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Physical and mental health status of American grandparents providing extensive child care to their grandchildren.

OBJECTIVE: to compare the physical, mental, and functional health status of grandparents providing extensive care to grandchildren (30+ hours per week or 90+ nights per year) with that of custodial grandparents, noncaregivers, and two categories of less intensive care providers. METHODS: Data on a subsample of 3260 respondents to the National Survey of Families and Households who reported being grandparents during the 1992 to 1994 interviews were analyzed. Chi-square tests, 1-way ANOVAs, and multiple regression analyses compared self-reported functional health limitations, depressive symptoms, and change in self-reported health status and depression for extensive caregivers (223), custodial grandparents (173), and 3 other types of grandparents providing less or no child care. RESULTS: Extensive caregivers had levels of depressive symptoms comparable to those of custodial caregivers and significantly higher than those of noncaregivers and less intense care providers. One in 5 extensive caregivers had clinically relevant levels of depressive symptoms. Two out of every 5 extensive caregivers had at least 1 limitation in activities of daily living. CONCLUSIONS: Providing extensive care for a grandchild was associated with elevated levels of depression. Physicians should be alert to family role changes and symptoms of depression in their older patients.

Aged↗

Leaving the welfare rolls: the health and mental health status of current and former welfare recipients.

This paper summarizes the mail survey findings of 1,634 respondents examining the impact of welfare reform, namely the Work and Gain Economic Self Sufficiency (WAGES) program, in two urban areas of Florida. The health and mental health status, quality of life, and service needs of adults and children who had left WAGES were compared with those of current recipients. Findings indicate that 60% of the respondents had left WAGES during a 14-month period. Compared to former WAGES recipients, current recipients reported significantly poorer health and mental health status. Additionally, the children of current recipients had significantly greater health needs compared to those of former WAGES recipients. Although no group difference existed regarding the children's mental health status, the percentage of children scoring above the criterion suggesting a need for further psychosocial evaluation was twice the rate that would be expected in a general pediatric sample. Transportation was the only service need in which a significant group difference was found, with current recipients reporting significantly greater need compared to former recipients. Compared to former WAGES recipients, current recipients reported significantly lower levels of satisfaction with their leisure opportunities, employment or educational status, financial condition, legal and safety, family's health, and with their overall quality of their lives.

Adult↗

The meaning of older adults' health appraisals: congruence with health status and determinant of mortality.

This study explored open-ended responses regarding attributions underlying health appraisals made by older adults, resulting in five categories (physical health, attitudinal/behavioral, externally focused, health transcendence, nonreflective). The older the respondents, the less likely they were to focus on physical aspects of their health. Health optimists were the most likely to make attitudinal/behavioral or health transcendent attributions, while poor-health realists were most likely to mention physical health aspects and least likely to make attitudinal or behavioral attributions. While poor-health realists were at the highest risk of dying within a three-year period, health optimists were significantly less likely to die than poor-health realists, in spite of sharing similar health status. Respondents who were unable to identify underlying attributions were significantly more likely to die than were those identifying any other attribution. In conclusion, health attributions provide unique insight into the complex relationship between older adults' health appraisals, health status, and mortality.

Age Factors↗

Total hip replacement. The preoperative health status of patients in Japan compared with England and the United States.

To explore the contribution of health care to the excellent health status enjoyed by the Japanese compared with other industrialized populations, the preoperative health status of a retrospective cohort of 256 patients who underwent total hip replacement in Japan was compared with 301 patients in England (and published data from the United States). Patients in Japan had less severe hip disease, less comorbidity (in particular, less cardiovascular disease), and were in better general health. This finding suggests that health care contributes little to explaining the better health of people in Japan compared with England and the United States.

Activities of Daily Living↗

The health status of elderly persons in the last year of life: a comparison of deaths by suicide, injury, and natural causes.

OBJECTIVES: This study identified health status variables related to suicide by elderly persons and compared the health status of suicide decedents with natural death and injury decedents. METHODS: Data were obtained from the 1986 National Mortality Followback Survey. RESULTS: When other variables were controlled for, suicide decedents were significantly more likely than injury decedents to have a history of cancer (odds ratio [OR] = 51.94), moderate (OR = 29.37) or heavy (OR = 22.87) alcohol use, and mental or emotional disorder (OR = 10.91) and to be White (OR = 18.54) and male (OR = 9.12). CONCLUSIONS: The findings indicate that a history of cancer should be considered as a risk for suicide in the elderly.

Activities of Daily Living↗

The health status of women in Oaxaca: determinants and consequences.

Survey data from a sample of 575 women from the city of Oaxaca de Juárez, Mexico, are analyzed to ascertain the effect of the receipt of job-related benefits, including health benefits, on the self-reported health status of women, their rating of the health of the members of their household, and their satisfaction with the health of the members of their household. Health status depends on the woman's age, her socioeconomic status, and the number of children she has borne. Her rating of the health of the members of her household is related to her age, her socioeconomic status, and her rating of her own health. Satisfaction with the physical health of the members of the household is a function her health, her rating of the health of her household, her age, her socioeconomic status and the number of children she has borne. The overall conclusion is that, in this study, it is socioeconomic and demographic factors that are important in determining the woman's health status, rather than the receipt of job-related benefits. That she reports good health is an important factor in her view of her family's health and her satisfaction with her own health and that of her family.

Adult↗

Jewish people and ageing: their emotional well-being, physical health status and use of services.

Little is known about what has been termed cultural gerontology, or the experience of ageing among members of particular ethnic minority groups. One of the greatest gaps in current knowledge relates to the subjective health status and use of health services among elderly people in ethnic minorities, particularly those who are Jewish. The research results reported here are from a survey of elderly people in City and Hackney, London. They show that Jewish respondents were more likely than other elderly people to report problems with emotional well-being, mental and physical health problems and problems with functional ability (tasks of daily living). Jewish respondents were also more likely to use services, particularly health services, than other respondents. The associations with service use generally held when controlling for health status.

Age Factors↗

Effects on mortality of getting the basic health examination under the Health Services for the Elderly Act and modification of the effects by health status among elderly persons in a rural community.

This longitudinal study examines the effect on mortality of regular use of the basic health examination under the Health Services for the Elderly Act and heterogeneity of the effect according to levels of physical and mental health status among community dwelling elderly persons. Of persons aged 65 and older who lived in Otsuki town, Kochi prefecture, and completed a questionnaire survey about health in February 1991, 1,470 survivors on the anniversary of the baseline survey were followed by the end of March 1996. Regularity of getting the examination was determined by the history of use of the examination in 1990 and 1991. Mortality reduction associated with annual use of the examination was observed in both the 65-74 and the 75 and older age groups and the benefit got smaller with advancing in age. In the 75 and older age group, the benefit from annual use of the examination was restricted to persons having no impairment in physical activities of daily living and those having favorable mental health. Biennial use of the examination was associated with the same amount of mortality reduction as annual use among persons having chronic conditions under treatment in the 65-74 age group. Regular use of the basic health examination at old ages is effective and the effectiveness varies by age range and level of functional health status.

Aged↗

Obesity and its comorbidities: present and future importance on health status in Switzerland.

OBJECTIVES: The objective of this study was to estimate the proportion of various diseases attributable to obesity in Switzerland in order to get a hint of its present and future importance on health status and on our health care budgets. METHODS: The population attributable risk (PAR) for each of 17 obesity-linked conditions was estimated as the proportion of each disease condition which is attributable to obesity. The fraction of each disease that is attributable to obesity in Switzerland was calculated using the proportion (prevalence) of obesity in Switzerland and the relative risk of suffering from a given obesity-related disease in Switzerland or comparable countries. RESULTS: With a PAR of 88.6% diabetes represents the disease with the highest proportion attributable to obesity in Switzerland. It is followed by a PAF of 26.8% for hypertension, 24.7% for oesophageal cancer and 24.4% for gallstones. PARs of 17.4% and 5.7% were estimated for coronary heart disease and depression. CONCLUSION: Treatment of these first four diseases represents 89% of the total health care costs attributable to obesity in Switzerland. The impact the present obesity epidemic on health status as well as its social and economic consequences must be recognised.

Adult↗

Relationship between general health status and the change in chewing ability: a longitudinal study of the frail elderly in Japan over a 3-year period.

OBJECTIVES: The aim of the present study was to identify the onset predictors of a change in chewing ability over a 3-year period in the frail elderly. METHODS: The subjects were frail elderly people living in southern Japan. Data were collected at baseline (n = 92) and 3 years later (n = 60). The dependent variable was a change in self-rated chewing ability. The independent variables were age, gender, number of present teeth, dentition, maximum bite force (evaluated using a pressure-sensitive foil), basic activities of daily living, self-rated general health status, higher level of competence (evaluated using Tokyo Metropolitan Institute of Gerontology index), cognitive status (evaluated by revised Hasegawa Dementia Rating scale), and quality of life (evaluated using Philadelphia Geriatric Center morale scale) at baseline. To identify the most reliable predictors, bivariate analysis and multiple logistic regression analysis were performed, with the change of chewing ability as the dependent variable. RESULTS: Bivariate analysis showed the change in chewing ability was significantly associated with general health status (p < 0.01), number of present teeth (p < 0.05) and maximum bite force (p < 0.01). Backward logistic regression analysis revealed that the most reliable predictor of a change in chewing ability at 3 years was general health status (odds ratio = 6.35, 95% CI = 1.69-23.88). CONCLUSION: The present findings suggest that general health status at baseline produces a change in chewing ability.

Activities of Daily Living↗

Opinions and self-reported health status of Italians seeking homeopathic treatment.

The use of homeopathy is increasing worldwide. This multi-centre cross-sectional study aims to describe the opinions and self-reported health status of a sample of Italian people seeking homeopathic care. A self-administered questionnaire including socio-demographic characteristics, knowledge and opinions about homeopathy, personal experience with homeopathy, and, self-reported health status (SF-12), was administered to a sample of people who had sought homeopathy. Of a possible 1229 individuals invited to participate, 1223 did so. The majority of the participants were female, young (mean age 42 years), well educated (mean 13 years of education). The reason for seeking care was for either physical or emotional conditions. Most participants had fair to good knowledge of homeopathy, and the self-experienced effect (subjective judgment on efficacy) was good regardless of the type of health condition reported. The Physical Component Summary (PCS-12) scores were similar to the general Italian population, but the Mental Component Summary (MCS-12) scores were lower in all relevant strata examined. This study provides information on the characteristics of people seeking homeopathic care, in particular the results of the SF-12 self-reported health status evaluation.

Adult↗

Health status indicators for the year 2000: projections for Allegheny County, Pennsylvania.

A consensus set of health status indicators was released in July 1991 by the Centers for Disease Control and Prevention for use by public health officials at the Federal, State, and local levels in identifying and monitoring issues of public health importance. These health status indicators have been projected for the Year 2000 in Allegheny County, PA, with linear regression analyses of historical data. Indications are that mortality rates for black infants, breast cancer mortality, suicide, lung cancer mortality, incidence of acquired immunodeficiency syndrome, and the number of measles cases likely will not meet the year 2000 targets in Allegheny County. These data will prove useful in monitoring progress towards the year 2000 objectives and provide comparative data for other geographic areas of the United States with similar demographic characteristics.

Acquired Immunodeficiency Syndrome↗

[Health status and functional limitations in the elderly population of the University Region of Health of Puerto Rico: methodologic aspects and prevalence estimates].

In order to plan the health services for the elderly population, it is necessary to quantify their health status and their functional capacity. In Puerto Rico, few epidemiological studies have been conducted regarding functional capacity and chronic diseases in the elderly population. One of the difficulties to undertake these studies is the high cost and risks to move this population for clinical exams, in addition to the methodology limitation of self-report in the elderly population. This study shows the use of logistic regression to estimate the prevalence of chronic diseases and functional capacity, when the observed data are not consisted with the planed sampling scheme. Four hundred and eighty-seven elderly persons (65 yr. and over) were interviewed in the municipalities of Canóvanas, Carolina, Loíza and Trujillo Alto in Puerto Rico, using a cross-sectional design. More than half of the elderly had visual problems (IC 95%: 54.8%, 63.8%), arthritis (IC 95%: 52.7%, 61.5%) and hypertension (IC 95%: 47.3%, 56.3%). In the case of hypertension, significant differences (p < 0.05) by sex were observed, where women reported a higher prevalence than men. One of the higher prevalences in the functional capacity status was with urine accidents. More than one-third of the population is estimated to have this problem (IC 95%: 34.7%, 43.4%). One-fourth of the population had limitations with going out for shopping (IC 95%: 23.9%, 31.9%) and using public and private transportation (IC 95%: 19.5%, 26.9%). We conclude that the applied methodology was consistent with the estimation presented in the literature and statistics from the Puerto Rico Health Department. However, it is necessary to continue assessing the design and analytical methodology, in order to undertake consistent and periodic evaluations of the elderly population.

Activities of Daily Living↗

Ethnic differences in adolescents' perceived health status: preliminary findings.

The purpose of this exploratory study was to identify ethnic differences in the perceived health status among three ethnic groups of adolescents. Significant differences were found for perceived health as measured by the General Health Rating Index (GHRI) [R2, 94) = 8.11, p = .0006]. Tukey's post hoc analysis showed that European American and Latino American subjects scored higher on the GHRI than African Americans. These preliminary findings have implications for further research on perceived health status among ethnically diverse populations of adolescents.

Adolescent↗

Delivery method and self-reported postpartum general health status among primiparous women.

Despite nearly four million deliveries in the United States each year, minimal information exists on unintended health consequences following childbirth, particularly in relation to delivery method. The purpose of this study was to assess the association between method of delivery and the general health status, sexual, bowel and urinary functioning of primiparous women as measured at 7 weeks postpartum. Data from the Statewide Obstetrical Review of Quality System (StORQS) Survey of Maternity Care in Washington State were analysed. Participants included all primiparous women with a delivery of a singleton infant discharged alive between August and December 1991 from 10 non-federal short-stay hospitals who responded to the StORQS Survey of Maternity Care (n = 971). The main outcome measures included the modified Medical Outcomes Study 36-Item Short-Form Health Survey and self-reported sexual, bowel and urinary functioning. At 7 weeks postpartum, women who had caesarean or assisted vaginal deliveries reported significantly lower postpartum general health status scores than women with unassisted vaginal delivery. Additionally, women with assisted vaginal delivery reported significantly worse sexual, bowel and urinary functioning. Our results suggest that more careful attention to the postpartum general health and sexual functioning of women with caesarean and assisted vaginal delivery may be merited.

Activities of Daily Living↗

Socioeconomic differences in incident depression in older adults: the role of psychosocial factors, physical health status, and behavioral factors.

OBJECTIVE: The objective of this study was to examine the association between socioeconomic status (SES) and the onset of depression in older adults and to determine the relative contribution of psychosocial factors, physical health status, and behavioral factors in explaining this link. METHODS: Data were from 2593 men and women, aged 55-85 years, participating in the Longitudinal Aging Study Amsterdam. Two indicators of SES were used: education and income. The onset of depression was measured over 9 years of follow-up. RESULTS: Adjusted hazard ratios of incident depression were significantly higher in those with low education and low income. Psychosocial factors explained on average 16% of the SES differences in incident depression, physical health status on average 7%, and behavioral factors less than 5%. CONCLUSION: In older adults, low SES predicted the incidence of depression. Part of this association was explained by psychosocial factors and physical health status.

Activities of Daily Living↗

[The effects of a health promotion program in rural elderly on health promotion lifestyle and health status].

PURPOSE: The purpose of this study was to identity the effects of a health promotion program for rural elderly on health promotion lifestyle and health status. METHOD: The study was a nonequivalent control group pre-post experimental design. Data collection was performed from April 12th, 2003 to August 2nd, 2003. The subjects were selected at Mari Myun Geochang Gun in Korea. 44 elders were in the experimental group and 45 elders were in the control group. The 16-week health promotion program was given to the experimental group. Data was analyzed by descriptive statistics, chi(2)-test, t-test, and ANCOVA test with SPSS/Win 10.0 program. RESULT: The experimental group showed higher scores of a health promotion lifestyle and perceived health status than the control group. In addition, systolic BP, heart rate, body fat and glucose of the experimental group were lower than the control group. Waist flexibility, left hand grip power, back strength and leg strength of the experimental group were higher than the control group. However, there were no significant differences in diastolic BP, total cholesterol and right hand grip power between the two groups. CONCLUSION: This health promotion program for rural elderly can be recommended as an effective nursing intervention in rural communities.

Aged↗

Measuring health status: information for primary care decision making.

Primary Care Trusts (PCTs), charged with improving the health of their population, need to measure the extent to which patients actually benefit from the health care that is provided for them. One way of achieving this is to measure health status of patients over time. The study described here reports on the feasibility of administering the EQ-5D in general practitioner (GP) surgeries and identifies how the results might be used by practices and PCTs to improve the health of their populations. The study took place in an opportunistic sample of 1942 patients attending GP surgeries. One year later, patients who had provided contact details were sent another EQ-5D together with a request for additional information about their use of health care services in the intervening time period. A total of 770 patients completed this follow-up questionnaire. There were significant age effects associated with variation in self-reported health status and also associated with top-level Read diagnostic codes in some groups of patients. The results showed that EQ-5D could be used by individual GP practices to identify patients with specific health problems. This knowledge can also be used by PCTs and other primary care organisations, to better target scarce health resources.

Activities of Daily Living↗