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PubMed1996

DMFT and treatment needs in adult population of Oviedo, Spain.

An epidemiological survey was carried out in 1992 researching dental caries and treatment needs in an adult population in Oviedo, Spain. A representative sample of 261 subjects, randomly obtained and stratified by age, was examined. Results show a dental decay prevalence of 99.6%; 12.5 DMFT index with 2.9, 7.5 and 2.1 mean values for D, M and F components. Women and the lower social class showed the highest DMFT index. Treatment needs reach a mean value of 12.1 teeth per person. Pontics are the most needed treatment, the mean value increases with age while the differences among age groups and social classes are statistically significant. The next most needed dental treatment is filling of one surface which decreases with age, is the same for men and women and higher among the middle social class; the differences are statistically significant among the social classes.

Adult↗
PubMed2002

Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study.

OBJECTIVES: To examine the combined effect of social class and weight at birth on cognitive trajectories during school age and the associations between birth weight and educational outcomes through to 33 years. DESIGN: Longitudinal, population based, birth cohort study. PARTICIPANTS: 10 845 males and females born during 3-9 March 1958 with information on birth weight, social class, and cognitive tests. MAIN OUTCOME MEASURES: Reading, maths, draw a man, copying designs, verbal and non-verbal ability tests at ages 7, 11, and 16, highest qualifications achieved by 33, and trajectories of maths standardised scores at 7-16 years. RESULTS: The outcome of all childhood cognitive tests and educational achievements improved significantly with increasing birth weight. Analysis of maths scores at 7 and of highest qualifications achieved by 33 showed that the relations were robust to adjustment for potential confounding factors. For each kilogram increase in birth weight, maths z score increased by 0.17 (adjusted estimate 0.15, 95% confidence interval 0.10 to 0.21) for males and 0.21 (0.20, 0.14 to 0.25) for females. Trajectories of maths z scores between 7 and 16 years diverged for different social class groups: participants from classes I and II increased their relative position on the score with increasing age, whereas classes IV and V showed a relative decline with increasing age. Birth weight explained much less of the variation in cognition than did social class (range 0.5-1.5% v 2.9-12.5%). CONCLUSIONS: The postnatal environment has an overwhelming influence on cognitive function through to early adulthood, but these strong effects do not explain the weaker but independent association with birth weight.

Adolescent↗
PubMedDate not supplied

Caretaking in the first year of life: the role of fathers, and mothers' social isolation.

Data are presented from a follow-up study of some 80 normal first or second born children on the extent of father participation childrearing. Though at both 30 and 60 weeks most fathers played regularly with their children, only a minority regularly undertook care-taking activities. Fathers were more participant at 60 weeks than 30 weeks especially with their daughters. No clear social class differences were found. The number of visitors to the home and excursions by mothers showed that social isolation during the day was quite widespread. Social class I and II families were less likely to have relatives in the neighbourhood and so received fewer visits and went out less often. Mothers going out without children showed less marked social class differences. Mothers of children who woke regularly at night and showed more 'difficult' behaviour went out without their children less often than the mothers of children not classified in this way.

Father-Child Relations↗
PubMed1991

Social differences in low birthweight and preterm deliveries in twins.

The relationship between low social class and low birthweight or preterm deliveries is well established in singletons but not in twins. We present a study using all twin deliveries registered in Belgium in 1983 and in Aberdeen between 1951 and 1983. No significant relationship was found between social class and low birthweight, very low birthweight or preterm deliveries in the Belgian sample. In Aberdeen, we found significantly higher rates of low birthweight twins in low social classes. This increase of low birthweight twins in low social classes occurred in Aberdeen during the period 1951-1968, but not in the more recent data.

Belgium↗
PubMed1996

Inequalities in self rated health in the 1958 birth cohort: lifetime social circumstances or social mobility?

OBJECTIVE: To investigate explanations for social inequalities in health with respect to health related social mobility and cumulative socioeconomic circumstances over the first three decades of life. DESIGN: Longitudinal follow up. SETTING: Great Britain. SUBJECTS: Data from the 1958 birth cohort study (all children born in England, Wales, and Scotland during 3-9 March 1958) were used, from the original birth survey and from sweeps at 16, 23, and 33 years. MAIN OUTCOME MEASURES: Subjects' own ratings of their health; social differences in self rated health at age 33. RESULTS: Social mobility varied by health status, with those reporting poor health at age 23 having higher odds of downward mobility than of staying in same social class. Men with poor health were also less likely to be upwardly mobile. Prevalence of poor health at age 33 increased with decreasing social class: from 8.5% in classes I and II to 17.7% in classes IV and V among men, and from 9.4% to 18.8% among women. These social differences remained significant after adjustment for effects of social mobility. Health inequalities attenuated when adjusted for social class at birth, at age 16, or at 23 or for self rated health at age 23. When adjusted for all these variables simultaneously, social differences in self rated health at age 33 were substantially reduced and no longer significant. CONCLUSIONS: Lifetime socioeconomic circumstances accounted for inequalities in self reported health at age 33, while social mobility did not have a major effect on health inequalities.

Adolescent↗
PubMed2005

Effect of grandparent's and parent's socioeconomic position on mortality among Danish men born in 1953.

BACKGROUND: The adverse effect on health of poor social circumstances might accumulate not only over the lifespan of the individual but also across generations. This study examines the effect of parent's and grandparent's socioeconomic position on all-cause mortality of their adult offspring. METHODS: 2890 males born in the metropolitan area of Copenhagen, Denmark in 1953, whose mothers were interviewed for information on family social background in 1968, were followed from 1968 to 2002 for information on vital status by record linkage to the Civil Registration System. The data were analysed using Cox regression models. RESULTS: All-cause mortality from age 15 to 49 years increased 25% [95% confidence interval (CI) 13-39%] for each number of parents or grandparents from working or unknown occupational social class. Offspring mortality decreased with the number of ancestors with a secondary school education hazard ratio [HR = 0.84 (95% CI 0.76-0.93)]. When the cumulative measures of ancestor's occupation and education were included in the same model, the estimates for the effect of occupational social class [HR = 1.19 (95% CI 1.06-1.34)] and education [HR = 0.91 (95% CI 0.80-1.03)] both attenuated. These relations only changed slightly when subject's own occupational class at age 22 years was taken into account. CONCLUSION: The adverse health effects of disadvantaged social circumstances accumulate not only over an individual's lifespan but also across generations. Cumulated occupational social class of ancestors seems to be an independent predictor of mortality in adult life after adjustment for subject's own social class at age 22 years.

Denmark↗
PubMed1996

Relationship between serum ferritin, alcohol intake, and social status in 2235 Danish men and women.

The objective was to examine the relationships between serum ferritin, alcohol intake, and socioeconomic factors (school education, occupational education, occupation, income, marital status, cohabitation status, housing, social class) in a population survey performed in Copenhagen County during 1982-1984. The participants were selected at random from the census register and comprised 2235 healthy Danish individuals, non-blood donors (1044 men, 1191 women) in cohorts being 30, 40, 50, and 60 years old. The participants gave a detailed social and medical history and had a clinical examination including blood samples. In all age-groups, men had significantly higher serum ferritin and alcohol intake than women. In men, there was no relationship between serum ferritin and social class. Significant relationships were observed between ferritin and occupation (unemployed and self-employed men had higher ferritin than those with other occupations) and ferritin and income (in younger men, ferritin displayed a steady increase with income). None of the social variables were related to the prevalence of iron deficiency or iron overload. Alcohol intake was related to occupation and income, but not to social class. In women, none of the social variables showed any significant relationship to ferritin levels or iron overload. The prevalence of small iron stores (serum ferritin < or = 30 micrograms/l) was lower and the intake of alcohol was higher in women from high social classes. In both men and women, serum ferritin displayed highly significant positive correlations with alcohol intake. Likewise, the prevalence of iron overload (serum ferritin > 90th percentile) was closely correlated to alcohol intake. In conclusion, socioeconomic factors per se had a minor influence on serum ferritin levels and iron status in Danes. The distinct association between alcohol intake and serum ferritin levels should be considered in future iron status surveys.

Adult↗
PubMed2005

Are there socioeconomic differences in responses to a commonly used self report measure of chronic illness?

BACKGROUND: Single questions on self-reported morbidity are commonly used in social or health surveys. It has been suggested that these may underestimate socioeconomic gradients in health because more disadvantaged social groups may have higher thresholds for defining illness. Method Face-to-face interviews by research nurses with community-based respondents in the West of Scotland, using a specially designed suite of prompts following up on responses to the UK General Household Survey (GHS) long-standing illness question. Participants were 858 respondents born in the early 1930s and 852 respondents born in the early 1950s (mean age at interview 59 and 40, respectively) classified by occupational social class and area deprivation. RESULTS: Adjusted for age and sex, the Relative Index of Inequality (RII) for reporting any condition in response to the GHS question was 2.14 (95% CIs 1.49-3.08) for social class and 2.01 (1.41-2.87) for Depcat. Among those not reporting any conditions to the GHS question, the RII for reporting conditions to any further prompts was 1.54 (0.87-2.70) for social class and 0.86 (0.50-1.46) for Depcat. The RIIs for reporting any condition after the initial question and all prompts were 2.16 (1.40-3.33) for social class and 1.50 (0.98-2.29) for Depcat. Across a range of conditions defined as more serious, and conditions classified by different ICD categories, socioeconomic status (SES) gradients after the initial question and all prompts were similar to, or less steep than, those produced by the GHS question alone. CONCLUSIONS: These data do not support the hypothesis that poorer social groups are more stoical and more likely to need detailed prompting in order to elicit morbidity. Nor do they support the hypothesis that SES gradients in morbidity are underestimated by using the GHS question rather than more detailed questioning. This suggests that responses to this type of question can be used in epidemiology and health needs assessment without major socioeconomic bias.

Adult↗
PubMed1980

The Cardiff cervical cytology study. Enumeration and definition of population and initial acceptance rates.

The Cardiff Cervical Cytology Study began in 1965. Its primary aim was to evaluate screening for neoplasia of the cervix uteri. The study population was all ever-married women, aged 25--69, resident within the Cardiff City area. The basic objective was that all such women should be screened three times. The population was enumerated by house-to-house visiting of the entire city and a register of eligible women was compiled. The first round of visiting finished early in 1971. The defined population numbered 70 869, of whom 45 915 (65%) had had one or more tests. The method of defining the population is described and details are given of the initial response rates in respect of the major demographic factors. The response rate varied with age and with social class. It declined from 92% in the age group 25--29 to 26% in the age group 65--69, and from 81% in Social Class I to 52% in Social Class V. The response was 5% to 10% lower among widowed, divorced, and separated women than among married women but was independent of age at first marriage and age at first pregnancy. Nulliparae showed a lower response rate than multiparae.

Adult↗
PubMed1997

[Influence of paid work on the perceived health state in women].

BACKGROUND: Several studies show that paid work has a positive effect on women's health, although few studies have shown this relationship in Southern-European countries. The aim of this paper was to analyze the self-perceived health status of women of Barcelona, Spain according to their type of work (homemaker or worker). PATIENTS AND METHODS: Cross sectional study using the 1992 Barcelona Health Interview Survey data. SUBJECTS: 1194 women aged 25 to 64 years old. Bivariate analysis of women's perceived health status by all other variables. A logistic regression model was performed with the dependent variable being women's self-perceived health status and the independent variables: type of work (homemaker or worker), age, number of chronic diseases, medical care visits, children under 12 years and elderly over 65 years living at home and social class based on occupation. RESULTS: 15.8% of workers and 31.4% of homemakers reported poor self-perceived health status (p < 0.05). This same distribution was maintained when adjusting for all independent variables. Social class had an important relationship with health, with women from lower social classes reporting poorer self-perceived health status than homemakers from upper social classes. CONCLUSIONS: The 1992 Barcelona Health Interview Survey analysis confirms that in Barcelona as well, paid work has a positive relationship on women's self-perceived health status.

Adult↗
PubMed1998

[The correlation between serum ferritin, alcohol consumption and social status in a population of 2235 Danes].

The objective was to examine the relationships between serum ferritin, alcohol consumption and sociodemographic factors (school education, occupational education, occupation, income, marital status, cohabituary status, housing, social class) in a survey performed in Copenhagen County during 1982-1984. The participants, selected at random, comprised 2235 Danish Caucasian individuals, all non-blood-donors (1044 men, 1191 non-pregnant women) in cohorts 30, 40, 50 and 60 years old. In all age groups, men had significantly higher serum ferritin and alcohol consumption than women. In men, there was no relationship between serum ferritin and social class. Significant relationships were observed between ferritin and occupation (unemployed and self-employed men had the highest ferritin and ferritin and income (ferritin increased with income). None of the social variables were associated with the prevalence of small or absent iron stores (serum ferritin < or = 30 micrograms/l) or abundant iron stores (serum ferritin > 300 micrograms/l). Alcohol consumption displayed relationships to occupation and become, but not to social class. In women, none of the social variables showed any relationship to ferritin levels or iron overload. The prevalence of small iron stores was lower and the make of alcohol was higher in women from high social classes. In both men and women, serum ferritin displayed significant positive correlations with alcohol consumption. Likewise, the prevalence of iron overload was closely correlated to alcohol consumption. In conclusion, sociodemographic factors per se had a minor influence on serum ferritin levels and iron status in Danes. The distinct association between alcohol consumption and serum ferritin should be considered in future epidemiological iron status surveys.

Adult↗
PubMed2002

Differences in the use of health services among people with and without epilepsy in the United Kingdom: socio-economic and disease-specific determinants.

We aim to examine the socio-economic, demographic and disease-specific determinants in the use of health services by patients with epilepsy, compared to people without epilepsy. We used data from the fourth national survey of morbidity in general practice, carried out in 1991-1992. Overall mean annual number of consultations with general practitioners, home visits and referrals to secondary care per person were calculated for people with epilepsy, stratified by age, sex and socio-economic status. The proportion of patients consulting for certain diseases or disease groups were also calculated for patients with epilepsy. Results were compared to these in people without epilepsy, and rate ratios were calculated. Patients with epilepsy consulted twice as often, required three to four times more home visits, and were referred to secondary care three times more often than people without epilepsy, irrespective of age, sex and social class. Among patients with epilepsy, consultation rates and home visits were higher in females, older people and people from the manual social classes. A higher proportion of patients with epilepsy consulted for neoplasms, haematological and mental health disorders, dementia, stroke and gastrointestinal bleeding. Older age and low social class were less strongly associated with health service utilisation than in people without epilepsy, indicating that people with epilepsy lose much of the protective effect of young age and high social class on health. Factors contributing to the higher utilisation of health services in people with epilepsy need to be studied further and their effects taken into account in the organisation of health services for people with epilepsy.

Adolescent↗
PubMed2001

Socioeconomic status and ischaemic heart disease mortality in middle-aged men: importance of the duration of follow-up. The Copenhagen Male Study.

OBJECTIVES: The predictive value of some risk factors may diminish with increasing duration of follow-up. This study was performed to elucidate the role of socioeconomic status as a risk factor for ischaemic heart disease (IHD) mortality in middle-aged men, testing the hypothesis that the role of mediators of the association of socioeconomic status with risk of IHD would diminish with increasing length of follow-up. METHODS: A cohort of 5249 men aged 40-59 was established in 1971. Baseline data on social class and other confounder variables were collected, and the cohort was followed through registers for 8, 15, and 22 years. In all, 5028 without a history of myocardial infarction or angina pectoris were included in the follow-up. Four factors associated with either occupation or lifestyle were strong mediators of the association found between social class and risk of fatal IHD, and were more common in the lower social classes (classes IV and V): occasional demand for vigorous activity at work, low leisure time physical activity level, high alcohol consumption, and smoking. RESULTS: After the first 8 years, 78 men had died due to IHD, after 15 years: 222, and after 22 years: 411. Compared with social classes I, II, and III, the age-adjusted relative risk (RR) with 95% CI for classes IV and V was 1.69, P < 0.05 after the first 8 years; adjusted for the above potential risk factors the RR dropped to 1.09, P = NS. Corresponding RR after 15 years were 1.67, P < 0.001 and 1.33, P = NS; and after 22 years, 1.59, P < 0.001 and 1.36, P < 0.05. CONCLUSIONS: Risk factors with an uneven social distribution related to occupation and lifestyle were strong mediators of the association of socioeconomic status with risk of IHD. A quite strong explanatory potential persisted but diminished with length of follow-up.

Adult↗
PubMed2000

Effect of Sardinian heritage on risk and age at onset of type 1 diabetes: a demographic case-control study of Sardinian migrants.

BACKGROUND: Children of Sardinian heritage are at high risk of type 1 diabetes, whereas no data are available in young adults. Age at onset of type 1 diabetes could be associated with different relative weight of genetic susceptibility and environmental determinants in the pathogenesis of the disease. We test this hypothesis in subjects with Sardinian heritage 0-29 years of age living in the city of Turin, a highly industrialized area in Northern Italy. METHODS: In all, 202 cases with onset of type 1 diabetes aged 0-29 years during 1984-1991 and 1010 controls randomly selected from residents of the city of Turin, frequency-matched by sex and year of birth to cases, were included in this study. Name and place of birth of parents were ascertained by postal inquiry and linkage with city population and census files. Social class was based on the highest educational level of parents abstracted from 1991 and 1981 census files. RESULTS: Differential effects on risk of type 1 diabetes of Sardinian heritage and social class in the age groups 0-14 and 15-29 years were found. In children with one and both Sardinian parents the odds ratios (OR) were 2.09 (95% CI : 0.85-5.15) and 3.20 (95% CI : 0.75-13.64); in young adults 0.81 (95% CI : 0.18-3.64) and 1.95 (95% CI : 0.51-7.40), respectively. In subjects with low social class the OR were 1.16 (95% CI : 0.68-1.97) in children and 0.66 (95% CI : 0.41-1.05) in young adults. CONCLUSIONS: This study shows higher risk of type 1 diabetes in subjects of Sardinian heritage; higher risk in children than in young adults and a protective effect of low social class in young adults. These findings are consistent with the hypothesis of heterogeneity of type 1 diabetes by age at onset, with prevailing genetic effect in childhood and environmental determinants in adulthood.

Adolescent↗
PubMed2003

Social inequalities and the common mental disorders: a systematic review of the evidence.

BACKGROUND: Of two large-scale government-commissioned studies of common mental disorders in the UK, one found occupational social class to be the strongest marker of risk while the other showed no clear relationship. This study reviews the published evidence on the links between conventional markers of social position and the common mental disorders in developed countries. METHODS: Inclusion criteria covered general population based studies with broad social class variation; samples of 3,000 or more adults of working age; identification of mental illness by validated instruments; social position identified by explicit standard markers; fieldwork undertaken since 1980; published output on key areas of interest. Incompatible study methods and concepts made statistical pooling of results invalid. RESULTS: Of nine studies, eight provide evidence of an association between one or more markers of less privileged social position and higher prevalence of common mental disorders. For some individual indicators in particular studies, no clear trend was evident, but no study showed a contrary trend for any indicator. The more consistent associations were with unemployment, less education and low income or material standard of living. Occupational social class was the least consistent marker. CONCLUSIONS: Common mental disorders are significantly more frequent in socially disadvantaged populations. More precise indicators of education, employment and material circumstances are better markers of increased rates than occupational social class.

Humans↗
PubMed1984

Drinking and occupational status in New Zealand men.

The self-reported alcohol consumption of various occupational groups in New Zealand is examined. A sample of 10,000, representative of the general adult population, was questioned in 1978-1979. Only data on men (N = 5000) are considered in the present study. Various occupations and groups of occupations are ranked on several variables of frequency and quantity of drinking. The interrelationships of these variables and the working conditions related to them are discussed. There is an association between drinking pattern and general social class, but 61% of the specific occupational groups form a cluster in the range of 25-60 ml of absolute alcohol consumed on one or two occasions per week. The extreme positions on drinking variables of specific occupational groups is examined in terms of job characteristics. Most of the correlations are very low; drinking at work is the highest. The relationships can best be described in terms of the social class of the occupational groups and the frequency vs quantity dichotomy. The distribution of the social classes in terms of drinking intensity is discussed. Employment in the lower classes is related to lower frequency and higher quantity of drinking, and higher cirrhosis mortality. Overall, social class appears to be a more important indicator than occupational group or drinking pattern.

Adolescent↗
PubMed2006

[Social factors influencing participation in self-help groups or organisations--results from selected questions for the health monitor].

OBJECTIVES: Using selected data collected by the Health Monitor (Bertelsmann-Stiftung) from 1,539 adults aged between 18 and 79 years this article describes which social factors have an impact on participation in self-help groups or organisations. Furthermore, questions about the length of participation, fields of self-help activity, and their usefulness were analysed. METHODS: All participants were approached in written form. The questionnaire included 103 health-related items (6 about self-help), and 15 demographic characteristics. The sample was weighted statistically by federal state, sex and age. RESULTS: 4.1% stated to be a member of self-help organisations for chronically ill or disabled people. On the whole, 9.1% have participated in self-help activities during their lifetime (currently active: 2.8%). Membership in self-help organisations increases with age, social class and according to personal involvement, whereas participation in self-help groups is quite different. The rate of participation of women is nearly twice as high as that of men (11.1 versus 6.9%). Generally, participation in self-help groups was also rated positively, but assessments vary with social class and the length of using them. CONCLUSION: Particularly with regard to the distribution of self-help participants depending on social class there are some discrepancies to other studies. These differences can supposedly be ascribed to methodical factors (e. g., social class index, sample size).

Adolescent↗
PubMed1985

Social inequalities and perceived health.

The association between morbidity and mortality indicators and low socio-economic status has been observed for many centuries. In 1980 the publication of the Black Report in Britain drew attention to the failure of the National Health Service to close the gap between rich and poor in relation to health status. The gradients of morbidity and mortality which are linked to social class have been observed throughout Europe, in the U.S.A. and Australia. However, information on how people feel, as opposed to how they become ill, and the cause of their death, is scarce. Measures of perceived need can provide important additions to routinely collected data because they give access to the experiential status of respondents and thus provide vital data on which to base planning, provision and evaluation of health services. A standard reliable and valid measure of perceived health, the Nottingham Health Profile, was used to conduct a postal survey of differential status in subjective health between social classes in England. The results showed statistically significant differences between social classes in the age group 20-44 years only. For both men and women these were in their experience of sleep problems, emotional problems and lack of energy. In all cases the lower the social class the greater the amount and severity of perceived distress. After the age of 45 these differences, although still present, were not so marked, perhaps because of the excess mortality rates in lower socio-economic groups and the lowering of expectations with age. It is suggested that younger people from unskilled and semi-skilled occupations and, of course, the unemployed, are more vulnerable than their better off compatriots because of a kind of psychic susceptibility which is a consequence of social circumstances and the inability to cushion the effects of ill health. A type of Marxian "immiseration' may occur whereby in contemporary society health status is undermined by spiritual and social impoverishment rather than by the gross poverty and grinding labour of the past. The results of this study indicate that changes in the allocation of health care resources may have only a minor influence on inequalities in health. Remedial action would, rather, need to take the more radical form of providing fulfillment for aspirations and enhancing well-being by introducing fundamental social, economic and environmental reforms.

Adult↗