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Food safety perceptions and behaviors of Kentucky consumers.
In several areas, Kentuckians practice more risky health behaviors than most of the rest of the nation. The Health Belief Model states that individuals with lower perceived risks practice less healthy behaviors. This study sought to determine if this was true for food safety by assessing food safety perceptions and behaviors of Kentucky consumers. Data were collected through a telephone questionnaire based on a survey by the U.S. Food and Drug Administration; 728 respondents participated. Food safety perceptions were analyzed by examining participants' responses to confidence in the safety of the food supply, perception of likelihood of people becoming sick because of foodborne illness, and perception of where food safety problems are most likely to occur. Significant differences were found in food safety perceptions for age, gender, household income, education, and employment in the food industry. Analysis of food safety behaviors revealed differences in food handling behaviors for gender, education level, household income, race, and households with a member aged 65 years or older. Significant relationships were found between respondents' food safety perceptions and behaviors. In general, Kentucky consumers who perceived higher risks exhibited safer food handling behaviors. Strategies to increase the understanding of real and perceived food safety risks in the home combined with strategies that target specific demographic groups may be the most effective approach to improve food handling practices. A better understanding of consumers' food safety risk perceptions and behaviors could lead to more effective food safety education materials and messages.
Adolescent↗
Midlife income, occupation, APOE status, and dementia: a population-based study.
OBJECTIVE: To examine the relationship between socioeconomic factors and APOE carrier status on the development of dementia. METHODS: Subjects were derived from random, population-based samples previously studied in surveys carried out in 1972, 1977, 1982, and 1987. After an average follow-up of 21 years, 1449 (73%) subjects aged 65 to 79 years were re-examined in 1998. The diagnosis of dementia among the nonparticipants was derived from patient records of the local hospitals and primary health care clinics. RESULTS: Low income level at old age was related to dementia, but low income level at midlife was not a risk factor for dementia. Dementia was also associated with decreasing income level, from midlife to old age 21 years later, when dementia was diagnosed. A sedentary occupation (office, service, or intellectual work) was associated with a decreased risk for dementia among participants; however, when the nonparticipants were included in the analysis, the associations were no longer significant. Low educational level and the APOE epsilon4 allele independently increased the risk for dementia. CONCLUSIONS: Reduction in income level during follow-up and low income level at old age might be the consequence of a dementing process rather than being associated with risk evolution of dementia.
Aged↗
Influence of sociodemographic factors in the prevalence of obesity in Spain. The SEEDO'97 Study.
OBJECTIVE: To analyse the influence of social and cultural factors in the prevalence of obesity in the Spanish adult population aged 25--60 y based on available population data. DESIGN: Pooled analysis of four cross-sectional nutrition surveys. SUBJECTS: A total of 5388 free-living subjects aged 25--60 y, respondents of the Nutritional Surveys carried out in four Spanish regions (Catalunya, Basque Country, Madrid and Valencia) from 1990 to 1994. The samples were pooled together and weighted to build a national random sample. MEASUREMENTS: Weight and height were measured on each individual by trained observers. Age, gender, educational level, occupation, habitat (rural/urban) and region were considered. Obesity was defined as body mass index > or = 30 kg/m(2). The protocol used in each survey was in accordance with the recommendations of the Spanish Society for the Study of Obesity (SEEDO). Logistic regression models were designed to analyse the influence of sociodemographic factors in the prevalence of obesity in men and women. RESULTS: The prevalence of obesity was higher in older age groups in men and women, odds ratio (OR) for every 10 y OR=1.40 (95% CI 1.39--1.41) for men and OR=1.86 (95% CI 1.85--1.87) for women. Logistic regression analysis adjusted for age showed higher obesity rates among low educated people, OR=1.80 (95% CI 1.78--1.81) in men and OR=2.36 (95% CI 2.29--2.42) in women (P<0.001). Among men the odds ratio for the prevalence of obesity in rural areas was OR=1.87 (95% CI 1.86--1.89), compared to cities. The geographical distribution showed higher obesity rates in the southeast. CONCLUSION: This study supports that obesity is a multifactorial problem. Older women with low educational level and low income seem to be the most susceptible group to weight gain. Therefore, Public Health Programs should consider this type of environmental factor when planning strategies aimed at preventing or reducing the problem of obesity in western societies.
Adult↗
Prevalence of childhood asthma in urban communities: the impact of ethnicity and income.
PURPOSE: The goal of this study was to assess the relationship between hospitalization rates and asthma prevalence in New York City children and investigate the role that sociodemographic factors play in asthma. METHODS: A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools, stratified according to neighborhood hospitalization rates. RESULTS: The overall student response rate was 76.9% (5250 students). Prevalence of current asthma was 17.9%, 9.59%, 6.39% (p < .001) in areas of high, median, and low asthma hospitalization rates, respectively. The overall prevalence of current asthma was 13.0%. Children living in predominantly low socioeconomic status (SES) communities had a 70% greater risk of current asthma, independent of their own ethnicity and income level. Asthma prevalence within different ethnic and income groups was consistently lower in neighborhoods of greater socioeconomic status, except among Puerto Rican children, who had high asthma prevalence, regardless of school attended or income. CONCLUSIONS: Prevalence of current asthma is strongly associated with attending a school in a low-income neighborhood. Although hospitalization rates have been used as an indicator of the burden of asthma in a neighborhood, it alone does not reflect the level of disparities that exist among communities with different socioeconomic backgrounds.
Asthma↗
Composite resin esthetic dentistry survey in New England.
This study collected information on various aspects of esthetic dentistry, including the time used and income produced while delivering treatment to noncarious teeth. A mail survey was sent to 521 randomly selected dentists in the six-state New England area (approximately 7% of the total active dentists in that region); the response rate was 74%. The results indicated that dentists are providing a substantial amount of esthetic treatment on noncarious teeth.
Adult↗
When do older patients change primary care physicians?
BACKGROUND: Concerns have been raised about changes in the health care system that may disrupt continuity of care and thereby reduce the quality of that care. The purpose of this study was to look at the reasons that older patients give for changing primary care physicians (PCPs) and to look at relationships between the duration of the PCP-patient relationship and the perceived quality of primary care received. METHODS: We analyzed data collected during the first 2 years of a longitudinal study of primary care patients 65 years of age and older. Variables included sociodemographic characteristics, duration of relationship with current PCP, reasons for leaving last PCP, estimated numbers of visits to PCP, other clinics, and emergency departments, and admissions to hospitals and nursing homes in the last year, self-rated health, 2 measures of health-related quality of life, and the Components of Primary Care Index (CPCI). RESULTS: 799 patients of 23 PCPs were enrolled in year 1 of the longitudinal study, and 579 were re-evaluated in year 2. The mean and median PCP-patient relationship durations were 10.27 and 8 years, respectively. Duration of the PCP-patient relationship was associated with greater patient age, income, level of education, and frequency of visits to the PCP. Longer relationship duration was also associated with higher scores on all 8 CPCI subscales. The distribution of reasons for changing PCP was associated with duration of relationship; those with a longer relationship were more likely to change involuntarily. Insurance-related reasons for changing PCP were more common in those who had changed more recently. One hundred and fourteen (14%) changed PCP during the first year of the study. Three CPCI subscale scores predicted PCP change, accumulated knowledge, communication, and family orientation. Eighty-seven percent changed involuntarily, 44% for insurance-related reasons and 40% because their doctors had moved, retired, or died. CONCLUSIONS: Older patients, particularly those who are older and have more education and income, tend to stay with their PCPs until they are forced to change. The longer they stay in the relationship, the better they feel about the quality of the primary services they receive. Changes in the health care system may have increased the number of patients forced to change PCP.
Aged↗
Trends and differentials in adolescent and young adult mortality in the United States, 1950 through 1993.
Using data from the National Vital Statistics System and the National Longitudinal Mortality Study, this study examined mortality trends and differentials from 1950 through 1993 among US adolescents and young adults according to sex, race/ethnicity, education, family income, marital status, and cause of dealth. No appreciable reduction in youth mortality has occurred, especially among men. Declines in youth mortality from accidents have been nearly ofset by increases in death rates from homicide, suicide, and firearm injuries. American Indians, Blacks, males, and those with least education and income were at increased risk of both overall and injury-specific youth mortality.
Adolescent↗
Socioeconomic differentials and neonatal mortality: racial comparison of California singletons.
The median family income of the zip code of maternal residence was used to estimate the presence and determine the extent of socioeconomic differentials in the neonatal mortality rates of a cohort of 401,399 white and of 66,577 black Californian singletons born from 1982 to 1983. The neonatal mortality rate in the white infants increased from 3.99 in mothers residing in zip codes with a median family income greater than $25,000 to 12.1 for mothers residing in zip codes with a median family income less than $11,000. With decreasing socioeconomic status there was also a significant increase in the percentage of white infants weighing less than 2,500 g (percentage of low birth weight increased from 3.75 to 8.33) and weighing less than 1,500 g (percentage of very low birth weight increased from 0.56 to 1.46). When the source of the socioeconomic difference in white neonatal mortality was partitioned, 77.4% was due to deterioration in the birth weight distribution and 22.6% to deterioration in the birth weight-specific mortality rates. For the black cohort, the neonatal mortality rate increased from 5.9 in the most, to 9.0 in the least affluent strata. Although decreasing residential median family income was associated with an increase in the percent low birth weight (8.19 v 12.86), the percentage of very low birth weight was not significantly different (1.59 v 2.10). When the source of the differential in black neonatal mortality was partitioned, only 29% was due to deterioration of the birth weight distribution, whereas 71% was secondary to less favorable birth weight-specific mortality rates.(ABSTRACT TRUNCATED AT 250 WORDS)
Black or African American↗
The world food situation and global grain prospects.
The basic realities of the distribution of the world's population, wealth, and agricultural production base are not conducive to an automatic stabilizing process for the world's hungry. Increasing volatility in the world grain production in the 1980's could create a problem of major proportions. By 1990, the developed world will account for 24 percent of the world's population, 85 percent of the world's economic activity, and around 50 percent of the world's grain production and consumption. On a per capita basis, the developed world will consume nearly three times as much grain as the developing countries which account for three-fourths of the world's population. Increased food aid, which is essential, is not the solution to the basic problem. The low-income countries need a massive infusion of capital investment, research support, and education if they are to build infrastructures that have the capacity to produce, distribute, and market food supplies. Other options serve only to prolong and aggravate the current disparities.
Climate↗
Respiratory illness in children attending daycare.
Daycare attendance has been associated with an increased occurrence of respiratory illness, but little is known about which children are at particular risk. Our objectives were to determine the association between the incidence of respiratory illness and attendance in daycare, and to determine if the risk is modified by selected sociodemographic factors. Using a prospective study design, 185 newborns in Prince Edward Island, Canada, were recruited between January 1997-March 2000. They were followed for 2 years or until the end-date of the study in September 2000. Information on daycare attendance and respiratory illness was collected twice monthly by telephone interviews of the parent. Comparing those who were ever in daycare more than 1 day per week (daycare group) to those who were not, the association between daycare and illness was stronger among children 15 months of age compared to those less than 3 months of age (P < 0.001), and stronger among those without siblings than those with siblings (P < 0.001). Among those not in daycare, family income was inversely related to the proportion of days with an illness episode: 9.8% (CI, 6.0, 13.6) if family income was < $30,000 vs. 5.2% (CI, 4.1, 6.3) if > or = $30,000 (P = 0.003). However, in the daycare group, income did not influence illness, with respective values of 14.6% (CI, 12.4, 16.8) vs. 13.2% (CI, 12.1, 14.3) (P = 0.21). In conclusion, younger children and those with siblings may be less susceptible to illness associated with daycare, and daycare attendance may negate a protective effect of higher income on respiratory illness.
Age Distribution↗
A prospective study of factors affecting age at menopause.
This paper describes a multivariate analysis of a 3-year prospective study of the covariates of age at menopause among women who were randomly sampled from a general population. This approach avoids three problems that may account for the inconsistent results of prior studies: recall bias in retrospectively collected data, failure to control confounding in data analyses, and self-selection in the target populations. At baseline, the 2014 subjects in this study were 46.5-56.5 years old and still menstruating. Median age at last menstruation estimated from a model of the marginal distribution of age at menopause, was 50.7 years. When covariates were considered singly, age at menopause varied with smoking, education and income but not with marital status, parity, location, height, weight or use of either oral contraceptives or menopausal estrogens. Multivariate analyses showed that education and income were confounded with smoking status. The results indicate that many previously identified sources of variation in age at menopause reflect confounding with smoking and self-selection in target populations, rather than real effects.
Adult↗
Prevalence of delusional ideation in a district in southwestern Uganda.
BACKGROUND: Population-based prevalence studies suggest that psychosis is a continuum distributed in the general population. AIM: To assess the prevalence of delusional ideation in young healthy individuals in a low-income country setting (Uganda) and to investigate possible relevant background factors. METHOD: Interviews were conducted in a district capital and in three rural villages, using the Peters et al. Delusions Inventory (PDI-21). RESULTS: Levels of delusional ideation and associated levels of distress, preoccupation, and conviction were higher than in studies conducted in Europe. Higher PDI-21 scores were associated with younger age and with urban residence. The urban effect was stronger in persons with a higher level of education. CONCLUSIONS: Although the factors that contribute to population differences in levels of delusional ideation are currently unknown, the results suggest that urban residence may be an important influence.
Adolescent↗
The impact of outcome orientation and justice concerns on tax compliance: the role of taxpayers' identity.
Previous research has yielded inconsistent evidence for the impact of justice perceptions on tax compliance. This article suggests a more differentiated view on the basis of 2 congenial theories of procedural and distributive justice. The group-value model and a categorization approach argue that taxpayers are more concerned about justice and less about personal outcomes when they identify strongly with the inclusive category within which procedures and distributions apply. Regression analyses of survey data from 2,040 Australian citizens showed that 2 forms of tax compliance (pay-income reporting and tax minimization) were determined by self-interest variables. For 2 other forms (nonpay income and deductions), inclusive identification had an additional effect and moderated the effects of self-interest and justice variables as predicted.
Adolescent↗
Physical, behavioral, and body image characteristics in a tri-racial group of adolescent girls.
OBJECTIVES: The purpose of this study was to evaluate physical characteristics, nutrient intake, physical activity level, and body image in white (CC), African-American (AA), and Hispanic-American (HA) female adolescents. RESEARCH METHODS AND PROCEDURES: High school volunteers were solicited for this study. Self-reported information was used to determine subject characteristics, family income, physical activity, body image, and nutrient intake. Physical evaluations were used to determine body mass index, percent body fat, fat distribution, resting heart rate, and blood pressure (BP). RESULTS: Results showed that AA girls displayed significantly higher diastolic BP than HA girls (p = 0.029). CC adolescents showed greater physical activity (p = 0.010) and lower adiposity than HA adolescents (p = 0.048), as well as lower subscapular skinfold than AA adolescents (p = 0.018). AA adolescents selected a higher ideal body size than CC girls (p = 0.038). There was also a significant difference in percentage carbohydrates (p < 0.034) and cholesterol consumed (p < 0.016) among groups, with CC girls showing the highest values for carbohydrates and lowest values for cholesterol intake among groups. DISCUSSION: Given our findings of higher adiposity and lower physical activity levels in HA adolescents and greater diastolic BP levels and subscapular skinfold in AA adolescents, more interventions should be targeted toward improving health-related variables among minority populations.
Adipose Tissue↗
Wealth inequality among older Americans.
Using the AHEAD study, this article examines the wealth distribution among American households with a member at least 70 years old. Household wealth is quite unevenly distributed among older American households. Those households in the top 10th percentile of the wealth distribution have 2,500 times as much wealth as those at the lowest 10th percent. This sharp wealth disparity relative to income dispersion is the dominant reason why older minority households have accumulated so little wealth compared to White households. Wealth varies by a factor of seven to one when both spouses are in poor health compared to when they say that they are in excellent health. Finally, AHEAD data on bequest intentions suggest a bifurcated bequest motive. Most older households plan to bequeath a modest financial inheritance, but about one-quarter expect to leave inheritances worth $100,000 or more.
Aged↗
Is it possible to reduce AIDS deaths without reinforcing socioeconomic inequalities in health?
BACKGROUND: The wide use of highly active antiretroviral therapy has led to an impressive improvement in AIDS survival after the mid-1990s in cities and countries with a high access to these medications. Notwithstanding its beneficial overall effect, antiretroviral therapy was also reported as a factor for the increase in socioeconomic inequalities in health, because AIDS patients have unequal access and adherence to these medications. METHODS: We assessed trends AIDS mortality in districts of Sao Paulo, Brazil, from 1995 to 2002, in order to test their association with area-level socioeconomic indices in a city with a large-scale and cost-free distribution of highly active antiretroviral therapy. We gathered information on yearly death rates due to AIDS, adjusted for gender, age group, income, instruction, living standards, and the human development index. Trend estimation used the autoregression procedure of exact maximum-likelihood estimation for time-series analysis. Regression analysis was used to study the association between the annual percentage decrease in AIDS deaths and socioeconomic indices. RESULTS: AIDS mortality decreased in Sao Paulo from 32.1 deaths (per 100 000 inhabitants) in 1995 to 11.2 deaths (per 100 000 inhabitants) in 2002. District-level figures of social development did not show an association with the annual percentage decrease in AIDS mortality, with all correlation coefficients corresponding to P-values >0.27. CONCLUSIONS: This observation indicates that the perspective of public policies addressed to the entire population contribute to reducing inequalities in health, while attaining an overall reduction in AIDS deaths, may have been feasible in the Brazilian context.
Acquired Immunodeficiency Syndrome↗
Comparability of telephone and household breast cancer screening surveys with differing response rates.
We compared telephone and household surveys as methods for obtaining information about breast cancer screening. The study population was comprised of women age 40 years or older who were permanent residents of two large areas of Florida. We contacted women using random digit dialing for the telephone survey. We used a stratified multistage design for the household survey. Response rates were 49% (telephone) and 77% (household). Distributions of most screening (mammography, clinical examination, and breast self-examination) and demographic variables were comparable for the two surveys; income was higher in the telephone survey. Both surveys underestimated the proportion of older women, based on 1990 Census data.
Adult↗