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PubMedDate not supplied

Secular shift in menarcheal age of Patiala (India) schoolgirls between 1974 and 1986.

The secular shift between 1974 and 1986 in the menarcheal age of Patiala schoolgirls has been explored. A total of 946 girls of higher and lower social classes (type of school being the criterion) were surveyed, out of which 421 were menstruating at the time of investigations. The median ages at menarche (by probits) of higher social class girls were 12.90 +/- 0.64 years in 1974 and 12.54 +/- 0.13 years in 1986, and of lower social class girls 14.40 +/- 0.47 years in 1974 and 13.65 +/- 0.18 years in 1986. The secular shift per decade in higher and lower social class girls is 0.30 years and 0.63 years, respectively. The social class differences during this period in menarcheal age have decreased.

Adolescent↗
PubMed2001

Ethnic and class differences in health in relation to British South Asians: using the new National Statistics Socio-Economic Classification.

The paper examines the use of the new measure of social class in the UK, the National Statistics Socio-Economic Classification (NS-SEC) and other socio-economic variables in explaining differences in health between British South Asians and the majority White population. There are a number of hypotheses which try to explain ethnic differences in health and yet there have been relatively few empirical studies which test the explanatory value of these hypotheses. Cross sectional data from the fourth National Survey of Ethnic Minorities (1993-1994) with 2860 white, 1268 Indian and 1771 Pakistani and Bangladeshi adult respondents are analysed. The associations of self-rated health with ethnicity, social class, local area deprivation and standard of living are analysed. Pakistani and Bangladeshi respondents have the poorest self-rated health, followed by Indians. Differences in self-rated health between ethnic groups reduce to non-significance after adjusting for social class, local area deprivation and standard of living. There is some evidence of social class differences in the health of Indians and not much evidence for Pakistanis and Bangladeshis. The NS-SEC is useful in explaining ethnic differences in health. The poorer health of Indians, Pakistanis and Bangladeshis compared to Whites may be largely understood in terms of factors related to occupational social class, material living conditions and local area deprivation.

Bangladesh↗
PubMed1999

Education, socioeconomic status and risk of cancer of the colon and rectum.

BACKGROUND: Socioeconomic correlates of cancer of the large bowel differ in various countries and calendar periods and may differ for the colon and rectum. Thus, the relationship between education and social class and risk of cancers of the colon and rectum was considered. METHODS: Combination of two hospital-based case-control studies conducted in six Italian centres between 1985 and 1996. Cases were 3533 patients aged < 79, with histologically confirmed cancer of the colon (n = 2180) or rectum (n = 1353), and controls were 7062 patients admitted to hospital for a wide spectrum of acute, non-neoplastic, non-digestive tract diseases. RESULTS: Compared to individuals with < 7 years of education the multivariate odds ratios (OR) of colon cancer for those with > or = 16 years were 2.45 (95% confidence interval [CI]: 1.87-3.23) in men and 1.29 (95% CI: 0.88-1.90) in women, with significant trends in risk. No significant association emerged between education and risk of rectal cancer, with OR of 1.18 (95% CI: 0.83-1.70) and 1.01 (95% CI: 0.61-1.67) respectively for men and women in the highest educational category compared to the lowest. Social class was also related to colon cancer risk: the OR were 2.30 (95% CI: 1.82-2.90) in men and 1.33 (95% CI: 1.03-1.73) in women in the highest versus the lowest social class. No association was found between social class and rectal cancer risk, with OR of 1.18 for either men or women in the highest as compared to the lowest social class. No significant heterogeneity was found for the association between education and colon cancer risk in either sex across strata of age at diagnosis, coffee, alcohol and vegetable intake, family history of the disease, and in anatomical subsites within the colon. CONCLUSION: This study, based on a uniquely large dataset, indicates that there are different social class correlates for colon and rectal cancer. Consequently the two sites should not be combined in studies considering lifestyle factors in the aetiology of these neoplasms.

Adult↗
PubMed1984

Equity and consultation rates in general practice.

An attempt was made to distinguish different types of consultations and their variation by social class by a secondary analysis of the second national morbidity survey in general practice. The greatest difference in consultation rates, comparing patients in social classes IV and V with those in classes I and II, was for life threatening, urgent, chronic, or incapacitating conditions, thus matching the presumed difference in need. For more trivial conditions and for symptoms not specifically diagnosed the difference between social classes was less, and for married women in various ways consultation rates suggested less care seeking by patients in the lower social classes. The different uses made of primary care is more illuminating and more relevant to the question of equality in use of services than crude overall consulting rates by social class.

Adolescent↗
PubMedDate not supplied

Factors other than risks in the workplace as determinants of socioeconomic differences in health in Italy.

To evaluate differences in mortality by social class and to determine the impacts of socioeconomic factors on health inequalities in Italy, mortality data from 1981-2001 were analyzed as a function of social class in Turin, controlling for occupational risks, housing conditions, and education. For general and cause-specific mortality, the weight of each socioeconomic indicator was evaluated on population-attributable fraction to social class. Among men, mortality risk was significantly higher in unskilled blue-collar workers (RR = 1.45). Among women, the differences by social class were slighter. Education and economic status mostly explain the mortality differences by social class in men, while economic status showed the highest contribution in women.

Adolescent↗
PubMedDate not supplied

HIV and hepatitis B seroprevalence in trauma patients in North Central Nigeria.

BACKGROUND: With the high prevalence rate of HIV and Hepatitis B virus infections in sub-Saharan Africa, infected surgical patients, especially those with fresh open wounds, pose significant danger of occupationally-acquired infections to health workers. METHOD: A two-year double blind study aimed at determining the seroprevalence rates of HIV and Hepatitis B virus infections among trauma patients with fresh open wounds in North Central Nigeria. RESULTS: There were 134 patients with fresh open wounds in this study; their ages ranged between 17-80 years with a mean of 30.9 +/-9.6 years and the male:female ratio was 5:1. All the patients were tested for both HIV and Hepatitis B virus infections. Six(4.5%) patients were positive for HIV-1 while 95(70.9%) patients were positive for Hepatitis B. In all, 3(2.2%) male and 3(2.2%) female patients tested positive for HIV-1 while 77(57.4%) males and 18(13.4%) females tested positive for Hepatitis B; 5(3.7%) patients tested positive for both HIV and Hepatitis B. Though every social class was represented, HIV infection rate was higher in Social Class V than in Social Class 1 but the class incidence rate for Hepatitis B was about the same ranging between 1.2 and 1.6 for both the upper and lower classes. The significance of this study was that the incidence of Hepatitis B virus infection in trauma patients was remarkably higher than the incidence of HIV infection. The implication is that emphasis on control of exposure of health care workers to blood borne infections in the workplace should be as strong for Hepatitis B virus infection as it is for HIV. CONCLUSION: The main finding of this study was the determination of the seroprevalence of HIV and Hepatitis B virus infections in trauma patients with open wounds which underpinned the dangers they pose to health care workers.

Adolescent↗
PubMed1990

Sugar consumption in 5 and 12-year-old school children in Ondo State, Nigeria in 1985.

In a previous study (Olojugba & Lennon, 1987) of 5 and 12-year-old children residing in Ondo State, Nigeria, it was shown that caries had increased (1977 to 1983) in children of both age groups in higher social class families; caries had also increased in the 12-year-old children but not in those aged 5 year olds among lower social class families. The object of the present study was to examine sugar consumption in samples of children of the same age groups drawn from the same population. One hundred families with siblings in both age groups were selected. 24-hour dietary records were obtained for each child; an inventory was also made of all food and drink stored within the home. The 5-year-old children from the higher social class families had 5.9 sugar intakes, as against 1.5 intakes among their lower social class urban counterparts. All the sugar-containing items were consumed by the 5-year-old children at home. The difference in the frequency of intake among those aged 12 years was much less obvious, 4.9 and 4.2 intakes respectively. Sixty-eight per cent of the intakes among the lower social class 12-year-old children was in the form of cheap sugar-containing drinks, ice lollies and sweets which they bought themselves and consumed away from home. These cheap sources of sugar were not available to their younger siblings. It was concluded that the sugar consumption patterns recorded in the children, and confirmed by the household food inventory, provided a plausible explanation of the previously reported changes in caries severity.

Adolescent↗
PubMed2001

Birthweight and behavioural problems in children: a modifiable effect?

BACKGROUND: Low birthweight has been shown to predict behavioural problems in children. Less is known about the effect of birthweight, and how this may interact with the social environment in determining behaviour in a general population sample. We have examined the relationship between birthweight and social factors on childhood psychological well-being. METHODS: Cross-sectional analysis of data on 5181 children aged 4-15 years from a randomly selected household population, the 1997 Health Survey for England. The main outcome measures were behavioural problems as defined by the Strengths and Difficulties Questionnaire (SDQ) in relation to birthweight and social environmental factors. RESULTS: Birthweight was a significant predictor of total difficulties score (odds ratio [OR] = 1.27, 95% CI : 1.07, 1.49), hyperactivity in boys (OR = 1.25, 95% CI : 1.05, 1.51), and peer problems in girls (OR = 1.24, 95% CI : 0.99, 1.53). There was a strong social class gradient in the prevalence of behavioural problems for all birthweight tertiles. Bivariate analysis showed that high total difficulties score was significantly more common in lower birthweight tertiles for social classes III non-manual and III manual (P:-value for trend 0.05 and 0.03, respectively). There were smaller, non-significant effects of birthweight on the prevalence of behavioural problems in social class I and II, and IV and V. Statistical tests for an interaction between birthweight and social class were not significant. CONCLUSIONS: Early life factors, such as birthweight and social class have important influences on psychological well-being in children. The birthweight effect is influenced by social factors, with the possibility that an advantaged social environment protects against the development of behavioural problems, and a disadvantaged environment increases the risk of behavioural problems, regardless of birthweight.

Adolescent↗
PubMed1993

Epidemiological approach to the explanation of social differentiation in mortality: the Whitehall studies.

A consistent feature of mortality statistics in England and Wales are the social class differences which have even widened in the decade from 1971 to 1981. Two large studies of British Civil Servants, the Whitehall and Whitehall II studies, add to the understanding of social class differences in mortality and morbidity. Some of their results are presented to illustrate current concepts of social class differences in health. There is no evidence for an effect of health selection. The magnitude of social class differences vary for different causes of death, presumably as a sign of the effect of specific factors for specific disease. The observation that social class differences apply to most causes of death, however, suggest that factors like early life experience, difference in behaviour, material and psychosocial conditions act in an unspecific way.

Adult↗
PubMed1990

Social determinants of nutrient intake in smokers and non-smokers during pregnancy.

STUDY OBJECTIVE: The aim was to investigate the effects of social factors (education, income, marital status, partners' employment status, housing tenure, social class), smoking, and maternal height on the dietary intake of pregnant women. DESIGN: The study was a prospective investigation on a two phase sample. SETTING: The study involved women attending the antenatal clinic at a district general hospital. PATIENTS: A group of pregnant Caucasian women, selected because they were heavy smokers (15+ cigarettes/day) (n = 94) and a randomly selected sample of never smokers (n = 112) were studied. MEASUREMENTS AND MAIN RESULTS: Data on social factors were collected by interviewer administered questionnaire. A 7 day weighed intake method was used to determine dietary intake at 28 weeks gestation. In univariate analyses, income, housing tenure and social class had significant effects on intakes of both macro- and micronutrients, and maternal education and smoking had significant effects on intakes of micronutrients. Using a stepwise multivariate analysis with income, smoking and maternal education, income was a significant factor in the intake of most nutrients but this effect disappeared when social class and housing tenure factors were entered into the model. Only social class and housing tenure had any significant effect on intakes of macronutrients--energy, protein and fat. Smoking and maternal education were the most important determinants of quality of diet (nutrient density); other factors had only negligible effects. Income was the only significant factor in alcohol intake. It is suggested that the effects of social class and income are overlapping. CONCLUSIONS: Smoking, being renters of accommodation, and being of minimum education and low social class are risk factors for poor dietary intake. It is recommended that such higher risk groups be specifically targeted for nutritional advice in pregnancy.

Body Weight↗
PubMed2000

The quality of care and influence of double health care coverage in Catalonia (Spain).

AIMS: To analyse inequalities by social class in children's access to and utilisation of health services in Catalonia (Spain), private health insurance coverage, and certain aspects of the quality of care received. DESIGN: Cross sectional study using data from the 1994 Catalan Health Interview Survey. SETTING: Child population of Catalonia. PARTICIPANTS: A representative sample of non-institutionalised children younger than 15 years (n = 2433). MAIN OUTCOME MEASURES: Health services utilisation, perceived health, type of health insurance (only National Health System (NHS) or both NHS and private health insurance), and social class. RESULTS: No inequalities by social class were found for the utilisation of health care services provided by the NHS among children in most need. Double health care coverage does not influence the social pattern of visits. Nevertheless, social inequalities still remain in the use of those health services provided only partially by the NHS (dentist) and when characteristics of the last consultation are taken into account. That is, subjects who paid for a private service waited an average of 14.8 minutes less than those whose visit was paid for by the NHS only. CONCLUSION: Equitable access and use of medical care services in relation to need, regardless of the type of insurance and social class of their children and families, has been achieved in this region of Spain; differences by social class remain for those services incompletely covered by national health insurance and aspects of the quality of care provided.

Adolescent↗
PubMed1993

[Social inequalities as a risk of ischemic heart disease--a matter of smoking habits? 17 years' follow-up in the Copenhagen Male Study].

The Copenhagen Male Study is a prospective, cardiovascular cohort study initiated in 1970 and consisting of 5249 employed men aged from 40 to 59 years. A total of 4710 men, who had reported their tobacco habits and were initially free of ischaemic heart disease (IHD), had their mortality and morbidity recorded over a 17-year period: 585 men suffered a first incident of ischaemic heart disease, and 248 cases were fatal. There was a strong social gradient in the risk of IHD, Kendall's Tau B = 0.12, p < 0.001. After adjusting for age, blood pressure, physical activity, body mass index and alcohol consumption in a multiple logistic regression equation, men in the lowest social class had a relative risk (95% confidence interval) of IHD of: RR = 3.6 (2.5- 5.3) compared to men in the highest social class. We determined whether differences in smoking habits could explain at least some of this large increase in risk. Adjusting for the above factors as well as the form of tobacco smoked, the amount of tobacco smoked and presence or absence of inhalation had very little effect on the estimate: the relative risk was 3.5 (2.4-5.2). There was no social gradient in age at the start of smoking. When comparing social class V to social class I according to smoking habits, the relative risk was 7.7 (2.6-22.4) in cigarette smokers, 6.0 (1.1-32.1) in pipe smokers, 3.5 (1.7-7.1) in mixed smokers, 2.25 (0.4-12.9) in cheroot smokers, 3.8 (2.4-5.9) in all smokers, 1.95 (0.8-4.6) in exsmokers and 4.7 (1.01-22.2) in never smokers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Like parent like child? Associations between drinking and smoking behaviour of parents and their children.

This paper examines the association between the smoking and drinking behaviours of parents and their adolescent children, and the effect of gender and social class upon this association. It is based on data collected from a cohort of young people and their parents, resident in the west of Scotland. Both social class and parental smoking behaviour were independently associated with young people's smoking, with young people from lower social class households or whose parents smoked being most likely to smoke. Social class and gender were independently associated with young people's drinking, with males and young people from non-manual households being most likely to drink. Parental drinking behaviour was associated positively with young people's drinking only in non-manual classes and among daughters. We conclude that it is important to take social class and gender into account since it may influence whether or not there is an association between the behaviour of young people and that of their parents, and it may influence young people's behaviour in addition to influences from parental behaviour.

Adolescent↗
PubMed2005

Lifecourse study of bone health at age 49-51 years: the Newcastle thousand families cohort study.

OBJECTIVE: To quantify the direct and indirect effects of fetal (position in family, weight, and social class at birth), childhood (breast feeding, growth, infections, and social class in childhood, age at menarche), and adult life (social class, alcohol consumption, smoking, diet, reproductive history, exercise, hormone replacement therapy use), and adult size (height, weight) on bone health at age 49-51 years, as measured by bone mineral density, total scanned bone area of the hip and lumbar spine, and femoral neck shaft angle. DESIGN: Follow up study of the Newcastle thousand families birth cohort established in 1947. PARTICIPANTS: 171 men and 218 women who attended for dual energy x ray absorptiometry scanning. MAIN RESULTS: Fetal life explained around 6% of variation in adult bone mineral density for men, but accounted for less than 1% for women. Adult lifestyle, including effects mediated through adult weight accounted for over 10% of variation in density for men and around 6% for women. Almost half of variation in bone area for men was explained by early life. However, most of this was mediated through achieved adult height and weight. In women, less than 5% of variation in bone area was accounted for by early life, after adjusting for adult size. Most of the variation in each of the indicators for both sexes was contributed either directly or indirectly by adult lifestyle and achieved adult height and weight. CONCLUSIONS: The effect of fetal life on bone health in adulthood seems to be mediated through achieved adult height.

Absorptiometry, Photon↗
PubMedDate not supplied

Socioeconomic status is associated with nocturnal blood pressure dipping.

OBJECTIVE: With the advent of ambulatory blood pressure monitoring has come the awareness that blood pressure (BP) normally drops, or "dips," at night by roughly 10%. A number of pathological conditions have been associated with the nondipping of nocturnal BP. In general, researchers have looked at dipping in neurological and cardiovascular disorders. We examined the extent to which nocturnal nondipping might be influenced by relatively gross measures of social environment. METHODS: This study examined 78 healthy adults and adults with mild hypertension who were not currently receiving medication, aged 25 to 52 years (mean age = 38.2). Forty-two participants self-identified as black and 36 identified as white. RESULTS: Age, body mass index, apnea-hypopnea index, screening BP, ethnicity, and socioeconomic status (SES) were significantly associated with nocturnal BP dipping, accounting for 41% of the variance in dipping (F[6,51] = 5.473, p <.001). When SES was entered on the last step of a hierarchical regression analysis, it independently accounted for 8% of the variance in dipping, even after accounting for ethnicity, such that the lower the SES, the more the nondipping. CONCLUSION: It remains to be seen what aspect of the social environment may be driving this association between nondipping and lower social class. However, investigators might consider including social class in their models in future studies.

Adult↗
PubMed1974

[The problem of cyclic basic structure of neurotic disorders].

The working hypothesis could be confirmed that a nuclear syndrome (Basis-syndrom) consisting of alterations in drive and mood as well as in autonomic activation, possibly contributing to neurotic disorders, is independent of such factors as sex, education, premorbid personality, duration of illness, age at onset of the illness, social mobility during the illness, number of pregnancies, family history, occupation, marital state, social class compared with that of parents, social contacts, or past physical illnesses. It was shown in a sample of 50 neurotic outpatients that the factor 'past illnesses' influenced the number of vegetative sumptoms prior to therapy. The effect of psychotherapy on psychic and vegetative disturbances was greater in women with children, i.e., not in occupations. In patients whose social class was not changed during the illness, the number of vegetative symptoms diminished more than in the others. In all the other cases, improvement was not related to the factors mentioned. This can be interpreted as supporting the hypothesis.

Adolescent↗
PubMed1984

Influence of patient characteristics on test ordering in general practice.

Information regarding all consultations was collected in seven general practices for one year. From these data we report on the use of laboratory tests and its association with patient characteristics--including social class, age, sex, and diagnosis--and with which doctor was consulted. Most of the requests were for technically simple tests of low cost. There was a noticeable variation in the use of tests with regard to all patient characteristics. Diagnosis, identity of doctor, age of patient, and social class were each shown by multivariate techniques to be independently related to use of tests. Whereas fewer tests were used per consultation for social classes III-V compared with other social classes, more were used per patient per year for these same groups, reflecting in part the higher consultation rates of social classes III-V. Variation in diagnoses fully accounted for the greater test ordering for women. Nearly two thirds of all tests were ordered for 10% of all patients who consulted and 7% of all registered patients. The results of our analysis suggest that this concentration is determined primarily by those patient characteristics most indicative of medical need and by which doctor is providing care.

Adolescent↗
PubMed1995

Relationships between socioeconomic status and drinking problems among black and white men.

We sought to examine the relationships between socioeconomic status and drinking problems within the Black and White male populations. A two-way interactions of social class with race/ethnicity, and with drinking consequences and alcohol dependence symptoms was hypothesized among drinkers. Drinking problems were regressed on social class, race/ethnicity, age, alcohol consumption, and drinking settings. Social class was based on a composite of respondent's income, education, and main wage earner's occupation. Two types of drinking problems were analyzed: drinking consequences and alcohol dependence symptoms. Our hypothesis was partially confirmed. Interactions of social class with race/ethnicity and with drinking problems were observed. Less affluent Black men reported greater numbers of drinking consequences and total drinking problems than less affluent White men; the reverse was true for affluent Black and White men. Results suggest that the relationships between socioeconomic status and drinking problems may vary by race/ethnicity.

Adult↗