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PubMed1991

Education level and rheumatoid arthritis: evidence from five data centers.

Data on 2,006 patients with rheumatoid arthritis (RA) for 1984 and 1986 were analyzed from 5 American Rheumatism Association Medical Information Systems patient centers to assess covariates of future disability. The dependent variable was the Health Assessment Questionnaire disability index, measured in 1986. Independent variables, measured in 1984, include years of schooling, age, age squared, sex, labor force status, occupation, marital status, race, income, sedimentation rate, log latex, number of tender joints, and duration of illness. A negative association between schooling and the disability index is strongly apparent for men and weaker in women. Results for men persist even after adjustment for occupation and income, but not after additional adjustment for biological variables. The effects of schooling upon progression of RA are complex and interpretation requires simultaneous assessment of a variety of other variables. Causal effects of level of schooling are seen with a social science perspective which considers the biologic data to represent dependent variables yet cannot be inferred from a clinical model which considers the biology of the disease as an independent variable.

Arthritis, Rheumatoid↗
PubMed2003

Adult outcomes in women who experienced parental violence during childhood.

OBJECTIVE: The aims of this work are to analyze the associations between violence suffered at the hands of fathers and mothers in childhood and adolescence and three outcomes in adulthood--having or not having children, marital status, and occupational status--controlling for the possible impact of partner violence. METHOD: This cross-sectional study examined a sample of 510 women, attending various health care and social services facilities in a Northern Italian city. Both quantitative and qualitative data were collected. RESULTS: Almost one quarter of the respondents reported some kind of abuse by one or both parents, and 18.2% had experienced physical and/or sexual violence by a partner or ex-partner; women abused by parents were more likely to experience partner violence. Irrespective of whether they experienced partner violence, women abused by parents were more likely to be childless, divorced or never married, and in a precarious occupational situation. CONCLUSIONS: This study is the first one carried out in Italy on this subject: results largely confirmed the trends found in studies in other countries. However, two of the associations which emerged, namely between parents' abuse and being divorced or never married and between parents' abuse and being childless, are worth noting, since they could be interpreted as failures or, on the contrary, as active and positive choices made by abused women in a difficult context. Qualitative data from case histories provided insights into the violence some women have suffered and its consequences, but also into women's great resilience and strengths.

Adolescent↗
PubMed1999

Gender differences in the prevalence of depression: a survey in primary care.

Epidemiological surveys demonstrate that unipolar depression is more common in females than in males. Gender-specific cultural and social factors may contribute to the female preponderance. This study explores this possibility in a cross-cultural sample of general-practice patients systematically recruited in the WHO study "Psychological Problems in Primary Care" conducted in 14 countries with identical sampling and assessment strategies. Although absolute prevalence rates are broadly varying between centers proposing that the gender ratio is nearly constant with 1:2. The cultural context does not contribute substantially to the female preponderance. This study lends some support to previous observations that the magnitude of female preponderance is associated with the number of symptoms associated with depression requested for caseness and inversely related to the degree of social impairment. Matching social role variables (marital status, children, occupational status) between females and males reduces the female excess by about 50% across all centers. Therefore, we conclude that social factors are inducing part of the preponderance of females among depressed cases.

Adult↗
PubMed2006

What predicts poor mother-infant interaction in schizophrenia?

BACKGROUND: Poor clinician-rated parenting outcome and observed interactive deficits in mothers with schizophrenia admitted to a psychiatric mother and baby unit (MBU) reflect continuing concerns over the parenting capacity of this group. However, little is known about whether interaction deficits are accounted for by severity of illness or adverse social circumstances typically experienced by these mothers. METHOD: Thirty-eight women with severe perinatal illness (schizophrenia n=13; affective disorders n=25) and their infants were observed in play interaction a week prior to MBU discharge. Clinical and sociodemographic data were also obtained. RESULTS: Mothers with schizophrenia and their infants were rated to have poorer interactive behaviour than the affective disorders group. Infant avoidance of the mother was associated with a lack of maternal sensitivity and responsiveness. The deficits in mother-infant interaction found in the schizophrenia group could not be accounted for by our measures of illness severity or factors relating to adverse social circumstances. CONCLUSIONS: The results replicate and extend previous findings showing poor interactive behaviours in mothers with schizophrenia, their infants, and in the dyad, in a range of areas following clinical recovery. The findings suggest that factors other than illness duration, dose of medication, marital status and occupational status are explanatory for the interactive deficits associated with maternal schizophrenia. Parenting interventions that aim to improve maternal sensitivity need to be developed specifically for this group.

Adult↗
PubMed2001

Characteristics of women exposed and unexposed to environmental tobacco smoke (ETS) in a general population sample of North Italy (Po River Delta epidemiological study).

To define qualitative and quantitative categories of exposure to environmental tobacco smoke (ETS) and to assess possible differences for life-style factors between exposed and unexposed women, we studied 867 nonsmoking women (8-73 aged), selected from a general population sample living in the Po Delta area (near Venice, North Italy). Information was collected by a standardized questionnaire. ETS exposure at home, at work or elsewhere was considered. There was a prevalence of ETS exposure of 46% in the whole sample; the rate had a negative association with age. Exposure to ETS occurred more frequently at home, either singly (56%) or in combination with school/work and other places (75%). Exposed women were significantly younger, taller and lighter than those unexposed. Logistic regression on 20+ aged women showed that single-separated-widowed, workers, women living in a rental house, and women with a central forced air heating were significantly more exposed to ETS. Crowding index (n inhabitants/n rooms of the house) was significantly higher in those exposed. These results indicate that ETS exposure is quite frequent in Italian women and that some life-style factors (e.g. marital status or occupational status or some home characteristics), should be considered in the study of relationship between passive smoking and respiratory health.

Adolescent↗
PubMed2001

Maternal smoking and gestational age in twin pregnancies.

BACKGROUND: A twin pregnancy imposes greater demands on maternal physiology and smoking may thus be associated theoretically with a greater risk of preterm delivery than in singleton pregnancies. POPULATION AND METHODS: From 1989 to 1996 all women who booked for antenatal care at the Department of Gynecology and Obstetrics, Aarhus University Hospital, Denmark were asked to fill in two questionnaires. Apart from smoking habits, these questionnaires provided information on medical and obstetric history together with information on sociodemographic and other lifestyle variables. Gestational age at delivery was calculated from ultrasonographically determined fetal biparietal diameter and information about the last menstrual period. Only women carrying twins were included in the present study (n=401). RESULTS: Mean gestational age was 5 days (95% CI 1-9 days) shorter among smokers compared with non-smokers. Among non-smokers mean gestational age was 261 days (+/-18), among women who smoked 1-9 and 10+ cigarettes per day 257 days (+/-23) and 255 days (+/-20), respectively. The overall risk of preterm delivery (< 37 weeks) and delivery before 34 completed weeks was 1.3 (95% CI 0.9-2.2) and 1.4 (95% CI 0.8-2.4), respectively. Primiparous women had shorter gestational age than did multiparous women. Still, among primiparous as well as among multiparous women gestational age decreased with smoking. Adjustment for maternal age, height and prepregnancy weight, alcohol and caffeine intake, marital status, education, occupational status, preterm birth in previous pregnancies, and in vitro fertilization in the present pregnancy did not change the results. CONCLUSIONS: Smoking has a substantial effect on mean gestational age in twin pregnancies, and a dose response like relationship is present.

Adolescent↗
PubMed2004

[Changes in smoking habits in Germany between 1985 and 2002].

Due to the great impact of smoking on health this study investigates secular trends in smoking habits in Germany between 1985 and 2002. Special emphasis is on social characteristics which are related to the pattern of the smoking habits in the general population. Data sources are four national health surveys, conducted between 1985 and 1998, and three waves of the 'Bertelsmann-Health-Monitor' in 2002 and 2003. Included from these representative cross-sectional surveys are only persons aged 25-69 years. The total number of study participants are 13,079 males and 13,732 females. Independent variables included are schooling, occupational status, household equivalent income, occupational status, family status, community size and a social risk indicator. The analysis shows convergence in the secular trend in smoking behaviour between males and females, with decreasing rates for males and increasing rates for females. Overall, no noteworthy success of preventive measures to reduce smoking in Germany can be seen. The marked social polarisation of smoking which already existed in 1985 continued. In comparison to other European countries there is a great need for enhancing activities regarding prevention of smoking by adults in Germany.

Adult↗
PubMed2004

[The development of obesity in Germany in the period from 1985 until 2000].

Due to the great increase in the prevalence of obesity in the industrialised countries during the last two decades we examined the development of this prevalence in Germany between 1985 and 2002. Data sources are four national health surveys conducted between 1985 and 1998 and three surveys of the "Bertelsmann Health Monitor" in 2002 and 2003. Included in these representative cross-sectional surveys were all persons aged 25-69 years. The total number of study participants was 12 984 males and 13 630 females. Based on recommendations of the WHO, moderate obesity is defined as body-mass-index > or = 30 and pronounced obesity as body-mass-index > or = 35. From 1985 to 2002, there was an increase in the prevalence of moderate obesity in males from 16.2 to 22.5 % and in females from 16.2 % to 23.5 %, whereas the increase in the prevalence of pronounced obesity in males was from 1.5 to 5.2 % and in females from 4.5 to 7.5 %. The most important social characteristics related to pronounced obesity prevalences are low educational status, low occupational status and low household income. Thus, the quality of future preventive measures aiming at reducing obesity prevalence among the general population should be evaluated inter alia in respect of their ability to cope with the social origins of obesity.

Adult↗
PubMed1999

Sociodemographic characteristics and drinking status as predictors of older women's health.

As part of a U.S. national survey of women's drinking and life experiences, the authors used responses from a subsample (n = 245) of women aged 55-90 years (M = 65.8 years) to examine the relationship of sociodemographic characteristics (income, marital status, and occupational status) and drinking status to several health outcomes (self-perceived general health, depression, sexual satisfaction, and sexual dysfunction). In all analyses, the authors controlled for respondent age. Results indicated that higher household income predicted greater lifetime and current sexual satisfaction with a partner as well as higher general health ratings. Women drinkers also reported better general health than did abstainers. An interaction between marital status (married or cohabitating vs. nonmarried) and employment status (employed vs. nonemployed) was a predictor of general health ratings. The authors found significant contrasts among the 4 groups when they controlled for age, income, and drinking status: (a) Among the employed respondents, the nonmarried women reported better general health than did the married women; and (b) among nonmarried respondents, the employed women reported better general health than did the nonemployed women.

Aged↗
PubMed1996

Smoking during pregnancy and preterm birth.

OBJECTIVE: To evaluate the association between smoking during pregnancy and preterm birth. DESIGN: A follow up study. SETTING: Department of Gynaecology and Obstetrics, Aarhus University Hospital, Denmark. PARTICIPANTS: Four thousand one hundred and eleven nulliparous women with singleton pregnancies who returned questionnaires about smoking habits at 16 weeks of gestation. RESULTS: The overall rate of preterm delivery was 4.3%. Smokers had a 40% higher risk of preterm birth compared with nonsmokers. A dose response relationship was found between smoking and risk of preterm birth. Adjustment for women's height, prepregnancy weight, age of the mother, marital status, education, occupational status, and alcohol intake did not change the results. Among women with an intake of less than 400 mg of caffeine per day no difference in the risk of preterm birth between smokers and nonsmokers was found. However, among women with an intake of more than 400 mg of caffeine per day, the risk of preterm birth was increased almost threefold among smokers compared with nonsmokers. Furthermore, among women with a high intake of caffeine a dose-response relationship was found; women smoking one to five cigarettes per day had no increased risk of preterm birth compared with nonsmokers with the same intake of caffeine, women smoking six to ten cigarettes per day had almost three times higher risk of preterm birth, and women smoking more than 10 cigarettes per day had almost five times higher risk of preterm birth compared with nonsmokers with the same intake of caffeine. CONCLUSIONS: Smoking increases the risk of preterm birth. The association between smoking and preterm birth was only present among women with a high intake of caffeine. However, whether smoking alone influences the risk of preterm birth among heavy consumers of caffeine needs further investigation.

Adolescent↗
PubMed1988

Eleven year follow-up of 300 young opioid addicts.

A cohort of 300 young opioid addicts (203 male and 97 female) attending the City of Copenhagen Drug Treatment Service (200) or the Nordvang Hospital (100) for first-time treatment during 1973 was personally followed up in 1980 and 1984. In both studies about 90% were traced. Outcome was classified on a four-step scale according to current drug status and occupational status. In 1984 24% of the cohort were classified in the best outcome class while 26% were dead, yielding an average mortality of 2.4% per year. Sixteen per cent were classified as substance users, including persons mostly abusing alcohol or tranquilizers. In contrast to our predictions in 1980 the number of persons achieving stable abstinence does not turn out to be steadily increasing with time. The number of active drug addicts declines mainly because they die, not because they achieve abstinence. According to more strict criteria less than 20% would be classified as truly recovered. Another 5 - 10% achieve some unstable abstinence. The long-term prognosis seems to be highly unfavourable for the study population as a whole.

Adolescent↗
PubMed1986

Drunkenness arrests: predictors of recurrence and effect of detoxication treatment.

Predictors of the recurrence of drunkenness arrests and the effect of detoxication treatment on outcome during a 12-14-month follow-up were studied among 560 arrestees. Arrestees were assigned on the basis of the last digit of their day of birth to a treatment group (odd digits) or a control group (even digits). Treatment was compulsory and consisted of a bath, rest, food and care provided by social workers, nurses and a physician at a detoxication station. In regression analysis, the number of subsequent arrests was significantly related to housing status, age, marital status and occupational status but not to treatment. Survival analyses indicated that the first and the second new arrest were significantly associated, in addition to the above-mentioned predictors, with sex but not with treatment. Relative risks between selected categories of predictor variables, estimated using Cox's proportional hazard models, varied between 1.2 and 2.5. Compulsory detoxication does not decrease the recurrence of drunkenness arrests.

Accidents, Traffic↗
PubMed1998

[Smoking during pregnancy and preterm delivery].

The purpose of the study was to evaluate the association between smoking during pregnancy and preterm birth. The overall rate of preterm delivery was 4.3%. Smokers had a 40% higher risk of preterm birth compared to non-smokers. A dose response relationship was found between smoking and risk of preterm birth. Adjustment for women's height, pre-pregnant weight, age of the mother, marital status, education, occupational status, and alcohol intake did not change the results. Among women with an intake of less than 400 mg of caffeine per day no difference in the risk of preterm birth between smokers and non-smokers was found. However, among women with an intake of more than 400 mg of caffeine per day, the risk of preterm birth was increased almost threefold among smokers compared to non-smokers. Furthermore, among women with a high intake of caffeine a dose response relationship was found between smoking and risk of preterm delivery.

Adolescent↗
PubMed1995

Do socio-economic status, marital status and occupation influence the prevalence of Helicobacter pylori infection?

AIMS: To review the influence of three factors on the prevalence of Helicobacter pylori infection: socio-economic status, marital status and occupation. METHODS: MEDLINE searches were performed using the Medical Subject Headings: Helicobacter pylori and socio-economic status, couples, children, transmission and occupation. All relevant articles were reviewed and scrutinized for further references. CONCLUSIONS: Lower socio-economic status and/or a low level of education are associated with an increase in the prevalence of H. pylori infection. There is no evidence that H. pylori is sexually transmitted and cohabitation among adult individuals is not a risk factor for transmission. A few studies suggest that the presence of (young) children may be required for spread within families. Data on occupational risk of H. pylori infection are sparse. Gastroenterologists and other health care workers may be at increased risk but the data are not conclusive.

Adult↗
PubMed1995

Work and family roles in relation to women's well-being: a longitudinal study.

Previous research on women has focused on the influence of the overall work- or family-role experiences rather than on the specific characteristics of each role. Using multidimensional measures of work- and family-role experiences, this study first examined (Time 1) the additive cumulative contributions of role experiences in the prediction of women's well-being (happiness and symptoms of psychological distress). While work overload significantly predicted distress at Time 2, none of the family-role variables were related to well-being. Second, as the sample was made up of two groups of women who differed in occupational status (secretaries and professional women), it was possible that the effects of overload on distress might be conditioned by occupational status. The group X overload interaction term was found to be highly significant (p < .007); high occupational status moderated the negative effects of work overload. By contrast, secretaries were adversely affected by work overload. These results are discussed in relation to the existing literature, with reference to women's work and family roles in relation to well-being, and the effects of occupational status on health outcomes.

Adult↗
PubMed2005

Occupation, marital status, and low-grade inflammation: mutual confounding or independent cardiovascular risk factors?

OBJECTIVE: We explored the relationships between inflammatory proteins, occupation, and marital status, and their independent associations with incidence of cardiovascular disease (CVD). METHODS AND RESULTS: Five inflammation-sensitive proteins (ISPs) (fibrinogen, ceruloplasmin, haptoglobin, alpha1-antitrypsin, orosomucoid) were measured in 6075 apparently healthy men. Incidence of coronary events and stroke was followed over 18 years in relation to occupation and marital status. All ISPs showed higher concentrations in divorced men and in manual workers. Except for fibrinogen, this remained significant after adjustments for confounding factors. Adjusted for traditional cardiovascular risk factors, incidence of coronary events was significantly increased in unskilled manual workers and in divorced men. The relative risks were slightly reduced after further adjustments for ISPs (from 1.79 to 1.70 in unskilled manual workers; from 1.58 to 1.51 in divorced men). All ISPs were significantly associated with incidence of coronary events, after adjustments for traditional risk factors. This relationship was essentially unchanged after further adjustments for occupation and marital status. CONCLUSIONS: Inflammation could contribute to, but not fully explain, the increased cardiovascular risk in manual workers and divorced men. Although the ISPs vary greatly by occupational and marital status, this does not confound the relationship between ISPs and incidence of CVD.

Adult↗
PubMedDate not supplied

Age and occupational activity status of 45-59-year-old Danes from 1984 to 1994.

Analyses of the occupational activity of the 45-59-year-old Danes in the 10-year period 1984-1994 show that the decrease in occupational activity status is marked for women at the age of 50 and for men about 5 years later. Moreover, it is not possible to detect an increase in the occupational activity, as far as the employment rate is concerned, of the 45-59-year-olds during the same 10-year period.

Adolescent↗
PubMed1999

Transitions and inequalities in acute myocardial infarction mortality in New South Wales, 1969-94.

OBJECTIVE: To chart the transition in myocardial infarction mortality in NSW between 1969 and 1994 and to determine whether spatial, marital and occupational status differentials increased over time, despite overall mortality decline. METHOD: The study was undertaken in NSW for the 25-year period from 1969 when mortality from ischaemic heart disease declined. The demographic and spatial analysis involved descriptive epidemiology and utilised the unit list mortality files of the Australian Bureau of Statistics which are based on detailed death certificate information. RESULTS: Spatial, marital and occupational status differentials in myocardial infarction mortality increased over time, more especially variations by occupational status, inland/metropolitan differences, and married/divorced or widowed variation. Spatial variations in mortality were not simply the result of occupational status differences as mortality from white collar groups was also elevated in inland areas. Spatial variation in mortality was not diluted due to the impact of immigration. CONCLUSIONS: Particular subgroups of people remained at risk and it is likely that differential access to ambulance services and travel time contribute, more particularly in inland rural areas. IMPLICATIONS: Groups at risk need to be more precisely targeted for preventative measures and public health initiatives, with particular implications for groups in inland rural areas, the Hunter Region, and outer lower income areas of Sydney.

Adult↗