months later, the changes in coding patterns had reverted to the initial findings. This appears to be an effective approach that could be used elsewhere to teach coding of patient care services as part of a practice management curriculum.
To determine the anemia trends among low-income US children, hematologic measurements obtained from children aged 6 to 60 months who were enrolled in public health programs in six states that were consistently monitored by the Centers for Disease Control Pediatric Nutrition Surveillance System were studied. Overall, the prevalence of anemia has declined steadily from 7.8% in 1975 to 2.9% in 1985. The prevalence of anemia declined significantly among children seen at preenrollment screening visits, as well as those seen at follow-up visits, suggesting a generalized improvement in childhood iron nutritional status in the United States, as well as a positive impact of public health programs. To ensure that the declining trend of anemia was not a function of a change in the population of children enrolled in the surveillance system, Tennessee nutrition surveillance records were further analyzed; these records were linked with birth records to obtain detailed socioeconomic status (SES) information. Even though the SES composition remained stable from 1975 to 1984, the prevalence of anemia has declined significantly within each SES group. These findings indicate a true decline in the prevalence of anemia among low-income children that is likely the result of improvements in childhood iron nutrition.
Apparent levels of household diet, perceptions of diet and food production, rural water supplies, attitudes to birth control, and household incomes and expenditure of families in rural areas in Transkei were studied. The results revealed problems of deficiencies in family energy intake and low incomes, such that at least 40% of rural families were living in a state of poverty. There is urgent need for an integrated development approach aimed at fulfilling basic needs.