Purpose: To examine, separately for boys and girls, whether socio-economic differences in drunkenness exist in adolescence, whether the level of exposure to school-related risk factors differ between socio-economic groups, and whether the relative contribution of school-related risk factors to drunkenness differ between socio-economic groups.
Andersen, Anette; Holstein, BjØrn E
Although socioeconomic status is a major contributing factor to health disparities, the mechanisms through which socioeconomic status influences health remain unclear. The purpose of the present study was to evaluate an a priori conceptual model of the pathways between socioeconomic status and modifiable health risk factors in a sample of 399 African Americans seeking smoking cessation treatment. A latent variable modeling approach was utilized to characterize the interrelationships among socioeconomic status, neighborhood disadvantage, social support, negative affect/perceived stress, and three specific modifiable risk factors (i.e., overweight/obesity, insufficient physical activity, at-risk drinking). Findings indicated that neighborhood disadvantage, social support, and negative affect/perceived stress function as pathways linking socioeconomic status and modifiable risk factors among African American smokers, and negative affect/perceived stress appears to play a key mediating role. Policy, community, and individual-level interventions may attenuate the impact of socioeconomic status on health by targeting intermediate psychosocial, environmental, and behavioral pathways.
Kendzor, Darla E.; Businelle, Michael S.; Mazas, Carlos A.; Cofta-Woerpel, Ludmila M.; Reitzel, Lorraine R.; Vidrine, Jennifer Irvin; Li, Yisheng; Costello, Tracy J.; Cinciripini, Paul M.; Ahluwalia, Jasjit S.; Wetter, David W.
In a national cohort comprising 1.5 million Danes born from 1966 to 1992, we studied the association between childhood socioeconomic status (SES) and the risk of multiple sclerosis (MS) from 1981 to 2007 using information about household income and parental educational levels at the person's 15th birthday. The association between childhood SES and MS was evaluated using MS incidence rate ratios with 95% confidence intervals obtained in log-linear Poisson regression analyses. We found no strong association between childhood SES and MS but did observe a tendency toward a reduced risk of MS among children from households with more highly educated parents, particularly mothers. Children whose mothers had a secondary (rate ratio = 0.95, 95% confidence interval: 0.86, 1.04) or higher (rate ratio = 0.86, 95% confidence interval: 0.76, 0.97) education had reduced risks of MS (5% and 14%, respectively) compared with children of mothers with a basic education (P for trend = 0.02). Results were practically unchanged in an analysis restricted to persons aged 15-29 years, among whom the possible effect of own SES on MS risk is considered limited. Overall, SES in childhood seems of no major importance for the subsequent risk of MS; however, offspring of well-educated mothers may be at a slightly reduced risk of MS.
Nielsen NM; Jørgensen KT; Bager P; Stenager E; Pedersen BV; Hjalgrim H; Koch-Henriksen N; Frisch M
Although socioeconomic status is a major contributing factor to health disparities, the mechanisms through which socioeconomic status influences health remain unclear. The purpose of the present study was to evaluate an a priori conceptual model of the pathways between socioeconomic status and modifiable health risk factors in a sample of 399 African Americans seeking smoking cessation treatment. A latent variable modeling approach was utilized to characterize the interrelationships among socioeconomic status, neighborhood disadvantage, social support, negative affect/perceived stress, and three specific modifiable risk factors (i.e., overweight/obesity, insufficient physical activity, at-risk drinking). Findings indicated that neighborhood disadvantage, social support, and negative affect/perceived stress function as pathways linking socioeconomic status and modifiable risk factors among African American smokers, and negative affect/perceived stress appears to play a key mediating role. Policy, community, and individual-level interventions may attenuate the impact of socioeconomic status on health by targeting intermediate psychosocial, environmental, and behavioral pathways. PMID:19757014
Kendzor, Darla E; Businelle, Michael S; Mazas, Carlos A; Cofta-Woerpel, Ludmila M; Reitzel, Lorraine R; Vidrine, Jennifer Irvin; Li, Yisheng; Costello, Tracy J; Cinciripini, Paul M; Ahluwalia, Jasjit S; Wetter, David W
The purpose of the present study was to describe the prevalence, patterns, and predictors of co-occurring modifiable cancer risk factors among African Americans seeking smoking cessation treatment, and to evaluate previously hypothesized models of the relationship between socioeconomic status and health behavior. Overweight/obesity, at-risk alcohol consumption, and insufficient physical activity were measured in 399 African American smokers. Analyses indicated that 92.8% of participants had at least one cancer risk factor in addition to smoking. Univariate ordinal logistic regression analyses revealed that female gender, unemployment, lower positive affect and greater negative affect were associated with having a greater number of cancer risk factors. Multivariate analyses yielded similar findings. A structural equation modeling approach indicated that stress/negative affect may function as one pathway linking socioeconomic status and modifiable cancer risk factors among African American smokers, and that gender has a direct effect on modifiable cancer risk factors. Thus, risk patterns identified within each gender group may guide the development of multiple risk factor interventions for African American smokers. Stress and negative affect may be an important treatment target within behavioral interventions for African American smokers of low socioeconomic status.
Kendzor, Darla E.; Cofta-Woerpel, Ludmila M.; Mazas, Carlos A.; Li, Yisheng; Vidrine, Jennifer Irvin; Reitzel, Lorraine R.; Costello, Tracy J.; Businelle, Michael S.; Ahluwalia, Jasjit S.; Cinciripini, Paul M.; Wetter, David W.
OBJECTIVE: To estimate mortality from diabetes mellitus (DM) for the period 2001-2011 in the Republic of Panama, by province/indigenous territory, and determine its relationship with biological and socioeconomic risk factors. METHODS: Cases for the years 2001-2011 with DM listed as the principal cause of death were selected from Panama's National Mortality Registry. Crude and adjusted mortality rates were generated by sex, age, and geographic area. Linear regression analyses were performed to determine the relationship between DM mortality and biological and socioeconomic risk factors. A composite health index (CHI) calculated from biological and socioeconomic risk factors was estimated for each province/indigenous territory in Panama. RESULTS: DM mortality rates did not increase for men or women during 2001-2011. Of the biological risk factors, being overweight had the strongest association with DM mortality. Of the socioeconomic risk factors, earning less than US$ 100 per month had the strongest association with DM mortality. The highest socioeconomic CHI scores were found in a province that is predominantly rural and in areas with indigenous populations. The highest biological CHI scores were found in urban-rural provinces and those with the highest percentage of elderly people. CONCLUSIONS: Regional disparities in the association between DM mortality and DM risk factors reaffirm the heterogeneous composition of the Panamanian population and the uneven distribution of biological and social determinant risk factors in the country and point to the need to vary management strategies by geographic area for this important cause of disability and death in Panama.
Motta JA; Ortega-Paz LG; Gordón CA; Gómez B; Castillo E; Herrera Ballesteros V; Pereira M
Background Cardiovascular diseases are the leading cause of death in the majority of developed and developing countries. African countries are currently facing an increase in both cardiovascular and transmitted diseases. In addition, cardiovascular risk varies among different socioeconomic groups. Thus, we determined the prevalence of modifiable cardiovascular risk factors in apparently healthy public-sector workers and investigated possible relationships with socioeconomic status. Methods We employed a cross-sectional study comprising 42.2% (n = 615) of the public-sector workers at Agostinho Neto University, 48% (n = 294) male and 52% (n= 321) female, with ages between 20 and 72 years and from various socioeconomic groups. The study was conducted from February 2009 to December 2010. Personal, anthropometric, biochemical, hemodynamic, socioeconomic, and physical activity data were collected. Results The prevalence rates of cardiovascular risk factors were as follows: hypertension, 45.2% (men 46.3%, women 44.2%, P > 0.05); hypercholesterolemia, 11.1% (men 10.5%, women 11.5%, P > 0.05); low high-density lipoprotein (HDL) cholesterol, 50.1% (men 36.9%, women 62.3%; P 0.05); smoking, 7.2% (men 10.2%, women 4.4%; P 0.05); overweight, 29.3% (men 27.3%, women 31.2%, P > 0.05); obesity, 19.6% (men 9.2%, women 29.0%; P < 0.05); sedentary lifestyle, 87.2% (men 83.0%, women 91,0%, P < 0.05); and left ventricular hypertrophy, 20% (men 32.0%, women 9.0%; P < 0.05). At least one risk factor was present in 27.7% of the sample; 15.2% had two risk factors, and 31.4% had three or more risk factors. Among the individuals with low socioeconomic status, 41.0% had three or more risk factors. Conclusions The results of this study suggest the existence of a high prevalence of multiple risk factors for cardiovascular disease in apparently healthy public-sector workers in Angola. The workers in lower socioeconomic groups had higher incidences of hypertension, smoking, and left ventricular hypertrophy.
The goal of this study was to investigate the extent to which socioeconomic status (SES) in young adults is associated with cardiovascular risk factor levels and carotid intima-media thickness (IMT) and their changes over a 6-year follow-up period.
Kestilä, P; Magnussen, CG; Viikari, JS; Kähönen, M; Hutri-Kähönen, N; Taittonen, L; Jula, A; Loo, BM; Pietikäinen, M
The purpose of the present study was to describe the prevalence, patterns, and predictors of cooccurring modifiable cancer risk factors among African-Americans seeking smoking cessation treatment and to evaluate previously hypothesized models of the relationship between socioeconomic status (SES) and health behavior. Overweight/obesity, at-risk alcohol consumption, and insufficient physical activity were measured in 399 African-American smokers. Analyses indicated that 92.8% of participants had at least one cancer risk factor in addition to smoking. Univariate ordinal logistic regression analyses revealed that female gender, unemployment, lower positive affect, and greater negative affect were associated with having a greater number of cancer risk factors. Multivariate analyses yielded similar findings. A structural equation modeling approach indicated that stress/negative affect may function as one pathway linking SES and modifiable cancer risk factors among African-American smokers and that gender has a direct effect on modifiable cancer risk factors. Thus, risk patterns identified within each gender group may guide the development of multiple risk factor interventions for African-American smokers. Stress and negative affect may be an important treatment target within behavioral interventions for African-American smokers of low SES. PMID:18842995
Kendzor, Darla E; Cofta-Woerpel, Ludmila M; Mazas, Carlos A; Li, Yisheng; Vidrine, Jennifer Irvin; Reitzel, Lorraine R; Costello, Tracy J; Businelle, Michael S; Ahluwalia, Jasjit S; Cinciripini, Paul M; Wetter, David W
Cardiovascular disease (CVD) is the leading industrial world cause of mortality. Lower social class groups have higher incidence of CVD and also display less favourable risk factor profiles. To investigate the association and gradient between major cardiovascular risk factors (smoking habit, serum lipid profile, blood pressure, relative body weight) and socio-economic position (proxy measures selected: education and occupation) data on 2592 men and 2866 women were analysed. The effect of potential confounding factors and effect modifiers was estimated. Linear and logistic regression modelling was performed for continuous and dichotomous outcomes respectively. The lower the grade of employment or the level of education, the higher was the prevalence of obesity in the study population. The association was stronger in women than in men. Higher education was associated with a lower prevalence of smoking among men and a higher prevalence among women. Systolic blood pressure was negatively related to socio-economic position in both men and women in the age-adjusted models. Attention should be concentrated on socio-economic differences in obesity and blood pressure in this population. PMID:11855579
Vescio, M F; Smith, G D; Giampaoli, S
BACKGROUND: Metabolic syndrome (MetS) increases the risk of cardiovascular disease and its development is determined by certain socioeconomic and lifestyle factors. AIM: To investigate the impact of socioeconomic and lifestyle factors on the risk of MetS and the underlying contributing factors in the Polish population aged 20-74 years. METHODS: Between 2003 and 2005, as part of the National Multicentre Health Survey (WOBASZ, Wieloo?rodkowe Badanie Stanu Zdrowia Ludno?ci), a random sample of Polish residents aged 20 to 74 years was investigated. Data on sociodemographic and anthropometric parameters, blood pressure, lipid and glucose levels and medical history were collected. MetS was defined according to the criteria proposed by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and by the International Diabetes Federation (IDF) in 2005. Data necessary to evaluate MetS and the socioeconomic characteristics were obtained for 5940 men and 6627 women. RESULTS: MetS was identified in 26.0% of men and 23.9% of women according to the AHA/NHLBI definition, and in 30.7% of men and 26.8% of women according to the IDF definition. In both genders older age, higher body mass index and current smoking increased the risk of developing MetS, whereas higher physical activity and good self-rated health decreased the risk. Moreover, women with higher education and in the higher quartile of alcohol intake were associated with a lower risk of having MetS. Household per-capita income did not affect the risk of having MetS in either gender. CONCLUSIONS: A relatively high percentage of individuals with MetS was observed in the Polish population aged 20 to 74 years. In both sexes, the risk of MetS and its contributing factors was significantly associated with age and the following lifestyle factors: body mass index, smoking, self-rated health and, additionally for women, higher education and alcohol intake.
Sygnowska E; Piwo?ska A; Wa?kiewicz A; Broda G
OBJECTIVE: Understand the links between race and C-reactive protein (CRP), with special attention to gender differences and the role of class and behavioral risk factors as mediators. METHOD: This study utilizes the National Social Life, Health, and Aging Project data, a nationally representative study of older Americans aged 57-85 to explore two research questions. First, what is the relative strength of socioeconomic versus behavioral risk factors in explaining race differences in CRP levels? Second, what role does gender play in understanding race differences? Does the relative role of socioeconomic and behavioral risk factors in explaining race differences vary when examining men and women separately? RESULTS: When examining men and women separately, socioeconomic and behavioral risk factor mediators vary in their importance. Indeed, racial differences in CRP among men aged 57-74 are little changed after adjusting for both socioeconomic and behavioral risk factors with levels 35% higher for black men as compared to white men. For women aged 57-74, however, behavioral risk factors explain 30% of the relationship between race and CRP. DISCUSSION: The limited explanatory power of socioeconomic position and, particularly, behavioral risk factors, in elucidating the relationship between race and CRP among men, signals the need for research to examine additional mediators, including more direct measures of stress and discrimination.
Herd P; Karraker A; Friedman E
A West Nile virus (WNV) human risk map was developed for Suffolk County, New York utilizing a case-control approach to explore the association between the risk of vector-borne WNV and habitat, landscape, virus activity, and socioeconomic variables derived from publically available datasets. Results of logistic regression modeling for the time period between 2000 and 2004 revealed that higher proportion of population with college education, increased habitat fragmentation, and proximity to WNV positive mosquito pools were strongly associated with WNV human risk. Similar to previous investigations from north-central US, this study identified middle class suburban neighborhoods as the areas with the highest WNV human risk. These results contrast with similar studies from the southern and western US, where the highest WNV risk was associated with low income areas. This discrepancy may be due to regional differences in vector ecology, urban environment, or human behavior. Geographic Information Systems (GIS) analytical tools were used to integrate the risk factors in the 2000-2004 logistic regression model generating WNV human risk map. In 2005-2010, 41 out of 46 (89%) of WNV human cases occurred either inside of (30 cases) or in close proximity (11 cases) to the WNV high risk areas predicted by the 2000-2004 model. The novel approach employed by this study may be implemented by other municipal, local, or state public health agencies to improve geographic risk estimates for vector-borne diseases based on a small number of acute human cases.
Rochlin I; Turbow D; Gomez F; Ninivaggi DV; Campbell SR
BACKGROUND: Although low socioeconomic status, and environmental factors are known risk factors for rheumatic heart disease in other societies, risk factors for rheumatic heart disease remain less well described in Uganda. AIMS AND OBJECTIVE: The objective of this study was to investigate the role of socio-economic and environmental factors in the pathogenesis of rheumatic heart disease in Ugandan patients. METHODS: This was a case control study in which rheumatic heart disease cases and normal controls aged 5-60 years were recruited and investigated for socioeconomic and environmental risk factors such as income status, employment status, distance from the nearest health centre, number of people per house and space area per person. RESULTS: 486 participants (243 cases and 243 controls) took part in the study. Average age was 32.37+/-14.6 years for cases and 35.75+/-12.6 years for controls. At univariate level, Cases tended to be more overcrowded than controls; 8.0+/-3.0 versus 6.0+/-3.0 persons per house. Controls were better spaced at 25.2 square feet versus 16.9 for cases. More controls than cases were employed; 45.3% versus 21.1%. Controls lived closer to health centers than the cases; 4.8+/-3.8 versus 3.3+/-12.9 kilometers. At multivariate level, the odds of rheumatic heart disease was 1.7 times higher for unemployment status (OR = 1.7, 95% CI = 1.05-8.19) and 1.3 times higher for overcrowding (OR = 1.35, 95% CI = 1.1-1.56). There was interaction between overcrowding and longer distance from the nearest health centre (OR = 1.20, 95% CI = 1.05-1.42). CONCLUSION: The major findings of this study were that there was a trend towards increased risk of rheumatic heart disease in association with overcrowding and unemployment. There was interaction between overcrowding and distance from the nearest health center, suggesting that the effect of overcrowding on the risk of acquiring rheumatic heart disease increases with every kilometer increase from the nearest health center.
Okello E; Kakande B; Sebatta E; Kayima J; Kuteesa M; Mutatina B; Nyakoojo W; Lwabi P; Mondo CK; Odoi-Adome R; Juergen F
Aims: The aim of this study is to estimate the associations of early and current socio-economic position (SEP) on adult cardiometabolic risk factors in the Indian Migration Study (N?=?7,067). Methods and Results: Linear mixed models were used to estimate associations between early and current SEP and cardiometabolic risk factors: systolic blood pressure (SBP), body fat and Homeostasis Model Assessment (HOMA) score. In males, high current SEP was associated with higher SBP. In both genders, high early and current SEP were associated with higher body fat, current SEP dominating the associations. High early SEP was associated with higher HOMA score in males only, and the effect size halved after adjustment for current SEP. High current SEP was associated with higher HOMA score more strongly in males than in females. Conclusion: Higher SEP, more importantly in adulthood than childhood, was associated with cardiometabolic risk factors in an Indian population. The relationship between SEP over the life course and urbanization should be considered in the Indian context when public health interventions to prevent cardiovascular disease are planned.
Sovio, Ulla; Giambartolomei, Claudia; Kinra, Sanjay; Bowen, Liza; Dudbridge, Frank; Nitsch, Dorothea; Smith, George Davey; Ebrahim, Shah; Ben-Shlomo, Yoav
To examine whether a low socio-economic status (SES) is an additional risk factor for glucose intolerance in Hong Kong Chinese with known risk factors for glucose intolerance, a total of 2847 Chinese subjects (473 men and 2374 women) were recruited from the community for assessment. They had known risk factors for glucose intolerance including a previous history of gestational diabetes, positive family history of diabetes in first degree relatives and equivocal fasting plasma glucose concentrations between 7 and 8 mmol/l or random plasma glucose concentrations between 8 and 11 mmol/l. The 2847 subjects were classified according to their education levels and occupations: education group 1 = high school or university, group 2 = middle school, group 3 = illiterate or up to elementary school; occupational group 1 = professional or managerial, group 2 = non-manual, group 3 = manual, group 4 = unskilled, group 5 = housewife or unemployed. Different socio-economic groups were well represented in this selected population. The distribution of educational groups in this study was similar to that recorded in the 1991 Hong Kong Census. When analysed according to education levels and after adjustment for age, women in the lowest social class had the highest prevalence of diabetes, body mass index, blood pressure and plasma glucose concentrations. Men with the lowest education level had the highest prevalence of diabetes after age adjustment. The age-adjusted odds ratio (95% confidence intervals) of having diabetes was 2.3 (1.3, 4.3) in female subjects and 2.5 (1.2, 5.4) in male subjects with the lowest SES compared to subjects with the highest SES. When categorised according to occupation and after adjustment for age, women in the lowest social class had the highest prevalence of diabetes and glycaemic indexes. The age-adjusted odds ratio of having diabetes was 4.5 (1.9, 10.9) in female subjects with the lowest SES compared to those with the highest SES. The corresponding age-adjusted odds ratio in male subjects was 1.9 (0.9, 3.9) but this was not statistically significant. In conclusion, a lower socio-economic class, categorised either by occupational or educational level, was an additional risk factor for diabetes in Hong Kong Chinese who had known risk factors for glucose intolerance. These subjects should have increased priority for health education and regular diabetes screening. Our findings further emphasise the complex relationships between societal affluence, personal income and educational level
Patients' beliefs about the causes of their heart disease (causal attributions) are important to effective medical communication, psychological adaptation, and adherence to advice. We assessed the extent to which causal attributions relate to risk factors, sex and socio-economic status in men and wo...
Perkins-Porras, L; Whitehead, DL; Steptoe, A
Background To determine correlation of multiple parameters of socioeconomic status with cardiovascular risk factors in India. Methods The study was performed at eleven cities using cluster sampling. Subjects (n?=?6198, men 3426, women 2772) were evaluated for socioeconomic, demographic, biophysical and biochemical factors. They were classified into low, medium and high socioeconomic groups based on educational level (15 yr formal education), occupational class and socioeconomic scale. Risk factor differences were evaluated using multivariate logistic regression. Results Age-adjusted prevalence (%) of risk factors in men and women was overweight or obesity in 41.1 and 45.2, obesity 8.3 and 15.8, high waist circumference 35.7 and 57.5, high waist-hip ratio 69.0 and 83.8, hypertension 32.5 and 30.4, hypercholesterolemia 24.8 and 25.3, low HDL cholesterol 34.1 and 35.1, high triglycerides 41.2 and 31.5, diabetes 16.7 and 14.4 and metabolic syndrome in 32.2 and 40.4 percent. Lifestyle factors were smoking 12.0 and 0.5, other tobacco use 12.7 and 6.3, high fat intake 51.2 and 48.2, low fruits/vegetables intake 25.3 and 28.9, and physical inactivity in 38.8 and 46.1%. Prevalence of >?=?3 risk factors was significantly greater in low (28.0%) vs. middle (23.9%) or high (22.1%) educational groups (p?=?3 major cardiovascular risk factors.
Gupta, Rajeev; Deedwania, Prakash C.; Sharma, Krishnakumar; Gupta, Arvind; Guptha, Soneil; Achari, Vijay; Asirvatham, Arthur J.; Bhansali, Anil; Gupta, Balkishan; Gupta, Sunil; Jali, Mallikarjuna V.; Mahanta, Tulika G.; Maheshwari, Anuj; Saboo, Banshi; Singh, Jitendra; Gupta, Rajiv
BACKGROUND: Adverse effects of single parenthood on children's health have been reported before. Socio-economic difficulties are discussed as mediating factors. As child health also depends on environmental conditions, we investigated the impact of environmental exposures and socio-economic factors on differences in health outcomes of children with single mothers vs. couple families. METHODS: Data on 17,218 pre-school children (47% female) from three cross-sectional surveys conducted during 2004-07 in Germany were analysed. Health and exposure assessment were primarily based on parental report. Effects of socio-economic indicators (maternal education, household income) and environmental factors (traffic load at the place of residence, perceived environmental quality) on associations of four health outcomes (parent-reported health status, asthma, overweight, psychological problems) with single parenthood were determined by logistic regression analyses. RESULTS: Children with single mothers showed an increased risk regarding parent-reported poor health status [boys: odds ratio (OR) 1.39 (95% confidence interval (CI): 1.06-1.82), girls: 1.73 (1.28-2.33)], psychological problems [boys: 1.90 (1.38-2.61), girls: 1.58 (1.03-2.42)], overweight [only boys: OR 1.23 (1.01-1.50) and asthma [only girls: OR 1.90 (1.15-3.15)]. Adjusting for socio-economic factors attenuated the strength of the association of family type with child health. Although environmental factors were associated with most health outcomes investigated and children of single mothers were more often exposed, these environmental factors did not alter the differences between children with single mothers and couple families. CONCLUSIONS: The increased health risks of children from single-mother families vs. couple families are partly explained by socio-economic factors, but not by the environmental exposures studied.
Scharte M; Bolte G
BACKGROUND: To determine correlation of multiple parameters of socioeconomic status with cardiovascular risk factors in India. METHODS: The study was performed at eleven cities using cluster sampling. Subjects (n = 6198, men 3426, women 2772) were evaluated for socioeconomic, demographic, biophysical and biochemical factors. They were classified into low, medium and high socioeconomic groups based on educational level (<10, 10-15 and >15 yr formal education), occupational class and socioeconomic scale. Risk factor differences were evaluated using multivariate logistic regression. RESULTS: Age-adjusted prevalence (%) of risk factors in men and women was overweight or obesity in 41.1 and 45.2, obesity 8.3 and 15.8, high waist circumference 35.7 and 57.5, high waist-hip ratio 69.0 and 83.8, hypertension 32.5 and 30.4, hypercholesterolemia 24.8 and 25.3, low HDL cholesterol 34.1 and 35.1, high triglycerides 41.2 and 31.5, diabetes 16.7 and 14.4 and metabolic syndrome in 32.2 and 40.4 percent. Lifestyle factors were smoking 12.0 and 0.5, other tobacco use 12.7 and 6.3, high fat intake 51.2 and 48.2, low fruits/vegetables intake 25.3 and 28.9, and physical inactivity in 38.8 and 46.1%. Prevalence of > = 3 risk factors was significantly greater in low (28.0%) vs. middle (23.9%) or high (22.1%) educational groups (p<0.01). In low vs. high educational groups there was greater prevalence of high waist-hip ratio (odds ratio 2.18, confidence interval 1.65-2.71), low HDL cholesterol (1.51, 1.27-1.80), hypertriglyceridemia (1.16, 0.99-1.37), smoking/tobacco use (3.27, 2.66-4.01), and low physical activity (1.15, 0.97-1.37); and lower prevalence of high fat diet (0.47, 0.38-0.57),overweight/obesity (0.68, 0.58-0.80) and hypercholesterolemia (0.79, 0.66-0.94). Similar associations were observed with occupational and socioeconomic status. CONCLUSIONS: Low educational, occupational and socioeconomic status Asian Indians have greater prevalence of truncal obesity, low HDL cholesterol, hypertriglyceridemia, smoking or tobacco use and low physical activity and clustering of > = 3 major cardiovascular risk factors.
Gupta R; Deedwania PC; Sharma K; Gupta A; Guptha S; Achari V; Asirvatham AJ; Bhansali A; Gupta B; Gupta S; Jali MV; Mahanta TG; Maheshwari A; Saboo B; Singh J; Gupta R
OBJECTIVE: to analyse the relationship between socioeconomic factors and the prevalence at birth of a selected group of congenital malformations (CM): neural tube defects (NTD), orofacial clefts (OFC), Down syndrome (DS). DESIGN: matched case-control study. The aim of the study was to compare the parental socioeconomic status of 485 children affected by one of the selected congenital malformations with an appropriate control group, using both a synthetic index, as well as comparing each socioeconomic characteristic. Socioeconomic measures included maternal and paternal education and employment. SETTING: Delivery certificate database from 18 Italian regions, years 2002-2003. MAIN OUTCOME MEASURES: odds ratio (OR) measuring the association between the presence at birth of specific CMs and socioeconomic factors, estimated through logistic regression models. RESULTS: the study showed a higher risk for NTD (OR 2.73; 95% CI 1.36-5.50) and OFC (OR 1.18; 95% CI 1.05-1.33)for parents in a low social class. As well, the estimated risk of DS is slightly higher, though not statistically significant (OR 1.08; 95% CI 0.98-1.19). Among the socioeconomic variables taken into consideration, the mother's education level represented a significant risk factor associated with OFC occurrence. CONCLUSION: the results suggested that the socioeconomic level may represent a selective risk factor for specific CMs, confirming the role that social inequalities have on health, in particular on reproductive health. Such evidences should be considered when programming specific actions aimed at preventing congenital malformations.
Rosano A; Del Bufalo E; Burgio A
UNLABELLED: Presbycusis, or the aging ear, involves mainly the inner ear and the cochlear nerve, causing sensorineural hearing loss. Risk factors include systemic diseases and poor habits that cause inner ear damage and lead to presbycusis. Correct identification of these risk factors is relevant for prevention. AIM: To evaluate the prevalence and to identify the risk factors of presbycusis in a sample aged over 40 years. STUDY DESIGN: A retrospective case series. SUBJECTS AND METHODS: medical records of 625 patients were evaluated. Presbycusis was identified using pure tone audiometry, speech audiometry and impedance testing of all patients. RESULTS: The prevalence of presbycusis was 36.1%; the mean age was 50.5 years ranging from 40 to 86 years; 85.5% were male and 14.5% werf female. Age, the male gender, diabetes mellitus, and hereditary hearing loss were identified as risk factors. Cardiovascular diseases, smoking and consumption of alcohol were not confirmed as risk factors, although these have often been mentioned as risk factors for presbycusis. CONCLUSION: Notwithstanding the idea that presbycusis has multiple risk factors, this study identified few risk factors for this disease.
Sousa CS; Castro Júnior Nd; Larsson EJ; Ching TH
OBJECTIVE: To evaluate the effect of socioeconomic status on late presentation of glaucoma. DESIGN: Prospective, multicentre, cross-sectional study. PARTICIPANTS: Newly diagnosed open-angle glaucoma. METHODS: Eligible subjects with newly diagnosed open-angle glaucoma underwent a comprehensive ocular examination and were classified as mild, moderate, or advanced according to the Canadian Ophthalmological Society glaucoma guidelines. Socioeconomic status was estimated by linking the subjects' postal code to the median household income in the 2006 Canadian population census at the level of dissemination areas. Five equal income groups ranging from the lowest to the highest income quintile were considered and compared regarding the frequency and proportion of moderate or advanced glaucoma. RESULTS: A total of 290 subjects were included in the analysis; 151 (52.1%) had mild, 79 (26.9%) moderate, and 60 (21.0%) advanced disease at initial diagnosis. Patients with newly diagnosed glaucoma were less likely to come from the poorest neighborhood areas (16.21%) when compared with an expected one fifth (20%) of patients presented in each of the 5 social economic groups (P = 0.56). Compared with people from the poorest neighborhood areas, people from the richest neighborhood areas had a marginally lower risk for having moderate or advanced glaucoma at first presentation (prevalence ratio 0.66, 95% confidence interval: 0.43-1.02, P = 0.06). This association was stronger among those ?65 years old (P = 0.006). CONCLUSIONS: To the best of our knowledge, this is the first study in Canada to provide evidence that socioeconomic deprivation is associated with greater severity of glaucoma at presentation, specifically for those ?65 years old. Consideration should be given to targeting poor neighborhood areas for glaucoma education, screening, or both.
Buys YM; Jin YP
BACKGROUND: The most fundamental way to decrease the burden of noncommunicable diseases (NCDs) is to identify and control their related risk factors. The goal of this study is to determine socioeconomic inequalities in risk factors for NCDs using concentration index based on Non-Communicable Disease Surveillance Survey (NCDSS) data in Kurdistan province, Islamic Republic of Iran in 2005 and 2009. METHODS: The required data for this study are taken from two NCDSSs in Kurdistan province in 2005 and 2009. A total of 2,494 persons in 2005 and 997 persons in 2009 were assessed. Concentration index was used to determine socioeconomic inequality. To assess the relationship between the prevalence of each risk factor and socioeconomic status (SES), logistic regression was used and odds ratio (OR) was calculated for each group, compared with the poorest group. RESULTS: The concentration index for hypertension was -0.095 (-0.158, -0.032) in 2005 and -0.080 (-0.156, -0.003) in 2009. The concentration index for insufficient consumption of fruits and vegetables was -0.117 (-0.153, -0.082) in 2005 and -0.100 (-0.153, -0.082) in 2009. The concentration index for the consumption of unhealthy fat and oil was -0.034 (-0.049, -0.019) in 2005 and -0.108 (-0.165, -0.051) in 2009. The concentration index for insufficient consumption of fish was -0.070 (-0.096, -0.044) in 2005. The concentration index for physical inactivity was 0.008 (-0.057, 0.075) in 2005 and 0.139 (0.063, 0.215) in 2009. In all the cases, the OR of the richest group to the poorest group was significant. CONCLUSION: Hypertension, insufficient consumption of fruits and vegetables, consumption of unhealthy fat and oil, and insufficient consumption of fish are more prevalent among poor groups. There was no significant socioeconomic inequality in the distribution of smoking, excess weight, and hypercholesterolemia. Physical inactivity was more prevalent among the rich groups of society in 2009. The reduction of socioeconomic inequalities must become a main goal in health-care policies.
Moradi G; Mohammad K; Majdzadeh R; Ardakani HM; Naieni KH
Data are lacking regarding the association of alcohol consumption with a broad range of other cancer risk factors. Objectives: 1) to assess which sociodemographic, lifestyle and dietary factors were associated with alcohol consumption; 2) to identify profiles of alcohol consumers by beverage type; 3) to estimate the number of cancer risk factors accumulated on the individual level according to alcohol consumption. Alcohol and dietary intakes were assessed by six 24h records among 29,566 adults of the NutriNet-Santé cohort. Factors associated with alcohol consumption (non-drinkers (reference)/<10g/d/?10g/d) were assessed by polytomic multivariate logistic regression stratified by gender. Among alcohol consumers, percentages of alcohol brought by each beverage type were compared across sociodemographic and lifestyle characteristics using Kruskal-Wallis rank tests. Several factors were associated with alcohol consumption ?10g/d in both genders: older age (Pmen =0.02, Pwomen <0.0001), smoking (Pmen&women <0.0001), higher socioprofessional category (Pmen&women <0.0001), higher income (Pmen =0.003, Pwomen <0.0001), and less healthy dietary intakes. Profiles of subjects varied across alcoholic beverage types. Men with history of cardiovascular disease (P=0.0002) or depression (P=0.03) and women with history of cirrhosis (P<0.0001) consumed less alcohol. In women, personal history of cancer was associated with a lower proportion of moderate alcohol users only (<10g/d, P=0.04). In both genders, higher alcohol drinkers clustered more cancer risk factors (median=5, apart from alcohol) than non-drinkers (median=4), P<0.0001. The multiplicity of deleterious lifestyle behaviours combined with alcohol drinking must be taken into account in cancer prevention efforts. Gender-specific medical advice for people with personal or family history of alcohol-related diseases, including cancer, should be strengthened. © 2013 Wiley Periodicals, Inc.
Touvier M; Druesne-Pecollo N; Kesse-Guyot E; Andreeva VA; Galan P; Hercberg S; Latino-Martel P
A study on risk factors for type 2 diabetes and cardiovascular disease (CVD) in 250 male and female adult subjects 20 years of age and over, pertaining to different socio-economic levels is being conducted in Hermosillo, Sonora, Mexico. Measurements of weight, height, waist/hip ratio, blood pressure, oral glucose tolerance test, blood levels of total of cholesterol, tryglicerides, LDL and HDL-cholesterol are being obtained. Body composition is being determined by deuterium dilution and infrared spectroscopy, air displacement plethysmography, skinfold thickness and bio-electrical impedance. Physical activity by questionnaire and diet by non-consecutive multiple 24 h recalls (to account for seasonal and inter-individual variability), will provide information on lifestyle and diet. At present, analysis of 141 subjects has been completed. Preliminary results showed high levels of overweight, 55% with BMI>25, and obesity, 17% with BMI>30. Subjects with abnormal glucose levels had significantly higher weight (p
Full Text Available Abstract Objectives The aim of the current study was to examine the influence of socioeconomic status (SES) on physiological (lipid profile, obesity indices) and behavioral (dietary habits, physical activity) cardiovascular disease (CVD) risk factors among primary schoolchildren in Istanbul. Design Cross sectional study. Setting One private school and two public schools from different SES districts in Istanbul. Participants 510 randomly selected children aged 12 and 13 years old (257 boys, 253 girls). Results The prevalence of overweight (15.2%) and the energy intake (p Conclusion The findings of the current study revealed a coexistence of both overweight and higher energy intake in middle/ high SES children, as well as a coexistence of underweight and lower physical activity levels in low SES children. These observations should guide the public health policy in developing appropriate intervention strategies to efficiently tackle these health and social issues early in life.
Manios Yannis; Dimitriou Maria; Moschonis George; Kocaoglu Bike; Sur Haydar; Keskin Yasar; Hayran Osman
Full Text Available Abstract in spanish OBJETIVO: Calcular la mortalidad por diabetes sacarina durante el período del 2001 al 2011 en la República de Panamá por provincias o comarcas indígenas, y determinar su relación con los factores de riesgo biológicos y socioeconómicos de aparición de la enfermedad. MÉTODOS: Se escogieron del Registro Nacional de Mortalidad de Panamá del 2001 al 2011 los casos en los cuales la diabetes constituyó la principal causa de muerte. Se calcularon las tasas de mortalida (more) d brutas y ajustadas desglosadas por sexo, edad y zona geográfica. Mediante análisis de regresión lineal se determinó la relación entre la mortalidad por diabetes y los factores de riesgo socioeconómicos y biológicos y se calculó un índice de salud compuesto con base en cada tipo de factores de riesgo en cada provincia o comarca indígena de Panamá. RESULTADOS: Las tasas de mortalidad por diabetes no aumentaron en los hombres ni las mujeres del 2001 al 2011. De los factores de riesgo biológicos, el exceso de peso exhibió la asociación más fuerte con la mortalidad por diabetes y el factor de riesgo socioeconómico que presentó una mayor asociación con la mortalidad fue un ingreso mensual inferior a US$ 100. Las puntuaciones más altas del índice de salud compuesto desde el punto de vista socioeconómico se obtuvieron en una provincia que es rural en su mayor parte y en zonas con poblaciones indígenas. Las puntuaciones más altas con los factores biológicos se observaron en las provincias urbanas y rurales y en las que contaban con el porcentaje más alto de personas ancianas. CONCLUSIONES: Las disparidades regionales de la asociación entre la mortalidad por diabetes sacarina y los factores de riesgo de padecer la enfermedad reafirman la composición heterogénea de la población de Panamá y la distribución desigual de los factores determinantes de riesgo biológicos y sociales en el país y ponen en evidencia la necesidad de diversificar las estrategias de manejo de esta importante causa de discapacidad y muerte, en función de las zonas geográficas en Panamá. Abstract in english OBJECTIVE: To estimate mortality from diabetes mellitus (DM) for the period 2001-2011 in the Republic of Panama, by province/indigenous territory, and determine its relationship with biological and socioeconomic risk factors. METHODS: Cases for the years 2001-2011 with DM listed as the principal cause of death were selected from Panama's National Mortality Registry. Crude and adjusted mortality rates were generated by sex, age, and geographic area. Linear regression analy (more) ses were performed to determine the relationship between DM mortality and biological and socioeconomic risk factors. A composite health index (CHI) calculated from biological and socioeconomic risk factors was estimated for each province/indigenous territory in Panama. RESULTS: DM mortality rates did not increase for men or women during 2001-2011. Of the biological risk factors, being overweight had the strongest association with DM mortality. Of the socioeconomic risk factors, earning less than US$ 100 per month had the strongest association with DM mortality. The highest socioeconomic CHI scores were found in a province that is predominantly rural and in areas with indigenous populations. The highest biological CHI scores were found in urban-rural provinces and those with the highest percentage of elderly people. CONCLUSIONS: Regional disparities in the association between DM mortality and DM risk factors reaffirm the heterogeneous composition of the Panamanian population and the uneven distribution of biological and social determinant risk factors in the country and point to the need to vary management strategies by geographic area for this important cause of disability and death in Panama.
Motta, Jorge A.; Ortega-Paz, Luis G.; Gordón, Carlos A.; Gómez, Beatriz; Castillo, Eva; Herrera Ballesteros, Víctor; Pereira, Manuel
BACKGROUND: Developing countries in South Asia, such as Bangladesh, bear a disproportionate burden of diarrhoeal diseases such as Cholera, Typhoid and Paratyphoid. These seem to be aggravated by a number of social and environmental factors such as lack of access to safe drinking water, overcrowdedness and poor hygiene brought about by poverty. Some socioeconomic data can be obtained from census data whilst others are more difficult to elucidate. This study considers a range of both census data and spatial data from other sources, including remote sensing, as potential predictors of typhoid risk. Typhoid data are aggregated from hospital admission records for the period from 2005 to 2009. The spatial and statistical structures of the data are analysed and Principal Axis Factoring is used to reduce the degree of co-linearity in the data. The resulting factors are combined into a Quality of Life index, which in turn is used in a regression model of typhoid occurrence and risk. RESULTS: The three Principal Factors used together explain 87% of the variance in the initial candidate predictors, which eminently qualifies them for use as a set of uncorrelated explanatory variables in a linear regression model. Initial regression result using Ordinary Least Squares (OLS) were disappointing, this was explainable by analysis of the spatial autocorrelation inherent in the Principal factors. The use of Geographically Weighted Regression caused a considerable increase in the predictive power of regressions based on these factors. The best prediction, determined by analysis of the Akaike Information Criterion (AIC) was found when the three factors were combined into a quality of life index, using a method previously published by others, and had a coefficient of determination of 73%. CONCLUSIONS: The typhoid occurrence/risk prediction equation was used to develop the first risk map showing areas of Dhaka Metropolitan Area whose inhabitants are at greater or lesser risk of typhoid infection. This, coupled with seasonal information on typhoid incidence also reported in this paper, has the potential to advise public health professionals on developing prevention strategies such as targeted vaccination.
Corner RJ; Dewan AM; Hashizume M
BACKGROUND: Low socioeconomic status (SES) has been associated with increased cardiovascular risk. However, the association between SES and stroke incidence in patients with acute myocardial infarction (AMI) has not been studied. We assessed the association between a multidimensional SES construct and long-term ischemic stroke incidence after AMI in a prospective community-based cohort study. METHODS: A total of 1261 consecutive patients aged ? 65 years discharged after first AMI from 8 hospitals in central Israel in 1992-1993 were followed for ischemic stroke for a mean (SD) period of 11 (4) years. The number of unfavorable SES factors, including lower than average family income, ? 8 years of education, unemployment, and absence of a steady partner, was the primary exposure. We estimated the directly adjusted cumulative incidence of stroke treating non-stroke death as a competing event using the Fine and Gray model for a subdistribution function. RESULTS: Low SES was associated with older age, female sex, higher risk factor prevalence, increased AMI severity and inferior treatment. Ischemic stroke was diagnosed in 142 patients. The adjusted cumulative incidence of ischemic stroke gradually increased with the number of unfavorable SES factors. The multivariable adjusted HRs (95% confidence intervals) for ischemic stroke were 1.5(0.9-2.4), 2.0(1.2-3.2) and 2.1(1.2-3.6) in patients with 1, 2 and ? 3 unfavorable SES factors respectively, compared with those with none. CONCLUSIONS: Our data support a dose-response relationship between SES and stroke risk after AMI and suggest a multidimensional vulnerability related to SES. These findings should be considered in planning secondary prevention strategies post-AMI.
Koton S; Gerber Y; Goldbourt U; Drory Y
Full Text Available Abstract Background The major aim of this study was to investigate whether maternal risk factors associated with socioeconomic status and small for gestational age (SGA) might be viable targets of interventions to reduce differential risk of SGA by socioeconomic status (socioeconomic SGA inequality) in the metropolitan area of Vancouver, Canada. Methods This study included 59,039 live, singleton births in the Vancouver Census Metropolitan Area (Vancouver) from January 1, 2006 to September 17, 2009. To identify an indicator of socioeconomic SGA inequality, we used hierarchical logistic regression to model SGA by area-level variables from the Canadian census. We then modelled SGA by area-level average income plus established maternal risk factors for SGA and calculated population attributable SGA risk percentages (PAR%) for each variable. Associations of maternal risk factors for SGA with average income were investigated to identify those that might contribute to SGA inequality. Finally, we estimated crude reductions in the percentage and absolute differences in SGA risks between highest and lowest average income quintiles that would result if interventions on maternal risk factors successfully equalized them across income levels or eliminated them altogether. Results Average income produced the most linear and statistically significant indicator of socioeconomic SGA inequality with 8.9% prevalence of SGA in the lowest income quintile compared to 5.6% in the highest. The adjusted PAR% of SGA for variables were: bottom four quintiles of height (51%), first birth (32%), bottom four quintiles of average income (14%), oligohydramnios (7%), underweight or hypertension, (6% each), smoking (3%) and placental disorder (1%). Shorter height, underweight and smoking during pregnancy had higher prevalence in lower income groups. Crude models assuming equalization of risk factors across income levels or elimination altogether indicated little potential change in relative socioeconomic SGA inequality and reduction in absolute SGA inequality for shorter height only. Conclusions Our findings regarding maternal height may indicate trans-generational aetiology for socioeconomic SGA inequalities and/or that adult height influences social mobility. Conditions affecting foetal and childhood growth might be viable targets to reduce absolute socioeconomic SGA inequality in future generations, but more research is needed to determine whether such an approach is appropriate.
Hayward Irene; Malcoe Lorraine; Cleathero Lesley A; Janssen Patricia A; Lanphear Bruce P; Hayes Michael V; Mattman Andre; Pampalon Robert; Venners Scott A
BACKGROUND: Previous studies have shown that deprived neighbourhoods have higher cardiovascular mortality and morbidity rates. Inequalities in the distribution of behaviour related risk factors are one possible explanation for this trend. In our study, we examined the association between cardiovascular risk factors and neighbourhood characteristics. To assess the consistency of associations the design is cross-national with data from nine industrial towns from the Czech Republic and Germany. METHODS: We combined datasets from two population based studies, one in Germany ('Heinz Nixdorf Recall (HNR) Study'), and one in the Czech Republic ('Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) Study'). Participation rates were 56% in the HNR and 55% in the HAPIEE study. The subsample for this particular analysis consists of 11,554 men and women from nine German and Czech towns. Census based information on social characteristics of 326 neighbourhoods were collected from local administrative authorities. We used unemployment rate and overcrowding as area-level markers of socioeconomic status (SES). The cardiovascular risk factors obesity, hypertension, smoking and physical inactivity were used as response variables. Regression models were complemented by individual-level social status (education) and relevant covariates. RESULTS: Smoking, obesity and low physical activity were more common in deprived neighbourhoods in Germany, even when personal characteristics including individual education were controlled for. For hypertension associations were weak. In the Czech Republic associations were observed for smoking and physical inactivity, but not for obesity and hypertension when individual-level covariates were adjusted for. The strongest association was found for smoking in both countries: in the fully adjusted model the odds ratio for 'high unemployment rate' was 1.30 [95% CI 1.02-1.66] in the Czech Republic and 1.60 [95% CI 1.29-1.98] in Germany. CONCLUSION: In this comparative study, the effects of neighbourhood deprivation varied by country and risk factor; the strongest and most consistent effects were found for smoking. Results indicate that area level SES is associated with health related lifestyles, which might be a possible pathway linking social status and cardiovascular disease. Individual-level education had a considerable influence on the association between neighbourhood characteristics and risk factors.
Dragano N; Bobak M; Wege N; Peasey A; Verde PE; Kubinova R; Weyers S; Moebus S; Möhlenkamp S; Stang A; Erbel R; Jöckel KH; Siegrist J; Pikhart H
Full Text Available Abstract Background Previous studies have shown that deprived neighbourhoods have higher cardiovascular mortality and morbidity rates. Inequalities in the distribution of behaviour related risk factors are one possible explanation for this trend. In our study, we examined the association between cardiovascular risk factors and neighbourhood characteristics. To assess the consistency of associations the design is cross-national with data from nine industrial towns from the Czech Republic and Germany. Methods We combined datasets from two population based studies, one in Germany ('Heinz Nixdorf Recall (HNR) Study'), and one in the Czech Republic ('Health, Alcohol and Psychosocial Factors in Eastern Europe (HAPIEE) Study'). Participation rates were 56% in the HNR and 55% in the HAPIEE study. The subsample for this particular analysis consists of 11,554 men and women from nine German and Czech towns. Census based information on social characteristics of 326 neighbourhoods were collected from local administrative authorities. We used unemployment rate and overcrowding as area-level markers of socioeconomic status (SES). The cardiovascular risk factors obesity, hypertension, smoking and physical inactivity were used as response variables. Regression models were complemented by individual-level social status (education) and relevant covariates. Results Smoking, obesity and low physical activity were more common in deprived neighbourhoods in Germany, even when personal characteristics including individual education were controlled for. For hypertension associations were weak. In the Czech Republic associations were observed for smoking and physical inactivity, but not for obesity and hypertension when individual-level covariates were adjusted for. The strongest association was found for smoking in both countries: in the fully adjusted model the odds ratio for 'high unemployment rate' was 1.30 [95% CI 1.02–1.66] in the Czech Republic and 1.60 [95% CI 1.29–1.98] in Germany. Conclusion In this comparative study, the effects of neighbourhood deprivation varied by country and risk factor; the strongest and most consistent effects were found for smoking. Results indicate that area level SES is associated with health related lifestyles, which might be a possible pathway linking social status and cardiovascular disease. Individual-level education had a considerable influence on the association between neighbourhood characteristics and risk factors.
Dragano Nico; Bobak Martin; Wege Natalia; Peasey Anne; Verde Pablo E; Kubinova Ruzena; Weyers Simone; Moebus Susanne; Möhlenkamp Stefan; Stang Andreas; Erbel Raimund; Jöckel Karl-Heinz; Siegrist Johannes; Pikhart Hynek
STUDY OBJECTIVE: To evaluate the possible role of low socioeconomic status (SES) as a risk factor for cardiovascular disease (CVD) among obstructive sleep apnea syndrome (OSAS) patients requiring treatment. DESIGN: Polysomnographic and demographic characteristics and associated morbidity were measured in 686 prospectively recruited adult OSAS patients from two regions in Israel. SETTING: Two university-affiliated sleep laboratories. MEASUREMENTS AND RESULTS: The multiple logistic regression (after adjusting for gender, body mass index [BMI], and smoking) revealed that the following are independent determinants for CVD in OSAS patients requiring treatment: each decrease in income level category (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1 to 1.7), age > or = 1 year (OR, 1.07; 95% CI, 1.04 to 1.1), hypertension (OR, 2.0; 95% CI, 1.3 to 3.1), and hyperlipidemia (OR, 3.7; 95% CI, 2.4 to 5.8); area under the receiver operating characteristic (ROC) = 81.9%. The multivariate determinants describing the low-SES OSAS patients included: minorities and immigrants combined (OR, 6.0; 95% CI, 2.9 to 12), female gender (OR, 2.4; 95% CI, 1.6 to 3.9), increased BMI (OR, 1.9; 95% CI, 1.3 to 2.9), unmarried status (OR, 1.9; 95% CI, 1.2 to 3.1), and years of education (> or = 1 year) [OR, 0.8; 95% CI, 0.7 to 0.8]; area under the ROC = 78.1%. CONCLUSION: In addition to the already known traditional risk factors, low SES was found to be a novel independent risk factor for CVD among adult OSAS patients requiring treatment.
Tarasiuk A; Greenberg-Dotan S; Simon T; Tal A; Oksenberg A; Reuveni H
STUDY OBJECTIVE: To evaluate whether socioeconomic status (SES) has a role in obstructive sleep apnea syndrome (OSAS) patients' decision to accept continuous positive airway pressure (CPAP) treatment. DESIGN: Cross-sectional study; patients were recruited between March 2007 and December 2007. SETTING: University-affiliated sleep laboratory. PATIENTS: 162 consecutive newly diagnosed (polysomnographically) adult OSAS patients who required CPAP underwent attendant titration and a 2-week adaptation period. RESULTS: 40% (n = 65) of patients who required CPAP therapy accepted this treatment. Patients accepting CPAP were older, had higher apnea-hypopnea index (AHI) and higher income level, and were more likely to sleep in a separate room than patients declining CPAP treatment. More patients who accepted treatment also reported receiving positive information about CPAP treatment from family or friends. Multiple logistic regression (after adjusting for age, body mass index, Epworth Sleepiness Scale, and AHI) revealed that CPAP purchase is determined by: each increased income level category (OR, 95% CI) (2.4; 1.2-4.6), age + 1 year (1.07; 1.01-1.1), AHI ( > or = 35 vs. < 35 events/hr) (4.2, 1.4-12.0), family and/or friends with positive experience of CPAP (2.9, 1.1-7.5), and partner sleeps separately (4.3, 1.4-13.3). CONCLUSIONS: In addition to the already known determinants of CPAP acceptance, patients with low SES are less receptive to CPAP treatment than groups with higher SES. CPAP support and patient education programs should be better tailored for low SES people in order to increase patient treatment initiation and adherence.
Simon-Tuval T; Reuveni H; Greenberg-Dotan S; Oksenberg A; Tal A; Tarasiuk A
BACKGROUND: Malnutrition continues to be a significant public health and development concern around the world with about one-third of the world's children malnourished. OBJECTIVE: To identify and determine the risk factors for undernutrition in children between 6 months and 2 years of age attending outpatient clinics of the pediatric hospital, University of Cairo. PARTICIPANTS AND METHODS: A matched case-control study design was applied. Two hundred malnourished children attending the outpatient malnutrition clinic of the Center for Social and Preventive Medicine (CSPM), Department of Pediatrics, Faculty of Medicine, Cairo University, and 200 healthy controls were included in the study. The study was conducted from January 2010 to June 2010. RESULTS: The mean ages of the patients and controls were 11.31 (±5.6) and 11.5 (±5.3) months, respectively. The identified socioeconomic risk factors for malnutrition in the bivariate analysis were maternal illiteracy [odds ratio (OR=1.85), 95% confidence interval (CI) 1.2-2.85], paternal illiteracy (OR=2.09, 95% CI 1.08-4.04), and large family size, with the number of children greater than three (OR=3.76, 95% CI 2.48-5.71). Logistic regression analysis revealed that the risk for malnutrition was independently associated with lack of exclusive breastfeeding for the first 6 months of life (OR=5.77, 95% CI 3.28-10.17), maternal illiteracy (OR=5.28, 95% CI 1.92-14.5), reluctance to seek medical advice during illness (OR=2.36, 95% CI 1.23-4.54), late initiation of breastfeeding after birth (OR=2.33, 95% CI 1.25-4.33), and nonattendance of health or nutrition sessions (OR=2.02, 95% CI 1.17-3.51). CONCLUSION AND RECOMMENDATIONS: Lack of parental education, poor nutritional behavior, and child-feeding practices are important risk factors among malnourished children. These characteristics can be used for identifying high-risk groups and for designing and targeting preventive intervention programs.
Abdelaziz SB; Hegazy R
BACKGROUND: There is evidence of an association between poor oral health and mortality. This association is usually attributed to inflammatory and nutrition pathways. However, the role of health behaviours and socioeconomic position has not been adequately examined. The aims of this study were to examine the association between oral health and premature death among middle-aged men and to test whether it was explained by socioeconomic position and behaviours. METHODS: Data were from the Vietnam Experience Study, a prospective cohort study of Vietnam War-era (1965-1971), American male army personnel. The authors examined risk of cause-specific and all-cause mortality in relation to poor oral health in middle age, adjusting for age, ethnicity, socioeconomic position, IQ, behavioural factors and systemic conditions. RESULTS: Men with poor oral health experienced a higher risk of cause-specific and all-cause mortality. HRs for all-cause mortality were 2.94 (95% CI 2.11 to 4.08) among individuals with poor oral health and 3.98 (95% CI 2.43 to 6.49) among edentates compared with those with good oral health after adjusting for ethnicity and age. The association attenuated but remained significant after further adjustment for systemic conditions, socioeconomic position and behaviours. Socioeconomic and behavioural factors explained 52% and 44% of mortality risks attributed to poor oral health and being edentate, respectively. CONCLUSION: The findings suggest that oral health-mortality relation is partly due to measured covariates in the present study. Oral health appears to be a marker of socioeconomic and behavioural risk factors related to all-cause mortality.
Sabbah W; Mortensen LH; Sheiham A; Batty D
Full Text Available Abstract Background Psychological factors and socioeconomic status (SES) have a notable impact on health disparities, including type 2 diabetes risk. However, the link between childhood psychosocial factors, such as childhood adversities or parental SES, and metabolic disturbances is less well established. In addition, the lifetime perspective including adult socioeconomic factors remains of further interest. We carried out a systematic review with the main question if there is evidence in population- or community-based studies that childhood adversities (like neglect, traumata and deprivation) have considerable impact on type 2 diabetes incidence and other metabolic disturbances. Also, parental SES was included in the search as risk factor for both, diabetes and adverse childhood experiences. Finally, we assumed that obesity might be a mediator for the association of childhood adversities with diabetes incidence. Therefore, we carried out a second review on obesity, applying a similar search strategy. Methods Two systematic reviews were carried out. Longitudinal, population- or community-based studies were included if they contained data on psychosocial factors in childhood and either diabetes incidence or obesity risk. Results We included ten studies comprising a total of 200,381 individuals. Eight out of ten studies indicated that low parental status was associated with type 2 diabetes incidence or the development of metabolic abnormalities. Adjustment for adult SES and obesity tended to attenuate the childhood SES-attributable risk but the association remained. For obesity, eleven studies were included with a total sample size of 70,420 participants. Four out of eleven studies observed an independent association of low childhood SES on the risk for overweight and obesity later in life. Conclusions Taken together, there is evidence that childhood SES is associated with type 2 diabetes and obesity in later life. The database on the role of psychological factors such as traumata and childhood adversities for the future risk of type 2 diabetes or obesity is too small to draw conclusions. Thus, more population-based longitudinal studies and international standards to assess psychosocial factors are needed to clarify the mechanisms leading to the observed health disparities.
Tamayo Teresa; Christian Herder; Rathmann Wolfgang
Obesity, type 2 diabetes and cardiovascular disease (CVD) are a major concern in many parts of the world. In northern Mexico, these problems have been reported to be higher than in the rest of the country. To assess the different risk factors based on body status (body composition, body size, fat distribution) and lifestyle factors (diet and physical activity) for the development of type 2 diabetes and CVD in men and women from different socioeconomic levels in north-west Mexico
Background: Obesity, type 2 diabetes and cardiovascular disease (CVD) are a major concern in many parts of the world. In Northern Mexico, these problems have been reported to be higher the in the rest of the country. Objective: To assess the different risk factors based on body status (body composition, body size, fat distribution) and lifestyle factors (diet and physical activity) for the development of type 2 diabetes and CVD in men and women from different socio-economic levels in north-west Mexico. Methods: Non probabilistic sample selection by invitation was used to recruit subjects, completing quotas by age groups, gender and socio-economic status. The study included 350 men and women, 20-84 years pertaining to low and high income groups from the city of Hermosillo, Sonora, Mexico. All subjects were measured for body weight, height, waist and hip circumferences, skinfolds, bioimpedance analysis (BIA), systolic and diastolic blood pressure SBP, DBP). Body mass index (BMI) and waist to hip ratio were calculated. An oral glucose tolerance test (OGTT) after a 12 hour fast was performed and blood samples were taken for analysis of insulin, leptin, total cholesterol, HDL, LDL-cholesterol and serum triglycerides. In 273 of the 350 subjects physical activity was studied by questionnaire. Activity was calculated as in categories of low, medium and high intensity and expressed as hours/day with respect to occupational and recreational activities. Physical activity level (PAL) was also calculated from the questionnaires. Body composition was investigated in more detail by air displacement plethysmography (densitometry) and by deuterium dilution in 200 subjects. Diet by 24 hour non-consecutive recalls in another sub-group of 135 male and female subjects. Statistical analysis was performed using NCSS statistical software using ANCOVA and regression procedures. Result: High levels of overweight (BMI >25) and obesity BMI>30) were found in this population group with 65 and 23.4% of them being in these categories respectively. After adjusting for sex and age, results showed that subjects with abnormal glucose tolerance levels had significantly higher weight (p0,120. In terms of body composition percent body fat by BL4 showed the best relationship to insulin sensitivity with the same index. Conclusions: Total body fat and regional fat distribution rather than body size may be a better alternative to assess risk levels for Type 2 diabetes and CVD. For population studies, this has to rely on appropriate field methods such as BIA. However, this has to be validated by recognised methodology such as deuterium dilution, DEXA or body density determinations that can provide the necessary information for specific predictive equation development. Work in Progress: Body composition by deuterium dilution determined by IR spectroscopy and plethysmography to validate BL4 are still in progress bt preliminary results show that either method can be used for validation purposes. Diet and physical activity data analysis will be completed by recruiting 50 mores subjects. Further analysis combining all possible risk indicators through multiple regression procedures are still pending as well as HOAL4 calculations. Take Home Message: The anthropometric evaluation of regional fat distribution and total body fat by BL4 might be an important field technique for type 2 diabetes and C VD risk assessment. Intervention studies that may use the findings in this study for this population would be warranted. (author)
OBJECTIVE: To establish whether socioeconomic differences in mortality exist in the Federal Republic of Germany and whether any such differences are attributable to material, structural, and lifestyle factors. METHODS: The database was the WHO-MONICA cohort study with two cross-sectional surveys performed in the Augsburg area in 1984/85 and 1989/90, and a mortality follow-up performed in 1997/98. The dataset comprised a total of 7268 persons of German nationality aged 25 to 72. RESULTS: Both men and women with lower educational qualifications have less economic resources (materialist thesis), are exposed to higher levels of physical stress at work (structuralist thesis) and lead a significantly less healthy lifestyle (cultural-behavioral thesis). Both males and females with the highest secondary school qualifications are more likely to engage in leisure-time physical activity, have a lower BMI and are less likely to be smokers, passive smokers or heavy drinkers. While these differences are reflected in a socioeconomic group-related mortality risk in males, our data disclose no significant correlation between socioeconomic group (operationalized on the basis of years of education) and mortality in females. CONCLUSIONS: This paper investigates the four most common hypotheses for the internationally well-documented phenomenon of socioeconomic group-related mortality on the basis of nationwide German longitudinal data. Regular nicotine consumption is by far the most significant controllable risk factor for mortality in both genders.
Full Text Available Abstract Background The purpose of this study is to identify factors affecting CSHCN's receiving needed specialty care among different socioeconomic levels. Previous literature has shown that Socioeconomic Status (SES) is a significant factor in CHSHCN receiving access to healthcare. Other literature has shown that factors of insurance, family size, race/ethnicity and sex also have effects on these children's receipt of care. However, this literature does not address whether other factors such as maternal education, geographic location, age, insurance type, severity of condition, or race/ethnicity have different effects on receiving needed specialty care for children in each SES level. Methods Data were obtained from the National Survey of Children with Special Health Care Needs, 2000–2002. The study analyzed the survey which studies whether CHSCN who needed specialty care received it. The analysis included demographic characteristics, geographical location of household, severity of condition, and social factors. Multiple logistic regression models were constructed for SES levels defined by federal poverty level: Results For the poorest children (,199% FPL) being uninsured had a strong negative effect on receiving all needed specialty care. Being Hispanic was a protective factor. Having more than one adult in the household had a positive impact on receipt of needed specialty care but a larger number of children in the family had a negative impact. For the middle income group of children (200–299% of FPL severity of condition had a strong negative association with receipt of needed specialty care. Children in highest income group (> 300% FPL) were positively impacted by living in the Midwest and were negatively impacted by the mother having only some college compared to a four-year degree. Conclusion Factors affecting CSHCN receiving all needed specialty care differed among socioeconomic groups. These differences should be addressed in policy and practice. Future research should explore the CSHCN population by income groups to better serve this population
Lykens Kristine A; Fulda Kimberly G; Bae Sejong; Singh Karan P
OBJECTIVES: This study investigated whether the association between workplace conditions and the risk of all-cause and cardiovascular mortality and acute myocardial infarction differed by socioeconomic status. METHODS: Prospective data were used to examine these associations in 2297 Finnish men, with adjustment for prevalent diseases and biological, behavioral, and psychosocial covariates, and stratified by employment status and workplace social support. RESULTS: Elevated age-adjusted relative hazards for all-cause mortality were found for men who reported high demands, low resources, and low income; high demands, high resources, and low income; and low demands, high resources, and low income. Similar patterns were found for cardiovascular mortality. In contrast, elevated age-adjusted relative hazards for acute myocardial infarction were observed only in men who reported high demands, low resources, and low income. These results did not differ by level of workplace social support or employment status. CONCLUSIONS: The negative effects of workplace conditions on mortality and of myocardial infarction risk depended on income level and were largely mediated by known risk factors.
Lynch J; Krause N; Kaplan GA; Tuomilehto J; Salonen JT
Full Text Available Abstract in portuguese OBJETIVO: Analisar os fatores de risco para o sobrepeso entre adolescentes agrupados em três níveis econômicos diferentes. MÉTODOS: Estudo transversal que incluiu 1779 adolescentes com idade de 11-17 anos, agrupados de acordo com a condição econômica (baixo, médio e alto). Os pais reportaram seus próprios dados antropométricos e os adolescentes tiveram seus dados antropométricos aferidos por avaliadores treinados, e também responderam a três questionários. R (more) ESULTADOS: A prevalência de sobrepeso foi de 16.7%, 23.8% e 26.3% nas classes econonômicas baixa, média e alta, respectivamente (P=0.001). Em todas as condições econômicas, o sobrepeso dos pais foi associado com o sobrepeso dos filhos (P Abstract in english OBJECTIVES: To analyze risk factors for overweight among adolescents grouped in three different socioeconomic levels. METHODS: This cross-sectional study included 1779 adolescents aged 11 to 17 years, grouped according to socioeconomic status (low, middle, and high). Parents reported their own anthropometric data and the adolescents had their anthropometric data taken by trained researchers, and completed three questionnaires. RESULTS: The prevalence of overweight was 16. (more) 7%, 23.8%, and 26.3% in low, middle and high socioeconomic status, respectively (P= 0.001). In all socioeconomic status, parent's overweight was associated with adolescent overweight (all P
Fernandes, Rômulo Araújo; Christofaro, Diego Giulliano Destro; Cardoso, Jefferson Rosa; Ronque, Enio Ricardo Vaz; Freitas Júnior, Ismael Forte; Kawaguti, Sandra Satie; Moraes, Augusto César Ferreira de; Oliveira, Arli Ramos de
The health disparities literature has identified a common pattern among middle-aged African Americans that includes high rates of chronic disease along with low rates of psychiatric disorders despite exposure to high levels of cumulative socioeconomic status (SES) risk. The current study was designed to test hypotheses about the developmental precursors to this pattern. Hypotheses were tested with a representative sample of 443 African American youths living in the rural South. Cumulative SES risk and protective processes were assessed at ages 11-13 years; psychological adjustment was assessed at ages 14-18 years; genotyping at the 5-HTTLPR was conducted at age 16 years; and allostatic load (AL) was assessed at age 19 years. A latent profile analysis identified 5 profiles that evinced distinct patterns of SES risk, AL, and psychological adjustment, with 2 relatively large profiles designated as focal profiles: a physical health vulnerability profile characterized by high SES risk/high AL/low adjustment problems, and a resilient profile characterized by high SES risk/low AL/low adjustment problems. The physical health vulnerability profile mirrored the pattern found in the adult health disparities literature. Multinomial logistic regression analyses indicated that carrying an s allele at the 5-HTTLPR and receiving less peer support distinguished the physical health vulnerability profile from the resilient profile. Protective parenting and planful self-regulation distinguished both focal profiles from the other 3 profiles. The results suggest the public health importance of preventive interventions that enhance coping and reduce the effects of stress across childhood and adolescence.
Brody GH; Yu T; Chen YF; Kogan SM; Evans GW; Beach SR; Windle M; Simons RL; Gerrard M; Gibbons FX; Philibert RA
Full Text Available Abstract Background Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. Methods This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002–2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Results Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Conclusions Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different patterns and varying degrees of socioeconomic inequalities across low- and middle-income settings. Interventions should aim to reach and achieve sustained benefits for high-risk populations.
Hosseinpoor Ahmad; Bergen Nicole; Kunst Anton; Harper Sam; Guthold Regina; Rekve Dag; d'Espaignet Edouard; Naidoo Nirmala; Chatterji Somnath
BACKGROUND: Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. METHODS: This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. RESULTS: Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. CONCLUSIONS: Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different patterns and varying degrees of socioeconomic inequalities across low- and middle-income settings. Interventions should aim to reach and achieve sustained benefits for high-risk populations.
Hosseinpoor AR; Bergen N; Kunst A; Harper S; Guthold R; Rekve D; d'Espaignet ET; Naidoo N; Chatterji S
BACKGROUND: A higher incidence of convulsive status epilepticus (CSE) has been reported in nonwhite compared to white populations. Socioeconomic factors can be intricately involved in observed ethnic "effects," and the importance of socioeconomic status on health conditions is widely recognized. Understanding the effect of socioeconomic factors on CSE would provide insights into etiology and management, leading to the development of novel prevention strategies. METHODS: From a population-based UK study on childhood CSE, we tested the hypothesis that socioeconomic deprivation independent of ethnicity increases the risk of childhood CSE. Home postal codes were used to measure the socioeconomic status of the neighborhood in which patients lived relative to that of the borough in which the neighborhood was located. The child's ethnicity was reported by parent(s). Relationships between socioeconomic status, ethnicity, and incidence were investigated using Poisson regression analysis. RESULTS: A total of 176 children were enrolled. The incidence of CSE in nonwhite children [18.5, 95% confidence interval (CI) 13.7-23.3/100,000/year] was 1.8 (95% CI 1.3-2.4) times greater than for white children (10.5, 95% CI 7.9-13.1/100,000/year) (p < 0.0005). Socioeconomic deprivation and Asian ethnicity were independently associated with increased incidence. For each point increase in Index of Multiple Deprivation (IMD) 2004, there was a 1.03 cumulative increased relative risk (95% CI 1.01-1.06, p = 0.007). Asian children were 5.7 times (95% CI 1.7-18.9) more likely than white children to have a first-ever episode of CSE (p = 0.004). Socioeconomic and ethnicity effects were related to etiology of CSE. INTERPRETATION: Ethnic and socioeconomic factors independently affect risk for prolonged febrile seizures and acute symptomatic CSE, but not for other types of childhood CSE.
Chin RF; Neville BG; Peckham C; Wade A; Bedford H; Scott RC
Full Text Available Abstract Background The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. Methods Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. Results In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. Conclusions We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects.
Schumann Barbara; Kluttig Alexander; Tiller Daniel; Werdan Karl; Haerting Johannes; Greiser Karin H
OBJECTIVES: To examine secular and socio-economic changes in cardiovascular disease risk factor prevalences in the Scottish population. This could contribute to a better understanding of why the decline in coronary heart disease mortality in Scotland has recently stalled along with a widening of socio-economic inequalities. DESIGN: Four Scottish Health Surveys 1995, 1998, 2003 and 2008 (6190, 6656, 5497 and 4202 respondents, respectively, aged 25-64 years) were used to examine gender-stratified, age-standardised prevalences of smoking, alcohol consumption, physical activity, fruit and vegetable consumption, discretionary salt use and self-reported diabetes or hypertension. Prevalences were determined according to education and social class. Inequalities were assessed using the slope index of inequality, and time trends were determined using linear regression. RESULTS: There were moderate secular declines in the prevalence of smoking, excess alcohol consumption and physical inactivity. Smoking prevalence declined between 1995 and 2008 from 33.4% (95% CI 31.8% to 35.0%) to 29.9% (27.9% to 31.8%) for men and from 36.1% (34.5% to 37.8%) to 27.4% (25.5% to 29.3%) for women. Adverse trends in prevalence were noted for self-reported diabetes and hypertension. Over the four surveys, the diabetes prevalence increased from 1.9% (1.4% to 2.4%) to 3.6% (2.8% to 4.4%) for men and from 1.7% (1.2% to 2.1%) to 3.0% (2.3% to 3.7%) for women. Socio-economic inequalities were evident for almost all risk factors, irrespective of the measure used. These social gradients appeared to be maintained over the four surveys. An exception was self-reported diabetes where, although inequalities were small, the gradient increased over time. Alcohol consumption was unique in consistently showing an inverse gradient, especially for women. CONCLUSIONS: There has been only a moderate decline in behavioural cardiovascular risk factor prevalences since 1995, with increases in self-reported diabetes and hypertension. Adverse socio-economic gradients have remained unchanged. These findings could help explain the recent stagnation in coronary heart disease mortalities and persistence of related inequalities.
Hotchkiss JW; Davies C; Gray L; Bromley C; Capewell S; Leyland AH
Full Text Available Abstract Background Our aims were to determine the pace of change in cardiovascular risk factors by age, gender and socioeconomic groups from 1994 to 2008, and quantify the magnitude, direction and change in absolute and relative inequalities. Methods Time trend analysis was used to measure change in absolute and relative inequalities in risk factors by gender and age (16-54, ? 55 years), using repeated cross-sectional data from the Health Survey for England 1994-2008. Seven risk factors were examined: smoking, obesity, diabetes, high blood pressure, raised cholesterol, consumption of five or more daily portions of fruit and vegetables, and physical activity. Socioeconomic group was measured using the Index of Multiple Deprivation 2007. Results Between 1994 and 2008, the prevalence of smoking, high blood pressure and raised cholesterol decreased in most deprivation quintiles. However, obesity and diabetes increased. Increasing absolute inequalities were found in obesity in older men and women (p = 0.044 and p = 0.027 respectively), diabetes in young men and older women (p = 0.036 and p = 0.019 respectively), and physical activity in older women (p = 0.025). Relative inequality increased in high blood pressure in young women (p = 0.005). The prevalence of raised cholesterol showed widening absolute and relative inverse gradients from 1998 onwards in older men (p = 0.004 and p ? 0.001 respectively) and women (p ? 0.001 and p ? 0.001). Conclusions Favourable trends in smoking, blood pressure and cholesterol are consistent with falling coronary heart disease death rates. However, adverse trends in obesity and diabetes are likely to counteract some of these gains. Furthermore, little progress over the last 15 years has been made towards reducing inequalities. Implementation of known effective population based approaches in combination with interventions targeted at individuals/subgroups with poorer cardiovascular risk profiles are therefore recommended to reduce social inequalities.
Scholes Shaun; Bajekal Madhavi; Love Hande; Hawkins Nathaniel; Raine Rosalind; O'Flaherty Martin; Capewell Simon
The study aimed to estimate prevalence of self-reported arthritis or rheumatism and associated factors. This was a cross-sectional population-based study in Florianopolis, Santa Catarina State, Brazil, with 1,720 adults ranging from 20 to 59 years of age. Presence of self-reported arthritis or rheumatism was analyzed with a hierarchical approach, considering demographic, socioeconomic, and behavioral variables and use of health services. Logistic regression was used to evaluate the association between the outcome and independent variables. Prevalence of self-reported arthritis or rheumatism was 7.7% (95%CI: 6.4-8.9). The odds of self-reported arthritis were twice as high in women, and increased self-reported arthritis was directly associated with BMI > 30 kg/m(2) and increasing age and inversely proportional to schooling. Self-reported arthritis or rheumatism was higher in this sample than in Brazilian adults in general in 2008. The results suggest the need to plan public health policies to address this problem.
Gomes RS; Peres KG
Full Text Available OBJECTIVES: To analyze risk factors for overweight among adolescents grouped in three different socioeconomic levels. METHODS: This cross-sectional study included 1779 adolescents aged 11 to 17 years, grouped according to socioeconomic status (low, middle, and high). Parents reported their own anthropometric data and the adolescents had their anthropometric data taken by trained researchers, and completed three questionnaires. RESULTS: The prevalence of overweight was 16.7%, 23.8%, and 26.3% in low, middle and high socioeconomic status, respectively (P= 0.001). In all socioeconomic status, parent's overweight was associated with adolescent overweight (all POBJETIVO: Analisar os fatores de risco para o sobrepeso entre adolescentes agrupados em três níveis econômicos diferentes. MÉTODOS: Estudo transversal que incluiu 1779 adolescentes com idade de 11-17 anos, agrupados de acordo com a condição econômica (baixo, médio e alto). Os pais reportaram seus próprios dados antropométricos e os adolescentes tiveram seus dados antropométricos aferidos por avaliadores treinados, e também responderam a três questionários. RESULTADOS: A prevalência de sobrepeso foi de 16.7%, 23.8% e 26.3% nas classes econonômicas baixa, média e alta, respectivamente (P=0.001). Em todas as condições econômicas, o sobrepeso dos pais foi associado com o sobrepeso dos filhos (P<0.05). Os estudantes de classes econômicas média e alta (RP=2.00) de escolas privadas foram associados com o sobrepeso, e estudantes de baixo nível sócio-econômico com comportamento sedentário (RP = 2,25) e alta ingestão de frituras (PR = 2.35). CONCLUSÃO: Em cada nível socioeconômico o sobrepeso é associado com diferentes fatores de risco de diferente formas, exceto para pais com sobrepeso.
Rômulo Araújo Fernandes; Diego Giulliano Destro Christofaro; Jefferson Rosa Cardoso; Enio Ricardo Vaz Ronque; Ismael Forte Freitas Júnior; Sandra Satie Kawaguti; Augusto César Ferreira de Moraes; Arli Ramos de Oliveira
OBJECTIVE: To verify the prevalence of intestinal parasitic infections among preschoolers and to identify the associated risk factors. METHODS: The study is a cross-sectional study nested in a cohort of children who were born and resident in Diamantina, Minas Gerais, Brazil. At the time of the study, all children were aged 60 months ± five months. They were recruited after written informed consent was obtained from parents or guardians. The study was carried out between July 2009 and July 2010. In total 214 children provided a stool sample for examination on intestinal parasitic infections. Information on potential risk factors for parasitosis was obtained from parents and guardians of the children by a questionnaire. Logistic regression was used for analysis. RESULTS: Intestinal parasitic infections were found in 27·5% (n = 59) of children. The boys' infection prevalence (26·1%, n = 36) was slightly lower than the infection prevalence of the girls (30·3%, n = 23), but not statistically different (p = 0·51). Fourteen children, (23·7%) were infected with two or more parasite species and forty-five (76·3%) with single parasites. A low per capita income of family was strongly associated with an increased risk for an infection (OR = 2·89; P = 0.003). Preschoolers whose mothers did not work outside home had a significantly lower risk for infection (OR = 0·41; p = 0·01). CONCLUSION: Intestinal parasite infection is a health problem among Diamantina preschoolers. Poverty was implicated as an important risk factor for infection, while the presence of the mother at home full-time was a protective factor.
Nobre LN; Silva RV; Macedo MS; Teixeira RA; Lamounier JA; Franceschini SC
BACKGROUND: Although many authors have investigated the impact of sex on the association between socio-economic status (SES) and suicide, a definite consensus has not yet emerged. Using Danish population registration data including 15 648 suicide deaths of individuals aged 18-65 year during 1981-97 and matched population controls, we investigate the associations of multiple SES factors with suicide risk and explore the sex-specific aspects of these associations. METHODS: We use conditional logistic regression models to estimate the statistical relationship between SES, sex and suicide. RESULTS: SES, proxied by low income, unskilled blue-collar work, non-specific wage work and unemployment, increases suicide risk more prominently for men than for women. Marital status has a comparable influence on suicide risk in both sexes; parenthood is protective against suicide, and the effect is larger for women. Living in a large city raises suicide risk for women but reduces it for men; residents with a foreign citizenship in Denmark have a lower risk of suicide compared with Danish citizens, but this protection is confined to male immigrants. CONCLUSIONS: Our results demonstrate that suicide risk is associated with a range of SES proxies but the strength and/or direction of the association can differ by sex. Risk assessment and, therefore, prevention approaches should take this into consideration.
Andrés AR; Collings S; Qin P
Full Text Available Abstract Background There is a dearth of information on diet-related chronic diseases in West Africa. This cross-sectional study assessed the rate of obesity and other cardiovascular disease (CVD) risk factors in a random sample of 200 urban adults in Benin and explored the associations between these factors and socio-economic status (SES), urbanisation as well as lifestyle patterns. Methods Anthropometric parameters (height, weight and waist circumference), blood pressure, fasting plasma glucose, and serum lipids (HDL-cholesterol and triglycerides) were measured. WHO cut-offs were used to define CVD risk factors. Food intake and physical activity were assessed with three non-consecutive 24-hour recalls. Information on tobacco use and alcohol consumption was collected using a questionnaire. An overall lifestyle score (OLS) was created based on diet quality, alcohol consumption, smoking, and physical activity. A SES score was computed based on education, main occupation and household amenities (as proxy for income). Results The most prevalent CVD risk factors were overall obesity (18%), abdominal obesity (32%), hypertension (23%), and low HDL-cholesterol (13%). Diabetes and hypertriglyceridemia were uncommon. The prevalence of overall obesity was roughly four times higher in women than in men (28 vs. 8%). After controlling for age and sex, the odds of obesity increased significantly with SES, while a longer exposure to the urban environment was associated with higher odds of hypertension. Of the single lifestyle factors examined, physical activity was the most strongly associated with several CVD risk factors. Logistic regression analyses revealed that the likelihood of obesity and hypertension decreased significantly as the OLS improved, while controlling for potential confounding factors. Conclusion Our data show that obesity and cardio-metabolic risk factors are highly prevalent among urban adults in Benin, which calls for urgent measures to avert the rise of diet-related chronic diseases. People with higher SES and those with a longer exposure to the urban environment are priority target groups for interventions focusing on environmental risk factors that are amenable to change in this population. Lifestyle interventions would appear appropriate, with particular emphasis on physical activity.
Sodjinou Roger; Agueh Victoire; Fayomi Benjamin; Delisle Hélène
Full Text Available Abstract Background Malaria is a major health issue in French Guiana. Amerindian communities remain the most affected. A previous study in Camopi highlighted the predominant role of environmental factors in the occurrence of malaria. However, all parameters involved in the transmission were not clearly identified. A new survey was conducted in order to clarify the risk factors for the presence of malaria cases in Camopi. Methods An open cohort of children under seven years of age was set up on the basis of biologically confirmed malaria cases for the period 2001-2009. Epidemiological and observational environmental data were collected using two structured questionnaires. Data were analysed with a multiple failures multivariate Cox model. The influence of climate and the river level on malaria incidence was evaluated by time-series analysis. Relationships between Anopheles darlingi human biting rates and malaria incidence rates were estimated using Spearman's rank correlation. Results The global annual incidence over the nine-year period was 238 per 1,000 for Plasmodium falciparum, 514 per 1,000 for Plasmodium visa and 21 per 1,000 for mixed infections. The multivariate survival analysis associated higher malaria incidence with living on the Camopi riverside vs. the Oyapock riverside, far from the centre of the Camopi hamlet, in a home with numerous occupants and going to sleep late. On the contrary, living in a house cleared of all vegetation within 50 m and at high distance of the forest were associated with a lower risk. Meteorological and hydrological characteristics appeared to be correlated with malaria incidence with different lags. Anopheles darlingi human biting rate was also positively correlated to incident malaria in children one month later. Conclusions Malaria incidence in children remains high in young children despite the appearance of immunity in children around three years of age. The closeness environment but also the meteorological parameters play an important role in malaria transmission among children under seven years of age in Camopi.
Stefani Aurélia; Hanf Matthieu; Nacher Mathieu; Girod Romain; Carme Bernard
The purpose of this study was to examine socio-economic differences in the risk of hospitalisation among children aged 0-5 years in Denmark from 1985 to 2004. All children born between 1985 and 2004 (n=1,278,286) were followed for hospital admissions for infectious diseases from the 29th day of life until the children reached the age of 6 years or the end of 2004, whichever came first. Information on parental socio-economic position (education, labour market attachment and household income) was gathered through record linkage with administrative registries. Infections were grouped into upper respiratory, lower respiratory, gastrointestinal, ear and fever infections. The data were analysed using Cox regression. Children of parents on sick leave or early retirement had an increased risk of being hospitalised with an infection compared with children of employed parents. A clear inverse educational gradient in risk of offspring hospitalisation was also found. From 1985 to 2004 the inverse associations between parental education and risk of hospitalisation grew stronger, whereas the comparatively weaker association between household income and risk of offspring hospitalisation decreased in magnitude. The association between socio-economic status and hospitalisation was strongest for lower respiratory, gastrointestinal and ear infections. This study documented a socially patterned hospitalisation of pre-school children in Denmark. Future studies should investigate possible explanations for the increased risk among children from families with low socio-economic status.
Biering-SØrensen, Sofie; SØndergaard, Grethe
African Americans suffer disproportionately from advanced and progressive chronic kidney disease (CKD). Socioeconomic factors are believed to play an important role in this disparity, and likely influence African Americans' increased risk of CKD through multiple pathways. Low socioeconomic status (SES) may contribute to racial disparities in CKD because of the greater prevalence of poverty, for example, among African Americans as compared with whites. However, low SES has a stronger relation with CKD among African Americans than among whites, underscoring that the context and magnitude of socioeconomic influences on CKD outcomes varies between these populations. These socioeconomic influences may produce new or potentiate existing racial differences in biology. This review discusses what is known about the role of SES in explaining racial disparities in CKD, highlights several knowledge gaps in this area, and suggests future directions toward the elimination of disparities in CKD.
Crews DC; Pfaff T; Powe NR
Full Text Available Abstract in portuguese OBJETIVO: investigar a associação de fatores de risco obstétricos, demográficos, socioeconômicos e psicossociais com a presença de risco ao desenvolvimento infantil nas faixas etária de um a dezoito meses de idade. MÉTODO: a amostra inicial foi constituída de 182 díades mãe-bebê e final de 58 díades. A coleta de dados ocorreu por meio da análise da interação mãe-bebê feita com base no Protocolo de Indicadores de Risco ao Desenvolvimento Infantil e de uma (more) entrevista que investigou aspectos socioeconômicos, demográficos, obstétricos e psicossociais na primeira etapa da pesquisa. Os dados foram organizados em uma planilha eletrônica e posteriormente convertidos para os aplicativos computacionais para análise estatística. RESULTADOS: os fatores de risco significantes para as quatro fases do protocolo foram, na faixa de zero a quatro meses o estado civil da mãe e o número de filhos; na faixa de quatro a oito meses o número de consultas pré-natal e a renda per capita; na faixa de oito a doze meses o planejamento da gestação; e na faixa de doze a dezoito meses o histórico de depressão materna, a idade da mãe e a profissão da mãe. CONCLUSÃO: a pesquisa demonstrou que as condições socioeconômicas, obstétricas, psicossociais e demográficas podem oferecer risco ao desenvolvimento infantil. Abstract in english PURPOSE: to investigate obstetric, demographic, socioeconomic and psychosocial risk factors of mother-child dyads for the occurrence of changes in the Risk Indicators for Child Development (IRDI) in children age groups from zero to 18 months. METHOD: the sample consisted of 182 mother-infant dyads. Data collection occurred through the analysis of mother-infant interaction ??based on the Risk Indicators for Child Development (IRDI) Protocol and on an interview (more) which investigated socio-economic, demographic, obstetric and psychosocial aspects in the first stage of the procedures. Data were organized into an electronic spreadsheet and then converted to computer software for statistical analisys. RESULTS: the significant risk factors for the four phases of IRDI were, in the range of zero to four months, the mother's marital status and number of children; in the range of four to eight months, the number of prenatal visits and per capita income; in the range of eight to twelve months, pregnancy planning; and in the range of twelve to eighteen months, maternal depression history, the mother's age and profession. CONCLUSION: the study demonstrated that the environment and the situations in which the mother-infant dyad is part of, may hinder or facilitate the development of the infant.
Crestani, Anelise Henrich; Mattana, Felipe; Moraes, Anaelena Bragança de; Souza, Ana Paula Ramos de
OBJECTIVE: To develop culturally competent community based blood pressure control programs for inner-city African Americans. DESIGN: Cross sectional study of randomly selected households from three experimental and three control communities. SETTING: Very low, moderately low and moderate socio-economic status (SES) inner-city communities in Chicago, Illinois. PARTICIPANTS: 957 African Americans adults, aged 18 and over from target communities. MAIN OUTCOME MEASURE: Household health assessments included employment, education and other demographic information, history of hypertension, disease prevalence, health behaviors, risk factor prevalence, stress, coping/John Henryism, social support, health care utilization and standardized assessments of blood pressure, height, and weight. RESULTS: There were no significant gender differences in blood pressure levels. Men had more hypertension than women, and women in the very low SES community had significantly more hypertension than women in the moderately low SES community. There was significantly more hypertension overall in the moderately low SES community. Age, education and BMI were the only factors significantly associated with systolic and diastolic blood pressure in all three communities. The very low SES community had significantly more obesity and more uninsured persons than the other communities. CONCLUSIONS: Intraracial diversity is an important factor to be considered in the development of community blood pressure control programs for African Americans. Age, gender, educational background and SES play a major role in influencing health behaviors and access to health care.
Shakoor-Abdullah B; Kotchen JM; Walker WE; Chelius TH; Hoffmann RG
Does IQ explain socio-economic differentials in total and cardiovascular disease mortality? Comparison with the explanatory power of traditional cardiovascular disease risk factors in the Vietnam Experience Study
The aim of this study was to examine the explanatory power of intelligence (IQ) compared with traditional cardiovascular disease (CVD) risk factors in the relationship of socio-economic disadvantage with total and CVD mortality, that is the extent to which IQ may account for the variance in this well-documented association.
Batty, G David; Shipley, Martin J
OBJECTIVE: To examine the relationships between socioeconomic status (SES), psychosocial vulnerability (hostility), and allostatic load. Allostatic load refers to the cumulative physiological cost of adaptation to stress. METHOD: We examined the relationships between SES (as measured by educational attainment), hostility, and allostatic load in the Normative Aging Study, a longitudinal study of community-dwelling men aged 21 to 80 years and free of known chronic medical conditions at entry in the 1960s. In 1986, the revised Minnesota Multiphasic Personality Inventory was administered by mail, from which a hostility measure was derived by summing the scores from three Cook-Medley subscales: Hostile Affect, Hostile Attribution, Aggressive Responding. An index of allostatic load was constructed from data collected during physical exams conducted between 1987 and 1990 (i.e. measures reflecting "wear and tear" on the cardiovascular, endocrine, and metabolic systems). Cross-sectional relationships between education, hostility, and allostatic load were examined in 818 men. RESULTS: Separate linear regression analyses indicated that lower levels of educational attainment and greater hostility were both associated with higher allostatic load scores (p < .05 and p < .01, respectively). Less education was also associated with higher hostility (p < .001). When allostatic load was regressed simultaneously on education and hostility, the effect of education was attenuated, while hostility (p < .05) maintained an independent effect. CONCLUSIONS: Our findings suggest that lower levels of education and greater hostility are associated with greater "wear and tear" on the body. The effects of education on allostatic load may be mediated by hostility.
Kubzansky LD; Kawachi I; Sparrow D
AIM: Prevalence and severity of dental caries in 14-year-olds of Northeast Italy were estimated, evaluating the dependence to SES. MATERIALS AND METHODS: An epidemiological survey was performed among a randomised cluster sample of 560 (290 M and 270 F) 14-year-olds attending secondary schools, to evaluate DMFS following WHO indications. Association between caries occurrence and SES was evaluated in a logistic regression model. To account for high proportion of zero scores (DMFS and DS distribution highly positively skewed) data was moreover modelled with negative binomial regression and zero-inflated models. RESULTS: Caries prevalence was 63.4% with a mean DMFS of 3.0 ± 3.8. A significant trend between means was observed regarding DS in the different SES levels: z = 2.22 p = 0.03 (occupational level) and z = 3.45 p<0.01 when SES was based on educational level. The Negative Binomial Regression model resulted more appropriate than the Poisson model because the dispersion parameter was significantly different from zero (alpha=1.5, 95% CI=1.3-1.8). Working class status showed significant association with DMFS (p=0.04) while using DS as dependent variable, working class subjects and subjects with medium-low and low educational level, showed a statistically significant association. CONCLUSION: Socioeconomic status is still a predictor for dental decay in the Italian 14-year-olds.
Ferro R; Besostri A; Olivieri A; Stellini E; Denotti G; Campus G
Full Text Available Abstract Background Though vascular factors may be important in the aetiology of late-life depression, it is not clear whether they have a major effect on the risk of depression after a stroke. We investigated the relationship between physiological, biochemical, neuro-imaging and socio-economic factors and late-phase post-stroke depression in a cross-sectional case-control study. Methods People living at home at least 9 months after a stroke were interviewed using a structured proforma. Depression was diagnosed according to DSM-IV criteria, together with a Montgomery Asberg (MADRS) score >17. Stroke survivors of similar age and functional status but without symptoms of, or recent treatment for, depression and with MADRS score Results Stroke survivors with depression were more likely than controls to have been smokers, to have had hypertension or peripheral arterial disease, and to have had more than one stroke or multiple discrete brainscan lesions. In univariate analysis they had significantly higher blood pressure, lower Mini-Mental State (MMSE) scores, higher serum homocysteine and lower folate levels, as well as more extensive white matter and basal ganglia changes on brainscan. In logistic regression, previous hypertension (OR 3.4), peripheral vascular disease (OR 4.7), number of strokes (OR 2), MMSE score (OR 0.76) and basal ganglia changes (OR 2.2), were independently associated with depression. Conclusion These results suggest that patients with hypertension, hyperhomocysteinaemia and other factors associated with cerebral small vessel disease, may be more susceptible to post-stroke depression. Future intervention trials should focus on such high risk groups.
Chatterjee Kausik; Fall Susan; Barer David
Full Text Available Abstract Background Low birth weight (LBW) is a public health problem linked to lack of equity in populations. Despite efforts to decrease the proportion of newborns with LBW, success has been quite limited. In recent years, studies focused on explaining how social factors influence this problem have shown that populations with greater inequities have a greater proportion of newborns with LBW. Methods The objective was to describe socioeconomic factors related to LBW adjusted by demographic, reproductive and health services variables in Mexico City. A case-control study was carried out in three hospitals with gynaecological and obstetrics services in Mexico City during the first half of 1996. During the recruiting period all children with LBW (cases), defined as newborns weighing Results We found that low socioeconomic level was the most important risk factor for LBW and was independent of other factors, including those related to reproduction and nutrition, smoking, morbidity during pregnancy, accessibility to health services and prenatal care (OR 2.68; 95% CI 1.19, 6.03). Conclusion We found that socioeconomic factors are relevant to LBW. However further research should be done in different population groups as well as developing precise ways of measuring socioeconomic factors and their role in reproductive health.
Torres-Arreola Laura P; Constantino-Casas Patricia; Flores-Hernández Sergio; Villa-Barragán Juan; Rendón-Macías Enrique
Does IQ explain socio-economic differentials in total and cardiovascular disease mortality? Comparison with the explanatory power of traditional cardiovascular disease risk factors in the Vietnam Experience Study.
AIMS: The aim of this study was to examine the explanatory power of intelligence (IQ) compared with traditional cardiovascular disease (CVD) risk factors in the relationship of socio-economic disadvantage with total and CVD mortality, that is the extent to which IQ may account for the variance in this well-documented association. METHODS AND RESULTS: Cohort study of 4289 US male former military personnel with data on four widely used markers of socio-economic position (early adulthood and current income, occupational prestige, and education), IQ test scores (early adulthood and middle-age), a range of nine established CVD risk factors (systolic and diastolic blood pressure, total blood cholesterol, HDL cholesterol, body mass index, smoking, blood glucose, resting heart rate, and forced expiratory volume in 1 s), and later mortality. We used the relative index of inequality (RII) to quantify the relation between each index of socio-economic position and mortality. Fifteen years of mortality surveillance gave rise to 237 deaths (62 from CVD and 175 from 'other' causes). In age-adjusted analyses, as expected, each of the four indices of socio-economic position was inversely associated with total, CVD, and 'other' causes of mortality, such that elevated rates were evident in the most socio-economically disadvantaged men. When IQ in middle-age was introduced to the age-adjusted model, there was marked attenuation in the RII across the socio-economic predictors for total mortality (average 50% attenuation in RII), CVD (55%), and 'other' causes of death (49%). When the nine traditional risk factors were added to the age-adjusted model, the comparable reduction in RII was less marked than that seen after IQ adjustment: all-causes (40%), CVD (40%), and 'other' mortality (43%). Adding IQ to the latter model resulted in marked, additional explanatory power for all outcomes in comparison to the age-adjusted analyses: all-causes (63%), CVD (63%), and 'other' mortality (65%). When we utilized IQ in early adulthood rather than middle-age as an explanatory variable, the attenuating effect on the socio-economic gradient was less pronounced although the same pattern was still present. CONCLUSION: In the present analyses of socio-economic gradients in total and CVD mortality, IQ appeared to offer greater explanatory power than that apparent for traditional CVD risk factors.
Batty GD; Shipley MJ; Dundas R; Macintyre S; Der G; Mortensen LH; Deary IJ
BACKGROUND: There is a paucity of data on patients with stroke/transient ischaemic attack in low- and middle-income countries. We sought to describe the characteristics and management of patients with an ischaemic stroke and recent transient ischaemic attack or minor ischaemic strokes in low- or middle-income countries. METHODS: The Outcomes in Patients with TIA and Cerebrovascular disease registry is an international, prospective study. Patients ?45 years who required secondary prevention of stroke (either following an acute transient ischaemic attack or minor ischaemic strokes (National Institutes of Health Stroke Scale <4) of <24?h duration, or recent (<6 months), stable, first-ever, non-disabling ischaemic stroke) were enrolled in 17 countries in Latin America, the Middle East, and Africa. The main measures of interest were risk factors, comorbidities, and socio-economic variables. RESULTS: Between January 2007 and December 2008, 3635 patients were enrolled in Latin America (n?=?1543), the Middle East (n?=?1041), North Africa (n?=?834), and South Africa (n?=?217). Of these, 63% had a stable, first-ever ischaemic stroke (median delay from symptom onset to inclusion, 25 days interquartile range, 7-77); 37% had an acute transient ischaemic attack or minor ischaemic stroke (median delay, two-days; interquartile range, 0-6). Prevalence of diabetes was 46% in the Middle East, 29% in Latin America, 35% in South Africa, and 38% in North Africa; 72% had abdominal obesity (range, 65-78%; adjusted P?0·001); prevalence of metabolic syndrome was 78% (range, 72-84%, P?0·001). Abnormal ankle brachial index (<0·9) was present in 22%, peripheral artery disease in 7·6%, and coronary artery disease in 13%. Overall, 24% of patients had no health insurance and 27% had a low educational level. INTERPRETATION: In this study, patients in low- and middle-income countries had a high burden of modifiable risk factors. High rates of low educational level and lack of health insurance in certain regions are potential obstacles to risk factor control. FUNDING: The Outcomes in Patients with TIA and Cerebrovascular disease registry is supported by Sanofi-Aventis, Paris, France.
Abboud H; Labreuche J; Arauz A; Bryer A; Lavados PG; Massaro A; Munoz Collazos M; Steg PG; Yamout BI; Vicaut E; Amarenco P
A total of 6600 pregnant urban women attending an antenatal clinic of a major hospital in Malawi were evaluated for risk factors for human immunodeficiency virus type 1 (HIV-1) infection. HIV-1 seroprevalence was 23% and significantly (P < .001) associated with markers of heterosexual activity (history of sexually transmitted diseases [STDs], more than one sexual partner, reports of husbands with other partners, and all prevalent STDs except chlamydial infection) and higher socioeconomic status (as measured by husband's education). History of injections, scarification, and transfusions were not associated with HIV-1 infection. In two logistic regression models, higher socioeconomic status was a risk factor for HIV-1 infection (odds ratio [OR] = 2.69, P < .001) but not for STDs (OR = 0.94, P = .30). The opposite associations between HIV-1 and socioeconomic status and STDs and socioeconomic status suggest that HIV prevention strategies, in addition to STD diagnosis and treatment, should include interventions to reduce high-risk sexual activity and promote condom use.
Dallabetta GA; Miotti PG; Chiphangwi JD; Saah AJ; Liomba G; Odaka N; Sungani F; Hoover DR
Using negative binomial and multi-level Poisson models, the authors determined the statistical significance of agricultural and socio-economic risk factors for rates of reported disease associated with Escherichia coli O157 in census subdivisions (CSDs) in Alberta, Canada, 2000-2002. Variables relating to population stability, aboriginal composition of the CSDs, and the economic relationship between CSDs and urban centres were significant risk factors. The percentage of individuals living in low-income households was not a statistically significant risk factor for rates of disease. The statistical significance of cattle density, recorded at a higher geographical level, depended on the method used to correct for overdispersion, the number of levels included in the multi-level models, and the choice of using all reported cases or only sporadic cases. Our results highlight the importance of local socio-economic risk factors in determining rates of disease associated with E. coli O157, but their relationship with individual risk factors requires further evaluation.
Pearl DL; Louie M; Chui L; Doré K; Grimsrud KM; Martin SW; Michel P; Svenson LW; McEwen SA
PURPOSE: To assess whether body mass index (BMI), blood pressure, and socioeconomic status in adolescence and early adulthood are independently related to the metabolic syndrome in adult women and men. METHODS: We based our work on a Swedish prospective cohort study that recruited participants at 16 years of age (N = 1083 at age 16; 403 women and 429 men at age 43, 78% of those still alive [N = 1071]). Blood pressure (BP) and BMI were assessed when participants were 16 and 21 years of age. At age 43, the metabolic syndrome was defined according to the International Diabetes Federation guidelines. Socioeconomic status (SES) was operationalized by the participant (age 21 and 43) or parent's (age 16) occupational status. Information on smoking, snuff, alcohol, and inactivity was collected at age 43. RESULTS: In women, SES at age 16 was independently related to the risk of metabolic syndrome. In women and men, BMI at age 16 was related to metabolic syndrome but was attenuated by BMI at age 21, which was significant in the final model; in women systolic BP displayed similar patterns. CONCLUSIONS: Our data seem to suggest two independent life course pathways for metabolic syndrome: one metabolic pathway for both women and men operating through BMI (for women also systolic BP) in adolescence and early adulthood, and for women, an apparently independent pathway through adolescent socioeconomic disadvantage.
Gustafsson PE; Persson M; Hammarström A
Full Text Available Background: Child vaccinations are one of most cost effective health programs that have weakened a number of child morbidity and mortality rate all over the world. Pakistan is considered one of the major country of the world, where people especially children are bound by many harmful infectious diseases like polio, hepatitis, viral infections etc. The effectiveness of routine childhood immunization programs relies on multiple factors. Socio-economic determinants have the potential to affect immunization programs. The purpose of the present study was to determine the association between socio-economic factors and polio vaccination coverage among children inPakistan. Methods: The study used data from the Pakistandemographic health survey (PDHS 2006-07 N 10023). The study focused on respondents who had births in last five years. Descriptive and inferential statistics were used to determine the association between variables. Spss version 20 was used for data analysis. A number of socioeconomic variables were used in chi square & binary logistic regression model to check out their association with polio vaccination coverage. Results: Study shows that most dominant factors associated with polio vaccination coverage were region that is NWFP OR 3.48 (odd ratio) with 95% confidence interval (C-I 2.06 & 3.13) & Punjab OR 2.54 (C-I 2.062 & 3.131), residence urban OR 1.626 (C-I 1.451 & 1.822), sex of child male OR 1.125 (C-I 1.008 & 1.256), age of mother 25 - 34 years OR 1.11 (C-I 0.978 & 1.276), wealth index rich OR 2.98 (C-I 2.55 & 3.48), age of child 4 - 5 years OR 1.17 (C-I 0.899 & 1.538), mother’s education higher OR 2.06 (C-I 1.776 & 2.411), father’s education higher OR 1.399 (C-I 1.221 & 1.203) ,father’s occupation professional OR 1.27 (C-I 0.929 & 1.737). Conclusion: In developing countries like Pakistan most of the children remain unvaccinated because of many socio-economic constraints. Poor marginalized people have a low awareness regarding the importance of polio vaccine. Along with social hierarchies, educational attainment of parents is a strong indicator of defining awareness level regarding vaccination.
Sheeba Arooj; Sitwat Ali; Nimra Baber; Atif Abbasi; Midhat Ali
Full Text Available Using register-based data on Finnish first marriages that were intact at the end of 1990 (about 2.1 million marriage-years) and followed up for divorce in 1991-1993 (n = 21,204), this research explored the possibility that the effect of spouses' socioeconomic position on divorce risk varies according to duration of marriage. The comparatively high divorce risks for spouses with little formal education and for spouses in manual worker occupations were found to be specific to marriages of relatively short duration. In contrast, such factors as unemployment, wife's high income, and living in a rented dwelling were found to increase divorce risk at all marital durations.
Full Text Available Purpose: The aim of this study is twofold – on the one hand, to analyze the relationship between incidence of breast cancer, income per capita and medical equipment across countries; after that, the study here discusses the drivers of the incidence of breast cancer across countries in order to pinpoint differences and similarities. Methods: The indicators used are incidence of breast cancer based on Age-standardized rate (ASW); Gross domestic product (GDP) per capita by purchasing power parity (current international $); computed tomography (CT) for cancer diagnosis. Data include 52 countries. The statistical analysis is carried out by correlation, ANOVA and an econometric modeling based on a multiple regression model of the breast cancer incidence on two explanatory variables. Results: Partial correlation is higher: rbreast cancer, GDP ? CT=60.3% (sign.0.00). The estimated relationship shows an expected incidence of breast cancer increase of approximately 0.05% for a GDP increase of 1% and an expected incidence of breast cancer increase of approximately 3.23% for a CT increase of 1%. ANOVA confirms that incidence of breast cancer is higher across richer countries, ceteris paribus.Conclusions: Empirical evidence shows that the breast cancer tends to be higher across richer countries, measured by GDP per capita and number of Computed Tomography. The main determinants of these findings can be due to several socio-economic factors, mainly localized in richer countries. In addition, this research may provide an alternative interpretation to the theory of Oh et al. (2010) on the influence of latitude on breast cancer, focusing on socio-economic factors rather than biologic root causes.
Anees B. Chagpar; Mario Coccia
Factores de riesgo de fallecer en domicilio por neumonía, de niños chilenos de estratos socioeconómicos bajos, Santiago de Chile (1990-1994) Risk factors for home deaths due to pneumonia among low socioeconomic level Chilean children
Full Text Available Background: Pneumonia is the main cause of late infant mortality in Chile. Over 60% of these deaths occur at home. The lack of hospital beds and the inadequate outpatient management are contributing factors. Aim: To assess risk factors for home deaths due to pneumonia in Chilean children. Patients and methods: The clinical and environmental histories of 53 (39 male) children that died due to pneumonia in their homes were analyzed. The cause of death was confirmed by necropsy with histopathological studies in all cases. These cases were compared with 88 control children of similar age, gender, socioeconomic status and living in the same geographical area of Metropolitan Santiago. Results: Fifty four percent of deceased children were of less than 3 months of age and only 3 cases and their controls were above1 year old. Identified risk factors for death were malnutrition with an odds ratio of 30.6 (CI 3.9-64.8, p< 0.001), low birth weight with an odds ratio of 5 (CI 1.8-14.1, p< 0.001), previous admissions to hospitals with an odds ratio of 5.79 (CI 2-17.1, p< 0.001), congenital malformations (mainly cardiac) with an odds ratio of 8.4 (CI 2-39.9, p= 0.001) and a history of bronchial obstruction with an odds ratio of 5.68 (p< 0.001). Identified maternal risk factors were smoking with an odds ratio of 4.13 (CI 1.6-10.7 p< 0.001) and being a teenager with an odds ratio of 4.3 (CI 1.7-11, p<0.001). Malnutrition, low birth weight, history of previous hospital admissions and having a teenager or smoker mother were considered as independent risk factors using a stepwise analysis. Conclusions: Chilean low income children have identifiable risk factors for death at their homes due to pneumonia, that can be preventively managed. (Rev Méd Chile 2000; 128: 627-32)
Leonardo Véjar E; Juan C Casterán; Patricia Navarrete; Salomé Sánchez; Patricio LeCerf S; Carlos Castillo D
Full Text Available Abstract in portuguese A presbiacusia é consequência de lesões histopatológicas da orelha interna e nervo coclear e leva à deficiência auditiva sensório-neural. Fatores de risco como doenças sistêmicas e hábitos inadequados são agravantes para presbiacusia. A identificação destes fatores é relevante para sua prevenção. OBJETIVO: Avaliar a prevalência da presbiacusia e correlacionar eventuais fatores de risco numa amostra populacional. CASUÍSTICA E MÉTODO: Estudo retrospectivo (more) de série de casos com amostragem aleatória de 625 prontuários de indivíduos sem e com presbiacusia determinada por avaliação audiológica convencional. Foi feita a análise da associação da presbiacusia com fatores de risco pré-estabelecidos. RESULTADOS: A prevalência da presbiacusia foi de 36,1% na amostra, com idade média de 50,5 anos e variou de 40 anos a 86 anos e foi constituída de 85,5% do gênero masculino e 14,5% do gênero feminino. Os fatores de risco associados foram idade, gênero masculino, diabetes melito e história familiar de presbiacusia. Não houve associação entre presbiacusia e profissão, hipertensão arterial sistêmica, dislipidemia, hábitos de fumar e de beber. CONCLUSÃO: Os resultados demonstram que, embora a presbiacusia apresente múltiplos fatores de risco enumerados na literatura, estes fatores na presente amostra foram limitados ao antecedente familiar de presbiacusia, idade, gênero masculino e diabetes melito. Abstract in english Presbycusis, or the aging ear, involves mainly the inner ear and the cochlear nerve, causing sensorineural hearing loss. Risk factors include systemic diseases and poor habits that cause inner ear damage and lead to presbycusis. Correct identification of these risk factors is relevant for prevention. AIM: To evaluate the prevalence and to identify the risk factors of presbycusis in a sample aged over 40 years. Study design: a retrospective case series. SUBJECTS AND METHOD (more) S: medical records of 625 patients were evaluated. Presbycusis was identified using pure tone audiometry, speech audiometry and impedance testing of all patients. RESULTS: The prevalence of presbycusis was 36.1%; the mean age was 50.5 years ranging from 40 to 86 years; 85.5% were male and 14.5% werf female. Age, the male gender, diabetes mellitus, and hereditary hearing loss were identified as risk factors. Cardiovascular diseases, smoking and consumption of alcohol were not confirmed as risk factors, although these have often been mentioned as risk factors for presbycusis. CONCLUSION: Notwithstanding the idea that presbycusis has multiple risk factors, this study identified few risk factors for this disease.
Sousa, Cláudia Simônica de; Castro Júnior, Ney de; Larsson, Erkki Juhani; Ching, Ting Hui
Full Text Available Presbycusis, or the aging ear, involves mainly the inner ear and the cochlear nerve, causing sensorineural hearing loss. Risk factors include systemic diseases and poor habits that cause inner ear damage and lead to presbycusis. Correct identification of these risk factors is relevant for prevention. AIM: To evaluate the prevalence and to identify the risk factors of presbycusis in a sample aged over 40 years. Study design: a retrospective case series. SUBJECTS AND METHODS: medical records of 625 patients were evaluated. Presbycusis was identified using pure tone audiometry, speech audiometry and impedance testing of all patients. RESULTS: The prevalence of presbycusis was 36.1%; the mean age was 50.5 years ranging from 40 to 86 years; 85.5% were male and 14.5% werf female. Age, the male gender, diabetes mellitus, and hereditary hearing loss were identified as risk factors. Cardiovascular diseases, smoking and consumption of alcohol were not confirmed as risk factors, although these have often been mentioned as risk factors for presbycusis. CONCLUSION: Notwithstanding the idea that presbycusis has multiple risk factors, this study identified few risk factors for this disease.A presbiacusia é consequência de lesões histopatológicas da orelha interna e nervo coclear e leva à deficiência auditiva sensório-neural. Fatores de risco como doenças sistêmicas e hábitos inadequados são agravantes para presbiacusia. A identificação destes fatores é relevante para sua prevenção. OBJETIVO: Avaliar a prevalência da presbiacusia e correlacionar eventuais fatores de risco numa amostra populacional. CASUÍSTICA E MÉTODO: Estudo retrospectivo de série de casos com amostragem aleatória de 625 prontuários de indivíduos sem e com presbiacusia determinada por avaliação audiológica convencional. Foi feita a análise da associação da presbiacusia com fatores de risco pré-estabelecidos. RESULTADOS: A prevalência da presbiacusia foi de 36,1% na amostra, com idade média de 50,5 anos e variou de 40 anos a 86 anos e foi constituída de 85,5% do gênero masculino e 14,5% do gênero feminino. Os fatores de risco associados foram idade, gênero masculino, diabetes melito e história familiar de presbiacusia. Não houve associação entre presbiacusia e profissão, hipertensão arterial sistêmica, dislipidemia, hábitos de fumar e de beber. CONCLUSÃO: Os resultados demonstram que, embora a presbiacusia apresente múltiplos fatores de risco enumerados na literatura, estes fatores na presente amostra foram limitados ao antecedente familiar de presbiacusia, idade, gênero masculino e diabetes melito.
Cláudia Simônica de Sousa; Ney de Castro Júnior; Erkki Juhani Larsson; Ting Hui Ching
The risk of progression from exposure to the tuberculosis bacilli to the development of active disease is a two-stage process governed by both exogenous and endogenous risk factors. Exogenous factors play a key role in accentuating the progression from exposure to infection among which the bacillary load in the sputum and the proximity of an individual to an infectious TB case are key factors. Similarly endogenous factors lead in progression from infection to active TB disease. Along with well-established risk factors (such as human immunodeficiency virus (HIV), malnutrition, and young age), emerging variables such as diabetes, indoor air pollution, alcohol, use of immunosuppressive drugs, and tobacco smoke play a significant role at both the individual and population level. Socioeconomic and behavioral factors are also shown to increase the susceptibility to infection. Specific groups such as health care workers and indigenous population are also at an increased risk of TB infection and disease. This paper summarizes these factors along with health system issues such as the effects of delay in diagnosis of TB in the transmission of the bacilli.
Narasimhan P; Wood J; Macintyre CR; Mathai D
Full Text Available Abstract Background Unnecessary ambulance use has become a socioeconomic problem in Japan. We investigated the possible relations between socioeconomic factors and medically unnecessary ambulance calls, and we estimated the incremental demand for unnecessary ambulance use produced by socioeconomic factors. Methods We conducted a self-administered questionnaire-based survey targeting residents of Yokohama, Japan. The questionnaire included questions pertaining to socioeconomic characteristics, dichotomous choice method questions pertaining to ambulance calls in hypothetical nonemergency situations, and questions on the city's emergency medical system. The probit model was used to analyze the data. Results A total of 2,029 out of 3,363 targeted recipients completed the questionnaire (response rate, 60.3%). Probit regression analyses showed that several demographic and socioeconomic factors influence the decision to call an ambulance. Male respondents were more apt than female respondents to state that they would call an ambulance in nonemergency situations (p Conclusion Results of the study suggest that several socioeconomic factors, i.e., age, gender, household income, and possession of a car, influence a person's decision to call an ambulance in nonemergency situations. Hesitation to use an ambulance and knowledge of the city's primary emergency medical center are likely to be important factors limiting ambulance overuse. It was estimated that unnecessary ambulance use is increased approximately 10% to 20% by socioeconomic factors.
Kawakami Chihiro; Ohshige Kenji; Kubota Katsuaki; Tochikubo Osamu
In this paper we examine the link between unemployment and health. The negative health selection hypothesis, which proposes that poor health poses an unemployment risk, is tested using data from the German Socio-Economic Panel (GSOEP). The statistical influence of health related variables on the duration of employment for a cohort of workers is estimated. Results from the Cox proportional hazards regression model show gender and nationality specific negative selection. In the event of a long or chronic illness female workers are at a higher risk of unemployment than male workers. Whereas chronic illness raises the probability of unemployment among foreign workers, there is no statistical evidence for this for German workers. The paper, thus, shows that health factors determining unemployment affect different types of workers in different ways. Consequently, results from aggregate studies may be misleading. A second result of the paper is that, irrespective of gender and nationality, there is strong evidence for lagged state dependence on previous spells of unemployment, i.e. individuals who had experienced unemployment previously were more at risk of renewed unemployment than those without such spells. These findings do not only confirm the selection hypothesis, but also illustrate how labour market risks are closely associated with attributes of social inequality and how this could result in the accumulation of risks for those who are socially or politically vulnerable in the labour market.
Full Text Available Abstract in portuguese OBJETIVO: Este estudo tem como objetivo identificar, utilizando modelagem estatística, os fatores de risco da anemia em crianças de 6 a 59 meses de idade no estado de Pernambuco, contemplando aspectos socioeconômicos e da dieta. MÉTODOS: A amostra constou de 746 crianças de 6 a 59 meses do estado de Pernambuco, nas quais foram realizados dosagem de hemoglobina e inquérito dietético recordatório de 24 horas. Foi analisado o risco de anemia em relação às variáve (more) is socioeconômicas e de consumo alimentar, utilizando modelos de análise multivariada. RESULTADOS: Os fatores de risco para a anemia foram: alta proporção de calorias do leite de vaca, baixa densidade de ferro não-heme, baixa idade e baixa escolaridade materna, destacando-se que as crianças com menos de 24 meses apresentaram risco 3,61 vezes maior de serem anêmicas em relação às demais. CONCLUSÕES: O presente estudo reforça a importância de se conhecer o consumo alimentar das crianças no país para melhor estabelecer a sua associação com a ocorrência da anemia. Os resultados revelaram que os fatores que mais explicaram o risco de anemia foram, com relação à dieta, a maior proporção de calorias do leite de vaca e menor densidade de ferro não-heme, além de idade menor de 24 meses e baixa escolaridade materna. Abstract in english OBJECTIVE: The objective of this study was to use statistical modeling to identify risk factors for anemia in children aged 6 to 59 months in the state of Pernambuco, covering socioeconomic and dietary aspects. METHODS: The sample comprised 746 children aged between 6 and 59 months from the state of Pernambuco. Their hemoglobin was assayed and a 24-hour dietary recall performed. Risk of anemia was analyzed with relation to socioeconomic variables and to dietary intakes, u (more) sing multivariate analysis models. RESULTS: The risk factors for anemia were: a high proportion of calories from cow's milk, low density of nonheme iron, low age and low maternal educational level; age was the most prominent factor, with children under 24 months exhibiting 3.61 times greater risk of being anemic than the older children. CONCLUSIONS: This study confirms the need for a clear picture of the dietary intake of children in Brazil, in order that associations with anemia can be better understood. Our results revealed that the dietary factors which were most responsible for risk of anemia were a greater proportion of calories from cow's milk and lower density of nonheme iron, in addition to age below 24 months and low maternal educational level.
Oliveira, Maria A. A.; Osório, Mônica M.; Raposo, Maria C. F.
Mortalidade neonatal no Município de São Paulo: influência do peso ao nascer e de fatores sócio-demográficos e assistenciais Neonatal mortality: socio-economic, health services risk factors and birth weight in the City of São Paulo
Full Text Available INTRODUÇÃO: A mortalidade neonatal no Município de São Paulo, apesar da sua tendência decrescente, constitui em um importante problema para a saúde pública. Os principais fatores de risco podem ser agrupados em quatro categorias básicas de variáveis: características do recém-nascido, características maternas, condições socioeconômicas e características dos serviços de saúde. O peso ao nascer e a prematuridade constituem fatores dominantes, compondo complexas redes de articulação com os demais. METODOLOGIA: Este é um estudo caso-controle, com base em dados vinculados do SIM e SINASC no Município de São Paulo, no primeiro semestre de 1995. Foi utilizada análise hierárquica, considerando quatro blocos de variáveis (características socioeconômicas, do recém-nascido, maternas e serviços de saúde) para o conjunto de recém-nascidos e para três grupos de peso ao nascer: BACKGROUND: Although neonatal mortality has been declining in the City of São Paulo, it still is an important public health problem. Four basic categories constitute risk factors: newborn characteristics, maternal characteristics, socio-economic conditions and quality of health care. Low birth weight and prematurity are the dominant factors and constitute a complex network with other factors. METHODS: A case-control study was carried out based on linked birth and death certificates of the City of São Paulo for the first semester of 1995. The study performed a hierarchical analysis, considering four blocks of variables (characteristics of the new-born; mothers, health care and socio-economic status) for all birth-weight groups together and separately for three birth-weight groups: 2,500g. RESULTS: The final model for all newborns together showed statistical significant association for mothers under 20 years of age, being born in a SUS hospital, birth weight <2,500g and prematurity. The three birth weight groups showed distinctive patterns of risk factors. Those <1,500g had lower mortality when born in a university hospital and caesarean section. The 1,500-2,499g group had increased risk for mortality with prematurity, male sex and high parity of mother. In the more than 2,500g group, risk factors for mortality were prematurity, adolescent mother, living in an area with low quality of life, being born in a SUS hospital and caesarean section. CONCLUSION: This study, while pointing out the enormous influence of low birth weight on neonatal mortality in São Paulo, demonstrated that different birth weight categories have distinct biological and social vulnerabilities with complex links, and that health services have an important role to play for each of them.
Marcia Furquim de Almeida; Hillegonda Maria Dutilh Novaes; Gizelton Pereira Alencar; Laura C. Rodrigues
A soft mathematical model, taking stock of the stochastic and cooperative features of the economy of thinking in the decision making, is aggregated to unveil hidden connections between energy policy and the energy technology choices of an establishment. Starting from several assumptions on the nature of the collective decisional behavior, one obtains a probabilistic interpretation of the mechanism of penetration of energy technologies. The probability that the establishment bets on a certain technological profile is given as a solution to a Fokker-Planck equation accounting for the decision game. It provides a topological variety that accomodates possible states of the system and their trajectories, and indicates ways in which different attractors drive the technology choice in the space of the energy policy. In this framework, a series of concepts (i.e., logistic evolution, resilience, stability, risks of disruption or crisis, energy security) can find in a natural way strikingly intuitive interpretations. Strategic games are possible on this ground, confirming facts of life and also showing predictive power. The complex and difficult to manage interdependence between energy policy and technology appears as a challenge to the long-term planning of alternative energy systems. To meet the challenge, preparedness for changes through a large freedom of choice on the technological options appears as a necessary complement to the faithful observance of the market drives, which stresses the importance of having available perceptive, coherent, reliable, and responsible mechanisms of decision making.
Ursu, I.; Gheorghe, A.; Purica, I.I.; Vamanv, D.
Previous longitudinal studies have demonstrated the importance of measuring stability of risk factors over time to correct for attenuation bias. The present aim was to assess the stability of scores for eight psychometric scales over a 2-yr. period and whether stability differed by socioeconomic pos...
Lundberg, Johanna; Karlsson, Nadine; Kristenson, Margareta
To investigate whether sex-specific associations exist between migraine, lifestyle or socioeconomic factors. We distinguished between the subtypes migraine with aura (MA) and migraine without aura (MO). In 2002, a questionnaire containing validated questions to diagnose migraine and questions on lifestyle and socioeconomic factors was sent to 46,418 twin individuals residing in Denmark. 31,865 twin individuals aged 20-71 were included. The twins are representative of the Danish population with regard to migraine and other somatic diseases and were used as such in the present study. An increased risk of migraine was significantly associated with lower level of schooling and education, retirement, unemployment, and smoking. A decreased risk of migraine was significantly associated with heavy physical exercise and intake of alcohol. Direct comparison between the subtypes showed a decreased risk of MA compared to MO in subjects with low education or weekly intake of alcohol. The risk of MA was increased compared to MO in unemployed or retired subjects. Direct comparison between sexes showed a decreased risk of migraine for men compared to women in subjects who were low educated, unemployed or studying. The risk was increased for men compared to women in subjects with heavy physical exercise, intake of alcohol, and body mass index >25. Migraine was associated with several lifestyle and socioeconomic factors. Most associations such as low education and employment status were probably due to the negative effects of having migraine while others such as smoking were risk factors for migraine.
Le, Han; Tfelt-Hansen, Peer
To investigate whether sex-specific associations exist between migraine, lifestyle or socioeconomic factors. We distinguished between the subtypes migraine with aura (MA) and migraine without aura (MO). In 2002, a questionnaire containing validated questions to diagnose migraine and questions on lifestyle and socioeconomic factors was sent to 46,418 twin individuals residing in Denmark. 31,865 twin individuals aged 20-71 were included. The twins are representative of the Danish population with regard to migraine and other somatic diseases and were used as such in the present study. An increased risk of migraine was significantly associated with lower level of schooling and education, retirement, unemployment, and smoking. A decreased risk of migraine was significantly associated with heavy physical exercise and intake of alcohol. Direct comparison between the subtypes showed a decreased risk of MA compared to MO in subjects with low education or weekly intake of alcohol. The risk of MA was increased compared to MO in unemployed or retired subjects. Direct comparison between sexes showed a decreased risk of migraine for men compared to women in subjects who were low educated, unemployed or studying. The risk was increased for men compared to women in subjects with heavy physical exercise, intake of alcohol, and body mass index >25. Migraine was associated with several lifestyle and socioeconomic factors. Most associations such as low education and employment status were probably due to the negative effects of having migraine while others such as smoking were risk factors for migraine.
Le, Ngoc Han; Tfelt-Hansen, Peer
The environmental risk factors related to the breast tumors (lumps) are essential in order to build strategies to decrease cancer incidence and mortality among different socioeconomic and cultural backgrounds. A case control study of 70 cases and 52 controls were classified into high, middle and low socioeconomic classes. The results revealed significant increased risk of breast tumors among working females, having positive family history, married with lower mean parity, with higher consumption of fatty meals, lesser meat intake. Non significant risk factors were the social class, exposure to ionizing radiation, non lactating. wearing tight bra, consumption of vegetables and fruits, oral contraceptive pill users and exposure to outdoor air pollution or indoor pollution as floors and wall paintings. In conclusion, this study highlights the positive life style for egyptian women so they can prevent some of the environmental risks of breast tumors. Increasing the awareness of breast diseases and regular examination remains the corner stone for early detection management of breast lumps.
Associations between socioeconomic status and cardiovascular risk factors in an urban population in China/ Association entre le niveau socio-économique et les facteurs de risque cardio-vasculaire dans une population urbaine de Chine/ Relación entre la situación socioeconómica y los factores de riesgo de enfermedades cardiovasculares en una población urbana de China
Full Text Available Abstract in spanish Se ha demostrado que la situación socioeconómica (SSE) es un factor importante en la progresión de las enfermedades cardiovasculares en los países desarrollados. En cambio, hay pocos datos sobre la relación entre la SSE y los factores de riesgo de contraer dichas enfermedades en los países en desarrollo. China es el país en desarrollo más grande del mundo, pero los informes precedentes de ese país en que se cuantifican los efectos de diferentes dimensiones de la (more) SSE en los factores de riesgo cardiovascular son escasos. Por esta razón, realizamos una evaluación transversal para investigar la relación entre el grado de instrucción, la ocupación, los ingresos y el estado civil, por un lado, y tres factores de riesgo de enfermedad cardiovascular - tensión arterial, índice de masa corporal y hábito de fumar - entre la población urbana de Tianjin, la tercera ciudad más populosa de China. En 1996 se realizó una encuesta de población transversal en Tianjin. La muestra para ese estudio se obtuvo por un procedimiento en dos etapas. Primero se tomaron al azar en la zona urbana 14 comunidades con un total de 400 000 habitantes. En la segunda etapa se tomaron al azar de los registros de población, en las comunidades muestreadas, 4000 personas de edad comprendida entre 15 y 69 años. La muestra se estratificó por sexos y grupos de edad (el grupo de más edad, 55-69 años). El presente estudio se ha limitado a las personas entrevistadas de edad comprendida entre 25 y 69 años (1615 varones y 1592 mujeres). Se determinaron en la encuesta cuatro indicadores socioeconómicos (grado de instrucción, ocupación, ingresos y estado civil), así como la tensión arterial, el índice de masa corporal y el hábito de fumar de los participantes. El grado de instrucción parece ser el más importante de los cuatro indicadores socioeconómicos en relación con los factores de riesgo cardiovascular en la población estudiada. En general, las personas con SSE más baja tenían niveles más altos de factores de riesgo cardiovascular, y la relación entre la SSE y los factores de riesgo cardiovascular fue más sistemática en las mujeres que en los varones. Asimismo, las diferencias fueron más amplias en las mujeres que en los varones. Nuestros hallazgos no parecen diferir de los observados en los países desarrollados. Abstract in english INTRODUCTIONS: In developed countries socioeconomic status has been proven to be an important factor in the progression of cardiovascular disease. The present article reports the results of a cross-sectional assessment to investigate the association between socioeconomic status and cardiovascular risk factors in a Chinese urban population. METHODS: In 1996, a behavioural risk factor survey was carried out in Tianjin, the third largest city in China. A sample of 4000 peopl (more) e aged 15-69 years, stratified by sex and 10-year age groups, was drawn randomly from urban areas of the city. The present study covers respondents aged 25-69 years (1615 men and 1592 women). Four socioeconomic indicators (education, occupation, income, and marital status), blood pressure, body mass index, and cigarette smoking were determined in the survey. RESULTS: Educational level seemed to be the most important measure of the four socioeconomic indicators in relation to the cardiovascular risk factors in the study population. People with lower socioeconomic status had higher levels of cardiovascular risk factors. The association between socioeconomic status and cardiovascular risk factors was more consistent among women than men. DISCUSSION: Our findings do not seem to differ from those observed in developed countries.
Yu, Zhijie; Nissinen, Aulikki; Vartiainen, Erkki; Song, Guide; Guo, Zeyu; Zheng, Gengwen; Tuomilehto, Jaakko; Tian, Huiguang
AIMS: The prevalence of diabetes is increasing, and screening of high-risk populations is recommended. A low attendance rate has been observed in many Type 2 diabetes screening programmes, so that an analysis of factors related to attendance is therefore relevant. This paper analyses the association between socioeconomic factors and attendance for Type 2 diabetes screening. METHODS: Persons aged 40-69 years (n = 4603) were invited to participate in a stepwise diabetes screening programme performed in general practitioners' offices in the county of Aarhus, Denmark in 2001. The study was population-based and cross-sectional with follow-up. The association between screening attendance in the high-risk population and socioeconomic factors was analysed by odds ratio. RESULTS: Forty-four percent of the estimated high-risk population attended the screening programme. In those with known risk for Type 2 diabetes, attenders were more likely to be older, to be unemployed and to live in the countryside than non-attenders. The risk for Type 2 diabetes was unknown for 21% of the study population; this group was younger and less likely to be cohabitant, skilled, or employed and to have middle or high income than the study population with known risk score for diabetes. CONCLUSIONS: A low attendance rate was found in this screening programme for Type 2 diabetes. No substantial socioeconomic difference was found between attenders and non-attenders in the high-risk population. Further research is needed to uncover barriers to screening of Type 2 diabetes in socioeconomically deprived persons Udgivelsesdato: 2009/5
Dalsgaard, E.M.; Lauritzen, T.
Full Text Available Background and Design: There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. In this study, we aimed to find out the risk factors which could play role in the etiopathogenesis in our pemphigus patients.Material and method: A total of 42 patients (15 male and 27 female) who were diagnosed as pemphigus with histopathological and direct immunoflurosence examinations in our clinic between the years 1998-2004, were interviewed for assessment of regarding with the subjects of the demographic properties, occupational groups, educational level, the number of pregnancies, stressfull life events, diet habits, smoking and alcohol consumption before the onset of the disease and the results were compared to 42 age and gender-matched controls with similar socioeconomic circumstances. Results: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were found to be statistically significant in pemphigus patients than in controls. Conclusion: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were assumed to play role in the etiopathogenesis and course of pemphigus.
Gül?en Tükenmez Demirc; Ay?e Tülin Mansur; ?kbal Esen Ayd?ngöz
OBJECTIVES: To examine the socio-economic, behavioural and Métis-specific factors that predict obesity among Métis children aged 6 to 14 years. Socio-economic factors included household structure and income, parental education and food insecurity. Cultural factors included knowledge of an Aboriginal language, participation in cultural activities, time spent with Elders and parental residential school attendance. METHODS: The 2006 Aboriginal Peoples Survey, Children and Youth component collected data about Métis children, including child height and weight, reported by the person most knowledgeable about the child (PMK). Multivariate binary logistic regression was used to predict obesity, defined using IOTF BMI cut-offs. After testing for interactions, models were stratified by age (6-10, 11-14) and gender. RESULTS: An estimated 18.5% of Métis boys and 14.4% of girls were obese. The effects of socio-economic factors and region varied across age and gender groups, although living in a lone-parent family and rural residence had consistent effects. Many effects of cultural variables were unexpected. Although PMK residential schooling was positively associated with obesity generally, the effects were negative among older girls. As expected, children participating in frequent physical activity generally had lower risk, independent of other factors. CONCLUSIONS: Although socio-economic factors are related to risk of obesity among Métis children, the effects may not be the same across age groups and for boys and girls. There is some evidence of independent effects of Métis-specific cultural factors, including parental residential schooling, on the risk of child obesity, but further investigation and better data are needed to understand these relationships.
Cooke MJ; Wilk P; Paul KW; Gonneville SL
The objective of this study was to evaluate and compare the motor coordination of Brazilian schoolchildren of different socioeconomic status in their first year of primary education. Factors associated with inadequate fine motor skills were identified. A total of 238 schoolchildren, 118 from a public school and 120 from a private school, were evaluated on fine motor skills using the Evolutional Neurological Examination. Statistical analysis was performed using univariate logistic regression followed by multivariate analysis. Children attending public school had a 5.5-fold greater risk of having inadequate fine motor skills for their age compared to children attending private school, while children who started school after four years of age had a 2.8-fold greater risk of having inadequate motor coordination compared to children who began school earlier. Data for this sample suggest socioeconomic factors and later entry of children to school may be associated with their fine motor skills.
Bobbio TG; Morcillo AM; Barros Filho Ade A; Concalves VM
Dynamic violent behavior risk factors have special significance since they constitute the main target for preventive intervention. Different dynamic factors as well as violent recidivism were assessed with, among other instruments, the environmental risk (Risk Management) section of the Argentinean version of the HCR-20 in 25 parolees from the Province of Buenos Aires Penitentiary System. Among other findings, the prevalence of the risk factors linked to substance abuse and socioeconomic deprivation, and the heterogeneous perception of the official institutions are very significant. Exposure to destabilizers was the factor most associated with violent recidivism.
Folino JO; Cáceres MS; Campos ML; Silveri M; Ucín S; Ascazibar M
Full Text Available Abstract Background Cutaneous melanoma (CM) is a cancer usually associated with high socio-economic level in the literature. Few studies have, however, assessed this relationship by gender and site or the association between CM and rurality. Methods A major-sized historical occupational Swedish cohort comprising 2,992,166 workers was used to estimate relative risk of cutaneous melanoma, broken down by gender and anatomical site, for occupational sectors (as a proxy of socio-economic class) and rurality. To this end, Poisson models were fitted for each site in men and women, including occupational sector and town size, with adjustment for age, period of diagnosis and geographical area as possible confounding factors. Results White collar workers presented a marked increased of risk in men in all melanoma cases, as well as in trunk, upper and lower limbs. This pattern was less clear for women, in which some heterogeneity appeared, as low risks in lower socioeconomic sectors in trunk, or risk excesses in white collar workers in lower limbs did not achieve statistical significance. Males also showed significant differences in risk by rural/urban distribution, but in women this association was limited to CM of lower limb. Risk of CM of head/neck did not vary by occupational sector or town size, thus depicting a specific epidemiological profile, which proved common to both sexes. Conclusion While differences in risk between men and women could suggest greater homogeneity in UV-exposure behaviour among women, the uniform risk pattern in head and neck melanoma, present in both sexes, might support the coexistence of different aetiological pathways, related to anatomical site.
Pérez-Gómez Beatriz; Aragonés Nuria; Gustavsson Per; Lope Virginia; López-Abente Gonzalo; Pollán Marina
PURPOSE: The aim of the present study was to describe sexual health in Spain according to three important indicators of the World Health Organization definition and explore the influence of socioeconomic factors. METHODS: We performed a population-based cross-sectional study of sexually active people aged 16-44 years residing in Spain in 2009 (2365 women and 2532 men). Three main aspects of sexual health were explored: sexual satisfaction, safe sex, and sexual abuse. The independent variables explored were age, age at first intercourse, reason for first intercourse, type of partner, level of education, country of origin, religiousness, parity, and social class. Bivariate and multivariate logistic regression models were fitted. RESULTS: Both men and women were quite satisfied with their sexual life, their first sexual intercourse, and their sexual relationships during the previous year. Most participants had practiced safe sex both at first intercourse and during the previous year. Levels of sexual abuse were similar to those in other developed countries. People of disadvantaged socioeconomic position have less satisfying, more unsafe, and more abusive sexual relationships. Women experienced more sexual abuse and had less satisfaction at their first intercourse. CONCLUSIONS: The state of sexual health in Spain is relatively good. However, we observed inequalities according to gender and socioeconomic position.
Ruiz-Muñoz D; Wellings K; Castellanos-Torres E; Alvarez-Dardet C; Casals-Cases M; Pérez G
Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: A matched case-control study in a less developed country Factores de riesgo hereditarios y socioeconómicos para labio o paladar hendido no asociados a un síndrome en México: estudio de casos y controles pareado
Full Text Available Introduction. From an epidemiological point of view, non-syndromic orofacial clefts are the most common oral congenital deformities worldwide.Objective. Family histories were traced and socioeconomic risk factors were identified for non-syndromic cleft lip with or without cleft palate.Material and methods. A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were patients attending a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered to collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated.Results. In the multivariate model, the following risk factors were identified: 1) low socioeconomic status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicly funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father's or mother's family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate; 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenatal care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with or without cleft palate (odds ratio=0.29).Conclusions. A "social gradient in health" was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomic status. Further characterization of risk factors will guide the assemblage of a pro-active counseling and prevention program for families at risk for non-syndromic cleft lip and cleft palate.Introducción. Desde el punto de vista epidemiológico, las hendiduras faciales son las deformidades orales más comunes alrededor del mundo.Objetivo. Identificar los factores de riesgo hereditarios y socioeconómicos relacionados con la presencia de labio o paladar hendido no asociados a un síndrome.Materiales y métodos. Se hizo un estudio de casos y controles en el que se incluyeron 208 casos con diagnóstico de labio, paladar hendido o ambos no asociados a un síndrome, los cuales fueron pareados por edad y sexo con 416 controles. Se incluyeron todos los pacientes quirúrgicos atendidos durante el periodo 2002-2004 en el programa estatal de labio o paladar hendido de Campeche, México. Se aplicó un cuestionario en el que se recogió información sobre variables sociodemográficas y socioeconómicas, así como sobre antecedentes hereditarios de labio o paladar hendido no asociados a un síndrome en la familia. Debido a que el diseño fue pareado, el análisis se hizo con regresión logística condicionada.Resultados. En el modelo multivariado para labio o paladar hendido no asociado a un síndrome se identificaron de forma significativa (p<0,05) los siguientes factores de riesgo: nivel socioeconómico bajo (razón de momios, RM=2,02), nacimiento en el sur del estado (RM=3,96), nacimiento en casa (RM=2,51) o nacimiento en hospital público (RM=4,08), antecedentes heredofamiliares paternos (RM=5,38), antecedentes heredofamiliares maternos (RM=4,11), tener otro hijo con labio o paladar hendido en la familia (RM=46,02), presentar algún otro defecto congénito asociado (RM=8,20) e infección en el embarazo (RM=2,90), y como factor protector, el cuidado prenatal y el uso de vitaminas (RM=0,29).Conclusiones. El mayor riesgo en nuestra muestra para labio, paladar hendido o ambos, no asociados a un síndrome, radica en las variables relacionadas con los antecedentes familiares y hereditarios, y las indicadoras de la posición socioecon&
Gladys Acuña-González; Carlo E. Medina-Solís; Gerardo Maupomé; Mauricio Escoffie-Ramírez; Jesús Hernández-Romano; María de L. Márquez-Corona; Arturo J. Islas-Márquez; Juan J. Villalobos-Rodelo
Full Text Available Objectives: The aim of this study was to determine socioeconomic features of cases with bronchiectasis and to determine predisposing factors which might play a role in the development of this condition.Patients and Methods: A total of 69 cases with bronchiectasis (43 males, 26 females; mean age 53.7±15.6 years) were retrospectively evaluated. Patients, totally in whom the was, predisposing factors for bronchiectasis, cigarette and alcohol consumptions, education and and monthly income levels were recorded.Results: Most of the cases multiple predisposing factors for bronchiectasis. Pneumonia (68%), measles (32%), and tuberculosis (18%) were the most common causes. Forty-two percent of the cases were primary school graduates and 20% never attended school. Fifty-five percent of the cases smoked cigarettes and 19% of the cases used alcohol. The mean monthly income was found to be 438.2±363 YTL.Conclusion: We concluded that bronchiectasis is prominent among individuals with low socioeconomic level.
Levent OZDEMIR; Erhan TABAKOGLU; Osman Nuri HATIPOGLU; Gundeniz ALTIAY; Burcu OZLEN; Abdullah CIFTCI; Tuncay CAGLAR
Family history and socioeconomic risk factors for non-syndromic cleft lip and palate: A matched case-control study in a less developed country/ Factores de riesgo hereditarios y socioeconómicos para labio o paladar hendido no asociados a un síndrome en México: estudio de casos y controles pareado
Full Text Available Abstract in spanish Introducción. Desde el punto de vista epidemiológico, las hendiduras faciales son las deformidades orales más comunes alrededor del mundo. Objetivo. Identificar los factores de riesgo hereditarios y socioeconómicos relacionados con la presencia de labio o paladar hendido no asociados a un síndrome. Materiales y métodos. Se hizo un estudio de casos y controles en el que se incluyeron 208 casos con diagnóstico de labio, paladar hendido o ambos no asociados a un sínd (more) rome, los cuales fueron pareados por edad y sexo con 416 controles. Se incluyeron todos los pacientes quirúrgicos atendidos durante el periodo 2002-2004 en el programa estatal de labio o paladar hendido de Campeche, México. Se aplicó un cuestionario en el que se recogió información sobre variables sociodemográficas y socioeconómicas, así como sobre antecedentes hereditarios de labio o paladar hendido no asociados a un síndrome en la familia. Debido a que el diseño fue pareado, el análisis se hizo con regresión logística condicionada. Resultados. En el modelo multivariado para labio o paladar hendido no asociado a un síndrome se identificaron de forma significativa (p Abstract in english Introduction. From an epidemiological point of view, non-syndromic orofacial clefts are the most common oral congenital deformities worldwide. Objective. Family histories were traced and socioeconomic risk factors were identified for non-syndromic cleft lip with or without cleft palate. Material and methods. A case-control study was carried out with 208 cases of non-syndromic cleft lip with or without cleft palate, and matched by age and sex with 416 controls. Cases were (more) patients attending a referral clinic from 2002 through 2004 in Campeche, Mexico. A questionnaire was administered to collect sociodemographic and socioeconomic variables as well as familial background relevant to non-syndromic cleft lip with or without cleft palate. Conditional logistic regression models were used; adjusted odds ratios and 95% confidence intervals were calculated. Results. In the multivariate model, the following risk factors were identified: 1) low socioeconomic status; 2) birth in the southern region of Campeche state; 3) home delivery or delivery in a publicly funded hospital; 4) occurrence of prior non-syndromic cleft lip with or without cleft palate cases in the father´s or mother´s family: 5) having a sibling with non-syndromic cleft lip with or without cleft palate; 6) the proband having another malformation, and 7) a history of infections during pregnancy. Prenatal care consisting of vitamin supplementation was a protective factor for non-syndromic cleft lip with or without cleft palate (odds ratio=0.29). Conclusions. A “social gradient in health” was seen to link oral malformation with diet components, and several socioeconomic and socio-demographic factors broadly encompassed in low socioeconomic status. Further characterization of risk factors will guide the assemblage of a pro-active counseling and prevention program for families at risk for non-syndromic cleft lip and cleft palate.
Acuña-González, Gladys; Medina-Solís, Carlo E; Maupomé, Gerardo; Escoffie-Ramírez, Mauricio; Hernández-Romano, Jesús; Márquez-Corona, María de L; Islas-Márquez, Arturo J; Villalobos-Rodelo, Juan J
Full Text Available Abstract Title An exploration of socioeconomic variation in lifestyle factors and adiposity in the Ontario Food Survey through structural equation models. Background Socioeconomic indicators have been inversely associated with overweight and obesity, with stronger associations observed among women. The objective of the present secondary analysis was to examine the relationships among socioeconomic measures and adiposity for men and women participating in the Ontario Food Survey (OFS), and to explore lifestyle factors as potential mediators of these associations. Methods The cross-sectional 1997/98 OFS collected anthropometric measurements, a food frequency questionnaire, data on socio-demographics (age, sex, income, and education) and physical activity from 620 women and 467 men, ages 18 to 75. Based on the 2003 Health Canada guidelines, waist circumference and BMI values were used to derive least risk, increased risk, and high risk adiposity groups. Structural equation modeling was conducted to examine increased risk and high risk adiposity in relation to education and income, with leisure time physical activity, fruit and vegetable intake, and smoking status included as potential mediators of these associations. Results The probability of high risk adiposity was directly associated with education (?-0.19, p Conclusion The socioeconomic context of adiposity continues to differ greatly between men and women. For women only in the OFS, fruit and vegetable intake contributed to the inverse association between education and high risk adiposity; however, additional explanatory factors are yet to be determined.
Ward Heather; Tarasuk Valerie; Mendelson Rena; McKeown-Eyssen Gail
BACKGROUND: Little is known about the simultaneous effect of socioeconomic status (SES), psychosocial, and health-related factors on race differences in mortality in older adults. PURPOSE: This study examined the association between race and mortality and the role of SES, health insurance, psychosocial factors, behavioral factors, and health-related factors in explaining these differences. METHODS: Data consisted of 2,938 adults participating in the Health, Aging and Body Composition study. Mortality was assessed over 8 years. RESULTS: SES differences accounted for 60% of the racial differences in all-cause mortality; behavioral factors and self-rated health further reduced the disparity. The racial differences in coronary heart disease mortality were completely explained by SES. Health insurance and behavioral factors accounted for some, but not all, of the race differences in cancer mortality. CONCLUSIONS: Race-related risk factors for mortality may differ by the underlying cause of mortality.
Thorpe RJ Jr; Koster A; Bosma H; Harris TB; Simonsick EM; van Eijk JT; Kempen GI; Newman AB; Satterfield S; Rubin SM; Kritchevsky SB
Full Text Available This research study is based on primary data collection from sunflower growers to assess the socioeconomic factors that are affecting the adoption of sunflower varieties in Sindh.Data samples have been selected from two districts; Badin and Thatta, as these districts are considered main sunflower growing areas in Sindh. The results reveal that Sunflower growers are using Hybrid varieties i.e. 43 percent planted Hysun-33, 29 percent Hysun-38 and 28 percent Hysun-37 varieties. The finding of research using multinomial logistic regression suggests that farm size and level of education significantly affected the adoption of sunflower varieties. These factors are statistically significant at p<0.05. Theother variables such as tenancy status and source of income are not statistically significant in the adoption of sunflower varieties in Sindh.
Ghulam Ali Jariko (Corresponding Author); Mumtaz Ali Junejo; Muhammad Saleem Rahpoto; Maqsood Zia Shah
Full Text Available The present study was conducted to determine the relationship between socio-economic factors and obesity within a population from Iran. Male and female subjects (n=4977) aged 15-65 years, were recruited from the Great Khorasan province of Iran using a cluster-stratified sampling method. Demographic and socioeconomic data were collected by questionnaire. Of the study population, 29.1% were overweight and 13.8% were obese. Being overweight and obese was significantly more prevalent among women than men and urban- compared to rural-dwellers. A high prevalence of overweight and obesity was seen among individuals who were divorced or widowed and among housewives, or individuals with poor education. Urbanization, age, illiteracy, female gender and divorced, or widowed status were significant predictors of obesity (p<0.001). The association of obesity with urban-dwelling which is consistent with previous reports was also found to be the most important determinant of obesity. The prevalence of obesity in urban residents of Iran is high, particularly among poorly educated women. A community-based approach using multiple strategies including appropriate education will be required to address this problem.
Habibollah Esmaeily; Mohsen Azimi-Nezhad; Majid Ghayour-Mobarhan; Mohammad-Reza Parizadeh; Mohammad Safarian; Mohammad-Javad Parizadeh; Bahareh Hassankhani; Elahe Salardini; Zaim-Kohan Houshang; Hossini Javad; Oladi Mohammad Reza; Gordon Ferns
Full Text Available Abstract Background Little is known about the socioeconomic differences in health-related behaviours in Japan. The present study was performed to elucidate the effects of individual and regional socioeconomic factors on selected health risk behaviours among Japanese adults, with a particular focus on regional variations. Methods In a nationally representative sample aged 25 to 59 years old (20,030 men and 21,076 women), the relationships between six risk behaviours (i.e., current smoking, excessive alcohol consumption, poor dietary habits, physical inactivity, stress and non-attendance of health check-ups), individual characteristics (i.e., age, marital status, occupation and household income) and regional (N = 60) indicators (per capita income and unemployment rate) were examined by multilevel analysis. Results Divorce, employment in women, lower occupational class and lower household income were generally associated with a higher likelihood of risk behaviour. The degrees of regional variation in risk behaviour and the influence of regional indicators were greater in women than in men: higher per capita income was significantly associated with current smoking, excessive alcohol consumption, stress and non-attendance of health check-ups in women. Conclusion Individual lower socioeconomic status was a substantial predictor of risk behaviour in both sexes, while a marked regional influence was observed only in women. The accumulation of risk behaviours in individuals with lower socioeconomic status and in women in areas with higher income, reflecting an urban context, may contribute to their higher mortality rates.
Fukuda Yoshiharu; Nakamura Keiko; Takano Takehito
Information on the health status and physical activity of Scottish adolescents is limited. This study examines the prevalence of cardiovascular disease (CVD) risk in Scottish adolescents by socioeconomic status (SES). Participants were recruited from two high schools that differed in the SES of the students in attendance. The sample included 73 boys and 34 girls (16.4 ± 0.6 years). Variables included anthropometry, physical activity, physical fitness, blood pressure, diet, and 11 metabolic markers of CVD risk. Significant sex differences (P ? 0.01) were noted for stature, waist circumference, waist-hip ratio, physical activity, cardiorespiratory fitness, muscular power, sprint speed, and several CVD risk factors: high-density lipoprotein (HDL), low-density lipoprotein (LDL), interleukin-6 (IL-6), and C-reactive protein (CRP) levels. Boys from a lower SES had significantly higher levels of glucose and plasminogen activator inhibitor-1 (PAI-1) but lower levels of adiponectin compared with boys from a higher SES. Girls from a lower SES had significantly (P ? 0.01) higher glucose and PAI-1 levels but lower levels of insulin and adiponectin than girls from a higher SES. High fat diets, low physical activity levels, and elevated CRP and total cholesterol levels were the CVD risk factors most commonly identified as being at-risk levels in this cohort, regardless of sex or SES. SES differences were not consistently apparent, but several CVD risk factors were identified as elevated in this sample of adolescents, regardless of sex or SES.
Buchan DS; Ollis S; Thomas NE; Simpson A; Young JD; Cooper SM; Malina RM; Cockcroft JR; Baker JS
We performed a survey on socioeconomic factors in 27 studies of children's environmental health funded by EU FP4 and FP5. Parental education was the most common measure (74%). Socioeconomic factors were predominantly considered as confounder (74%) and less often as effect modifier (33%) or independent variable (37%). The awareness of the need to study the impact of socioeconomic factors further seems to have increased in recent years. PMID:15971499
Bolte, Gabriele; Kohlhuber, Martina; Weiland, Stephan K; Zuurbier, Moniek; Stansfeld, Stephen; Heinrich, Joachim
We performed a survey on socioeconomic factors in 27 studies of children's environmental health funded by EU FP4 and FP5. Parental education was the most common measure (74%). Socioeconomic factors were predominantly considered as confounder (74%) and less often as effect modifier (33%) or independent variable (37%). The awareness of the need to study the impact of socioeconomic factors further seems to have increased in recent years.
Bolte G; Kohlhuber M; Weiland SK; Zuurbier M; Stansfeld S; Heinrich J
Accurately defining disease distributions and calculating disease risk is an important step in the control and prevention of diseases. Geographical information systems (GIS) and remote sensing technologies, with maximum entropy (Maxent) ecological niche modelling computer software, were used to create predictive risk maps for Chagas disease in Bolivia. Prevalence rates were calculated from 2007 to 2009 household infection survey data for Bolivia, while environmental data were compiled from the Worldclim database and MODIS satellite imagery. Socio-economic data were obtained from the Bolivian National Institute of Statistics. Disease models identified altitudes at 500-3,500 m above the mean sea level (MSL), low annual precipitation (45-250 mm), and higher diurnal range of temperature (10-19 °C; peak 16 °C) as compatible with the biological requirements of the insect vectors. Socio-economic analyses demonstrated the importance of improved housing materials and water source. Home adobe wall materials and having to fetch drinking water from rivers or wells without pump were found to be highly related to distribution of the disease by the receiver operator characteristic (ROC) area under the curve (AUC) (0.69 AUC, 0.67 AUC and 0.62 AUC, respectively), while areas with hardwood floors demonstrated a direct negative relationship (-0.71 AUC). This study demonstrates that Maxent modelling can be used in disease prevalence and incidence studies to provide governmental agencies with an easily learned, understandable method to define areas as either high, moderate or low risk for the disease. This information may be used in resource planning, targeting and implementation. However, access to high-resolution, sub-municipality socio-economic data (e.g. census tracts) would facilitate elucidation of the relative influence of poverty-related factors on regional disease dynamics.
Mischler P; Kearney M; McCarroll JC; Scholte RG; Vounatsou P; Malone JB
Full Text Available The data for this study has been collected from a questionnaire examining the relationship between birth weight of the new born and some physical and socio-economic characteristics of the mother. Between Dec.1975 to Jan.1976, 1553 women who had referred to two hospitals in Tehran for labor: 981 to Farah Maternity and 572 to Firoozgar Hospital have been interviewed. The results of the study have indicated that women who had referred to Firoozgar Hospital, were older, more literate, had higher per capita income, used more contraceptives and had fewer pregnancies, all these figures are statistically significant. Regression analysis indicates that factors such as age of the mother, literacy, household income, husband's job position are not significant towards increase of abortion rate amongst these women, but when these factors are fixed and place of reference is analyzed this variable becomes significant, increase of abortion, which have not been considered in this study. Parity regardless of the above factors increases abortion rate and for each increase in the number of pregnancy, mean number of abortion is increased by 0.09.
A.Majd; S.Kohansedgh; H.Malek-Afzali
This study investigates the influence of neighbourhood socioeconomic conditions on women's likelihood of experiencing intimate partner violence (IPV) in Sao Paulo, Brazil. Data from 940 women who were interviewed as part of the WHO multi-country study on women's health and domestic violence against women, and census data for Sao Paulo City, were analyzed using multilevel regression techniques. A neighbourhood socioeconomic-level scale was created, and proxies for the socioeconomic positions of the couple were included. Other individual level variables included factors related to partner's behaviour and women's experiences and attitudes. Women's risk of IPV did not vary across neighbourhoods in Sao Paulo nor was it influenced by her individual socioeconomic characteristics. However, women in the middle range of the socioeconomic scale were significantly more likely to report having experienced violence by a partner. Partner behaviours such as excessive alcohol use, controlling behaviour and multiple sexual partnerships were important predictors of IPV. A women's likelihood of IPV also increased if either her mother had experienced IPV or if she used alcohol excessively. These findings suggest that although the characteristics of people living in deprived neighbourhoods may influence the probability that a woman will experience IPV, higher-order contextual dynamics do not seem to affect this risk. While poverty reduction will improve the lives of individuals in many ways, strategies to reduce IPV should prioritize shifting norms that reinforce certain negative male behaviours. PMID:22361088
Kiss, Ligia; Schraiber, Lilia Blima; Heise, Lori; Zimmerman, Cathy; Gouveia, Nelson; Watts, Charlotte
Pediatric obesity has reached critical proportions. Although this pandemic touches individuals from all socioeconomic, racial, and ethnic backgrounds, the trend is more prevalent among children from families of lower-socioeconomic classes. The causes of this separation in obesity rates by socioeconomic background are multifold but include differences in the availability of healthier foods in homes and schools, as well as the availability of safe environments for physical activity. Equally concerning are increases in the diagnosis of type 2 diabetes among certain ethnic groups and discrepancies in health care availability to children of lower-socioeconomic backgrounds. As our society attempts to improve the lifestyle of our children and decrease rates of obesity, it will be important to give focus to children of lower socioeconomic backgrounds in planning these potential interventions. PMID:19505621
Lieb, David C; Snow, Rodney E; DeBoer, Mark D
Pediatric obesity has reached critical proportions. Although this pandemic touches individuals from all socioeconomic, racial, and ethnic backgrounds, the trend is more prevalent among children from families of lower-socioeconomic classes. The causes of this separation in obesity rates by socioeconomic background are multifold but include differences in the availability of healthier foods in homes and schools, as well as the availability of safe environments for physical activity. Equally concerning are increases in the diagnosis of type 2 diabetes among certain ethnic groups and discrepancies in health care availability to children of lower-socioeconomic backgrounds. As our society attempts to improve the lifestyle of our children and decrease rates of obesity, it will be important to give focus to children of lower socioeconomic backgrounds in planning these potential interventions.
Lieb DC; Snow RE; DeBoer MD
A broad survey is given of risk factors for neoplasms. The main carcinogenic substances (including also ionizing radiation and air pollution) are listed, and are correlated with the risk factors for various cancers most frequently explained and discussed in the literature. The study is intended to serve as a basis for a general assessment of the incidence of neoplasms in children, and of cancer mortality in the entire population of Bavaria in the years 1983-1989, or 1979-1988, respectively, with the principal idea of drawing up an environment-related health survey. The study therefore takes into account not only ionizing radiation as a main risk factor, but also other risk factors detectable within the ecologic context, as e.g. industrial installations and their effects, refuse incineration plants or waste dumps, or the social status. (orig./MG)
Low back and neck pain is a common problem and one of enormous social, psychologic, and economic burden. It is estimated that 15% to 20% of adults have back pain during a single year and 50% to 80% experience at least one episode of back pain during a lifetime. Low back pain afflicts all ages, from adolescents to the elderly, and is a major cause of disability in the adult working population. Risk factors for developing spine pain are multidimensional; physical attributes, socioeconomic status, general medical health and psychologic state, and occupational environmental factors all contribute to the risk for experiencing pain.
Owing to significantly improved outcomes, vaginal hysterectomy is the recommended standard approach when feasible in preference to abdominal hysterectomy. It is, however, not clear whether the use of vaginal hysterectomy varies with the women's socioeconomic background.
Daugbjerg, Signe B; Ottesen, Bent
Full Text Available Abstract Background A relatively consistent body of research supports an inverse graded relationship between socioeconomic status (SES) and cardiovascular disease (CVD). More recently, researchers have proposed various life course SES hypotheses, which posit that the combination, accumulation, and/or interactions of different environments and experiences throughout life can affect adult risk of CVD. Different life course designs have been utilized to examine the impact of SES throughout the life course. This systematic review describes the four most common life course hypotheses, categorizes the studies that have examined the associations between life course SES and CVD according to their life course design, discusses the strengths and weaknesses of the different designs, and summarizes the studies' findings. Methods This research reviewed 49 observational studies in the biomedical literature that included socioeconomic measures at a time other than adulthood as independent variables, and assessed subclinical CHD, incident CVD morbidity and/or mortality, and/or the prevalence of traditional CVD risk factors as their outcomes. Studies were categorized into four groups based upon life course design and analytic approach. The study authors' conclusions and statistical tests were considered in summarizing study results. Results Study results suggest that low SES throughout the life course modestly impacts CVD risk factors and CVD risk. Specifically, studies reviewed provided moderate support for the role of low early-life SES and elevated levels of CVD risk factors and CVD morbidity and mortality, little support for a unique influence of social mobility on CVD, and consistent support for the detrimental impact of the accumulation of negative SES experiences/conditions across the life course on CVD risk. Conclusions While the basic life course SES study designs have various methodologic and conceptual limitations, they provide an important approach from which to examine the influence of social factors on CVD development. Some limitations may be addressed through the analysis of study cohorts followed from childhood, the evaluation of CVD risk factors in early and middle adulthood, and the use of multiple SES measures and multiple life course analysis approaches in each life course study.
Pollitt Ricardo A; Rose Kathryn M; Kaufman Jay S
Full Text Available Introduction. Stroke is the third cause of mortality both in men and in women throughout the world. In Serbia, stroke is the first cause of mortality in women older than 55 years of age and the second cause of death in men of the same age. Both ischemic heart diseases and ischemic stroke correlate with the same predisposing, potentially modifiable risk factors (hypertension, abnormal blood lipids and lipoproteins, cigarette smoking, physical inactivity, obesity, diabetes mellitus). Stroke does not usually occur on its own. Patients with stroke have a high prevalence of associated medical problems. These conditions may predict the stroke (”preexisting conditions”), occur for the first time after stroke (”post-stroke complications”), or present as manifestations of preexisting medical conditions after stroke. Risk factors. Risk factors for stroke are divided into the three groups: risk factors which cannot be influenced on such as: age, gender, positive family history of stroke, race; those which are modifiable such as: hypertension, diabetes mellitus, smoking cigarettes, obesity, physical inactivity and the third group consists of potential risk factors for stroke (consumption of alcohol, hormones, changes in fibrinolysis, changes in blood. Conclusion. Stroke remains a leading cause of long-term disability and premature death of both men and women. Consequently, stroke survivors are often handicapped and doomed to sedentary lifestyle which restrains performance of activities of daily living, increases the risk for falls, and may contribute to a higher risk for recurrent stroke and cardiovascular disease. Prevention of stroke is still a great medical and social problem. Further studies are required to investigate potential risk factors for the occurrence of stroke as well as the measures of primary and secondary prevention.
Mandi? Milan; Ran?i? Nataša
BACKGROUND: Neighborhood amenities and resources plausibly determine individual modifiable risk factors for colon and rectal cancer. Evidence on the associations between neighborhood socioeconomic status (SES) and incident colon and rectal cancer is limited. METHODS: The authors analyzed a prospective cohort of 111,129 women in the Nurses' Health Study with no history of cancer in 1986 followed to 2006. Neighborhood SES was based on Census-derived characteristics of block groups of residence. Cox models were used to estimate the multivariate-adjusted associations between neighborhood SES and incident colon and rectal cancer, and to examine for effect modification. For significant associations, path models were estimated with behavioral risk factors included as potential mediators. RESULTS: Neighborhood SES was unassociated with colon cancer among all women. However, among women with college or greater education, higher neighborhood SES was inversely related to colon cancer (P for trend = .01; P for interaction between neighborhood SES and education = .03). Path analysis suggested mediation by red meat intakes and body mass index (BMI). Higher neighborhood SES was inversely related to rectal cancer among all women (relative risk in highest quintile, 0.64; 95% confidence interval, 0.44-0.93; P for trend = .08). Path analysis was consistent with mediation by multivitamin use and BMI. CONCLUSIONS: These findings suggest that living in a higher-SES neighborhood may protect against rectal cancer in women and colon cancer in higher-educated women, mediated by selected behavioral risk factors. Risk factor differences between colon and rectal cancer may account for discrepancies in estimated neighborhood effects by cancer site.
Kim D; Masyn KE; Kawachi I; Laden F; Colditz GA
Full Text Available A number of students in the urban and rural areas of N-W.F.P (Pakistan) and control group were collected to examine the various socio-economic factors which affect our education system. A logistic regression was applied to analyze the data and to select a parsimonious model. The response variable for the study is literate (illiterate) person(s) and the risk factors are Father literacy [FE], Father income[FI] Parents’ attitude towards education[PA], Mother literacy [ME], Present examination system [PE], Present education curriculum [PC].The results of the analysis show that the factors Father Education combined with Parents’ Attitude towards Education, Father Income combined with Mother Education, Father Income combined with Parents’ Attitude towards Education are some of the factors which affect the education in N-W.F.P. Thus we concluded that there are a number of socioeconomic factors which affect our education.
Atta Ur RAHMAN; Salah UDDIN
OBJECTIVE--To investigate the relation between socioeconomic deprivation and pathological prognostic factors in women with breast cancer as a possible explanation for socioeconomic differences in survival. DESIGN--Retrospective analysis of data from cancer registry and from pathology and biochemistr...
Carnon, A. G.; Ssemwogerere, A.; Lamont, D. W.; Hole, D. J.; Mallon, E. A.; George, W. D.; Gillis, G. R.
The use of socioeconomic factors in mapping tuberculosis risk areas in a city of northeastern Brazil Uso de factores socioeconómicos en la localización de áreas con riesgo de tuberculosis en una ciudad del nordeste de Brasil
Full Text Available In Brazil the challenge of meeting the needs of those living in deprived areas has generated discussions on replacing the existing approach to epidemiological surveillance with an integrated public health surveillance system. This new approach would supplant the traditional focus on high-risk individuals with a method for identifying high-risk populations and the areas where these persons live. Given the magnitude of the problem that tuberculosis (TB) poses for Brazil, we chose that disease as an example of how such a new, integrated public health surveillance system could be constructed. We integrated data from several sources with geographic information to create an indicator of tuberculosis risk for Olinda, a city in the Brazilian state of Pernambuco. In order to stratify the urban space in Olinda and to check for an association between the resulting TB risk gradient and the mean incidence of the disease between 1991 and 1996, we applied two different methods: 1) a "social deprivation index" and 2) principal component analysis followed by cluster analysis. Our results showed an association between social deprivation and the occurrence of TB. The results also highlighted priority groups and areas requiring intervention. We recommend follow-up that would include treating acid-fast bacilli smear-positive pulmonary TB cases, tracing of these persons' contacts, and monitoring of multidrug-resistant cases, all in coordination with local health services.En Brasil, el reto de satisfacer las necesidades de los residentes en zonas pobres ha generado discusiones sobre la sustitución del actual abordaje de la vigilancia epidemiológica por un sistema integrado de vigilancia de la salud pública. Este nuevo abordaje debería sustituir el tradicional enfoque en los individuos de alto riesgo por un método destinado a identificar las poblaciones de alto riesgo y las zonas en las que viven. Dada la magnitud del problema de la tuberculosis en Brasil, elegimos esta enfermedad como un ejemplo de cómo se podría concebir este nuevo sistema integrado de vigilancia de la salud pública. Se reunieron los datos de varias fuentes y la información geográfica para crear un indicador del riesgo de tuberculosis en Olinda, ciudad del estado de Pernambuco. Con el fin de estratificar el espacio urbano de Olinda y de buscar una asociación entre el gradiente del riesgo de tuberculosis y la incidencia media de la enfermedad entre 1991 y 1996, se aplicaron dos métodos diferentes: 1) un "índice social de pobreza", y 2) un análisis de componentes principales seguido de un análisis por grupos. Los resultados obtenidos revelaron una asociación entre la pobreza y la aparición de la tuberculosis y también señalaron grupos y zonas prioritarias que requerían intervención. Se recomienda un seguimiento que debería incluir el tratamiento de los casos de tuberculosis pulmonar con baciloscopia positiva, la identificación de los contactos de estos individuos y el control de los casos resistentes a múltiples fármacos, todo ello en coordinación con los servicios de salud locales.
Wayner V. Souza; Ricardo Ximenes; Maria F. M. Albuquerque; Tiago M. Lapa; José L. Portugal; Maria L. C. Lima; Celina M. T. Martelli
Full Text Available Abstract Background Risk factors are often considered individually, we aimed to investigate the prevalence of combinations of multiple behavioural risk factors and their association with socioeconomic determinants. Methods Multinomial logistic regression was used to model the associations between socioeconomic factors and multiple risk factors from data in the Scottish Health Survey 2003. Prevalence of five key risk - smoking, alcohol, diet, overweight/obesity, and physical inactivity, and their risk in relation to demographic, individual and area socioeconomic factors were assessed. Results Full data were available on 6,574 subjects (80.7% of the survey sample). Nearly the whole adult population (97.5%) reported to have at least one behavioural risk factor; while 55% have three or more risk factors; and nearly 20% have four or all five risk factors. The most important determinants for having four or five multiple risk factors were low educational attainment which conferred over a 3-fold increased risk compared to high education; and residence in the most deprived communities (relative to least deprived) which had greater than 3-fold increased risk. Conclusions The prevalence of multiple behavioural risk factors was high and the prevalence of absence of all risk factors very low. These behavioural patterns were strongly associated with poorer socioeconomic circumstances. Policy to address factors needs to be joined up and better consider underlying socioeconomic circumstances.
Lawder Richard; Harding Oliver; Stockton Diane; Fischbacher Colin; Brewster David H; Chalmers Jim; Finlayson Alan; Conway David I
PURPOSE: In 2003, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published a set of risk factors for amblyopia. The intent was to promote uniformity of reporting and development in screening. Because this prevalence is not yet known, this meta-analysis is an attempt to estimate it. METHODS: Major community preschool eye examination studies were reviewed and AAPOS cut-offs estimated. RESULTS: The approximate prevalence of anisometropia is 1.2%, hyperopia is 6%, astigmatism is 15%, myopia is 0.6%, strabismus is 2.5%, and visual acuity less than 20/40 is 6%. The mean combined prevalence is 21% ± 2% compared to a prevalence of amblyopia 20/40 and worse of 2.5%. CONCLUSIONS: Knowing risk factor prevalence simplifies validation efforts. Amblyopia screening with a risk factor sensitivity less than 100% is expected and desirable.
Full Text Available Teenage pregnancy is a worldwide medical and social issue, associated with many physical, psychological and social consequences and can result in birth, miscarriage or abortion. Aim: The aim of the present study is to find those risk factors that contribute to teenage pregnancy. Results: In U.S.A., according to data from Unicef, the birth rate among teenagers touches the 52.1% and it is four times higher, than the corresponding rate recorded in the countries of Western Europe. The United Kingdom has the highest rate of teenage pregnancy in Europe and in contrast to the decline in the rate of teenage pregnancy, recorded in the remaining countries of Western Europe, this figure has remained relatively stable, especially in adolescents aged 16 years and below. In Greece, according to National Statistics Office, in 2007, we had 3.129 births by teenagers under 18, with 75 births by teenagers under 15. The main factors contributing to the incidence of teenage pregnancy are socioeconomic factors, the family, the education and the sexual behavior of teenagers. Conclusions.It is necessary the state, through the health services and the education programs, to provide modern sex education in schools, as well as programs of prevention and health education in primary health care. The cooperation of these authorities is essential, to better address the extent and consequences of teenage pregnancy.
Maria Siettou; Maria Saridi
Full Text Available Background/Aim. The prevalence of overweight and obesity is increasing at an alarming rate and it is a manifestation of the epidemics of a sedentary lifestyle and excessive energy intake. The aim of this study was to determine the prevalence of overweight and obesity in the population of the Province of Vojvodina, Serbia, and to examine the association between obesity and socioeconomic and lifestyle factors. Methods. A cross-sectional study conducted in the Province of Vojvodina in 2006 involved 3 854 participants aged 20 years and over (1 831 men and 2 023 women). The study was a countinuation of the baseline study conducted in 2000 (n = 2 840, 1 255 men and 1 585 women). The main outcome measures were overweight and obesity (Body Mass Index - BMI ? 25 kg/m2), sociodemographic factors, including nutrition habits - having breakfast everyday and television watching frequency. Results. The prevalence of overweight and obesity in both sexes in 2006 was 57.4% (35.7% were overweight and 21.7% obese). The prevalence of overweight was higher in men (41.1%) than in women (30.9%) (p < 0.001) while obesity was higher in women (23.1%) as compared to men (20.2%) (p = 0.035). For both sexes, overweight rates were highest at the age 60-69 (men 44.8% and women 39.1%) while obesity rates were peaked to men aged 50-59 (25.1%) and women aged 60-69 years (37.8%). Increasing ageing, males, rural population, single examinees, lower educational level, improved income, examinees that never/sometimes have breakfast and frequently watch TV were associated with obesity. Conclusions. The population of Vojvodina, with 23.1% obese women and 20.2% obese men is one of severely affected European populations. High prevalence of obesity requires urgent public health action. Healthy lifestyle, balanced nutrition with low energy intake and increased physical activity have to be promoted within a prevention strategy and obesity management.
Gruji? Vera; Martinov-Cvejin Mirjana; A?-Nikoli? Eržebet; Dragni? Nataša; Mijatovi?-Jovanovi? Vesna; Kvrgi? Svetlana; Travar Sonja
Study objective: To study geographical differences in mortality and disability and sosio-economic status in Oslo, Norway. Setting: A total of 25 local authority districts within the city of Oslo. Design: Analysis of age adjusted mortality rates aged 0-74 in the period 1991-1994, and cross sectional data on disability pensioners aged 50-66 and socio-economic indicators (low education, single parenthood, unemployment, high income) in 1994. Main outcome measures: The levels of correlation between the health outcomes (mortality and disability) and sosio-economic exposure variables. Main results: The geographical patterns of mortality and disability display substantial similarities and show strong linear correlation with area measures of socio-economic deprivation. The ratios between the highest and lowest area mortality rates were 3.3 for men and 2.1 for women, while the high-low ratios of disability were 7.0 for men and 3.8 for women. For women deprivation measures are better correlated with disability than mortality. While disability and mortality display similar correlations with deprivation measures for men. Conclusions: The social gradients in health are substantial in Oslo. Further ecological analysis of cause specific morbidity and mortality and the distribution of risk factors ought to be done to identify problem areas suitable for interventions. However, to understand the mechanisms and the relative importance of each etiological factor, studies based on individual data have to be performed.
HPV infection is considered as an independent risk factor for head and neck squamous cell carcinomas (HNSCC). Due to highly variable prevalence results in numerous studies, it is, however, difficult to estimate the relevance of HPV infection as risk factor for a specific patient collective. This study aimed to elucidate the disparities of HPV prevalence by analyzing socioeconomically and regionally different patient collectives. Two age, gender, stage and tumor location matched cohorts of 18 private health insured (PHIP) and 16 statutory health insured patients (SIP) suffering from an oropharyngeal squamous cell carcinoma (OSCC) and treated at a university hospital were screened for p16 overexpression and HPV infection by immunohistochemistry and PCR. In addition 85 HNSCC patients of an otolaryngology private practice (PPP) in a rural area were screened for p16 overexpression and positive cases were tested for HPV infection. HPV prevalence was 72.2 % in the PHIP collective in comparison to 25.0 % (p = 0.015) in the SIP collective with a significantly improved 5-year overall survival (p = 0.003) of the PHIP collective. The total HPV prevalence of PPP group was 7.1 % with the highest infection rate in tonsillar carcinomas (33.3 %) and a larger percentage of female patients in the HPV positive group (p = 0.037). This study shows that variable HPV infection rates in HNSCC can be caused by the selection of particular patient collectives, which suggest taking socioeconomic and regional factors into account for a decision on HPV testing, if it is not performed on a routine basis.
Krupar R; Hartl M; Wirsching K; Dietmaier W; Strutz J; Hofstaedter F
Perioperative anaphylactic as well as anaphylactoid reactions can be elicited by drugs, diagnostic agents, antiseptics, disinfectants and latex. In some individuals, allergic reactions occur in the absence of any evident risk factor. Previous history of specific safe exposure to a product does not permit to exclude the risk of having a reaction. We have systematically reviewed characteristics in the patient's history or clinical parameters that affect the risk of developing reactions during anesthesia. Evidence shows that patients with previous unexplained reaction during anesthesia are at risk for perioperative allergic reactions. An allergic reaction to an agent is associated with previous reaction to a product that is related with the culprit agent. Multiple surgery procedures, professional exposure to latex and allergy to fruit are associated with an increased frequency of latex allergy. It has been shown that in some instances, allergic perioperative reactions may be more common in atopic patients and in females. PMID:22014923
Caffarelli, C; Stringari, G; Pajno, G B; Peroni, D G; Franceschini, F; Dello Iacono, I; Bernardini, R
Abstract Aim Aim of the study was to evaluate the impact of demographic factors (DGF) and socio-economic status (SES) on survival after pancreatic cancer resection in a German setting. Methods Patients with pancreatic adenocarcinoma and pancreaticoduodenectomy were id...
Full Text Available Literacy is a dynamic process. The distribution of literacy is uneven in different parts of a region. The various geographical factors like the nature of relief, amount of rainfall, agricultural productivity, availability of water, accessibility etc. influence the distribution of population. The influence of these factors is clearly seen in the socioeconomic development of the region. This socio-economic development directly and indirectly accelerates the rate of literacy. As the Western Satpura region is socioeconomically less developed, therefore, the proportion of literate population is less and the rate of acceleration is also rather slow.
R. C. AHIRE; A. A. BADGUJAR
OBJECTIVE:: Pelvic pain is a primary symptom of women referred for hysterectomy. This study identified risk factors for purchase of prescribed analgesics before and after hysterectomy and examined purchase changes after hysterectomy, specifically focusing on socioeconomic effects. METHODS:: Nearly all Danish women (n=13,420) with a hysterectomy on benign indication between 2004 and 2006 were included in a registry-based follow-up study. Information on prescription analgesic purchase was from the Danish National Prescription Registry. Factors associated with a purchase and associations between socioeconomic factors and changes in analgesic purchase were assessed. RESULTS:: Analgesic purchase after hysterectomy was independently predicted by age below 35 or above 65 years, body mass index >29.9, high American Society of Anesthesiologists (ASA) score, uterus weight
Daugbjerg, Signe B; Brandsborg, Birgitte
OBJECTIVE: To assess the prevalence of gingival bleeding, calculus and periodontal pockets among 18-year-old males. In addition, to verify whether these conditions are associated with years of education and family income. METHODS: A cross sectional survey was carried out. A representative sample of 18-year-old males living in Florianópolis, Brazil, was selected from the Brazilian Army applicant list. Clinical and socioeconomic data were collected through dental examinations and interviews, respectively. Socioeconomic data included the subjects and their parents' years of education, and family income. A single dentist carried out the dental examinations looking for gingival bleedings after probing, calculus and shallow and deep periodontal pockets (3.5 mm to 5.5 mm and 5.5 mm and over). The associations between periodontal conditions and socioeconomic variables were analyzed using the qui-square test. RESULTS: A total of 286 people participated in the study. Intra-examiner agreement was high. All kappa values were above 0.7. The prevalence of gingival bleeding, calculus, shallow and deep periodontal pockets were 86%, 50.7%, 7.7% and 0.3% respectively. There were associations between gingival bleeding and all socioeconomic variables (p<0.001). Calculus were associated with the subject's and their father's low educational level (p<0.05) and with their mother's low educational level (p<0.01). Periodontal pockets were associated with their father's low educational level (p<0.05). CONCLUSIONS: The prevalence of periodontal pockets was very low, while gingival bleeding and calculus were high. General periodontal health of the studied population was good.
Gesser HC; Peres MA; Marcenes W
Problem: In recent years a considerable number of papers have examined socioeconomic factors influencing the number and the outcome of traffic accidents. There is however more research needed to confirm the previous results in order to generalize them and a need to examine additional factors that might have an impact. Method: This paper uses both regional panel data and national time series data combined with filtering techniques to determine what factors influence the number of accidents, the accident outcome and detected drunk driving. Results: Using time series data, it is found that the number of traffic fatalities increases for both per capita and per person kilometer travelled during economic booms. This indicates that the death risk rises not only because of increased mileage or motorization during booms. Using panel data, it is found that traffic fatalities decrease with unemployment, whereas personal injuries increase on a per capita basis with youth and the number of cars. In contrast to property crimes and other types of crime, drunk driving in Sweden decreases during economic contractions. Discussion: The main policy conclusion from our results is that resources for safety measures should not be spend uniformly across time and space. Instead, safety measures should be concentrated to areas with a high share of young people and to periods with low unemployment. The results of the time series analysis suggest that factors other than increased mileage during booms contribute to the higher rate of fatalities during good times. Increased risk taking, such as drunk driving, might be an explanatory factor. Impact on Industry: The results might be interesting for safety-oriented car and truck producers as well for developers of traffic safety products, since the results indicate in what regional markets and under what market conditions their products are most needed.
Problem: In recent years a considerable number of papers have examined socioeconomic factors influencing the number and the outcome of traffic accidents. There is however more research needed to confirm the previous results in order to generalize them and a need to examine additional factors that might have an impact. Method: This paper uses both regional panel data and national time series data combined with filtering techniques to determine what factors influence the number of accidents, the accident outcome and detected drunk driving. Results: Using time series data, it is found that the number of traffic fatalities increases for both per capita and per person kilometer travelled during economic booms. This indicates that the death risk rises not only because of increased mileage or motorization during booms. Using panel data, it is found that traffic fatalities decrease with unemployment, whereas personal injuries increase on a per capita basis with youth and the number of cars. In contrast to property crimes and other types of crime, drunk driving in Sweden decreases during economic contractions. Discussion: The main policy conclusion from our results is that resources for safety measures should not be spend uniformly across time and space. Instead, safety measures should be concentrated to areas with a high share of young people and to periods with low unemployment. The results of the time series analysis suggest that factors other than increased mileage during booms contribute to the higher rate of fatalities during good times. Increased risk taking, such as drunk driving, might be an explanatory factor. Impact on Industry: The results might be interesting for safety-oriented car and truck producers as well for developers of traffic safety products, since the results indicate in what regional markets and under what market conditions their products are most needed. PMID:23932686
Krüger, Niclas A
Diabetic retinopathy (DR) occurs in about 95% of patients with type 1 diabetes mellitus (DM) and in 60% of type 2 DM patients and it is the main cause of legal blindness in adult people. The aim of this manuscript was to review the main risk factors for DR. The major environmental risk factors are hyperglycemia, high blood pressure levels, and long-term duration of DM. However, not all patients will not develop DR, suggesting the presence of a genetic predisposition to DR, especially for severe forms of DR. Special strategies has been used to evaluate the genetic role in DR. Family studies shown that there is a familial aggregation of DR. Candidates genes have been studied (RAGE; VEGF; PPAR-delta; ICAM-1; ECA; ENPP 1; eNOS) and positive or negative associations with DR were demonstrated. Some chromosomes were also associated to DR in selected populations. Finally, genetic expression studies reinforce the association of candidate genes, or participation of others genes, with the presence of DR. DR is a common complication of DM and, along with non-genetic or environmental risk factors, the identification of genes related to DR could result in more specific and efficient DR treatment.
Esteves J; Laranjeira AF; Roggia MF; Dalpizol M; Scocco C; Kramer CK; Azevedo MJ; Canani LH
In this study we tested whether children from Dutch-immigrant families are at increased risk for maltreatment, and if so, what factors could explain this risk. Three data sources from the second Netherlands Prevalence Study of Maltreatment of Youth (NPM-2010) were used to answer these questions. First, 1127 professionals from various occupational branches (sentinels) were asked to report each child (including some background information on the child and family) for whom they suspected child maltreatment during a period of three months. Second, we included the 2010 data from the Dutch Child Protective Services and third, 1759 high school students aged 11-17 years filled out a questionnaire on their experiences of maltreatment in the past year. We found that children from traditional immigrant families with a relatively long migration history in the Netherlands (Turkish, Moroccan, Surinamese, and Antillean) and from nontraditional immigrant families (African [except Morocco], Eastern European, Central Asian, and South and Central American; often refugees) were at increased risk for child maltreatment compared to native Dutch families. However, in the professionals' and CPS data this risk disappeared for the traditional immigrant families after correction for educational level of the parents and for step-parenthood. Within the group of families with low education or step-parents, the risk for child maltreatment was similar for traditional immigrant families as for native Dutch families. Nontraditional families remained at increased risk after correction for sociodemographic and family factors. In conclusion, we found that children from both traditional and nontraditional immigrant families are at increased risk for maltreatment as compared to children from native Dutch families. For the traditional immigrants this risk could partially be explained by socioeconomic status. This implies that socioeconomic factors should be taken into account when outlining policies to fight child maltreatment.
Alink LR; Euser S; van Ijzendoorn MH; Bakermans-Kranenburg MJ
AIM: To examine associations between socio-economic, familial and perinatal factors with overweight/obesity in 6- and 12-year-old schoolchildren. METHODS: Eligible year-1 (1765/2238, mean age 6.7 years) and year-7 students (2353/3144, mean age, 12.7 years) from a random cluster sample of 55 Sydney schools were examined during 2003-2005. Height, weight and body mass index were measured. Overweight or obesity was classified using International Obesity Task Force cut points. Information about each child's socio-demographic status, familial and perinatal information was sought in parental questionnaires. RESULTS: After multivariate adjustment, lower parental education was significantly associated with prevalent overweight and obesity in 6-year-old children, odds ratio (OR) 1.52 (95% confidence interval (CI) 1.15-2.01) and OR 2.16 (CI 1.34-4.13), respectively. Smoking during pregnancy was associated with a higher likelihood of being obese among both 6- and 12-year-old children, OR 1.90 (CI 1.05-3.46) and OR 1.78 (CI 1.22-2.61). Population attributable risk estimates indicate that 14.9% and 10.1% of prevalent cases of obesity in 12-year-old children may be attributable to being: an only child or a heavy newborn, respectively. CONCLUSIONS: We show interdependent relationships between socio-economic, familial and perinatal factors and childhood weight status. Improved understanding of these pathways may help in developing childhood obesity prevention strategies.
Gopinath B; Baur LA; Burlutsky G; Robaei D; Mitchell P
Socioeconomic development, family income, and psychosocial risk factors: a study of families with children in public elementary school/ Desenvolvimento socioeconômico, renda monetária familiar e fatores de risco psicossociais: um estudo com famílias da rede pública do ensino fundamental
Full Text Available Abstract in portuguese O objetivo deste artigo é avaliar os reflexos do recente crescimento econômico brasileiro sobre o rendimento monetário, o padrão de consumo familiar e os riscos em que vivem famílias da rede pública do Ensino Fundamental do Município de São Gonçalo, Rio de Janeiro, Brasil. São analisadas as seguintes informações sobre as famílias de 447 crianças que participaram de duas ondas de estudo longitudinal: estrato social, renda familiar per capita, evolução de re (more) nda no período e fatores psicossociais. Os resultados indicam incremento financeiro em 74,8% das famílias, acompanhado de aumento no consumo de bens materiais e no acesso a serviços de saúde. Esse crescimento não pode ser tomado como garantia de melhoria nas condições de vida e saúde, já que é gasto com a aquisição de produtos e necessidades básicas que não chegam a afetar substancialmente a forma de inserção social em que vivem as famílias. Os fatores de risco psicossociais mostraram-se frequentes, porém decrescentes nas famílias estudadas, o que pode refletir a melhoria da situação de vida familiar ou ser decorrente da etapa do desenvolvimento infantil. Abstract in english This article aims to evaluate the effects of Brazil's recent economic growth on the monetary income, consumption patterns, and risk exposures of families with children enrolled in the public elementary school system in São Gonçalo, Rio de Janeiro State, Brazil. The article analyzes the following information on families of 447 children that participated in two waves in a longitudinal study: social stratum, per capita family income, evolution in income over a three-year p (more) eriod, and psychosocial factors. The findings showed a 74.8% increase in the families' income, accompanied by an increase in the consumption of material assets and access to health services. This increase should not be interpreted as a guarantee of improved living and health conditions, since it was spent on basic products and needs that do not substantially affect the families' form of social inclusion. Psychosocial risk factors were frequent among the families, but decreased during the study period, which may either reflect the improved family situation or result from the later stage in child development.
Assis, Simone Gonçalves de; Pires, Thiago; Pesce, Renata Pires; Avanci, Joviana Quintes; Oliveira, Raquel V. C.
Socioeconomic development, family income, and psychosocial risk factors: a study of families with children in public elementary school Desenvolvimento socioeconômico, renda monetária familiar e fatores de risco psicossociais: um estudo com famílias da rede pública do ensino fundamental
Full Text Available This article aims to evaluate the effects of Brazil's recent economic growth on the monetary income, consumption patterns, and risk exposures of families with children enrolled in the public elementary school system in São Gonçalo, Rio de Janeiro State, Brazil. The article analyzes the following information on families of 447 children that participated in two waves in a longitudinal study: social stratum, per capita family income, evolution in income over a three-year period, and psychosocial factors. The findings showed a 74.8% increase in the families' income, accompanied by an increase in the consumption of material assets and access to health services. This increase should not be interpreted as a guarantee of improved living and health conditions, since it was spent on basic products and needs that do not substantially affect the families' form of social inclusion. Psychosocial risk factors were frequent among the families, but decreased during the study period, which may either reflect the improved family situation or result from the later stage in child development.O objetivo deste artigo é avaliar os reflexos do recente crescimento econômico brasileiro sobre o rendimento monetário, o padrão de consumo familiar e os riscos em que vivem famílias da rede pública do Ensino Fundamental do Município de São Gonçalo, Rio de Janeiro, Brasil. São analisadas as seguintes informações sobre as famílias de 447 crianças que participaram de duas ondas de estudo longitudinal: estrato social, renda familiar per capita, evolução de renda no período e fatores psicossociais. Os resultados indicam incremento financeiro em 74,8% das famílias, acompanhado de aumento no consumo de bens materiais e no acesso a serviços de saúde. Esse crescimento não pode ser tomado como garantia de melhoria nas condições de vida e saúde, já que é gasto com a aquisição de produtos e necessidades básicas que não chegam a afetar substancialmente a forma de inserção social em que vivem as famílias. Os fatores de risco psicossociais mostraram-se frequentes, porém decrescentes nas famílias estudadas, o que pode refletir a melhoria da situação de vida familiar ou ser decorrente da etapa do desenvolvimento infantil.
Simone Gonçalves de Assis; Thiago Pires; Renata Pires Pesce; Joviana Quintes Avanci; Raquel V. C. Oliveira
AIMS/HYPOTHESIS: The objective of this study was to use Scottish national data to assess the influence of type 2 diabetes on the risk of cancer at 16 different sites, while specifically investigating the role of confounding by socioeconomic status in the diabetes-cancer relationship. METHODS: All people in Scotland aged 55-79 years diagnosed with any of the cancers of interest during the period 2001-2007 were identified and classified by the presence/absence of co-morbid type 2 diabetes. The influence of diabetes on cancer risk for each site was assessed via Poisson regression, initially with adjustment for age only, then adjusted for both age and socioeconomic status. RESULTS: There were 4,285 incident cancers in people with type 2 diabetes. RR for any cancers (adjusted for age only) was 1.11 (95% CI 1.05, 1.17) for men and 1.33 (1.28, 1.40) for women. Corresponding values after additional adjustment for socioeconomic status were 1.10 (1.04, 1.15) and 1.31 (1.25, 1.38), respectively. RRs for individual cancer sites varied markedly. CONCLUSIONS/INTERPRETATION: Socioeconomic status was found to have little influence on the association between type 2 diabetes and cancer.
Walker JJ; Brewster DH; Colhoun HM; Fischbacher CM; Leese GP; Lindsay RS; McKnight JA; Philip S; Sattar N; Stockton DL; Wild SH
OBJECTIVE: To describe the relationship of smoking, sex, and socioeconomic factors with age-related cataract in Malay adults in Singapore. METHODS: In a population-based study, 3280 Malay individuals aged 40 to 80 years participated (78.7% response rate). All had interviews, systemic examination, and laboratory investigations. Lens opacity was graded from slitlamp and retroillumination photographs using the Wisconsin Cataract Grading System. Smoking-cataract associations were compared with the Blue Mountains Eye Study in Australia. RESULTS: Of 2927 participants (89.2%) with gradable lens photographs, 1338 (45.7%) had cataract. After adjusting for age, sex, body mass index, hypertension, and diabetes, current smokers had a higher prevalence of nuclear cataract (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.46-2.98), cortical cataract (OR, 1.33; 95% CI, 1.02-1.74), posterior subcapsular cataract (OR, 1.39; 95% CI, 1.02-1.91), or any cataract (OR, 1.48; 95% CI, 1.10-1.99). These associations were not seen in the Blue Mountains Eye Study. Primary or lower education (OR, 1.67; 95% CI, 1.06-2.64) and low monthly income (OR, 1.43; 95% CI, 1.09-1.87) were both associated with nuclear cataract, while small-sized public housing was associated with posterior subcapsular cataract (OR, 1.70; 95% CI, 1.28-2.25). Among men, 43.5% currently smoked compared with only 3.2% of women. The population attributable risk of nuclear cataract due to smoking was estimated to be 17.6% in men. CONCLUSIONS: Smoking and indicators of low socioeconomic status were associated with cataract in Malay persons, with 1 in 6 nuclear cataract cases in men attributable to smoking. Smoking-cataract associations were stronger in Malay than in white persons.
Wu R; Wang JJ; Mitchell P; Lamoureux EL; Zheng Y; Rochtchina E; Tan AG; Wong TY
Risk perception is one of important subjects in management psychology and cognitive psychology. It is of great value in the theory and practice to investigate the societal hazards that the public cares a lot especially in Socio-economic transition period. A survey including 30 hazards and 6 risk attributes was designed and distributed to about 2, 485 residents of 8 districts, Beijing. The major findings are listed as following: Firstly, a scale of societal risk perception was designed and 2 factors were identified (Dread Risk & Unknown Risk). Secondly, structural equation model was used to analyze the influence factors and mechanism of societal risk perception. Risk preference, government support and social justice could influence societal risk perception directly. Government support fully moderated the relationship between government trust and societal risk perception. Societal risk perception influenced life satisfaction, public policy preferences and social development belief.
Zheng, Rui; Shi, Kan; Li, Shu
Mosquito-borne Sindbis virus (SINV) causes rash-arthritis syndrome in Finland. Major outbreaks with approximately 7-year cycles have caused substantial burden of illness. Forest dwelling grouse are suspected to be amplifying hosts, with the infection transmitted to humans by mosquito bites. SINV infection surveillance data for 1984–2010 were used to create a negative binomial hurdle model, with seasonality, long-term cycles, climatic, ecological and socioeconomic variables. Climatic factors during early summer and amount of snow in April described the occurrence and incidence of SINV infections. Regulated water shore and hatch-year black grouse density described the occurrence, while population working in agriculture, agricultural land(negative) and income (negative) described the incidence of the disease. The prediction for 2009 was 85 cases (95% prediction interval 2-1187), while the actual occurrence was 106. We identified novel and known risk factors. The prevention of SINV infections in regulated water areas by infected mosquito populations should be targeted. PMID:23158410
Jalava, K; Sane, J; Ollgren, J; Ruuhela, R; Rätti, O; Kurkela, S; Helle, P; Hartonen, S; Pirinen, P; Vapalahti, O; Kuusi, M
Mosquito-borne Sindbis virus (SINV) causes rash-arthritis syndrome in Finland. Major outbreaks with approximately 7-year cycles have caused substantial burden of illness. Forest dwelling grouse are suspected to be amplifying hosts, with the infection transmitted to humans by mosquito bites. SINV infection surveillance data for 1984–2010 were used to create a negative binomial hurdle model, with seasonality, long-term cycles, climatic, ecological and socioeconomic variables. Climatic factors during early summer and amount of snow in April described the occurrence and incidence of SINV infections. Regulated water shore and hatch-year black grouse density described the occurrence, while population working in agriculture, agricultural land(negative) and income (negative) described the incidence of the disease. The prediction for 2009 was 85 cases (95% prediction interval 2-1187), while the actual occurrence was 106. We identified novel and known risk factors. The prevention of SINV infections in regulated water areas by infected mosquito populations should be targeted.
Jalava K; Sane J; Ollgren J; Ruuhela R; Rätti O; Kurkela S; Helle P; Hartonen S; Pirinen P; Vapalahti O; Kuusi M
BACKGROUND: This study examined the association between social, demographic, and psychologic factors and smoking status among Appalachian Ohio women. A secondary aim examined whether specific factors could be identified and segmented for future tailored treatment of tobacco dependence. METHODS: A cross-sectional survey (n=570) obtained information about social, demographic, and psychologic factors and smoking. Logistic regression described associations between these characteristics and smoking status. Chi-square automatic interaction detection (CHAID) analyses identified subgroups at risk for smoking. RESULTS: Fifty-two percent never smoked, with 20.5% and 27.5% categorized as former and current smokers, respectively. Women with low adult socioeconomic position (SEP) were more likely to smoke (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.74-5.34) compared to high SEP women. Other factors associated with current smoking included age 31-50 (OR 2.30, 95% CI 1.22-4.33), age 18-30 (OR 3.29, 95% CI 1.72-5.34), Center for Epidemiologic Studies Depression scale (CES-D) score?16 (OR 1.99, 95% CI 1.31-3.05), and first pregnancy at age<20 (OR 1.74, 95% CI 1.14-2.66). The prevalence of smoking was 50% among those with four or more risk factors compared to 10% for those reporting no risk factors. CHAID analyses identified low adult SEP and depressive symptoms as the combination of risk factors most strongly associated with smoking; 49.3% of women in this subgroup currently smoked. CONCLUSIONS: Low SEP in adulthood, maternal circumstances, and depressive symptoms are associated with current smoking. Tailored cessation interventions that address these risk factors should be developed and further evaluated in an attempt to reduce disparities in smoking prevalence among this vulnerable group of women.
Wewers ME; Salsberry PJ; Ferketich AK; Ahijevych KL; Hood NE; Paskett ED
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In studies of the SAT, correlations of SAT scores, high school grades, and socioeconomic factors (SES) are usually obtained using a university as the unit of analysis. This approach obscures an important structural aspect of the data: The high school grades received by a given institution come from a large number of high schools, all of which have…
Zwick, Rebecca; Greif Green, Jennifer
|The purpose of this study was to investigate the contributions of socioeconomic status (SES) in predicting social cognitive career theory (SCCT) factors. Data were collected from 738 college students in Taiwan. The results of the partial least squares (PLS) analyses indicated that SES significantly predicted career decision self-efficacy (CDSE);…
Huang, Jie-Tsuen; Hsieh, Hui-Hsien
It is highly probable that nutritionally-related geographic and socioeconomic factors may modulate the conversion of early stages of Helicobacter pylori-associated chronic active gastritis (chronic superficial gastritis [CSG] and chronic deep gastritis [CDG]) to chronic atrophic gastritis (CAG). The factors would be diets low in antioxidant vitamins and other micronutrients. In regions of the world and population groups with high socioeconomic level in which these modulating factors are absent, chronic active gastritis tends to stay in its early stages of CSG or CDG and to predispose to duodenal ulcer. On the contrary, in regions and population groups with low socioeconomic level in which the modulating factors are present, the frequency of CAG increases markedly. When CAG becomes severe and diffuse, hypochlorhydria ensues. Hypochlorhydria decreases the predisposition to duodenal ulcer, while CAG, a precancerous lesion, predisposes to gastric cancer of the intestinal type. The real role of the modulating factors already mentioned could be elucidated doing a multicentric study to determine endoscopically and histologically, in large series of dyspeptic patients from various regions of the world and with different socioeconomic levels, prevalence rates of duodenal ulcer, gastric ulcer, gastric cancer, Helicobacter pylori-associated CAG and intestinal metaplasia of the gastric mucosa, and to correlate these prevalence rates with blood levels of antioxidant capacity and related micronutrients. Latin America, because of its diversity in regions, geographic characteristics and population socioeconomic levels, seems to be the ideal place to conduct a study of that type. If the study could be performed, it would undoubtedly constitute an important contribution to a better understanding of Helicobacter pylori-associated gastroduodenal pathology.
INTRODUCTION: Relatively little is known about the socioeconomic correlates of phthalate metabolite urine concentrations among the general population, exposures of increasing public health concern, particularly for women of reproductive age. METHODS: We pooled data from the 2001-2008 cycles of the National Health and Nutrition Examination Survey to examine the associations between phthalate metabolite concentrations (including the molar sum of four di-2-ethylhexyl phthalate (DEHP) metabolites, the molar sum of two dibutyl phthalate (DBP) metabolites, and metabolites of benzylbutyl phthalate (BzBP) and diethyl phthalate (DEP)) with socioeconomic indicators (including ethnicity, education, income, and food security status) among women 20 to 39 years age. We also derived a socioeconomic status summary measure using factor analysis and investigated its associations with metabolite concentrations. RESULTS: In fully adjusted models, the lowest quartile of overall socioeconomic status was associated with 1.83 (95% CI=1.54-2.17) times the concentrations of mono-benzyl phthalate (MBzP), and 0.72 (95% CI=0.54-0.98) times the concentrations of (molar sum) DEHP metabolites compared with the highest quartile of overall socioeconomic status. This latter association was driven primarily by educational attainment. All Non-White ethnicities combined had 1.24 (95% CI=1.09-1.40) times the concentrations of (molar sum) DBP metabolites, 1.32 (95% CI=1.12-1.56) times the mono-ethyl phthalate (MEP) concentrations, and 0.82 (95% CI=0.71-0.96) the concentrations of MBzP of Non-Hispanic Whites. CONCLUSIONS: Biomarkers of phthalate exposure vary with socioeconomic factors in women of reproductive age in the United States. Given the public health concern surrounding phthalate exposure, more research is needed to elucidate the reasons for these differences.
Kobrosly RW; Parlett LE; Stahlhut RW; Barrett ES; Swan SH
Full Text Available This study adopted a survey design. Questionnaire was administered on 215 respondents in Ibadan metropolis selected randomly. The objectives of the study are to examined the influence of some socio-economic factors on solid waste generation and disposal in Ibadan Metropolis. The nature and composition of solid waste generated, methods of disposal and relationship that exist between the socio-economic characteristics of the people and solid waste generation and disposal were also identified. Data for this study were obtained through the administration of questionnaire and review of existing literature. The information obtained from the field was analyzed using frequency and correlation matrix. The finding showed that the composition of waste generated in Ibadan Metropolis was a reflection of variation of socio-economic factors of the people. Also, socio-economic factors such as income, age, education, occupation and building types had greater influence on the choice of method of disposal in Ibadan Metropolis. It was recommended therefore that effective solid waste management can be achieved through the adoption of urban renewal strategy on the chaotic areas, provision of sizable fund by the government and proper education to the people among others.
Kayode, A. M.; Omole, F. K.
OBJECTIVES: Investigations concerning the relationship between socioeconomic status and dental caries have been conducted mainly in Western countries. The purpose of this longitudinal study was to examine the impact of socioeconomic factors, such as maternal occupation, household income, and parental educational levels, on the risk of dental caries in young Japanese children. METHODS: A cohort of 315 preschool children was used. Information pertaining to exposure and potentially confounding factors was obtained by means of questionnaires administered to expectant mothers prior to delivery and subsequently when their children were in the ranges of 2-9, 16-24, 29-39, and 41-49 months of age. Outcome data were collected when the children were between 41 and 50 months old. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled. RESULTS: Compared with maternal or paternal education of less than 13 years, maternal or paternal education of 15 years or longer was significantly associated with a decreased risk of dental caries in children: the adjusted odds ratios for maternal and paternal education levels ?15 years compared with <13 years of maternal and paternal education were 0.32 (95 percent confidence interval: 0.14-0.71) and 0.45 (95 percent confidence interval: 0.23-0.88), respectively. No relationship between maternal occupation or household income and the risk of children's dental caries was found. CONCLUSIONS: Higher levels of parental education, in particular maternal education, may be associated with reduced risk of dental caries in preschool children.
Tanaka K; Miyake Y; Sasaki S; Hirota Y
PURPOSE: Advanced maternal age and altered recombination are known risk factors for Down syndrome cases due to maternal nondisjunction of chromosome 21, whereas the impact of other environmental and genetic factors is unclear. The aim of this study was to investigate an association between low maternal socioeconomic status and chromosome 21 nondisjunction. METHODS: Data from 714 case and 977 control families were used to assess chromosome 21 meiosis I and meiosis II nondisjunction errors in the presence of three low socioeconomic status factors: (i) both parents had not completed high school, (ii) both maternal grandparents had not completed high school, and (iii) an annual household income of <$25,000. We applied logistic regression models and adjusted for covariates, including maternal age and race/ethnicity. RESULTS: As compared with mothers of controls (n = 977), mothers with meiosis II chromosome 21 nondisjunction (n = 182) were more likely to have a history of one low socioeconomic status factor (odds ratio = 1.81; 95% confidence interval = 1.07-3.05) and ?2 low socioeconomic status factors (odds ratio = 2.17; 95% confidence interval = 1.02-4.63). This association was driven primarily by having a low household income (odds ratio = 1.79; 95% confidence interval = 1.14-2.73). The same statistically significant association was not detected among maternal meiosis I errors (odds ratio = 1.31; 95% confidence interval = 0.81-2.10), in spite of having a larger sample size (n = 532). CONCLUSION: We detected a significant association between low maternal socioeconomic status and meiosis II chromosome 21 nondisjunction. Further studies are warranted to explore which aspects of low maternal socioeconomic status, such as environmental exposures or poor nutrition, may account for these results.
Hunter JE; Allen EG; Shin M; Bean LJ; Correa A; Druschel C; Hobbs CA; O'Leary LA; Romitti PA; Royle MH; Torfs CP; Freeman SB; Sherman SL
PURPOSE: Exposure to natural disasters has been associated with increased risk for various forms of psychopathology. Evidence indicates that socioeconomic status (SES) may be important for understanding post-disaster psychiatric distress; however, studies of SES-relevant factors in non-Western, disaster-exposed samples are lacking. The primary aim of the current study was to examine the role of pre-typhoon SES-relevant factors in relation to post-typhoon psychiatric symptoms among Vietnamese individuals exposed to Typhoon Xangsane. METHODS: In 2006, Typhoon Xangsane disrupted a mental health needs assessment in Vietnam in which the Self Reporting Questionnaire-20 (SRQ-20), and the Demographic and Health Surveys Wealth Index, a measure of SES created for use in low-income countries, were administered pre-typhoon. The SRQ-20 was re-administered post-typhoon. RESULTS: Results of a linear mixed model indicated that the covariates of older age, female sex, and higher levels of pre-typhoon psychiatric symptoms were associated with higher levels of post-typhoon psychiatric symptoms. Analysis of SES indicators revealed that owning fewer consumer goods, having lower quality of household services, and having attained less education were associated with higher levels of post-typhoon symptoms, above and beyond the covariates, whereas quality of the household build, employment status, and insurance status were not related to post-typhoon psychiatric symptoms. CONCLUSION: Even after controlling for demographic characteristics and pre-typhoon psychiatric symptoms, certain SES factors uniquely predicted post-typhoon psychiatric distress. These SES characteristics may be useful for identifying individuals in developing countries who are in need of early intervention following disaster exposure.
Brown RC; Trapp SK; Berenz EC; Bigdeli TB; Acierno R; Tran TL; Trung LT; Tam NT; Tuan T; Buoi LT; Ha TT; Thach TD; Amstadter AB
Full Text Available Hepatitis C virus (HCV) infection in adults is the leading cause of chronic disease and cirrhosis. Globally, an estimated 200 million persons are chronically infected with HCV and 3 to 4 million persons are newly infected each year. Improved sanitary and socioeconomic conditions over time have greatly affected the frequency of HCV infection causing a decreased risk of infection along generation. However, the younger population is particularly at risk due to certain practices (use of intravenous drugs, tattooing, piercing) known to favor HCV transmission. Such practices often begin during adolescence when awareness of hepatitis C is low. We have conducted a prospective study in which have been included 286 patients with chronic hepatitis C hospitalized in the Clinic Hospital of Infectious Diseases Iasi between 2004 and 2007. The aim of this study was to investigate the risk factors for the acquisition of hepatitis C virus in patients with chronic hepatitis. The study confirms that the most relevant risk factors for the acquisition of HCV are transfusions of blood before 1993 (32%) followed by dental procedures (25,5%) and health care related procedures (20%). Accidental needlstick, was reported by 16 patients (5,6%). Patients older than 40 years had a significant higher rate of declared risk factors compared with younger patients (p=0,038). The results of this study stress the need of strict adherence to universal precautionary measures. Because the quality of knowledge regarding hepatitis C is very poor among adolescents it would be beneficial for public health a strong intervention to present the most relevant risk factors for the acquisition of this virus.
Egidia MIFTODE; Daniela LECA; Mihaela RADU; Razvan MIFTODE
Full Text Available Abstract Background Socioeconomic inequalities in health are a global problem, not only among the adult population but also among children. However, studies concerning young children especially are rare. The aim of this study was to describe the health of Finnish children under 12 years of age, and the socioeconomic factors associated with health. The socioeconomic factors were parental education level, household net income, and working status. Methods A population-based survey among Finnish children aged under 12 years (n = 6,000) was conducted in spring 2007. A questionnaire was sent to parents, and a response rate of 67% was achieved. Each child's health was explored by asking a parent to report the child's health status on a 5-point Likert scale, current symptoms from a symptoms list, and current disease(s) diagnosed by a physician. The final three outcome measures were poor health, the prevalences of psychosomatic symptoms, and long-term diseases. Data were analysed using Pearson's Chi-Square tests, and logistic regression analysis with 95% confidence intervals (CIs). P-values ?0.05 were considered as statistically significant. Results In total, 3% of parents reported that their child's health status was poor. The prevalences of psychosomatic symptoms and long-term diseases were both 11%. The probability for poor health status was lowest among children aged 3-6 and 7-11 years, and for psychosomatic symptoms among 3-6-year-old children, whereas the odds ratios for long-term diseases was highest among children aged 7-11 years. Parental socioeconomic factors were not associated with the children's health. Conclusions Most of the children were reported by their parent to have good health status, and approximately one tenth had experienced some psychosomatic symptoms or long-term diseases. Our study suggests that parental socioeconomic factors are not associated with the health of children aged under 12 years in Finland.
Siponen Sanna M; Ahonen Riitta S; Savolainen Piia H; Hämeen-Anttila Katri P
BACKGROUND: Lower limb venous ulceration ranks among the 10 most common medical problems in Western countries and has significant socioeconomic impact. The aim of this study was to identify the risk factors for unhealed, recurrent, and large ulcers and to characterize patients with active or recently healed venous ulcers. METHODS: We identified 97 patients and assessed 103 ulcerated limbs in 90 patients. All patients underwent clinical examination, arterial and venous system evaluation, ankle-brachial index determination, and ultrasound of the affected limb. Clinical characteristics included age, gender, race, ulcer duration, time since first episode, history of recurrence, localization of ulcer, ulcer area, eczema, ochre dermatitis, lipodermatosclerosis, pain, body mass index, and medical history data. Risk factors were identified by univariate analysis and estimated odds ratios. RESULTS: We assessed 90 patients (103 limbs) with active or healed venous leg ulcers, of whom 84.4% were Caucasian and 68.9% were female. Mean age was 56.0 ± 13.3 years. Ulcers had remained unhealed for <1 year in 40.7%. Lipodermatosclerosis, lower limb hyperpigmentation, edema, and eczema were seen in 96.7%, 95.6%, 94.4%, and 51.1% of patients, respectively. Pain was a frequent symptom in 74.4%. Body mass index was assessed in 85 patients: 30.6% were slightly, 36.5% moderately, and 7% severely obese. Patient age >60 years (odds ratio [OR] 4.0), extensive lipodermatosclerosis (OR 8.7), and previous history of ulceration (OR 19.9) were risk factors for unhealed ulcers. Time since first ulcer episode ? 2 years (OR 29.2) and incompetence of venous systems (OR 1.6) were risk factors for recurrence. CONCLUSIONS: Longstanding and large ulcers and recurrences are the main problems encountered by venous ulcer patients. Severe lipodermatosclerosis, previous ulcer history, and time since first ulcer episode ? 2 years are significant risk factors.
Abbade LP; Lastória S; Rollo Hde A
Public health concern regarding depression has recently increased as a result of the rise in the rate of adolescent suicide, with a probable concomitant rise in the rate of depression in this age group. The rise appears to be both a period effect, in that increased rates are now observed across age categories, and a cohort effect, in that being born after 1960 also contributes to the increase. The clinical phenomena and epidemiology of depression in adolescence are reviewed. Diagnostic criteria for depressive mood and depressive syndrome are similar to those in adults. However, the predictive value of a depressive episode in adolescence, and whether the occurrence of depression in adolescence is a transient developmental experience or whether it predicts a particular subtype of future depression, are at present unknown. The familial, social and personal risk factors for adolescent depression are reviewed, The major factors are: parental history of affective illness, childhood experience of parental loss, and female gender. Other factors, such as birth order and sibling factors, socio-economic status, race, religion, geography, concomitant medical illness, intelligence, career aspirations, substance abuse and life events, are reviewed, although their relative contributions as risk factors are less clear-cut. It is proposed that cross-sectional, retrospective and longitudinal studies are required to clarify important areas of uncertainty.
Wells VE; Deykin EY; Klerman GL
Full Text Available This paper attempts to understand the factors of the slow progress in the coverage of basic childhood immunisation in India using three rounds of National Family Health Survey (NFHS) data. States are selected on the basis of changes in full immunisation coverage during 1992-2005. Bivariate, multivariate, and dropout rates are used to understand the differentials and changes in immunisation coverage. The result reveals substantial improvement in partial immunisation in most states; however, the increase in full immunisation coverage has been slower. Two crucial determinants of the full immunisation coverage in selected states are availability of health card and antenatal care (ANC) visits of mother. Further, higher drop out of DPT3 and measles are responsible for slow increase in full immunisation coverage in selected states. The dropout rate between BCG-measles remains very high. The measles vaccination is very poorly addressed in India, due to which full immunisation is low. Mother’s education, standard of living, mass media exposure, and availability of health card are appeared as significant predictor in explaining the full immunisation coverage irrespective of time. Descriptive statistics and multinomial logistic regression analysis are used in the study. Results indicate a steady increase in coverage of full immunisation in last 14 years, while the increase was higher during 1992-1998 but lower during 1998-2005.
Full Text Available Objective: To find out risk factors for hepatitis C infection in obstetric patients in a teaching hospital. Study Design – Observational study. Place and Duration At Sir Ganga Ram Hospital, Lahore during a period of one year. Subjects and Methods –Cases of hepatitis C infection, diagnosed on the basis of screening for antibodies for Hepatitis C were included in the study. A proforma was designed and details of each case including maternal demographics and associated risk factors were entered. Result Fifty three obstetric patients were positive for Hepatitis C virus antibodies in one year of study period. Majority of women were among 25-29 years of age, belong to low socioeconomic status, illiterate and among parity range of 2-5. Previous history of surgical procedures was in 66% of subjects while 62% had history of injections. Ear piercing in unsterilized conditions by non skilled person was also present in significant number (43%) while 17% had history of blood transfusions. Conclusion: Hepatitis C infection is linked to surgical procedures, injections and ear piercing in this study. However, to identify all associated maternal risk factors, larger studies at multiple centres will be required and strategies should be made to prevent its’ transmission.
NUZHAT PARVEEN KHAWAJA
Full Text Available Abstract in english The aim of this paper was to assess the epidemiology of traumatic dental injury (TDI) in preschool children and its relation to socioeconomic and clinical factors. This study was carried out in Santa Maria, Brazil, during National Children's Vaccination Day, and 441 children aged 12 to 59 months were included. Data about socioeconomic status were collected through a semi-structured questionnaire administered to parents. Calibrated examiners evaluated the prevalence of TDI (more) , overjet, and lip coverage. Data were analyzed with a Poisson regression model (PR; 95% confidence intervals). The TDI prevalence was 31.7%. The maxillary central incisors were the most frequently traumatized teeth. The most common TDI was enamel fracture. No association was found between TDI prevalence and the socioeconomic status of children. After adjustments were performed, the eldest children with an overjet > 3 mm were more likely to have TDI than their counterparts. The data indicated a high prevalence of TDI. Only overjet was a strong predictor for TDI, whereas socioeconomic factors were not associated with TDI in this age group.
Piovesan, Chaiana; Guedes, Renata Saraiva; Casagrande, Luciano; Ardenghi, Thiago Machado
STUDY OBJECTIVE: To estimate relative odds ratios and to ascertain the relative contribution of each socioeconomic covariate in explaining racial disparities in self assessed health status (for example, global health perceptions and functional limitations of daily activities). DESIGN: National representative data from the 1987-88 national survey of families and households, a multistage, stratified probability sample of non-institutionalised American adults age 19 and older, were used. Logistic regression models enabled a multistage building strategy to be used in the analyses. PARTICIPANTS AND SETTING: The study included three racial groups: whites (n = 9419), blacks (n = 2391), and Hispanics (n = 1004). While face to face interviews were carried out with each respondent, some portions of the interview were self administered to collect sensitive information. MAIN RESULTS: Compared with whites, blacks and Hispanics were more likely to assess health as poor and report having functional limitations of daily activities. Socioeconomic factors tended to play a different role in explaining racial disparities in self assessed health status. In global health, education tended to play a significant role in accounting for health disparities between whites and Hispanics. In functional limitations, none of the covariates explained racial differences for blacks, whereas for Hispanics, education and marital status explained racial differences. CONCLUSIONS: The debate over whether race is a proxy for socioeconomic conditions or race influences health independent of socioeconomic factors depends on the measure of health and racial group included in the study. Future studies should examine separately the differential impacts of various socioeconomic factors on varying domains of health.
Ren XS; Amick BC 3rd
Risk factors play an important role in an individual's response to periodontal infection. Identification of these risk factors helps to target patients for prevention and treatment, with modification of risk factors critical to the control of periodontal disease. Shifts in our understanding of periodontal disease prevalence, and advances in scientific methodology and statistical analysis in the last few decades, have allowed identification of several major systemic risk factors for periodontal disease. The first change in our thinking was the understanding that periodontal disease is not universal, but that severe forms are found only in a portion of the adult population who show abnormal susceptibility. Analysis of risk factors and the ability to statistically adjust and stratify populations to eliminate the effects of confounding factors have allowed identification of independent risk factors. These independent but modifiable, risk factors for periodontal disease include lifestyle factors, such as smoking and alcohol consumption. They also include diseases and unhealthy conditions such as diabetes mellitus, obesity, metabolic syndrome, osteoporosis, and low dietary calcium and vitamin D. These risk factors are modifiable and their management is a major component of the contemporary care of many periodontal patients. Genetic factors also play a role in periodontal disease and allow one to target individuals for prevention and early detection. The role of genetic factors in aggressive periodontitis is clear. However, although genetic factors (i.e., specific genes) are strongly suspected to have an association with chronic adult periodontitis, there is as yet no clear evidence for this in the general population. It is important to pursue efforts to identify genetic factors associated with chronic periodontitis because such factors have potential in identifying patients who have a high susceptibility for development of this disease. Many of the systemic risk factors for periodontal disease, such as smoking, diabetes and obesity, and osteoporosis in postmenopausal women, are relatively common and can be expected to affect most patients with periodontal disease seen in clinics and dental practices. Hence, risk factor identification and management has become a key component of care for periodontal patients.
Genco RJ; Borgnakke WS
Full Text Available The present case control study included 322 cases of sexually transmitted diseases and equal number of age group matched and sex pair matched controls from the Skin and Venereal Disease out patient department of Indira Gandhi Medical College, Nagpur. Of the six study factors viz. type of family, educational status, religion, socioeconomic status, marital status and social disharmony, except for religion and socioeconomic status other four factors were found to be significantly associated with sexually transmitted diseases?
Shendre Mohan; Tiwari Rajnaraayan
Cardiovascular diseases (CVD) are the primary cause of death in women. Guidelines for identifying high-risk individuals have been developed, e.g. the Dutch Guideline on Cardiovascular Risk Management. In the most recent version of this guideline, diabetes mellitus (DM) and rheumatoid arthritis (RA) are cited as cardiovascular risk factors; therefore, individuals with these conditions are identified as being at high risk. As with DM and RA, there is strong evidence that the experience of having a hypertensive disorder during pregnancy is a cardiovascular risk factor. This is particularly the case for early preeclampsia, which constitutes a 7-fold increased risk of ischemic heart disease. However, in the Netherlands, there are no guidelines and there is no consensus on how to screen or treat these women. Trial evidence is therefore urgently needed to substantiate the value of cardiovascular risk management for those women with a history of hypertension during pregnancy.
Heida KY; Franx A; Bots ML
Cardiovascular diseases (CVD) are the primary cause of death in women. Guidelines for identifying high-risk individuals have been developed, e.g. the Dutch Guideline on Cardiovascular Risk Management. In the most recent version of this guideline, diabetes mellitus (DM) and rheumatoid arthritis (RA) are cited as cardiovascular risk factors; therefore, individuals with these conditions are identified as being at high risk. As with DM and RA, there is strong evidence that the experience of having a hypertensive disorder during pregnancy is a cardiovascular risk factor. This is particularly the case for early preeclampsia, which constitutes a 7-fold increased risk of ischemic heart disease. However, in the Netherlands, there are no guidelines and there is no consensus on how to screen or treat these women. Trial evidence is therefore urgently needed to substantiate the value of cardiovascular risk management for those women with a history of hypertension during pregnancy. PMID:23965245
Heida, K Y; Franx, A; Bots, M L
Full Text Available Autism is a devastating childhood condition that has emerged as an increasing social concern just as it has increased in prevalence in recent decades. Autism and the broader category of autism spectrum disorders are among the increasingly seen examples in which there is a fetal basis for later disease or disorder. Environmental, genetic, and epigenetic factors all play a role in determining the risk of autism and some of these effects appear to be transgenerational. Identification of the most critical windows of developmental vulnerability is paramount to understanding when and under what circumstances a child is at elevated risk for autism. No single environmental factor explains the increased prevalence of autism. While a handful of environmental risk factors have been suggested based on data from human studies and animal research, it is clear that many more, and perhaps the most significant risk factors, remain to be identified. The most promising risk factors identified to date fall within the categories of drugs, environmental chemicals, infectious agents, dietary factors, and other physical/psychological stressors. However, the rate at which environmental risk factors for autism have been identified via research and safety testing has not kept pace with the emerging health threat posed by this condition. For the way forward, it seems clear that additional focused research is needed. But more importantly, successful risk reduction strategies for autism will require more extensive and relevant developmental safety testing of drugs and chemicals.
Rodney R. Dietert; Janice M. Dietert; Jamie C. Dewitt
The measurement of the risk-related impacts from the siting of a high-level nuclear waste (HLNW) repository represents a new and important addition to conventional socioeconomic impact studies. In particular, the driving forces behind these impacts are the risks people perceive to be associated with the repository. Measuring the risk impacts requires a complementary set of approaches, of which, risk surveys are the cornerstone.a The purpose of these surveys is to provide scientifically defensible measures of the risk-related impacts. The risk surveys follow directly from a conceptual framework of how the HLNW repository affects peoples` perceptions and, ultimately, their behaviors. These surveys describe and measure: Characteristics of individuals, Risks people perceive from the HLNW repository, Views, or mind sets, they form about the HLNW repository, Changes in behaviors--e.g., changes in retirement decisions or industrial relocations--induced by the location of the repository, and Changes in well-being of Nevada citizens, if the repository were located at Yucca Mountain.
Kunreuther, H. [Pennsylvania Univ., Philadelphia, PA (United States). Wharton School of Finance and Commerce; Slovic, P. [Decision Research, Eugene, OR (United States); Nigg, J. [Arizona State Univ., Tempe, AZ (United States); Desvousges, W.H. [Research Triangle Inst., Research Triangle Park, NC (United States)
The measurement of the risk-related impacts from the siting of a high-level nuclear waste (HLNW) repository represents a new and important addition to conventional socioeconomic impact studies. In particular, the driving forces behind these impacts are the risks people perceive to be associated with the repository. Measuring the risk impacts requires a complementary set of approaches, of which, risk surveys are the cornerstone.a The purpose of these surveys is to provide scientifically defensible measures of the risk-related impacts. The risk surveys follow directly from a conceptual framework of how the HLNW repository affects peoples' perceptions and, ultimately, their behaviors. These surveys describe and measure: Characteristics of individuals, Risks people perceive from the HLNW repository, Views, or mind sets, they form about the HLNW repository, Changes in behaviors--e.g., changes in retirement decisions or industrial relocations--induced by the location of the repository, and Changes in well-being of Nevada citizens, if the repository were located at Yucca Mountain.
[en] Child malnutrition is a major public health and development concern in most of the poor communities leading to high morbidity and mortality. Various studies have highlighted the factors involved. The present study focuses on socioeconomic inequality resulting in malnutrition. Objectives of the Study were to find the Impact of socio-economic factors on nutritional status in primary school children. Methods: It was a cross sectional survey conducted at Lahore from February to August 2005 among primary schools from public and private sectors to assess the nutritional status of primary school going children age 5-11 years belonging to different socio economic classes of the society. Systematic random sampling technique was applied to collect the sample. Body Mass Index in relation to NHANES reference population was used for assessing nutritional status. Results: The nutritional status of children from lower socio economic class was poor as compared to their counter parts in upper socio economic class. Children with BMI
OBJECTIVE: To verify the association between the behavioral, biopsychological, and socioeconomic factors in overweight and obese students. SUBJECTS AND METHODS: The sample involved 393 students from state and private schools in Florianópolis/SC, mean age of 9.9 ± 1.7, with 41% male subjects. A questionnaire adapted from Oliveira e cols. was applied in the interview; anthropometric information (body mass and height) was used to calculate the BMI, and individuals were classified in overweight and obese according to Conde and Monteiro. RESULTS: As for the distribution of obesity and overweight by gender, girls showed a similar degree, while among boys, overweight individuals represented 77% of the sample. There were associations between female gender, economic status, ethnicity, school, and type of food with p ranging from < 0.001 to 0.003. CONCLUSION: It was found that the behavioral, biopsychological, and socioeconomic factors seem to interfere with overweight and obesity in students of Florianópolis.
Guimarães AC; Feijó I; Soares A; Fernandes S; Machado Z; Parcias SR
Full Text Available The aim of this study was to determine and quantify the socio-economic factors influencing decision by meat agribusiness operators to add value to their products, describe and characterize the existing systems of value addition in rural Kenya. The study carried out a census of 120 butchery operators in Igembe north district. Data was collected with the help of a structured questionnaire. Using a probit model to evaluate the socioeconomic factors influencing the decision to add value, the study found that credit, management’s level of education and age significantly influenced the decision to engage in value addition. The study therefore recommends policy interventions to enhance access to credit, reduce illiteracy levels among rural entrepreneurs through training and extension services.
P.M. Ngore; P.M. Mshenga; G Owuor; B. K. Mutai
OBJECTIVES: To analyze the relationship between maternal and infant health and socioeconomic, cultural, and sanitation factors in Argentina; to evaluate how health program quality affects the primary health indicators for mothers and infants. METHODS: This is a cross-sectional study with multiple variables. The authors studied six indicators for maternal and infant health: rates for maternal, infant, neonatal, and postneonatal mortality; the percentage of newborns with low birthweight; and the percentage of premature newborns. The study was conducted in 79 administrative units in 13 provinces that represent different geographic regions of Argentina. They included (1) the provinces of Salta and Jujuy in northwest Argentina; (2) the provinces of Córdoba, Santa Fe, and Buenos Aires in central Argentina; (3) the provinces of Entre Ríos and Misiones in the Mesopotamia or northeast region; (4) the provinces of San Luis, San Juan, and Mendoza in the Cuyo or northwest, Andean region; and (5) the provinces of Neuquén, Río Negro, and Chubut in the south. The explanatory variable in the study was the quality of health programs, controlled by socioeconomic, cultural, and sanitation factors in 1999 and 2000. The definition of program quality ("poor," "average," "good," and "very good") was based on quantitative and qualitative analysis of selected variables such as policies, organization, and procedures as determined by the investigators. Documentation was obtained from secondary official sources. The investigators interviewed 117 health system managers (including supervisors of provincial and local health programs, administrators of maternal and child health programs, and hospital directors), who provided information on characteristics and indicators of the health programs. RESULTS: There were marked geographic differences in the levels of maternal and infant health, medical care, and socioeconomic, cultural, and sanitation factors. Only 10.0% of health programs were classified as "very good," 35.4% as "good," 31.6% as "average," and 23.0% as "poor." There was a significant correlation (P < 0.05) between rates of infant and postneonatal mortality and adverse socioeconomic circumstances. There was also a significant correlation between the percentage of low birthweight infants and the quality of health programs. CONCLUSIONS: There are clear disparities in the level of maternal and infant health care in different administrative units in Argentina. The infant mortality rate was associated with variations in socioeconomic, cultural, and sanitation factors and with the quality of health programs. Health programs improved infant health when appropriately implemented, even in adverse socioeconomic and sanitation conditions.
Etchegoyen G; Paganini JM
To develop an effective waste management strategy for a given region, it is important to know the amount of waste generated and the composition of the waste stream. Past research has shown that the amount of waste generated is proportional to the population and the average mean living standards or the average income of the people. In addition, other factors may affect the amount and composition of waste. These are climate, living habits, level of education, religious and cultural beliefs, and social and public attitudes. This paper presents the findings of a study carried out in a suburban municipal area in Sri Lanka to determine the solid waste generation rate and waste composition based on field surveys and to determine the related socio-economic factors. A database was developed that included information on the quantity and composition of waste generated in a sample of households in the study area over a time period. The collected data was analysed to relate waste generation and composition data to various socio-economic factors. Over 400 sample households were selected for the study using a stratified random sampling methodology based on municipal wards and property values. A technique that considers both the number of households in a particular income group (property value range) and the standard deviation of property values within a given income group was used to determine the appropriate sample size for each municipal ward. Through category and regression analyses, the quantities of waste and waste composition were related to several socio-economic factors. The paper describes the basis for the sample selection, the methodology adopted for data collection, the socio-economic parameters used for the analysis, and the relationships developed from the analysis.
Bandara NJ; Hettiaratchi JP; Wirasinghe SC; Pilapiiya S
To develop an effective waste management strategy for a given region, it is important to know the amount of waste generated and the composition of the waste stream. Past research has shown that the amount of waste generated is proportional to the population and the average mean living standards or the average income of the people. In addition, other factors may affect the amount and composition of waste. These are climate, living habits, level of education, religious and cultural beliefs, and social and public attitudes. This paper presents the findings of a study carried out in a suburban municipal area in Sri Lanka to determine the solid waste generation rate and waste composition based on field surveys and to determine the related socio-economic factors. A database was developed that included information on the quantity and composition of waste generated in a sample of households in the study area over a time period. The collected data was analysed to relate waste generation and composition data to various socio-economic factors. Over 400 sample households were selected for the study using a stratified random sampling methodology based on municipal wards and property values. A technique that considers both the number of households in a particular income group (property value range) and the standard deviation of property values within a given income group was used to determine the appropriate sample size for each municipal ward. Through category and regression analyses, the quantities of waste and waste composition were related to several socio-economic factors. The paper describes the basis for the sample selection, the methodology adopted for data collection, the socio-economic parameters used for the analysis, and the relationships developed from the analysis. PMID:17450419
Bandara, Nilanthi J G J; Hettiaratchi, J Patrick A; Wirasinghe, S C; Pilapiiya, Sumith
BACKGROUND: Socioeconomic adversity in early life has been hypothesized to "program" a vulnerable phenotype with exaggerated inflammatory responses, so increasing the risk of developing type 2 diabetes in adulthood. The aim of this study is to test this hypothesis by assessing the extent to which the association between lifecourse socioeconomic status and type 2 diabetes incidence is explained by chronic inflammation. METHODS AND FINDINGS: We use data from the British Whitehall II study, a prospective occupational cohort of adults established in 1985. The inflammatory markers C-reactive protein and interleukin-6 were measured repeatedly and type 2 diabetes incidence (new cases) was monitored over an 18-year follow-up (from 1991-1993 until 2007-2009). Our analytical sample consisted of 6,387 non-diabetic participants (1,818 women), of whom 731 (207 women) developed type 2 diabetes over the follow-up. Cumulative exposure to low socioeconomic status from childhood to middle age was associated with an increased risk of developing type 2 diabetes in adulthood (hazard ratio [HR]?=?1.96, 95% confidence interval: 1.48-2.58 for low cumulative lifecourse socioeconomic score and HR?=?1.55, 95% confidence interval: 1.26-1.91 for low-low socioeconomic trajectory). 25% of the excess risk associated with cumulative socioeconomic adversity across the lifecourse and 32% of the excess risk associated with low-low socioeconomic trajectory was attributable to chronically elevated inflammation (95% confidence intervals 16%-58%). CONCLUSIONS: In the present study, chronic inflammation explained a substantial part of the association between lifecourse socioeconomic disadvantage and type 2 diabetes. Further studies should be performed to confirm these findings in population-based samples, as the Whitehall II cohort is not representative of the general population, and to examine the extent to which social inequalities attributable to chronic inflammation are reversible.
Stringhini S; Batty GD; Bovet P; Shipley MJ; Marmot MG; Kumari M; Tabak AG; Kivimäki M
This article investigates how socio-economic factors and incentives affect farmers’ investment behaviour. The motivation is a need for a better quantitative knowledge of investment behaviour in order to support farmers’ investment decisions through extension services and public investment support schemes. Data from a questionnaire survey among 208 Danish pig producers are analysed by use of logistic regression and the relationships between socio-economic factors, investment incentives and farmers’ investment behaviour are empirically revealed. The results show that the farmers who rank economic incentives as the most important when making investments are those who yield the best financial results. Off-farm income and partial productivity were also higher on these farms. As hypothesised, young farmers with a large production are more likely to invest in real assets than others. No cross sectional trends relating the incentives for making investments to the investment propensity were identified. One important policy implication of the results is that improved knowledge of the socio-economic factors and their influence on investment behaviour and incentives may reduce the deadweight loss associated with many governmental investment programmes.
Olsen, Jakob Vesterlund; Lund, Mogens
Full Text Available This study was conducted to determine Environmental, Demogrphic and Socioeconomic factors influencing adoption of artisanal fisheries resources conservation measures based on the perspectives of Artisanal fishers in Delta, Rivers and Bayelsa states, Niger Delta, Nigeria. The study was conducted for a period of one year (January 2008 to Decmber 2008). With the aid of well-structured questionnaires the desired information were collected and analyzed. A total sample size of 1,200 respondents within the study area, were selected using random sampling technique. Logistic regression technique was used to determine the impact of the independent variables on willingness to adopt fisheries conservation measures. The regression analysis result show that eleven (11) independent variables (Public Enlightenment, Regulatory pressure, Environmental stewardship, Severity of pollutants, Economic circumstances, Institutional Support, Information access, Highest Education, Fishing Experience, Legal Structure and Age) were factors that influence willingness to adopt conservation measures by the fishers. However, the level of influence was found to vary differently in the three states studied depending on the socioeconomic and educational status and other peculiarities of each of the state. Generally, based on the result of the logit analysis of the perspectives of the artisanal fisher respondents, it is therefore inferred that the willingness to adopt fisheries resources conservation measures in the Niger Delta by the Artisanal Fishers, is significantly a function of the studied demographic, socioeconomic, psychological, institutional and environmental factors as specified by the eleven variables.
J.A. Akankali; A. Chindah
This portion of the Energy vision 2020 draft report discusses the socioeconomic environment of the Tennessee Valley region. It describes the region and mentions geographical factors, current economy, the agricultural sector, and future trends in the economy of the region.
Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran. Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering. Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8% (95% CI: 27.7-41.7). A significant difference was observed among depression scores before and after delivery (P ? 0.001). Type of delivery (P = 0.044), low socioeconomic status (P = 0.011), and women having low educational level (P = 0.009) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95% CI: 1.22-2.28, P = 0.003). Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports.
Taherifard P; Delpisheh A; Shirali R; Afkhamzadeh A; Veisani Y
Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran. Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering. Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8% (95% CI: 27.7-41.7). A significant difference was observed among depression scores before and after delivery (P ? 0.001). Type of delivery (P = 0.044), low socioeconomic status (P = 0.011), and women having low educational level (P = 0.009) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95% CI: 1.22-2.28, P = 0.003). Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports. PMID:23984055
Taherifard, Pegah; Delpisheh, Ali; Shirali, Ramin; Afkhamzadeh, Abdorrahim; Veisani, Yousef
Background. Postpartum depression (PPD) is considered as one of the mood disturbances occurring during 2-3 months after delivery. The present study aimed to determine the prevalence of PPD and its associated risk factors in border city of Ilam, western Iran. Methods. Through a descriptive cross-sectional study in 2011, overall, 197 women who attended Obstetrics & Gynecology clinics postpartumly in the border city of Ilam, western Iran, were randomly recruited. A standard questionnaire that was completed by a trained midwife through face to face interviews was used for data gathering. Results. Mean age ± standard deviations was 27.9 ± 5.2 years. Prevalence of PPD was estimated to be 34.8% (95% CI: 27.7–41.7). A significant difference was observed among depression scores before and after delivery (P ? 0.001). Type of delivery (P = 0.044), low socioeconomic status (P = 0.011), and women having low educational level (P = 0.009) were the most important significant risk factors associated with PPD. The regression analysis showed that employed mothers compared to housekeepers were more at risk for PPD (adjusted OR = 2.01, 95% CI: 1.22–2.28, P = 0.003). Conclusions. Prevalence of PPD in western Iran was slightly higher than the corresponding rate from either national or international reports.
Taherifard, Pegah; Delpisheh, Ali; Shirali, Ramin; Afkhamzadeh, Abdorrahim; Veisani, Yousef
Studies have persistently associated esophageal squamous cell carcinoma (ESCC) risk with low socioeconomic status (SES), but this association is unexplored in Kashmir, an area with a high incidence of ESCC in the northernmost part of India. We carried out a case-control study to assess the association of multiple indicators of SES and ESCC risk in the Kashmir valley. A total number of 703 histologically confirmed ESCC cases and 1664 controls matched to the cases for age, sex, and district of residence were recruited from October 2008 to January 2012. Conditional logistic regression models were used to calculate unadjusted and adjusted odds ratios and 95% confidence intervals. Composite wealth scores were constructed based on the ownership of several appliances using multiple correspondence analyses. Higher education, living in a kiln brick or concrete house, use of liquefied petroleum gas and electricity for cooking, and higher wealth scores all showed an inverse association with ESCC risk. Compared to farmers, individuals who had government jobs or worked in the business sector were at lower risk of ESCC, but this association disappeared in fully adjusted models. Occupational strenuous physical activity was strongly associated with ESCC risk. In summary, we found a strong relationship of low SES and ESCC in Kashmir. The findings need to be studied further to understand the mechanisms through which such SES parameters increase ESCC risk.
Dar NA; Shah IA; Bhat GA; Makhdoomi MA; Iqbal B; Rafiq R; Nisar I; Bhat AB; Nabi S; Masood A; Shah SA; Lone MM; Zargar SA; Islami F; Boffetta P
PURPOSE: This study compares polydrug use in national and inner city samples to (1) examine patterns of use underlying different prevalence rates and (2) identify how inner city polydrug use needs targeting in ways not suggested by national research. METHODS: Latent class analyses on indicators of illicit drug use in the last year, hazardous alcohol use, and cigarette smoking were compared between the inner city 2008-2010 South East London Community Health study (n = 1698) and the nationally representative 2007 Adult Psychiatric Morbidity Survey in England (n = 7403). Multinomial logistic regressions then examined latent class solutions with demographic and socioeconomic factors. RESULTS: Both samples revealed three notably similar classes of polydrug users: a "high-drug" group using multiple substances; a "moderate-drug" group using cannabis, alcohol, and cigarettes; and a "low-drug" group reporting minimal alcohol and cigarette use. However, South East London Community Health reported lower risks of polydrug use for ethnic minorities but not for more educated participants. CONCLUSIONS: Despite higher polydrug use prevalence in the inner city, latent classes of polydrug users were similar between samples. Some demographic and socioeconomic factors differed between the samples, suggesting the need for inner city services to use both local and national data for policy planning.
Carter JL; Strang J; Frissa S; Hayes RD; Selcoh Study Team; Hatch SL; Hotopf M
Alzheimer disease (AD) is the most common cause of dementia in elderly patients. Identification of risk factors for AD would contribute to the understanding of AD pathogenesis and thus, help in the development of preventive methods. Early-onset familial AD is associated with mutations of the genes encoding amyloid precursor protein (APP), presenilin 1 (PS-1), or PS-2, resulting in the overproduction of amyloid beta-protein. Epidemiological and case-control studies have led to the identification of several risk factors for sporadic AD. The most concrete genetic risk factor for AD is the epsilon4 allele of apolipoprotein E gene (APOE). In addition, several genes such as CTNNA3, GAB2, PVRL2, TOMM40, and APOC1 are known to be the risk factors that contribute to AD pathogenesis. On the other hand, nongenetic risk factors, such as age, sex, alcohol consumption, smoking, depression, head injury, and nutrition have also been reported. Although aging is the strongest risk factor for AD, the mechanisms underlying the development of AD as a result of ageing remain to be elucidated.
Ikeda T; Yamada M
HBC is common, accounting for approximately 9% of the total breast cancer burden. Given 142,000 cases of breast cancer expected to occur in 1989, this would represent 12,780 cases of HBC patients. Soberingly, each patient represents a family with a variable number of inordinately high risk patients. HBC's natural history is distinctive and enables the identification of at risk patients who can benefit from highly targeted surveillance/management strategies. High priority must be given to development of biomarkers that will one day be found to have acceptable sensitivity and specificity to genotype status. Thus, we would then be able to tell which of the first-degree relatives of affected members have inherited the deleterious gene. This would result in a significant saving of time and money that would otherwise be expended through intensive surveillance strategies. We need cost-benefit research to induce third party carriers to defray expenses for surveillance. Finally, priority attention must be given to biomolecular research for identification of markers of acceptable sensitivity and specificity to the cancer-prone genotype. Eventual cloning of the deleterious gene(s) could lead to knowledge about its chemical and physiologic products, thereby enabling anticancer pharmacologic research. The reward could then be improved control and even prevention of breast cancer, and possibly of the associated cancers in heterogenous forms of this disease. PMID:2692910
Lynch, H T; Watson, P; Lynch, J F
HBC is common, accounting for approximately 9% of the total breast cancer burden. Given 142,000 cases of breast cancer expected to occur in 1989, this would represent 12,780 cases of HBC patients. Soberingly, each patient represents a family with a variable number of inordinately high risk patients. HBC's natural history is distinctive and enables the identification of at risk patients who can benefit from highly targeted surveillance/management strategies. High priority must be given to development of biomarkers that will one day be found to have acceptable sensitivity and specificity to genotype status. Thus, we would then be able to tell which of the first-degree relatives of affected members have inherited the deleterious gene. This would result in a significant saving of time and money that would otherwise be expended through intensive surveillance strategies. We need cost-benefit research to induce third party carriers to defray expenses for surveillance. Finally, priority attention must be given to biomolecular research for identification of markers of acceptable sensitivity and specificity to the cancer-prone genotype. Eventual cloning of the deleterious gene(s) could lead to knowledge about its chemical and physiologic products, thereby enabling anticancer pharmacologic research. The reward could then be improved control and even prevention of breast cancer, and possibly of the associated cancers in heterogenous forms of this disease.
Lynch HT; Watson P; Lynch JF
Full Text Available Forest transitions (FT) occur when socioeconomic development leads to a shift from net deforestation to reforestation; these dynamics have been observed in multiple countries across the globe, including the island of Puerto Rico in the Caribbean. Starting in the 1950s, Puerto Rico transitioned from an agrarian to a manufacturing and service economy reliant on food imports, leading to extensive reforestation. In recent years, however, net reforestation has leveled off. Here we examine the drivers of forest transition in Puerto Rico from 1977 to 2000 at two subnational, nested spatial scales (municipality and barrio) and over two time periods (1977-1991 and 1991-2000). This study builds on previous work by considering the social and biophysical factors that influence both reforestation and deforestation at multiple spatial and temporal scales. By doing so within one analysis, this study offers a comprehensive understanding of the relative importance of various social and biophysical factors for forest transitions and the scales at which they are manifest. Biophysical factors considered in these analyses included slope, soil quality, and land-cover in the surrounding landscape. We also considered per capita income, population density, and the extent of protected areas as potential factors associated with forest change. Our results show that, in the 1977-1991 period, biophysical factors that exhibit variation at municipality scales (~100 km²) were more important predictors of forest change than socioeconomic factors. In this period, forest dynamics were driven primarily by abandonment of less productive, steep agricultural land in the western, central part of the island. These factors had less predictive power at the smaller barrio scale (~10 km²) relative to the larger municipality scale during this time period. The relative importance of socioeconomic variables for deforestation, however, increased over time as development pressures on available land increased. From 1991-2000, changes in forest cover reflected influences from multiple factors, including increasing population densities, land development pressure from suburbanization, and the presence of protected areas. In contrast to the 1977-1991 period, drivers of deforestation and reforestation over this second interval were similar for the two spatial scales of analyses. Generally, our results suggest that although broader socioeconomic changes in a given region may drive the demand for land, biophysical factors ultimately mediate where development occurs. Although economic development may initially result in reforestation due to rural to urban migration and the abandonment of agricultural lands, increased economic development may lead to deforestation through increased suburbanization pressures.
Charles B. Yackulic; Matthew Fagan; Meha Jain; Amir Jina; Yili Lim; Miriam Marlier; Robert Muscarella; Patricia Adame; Ruth DeFries; Maria Uriarte
Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries and periodontal disease were assessed by DMF-T and CPI indices. The adolescent's perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health.
Ferreira LL; Brandão GA; Garcia G; Batista MJ; Costa Lda S; Ambrosano GM; Possobon Rde F
Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries and periodontal disease were assessed by DMF-T and CPI indices. The adolescent's perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health. PMID:23896929
Ferreira, Luale Leão; Brandão, Gustavo Antônio Martins; Garcia, Gustavo; Batista, Marília Jesus; Costa, Ludmila da Silva Tavares; Ambrosano, Gláucia Maria Bovi; Possobon, Rosana de Fátima
Aim: Worldwide obesity levels have increased unprecedentedly over the past couple of decades. Although the prevalence, trends and associated socio-economic factors of the condition have been extensively reported in Western populations, less is known regarding South Asian populations. Methods: A review of articles using Medline with combinations of the MeSH terms: 'Obesity', 'Overweight' and 'Abdominal Obesity' limiting to epidemiology and South Asian countries. Results: Despite methodological heterogeneity and variation according to country, area of residence and gender , the most recent nationally representative and large regional data demonstrates that without any doubt there is a epidemic of obesity, overweight and abdominal obesity in South Asian countries. Prevalence estimates of overweight and obesity (based on Asian cut-offs: overweight ? 23 kg/m(2), obesity ? 25 kg/m(2)) ranged from 3.5% in rural Bangladesh to over 65% in the Maldives. Abdominal obesity was more prevalent than general obesity in both sexes in this ethnic group. Countries with the lowest prevalence had the highest upward trend of obesity. Socio-economic factors associated with greater obesity in the region included female gender, middle age, urban residence, higher educational and economic status. Conclusion: South Asia is significantly affected by the obesity epidemic. Collaborative public health interventions to reverse these trends need to be mindful of many socio-economic constraints in order to provide long-term solutions. © 2013 S. Karger GmbH, Freiburg.
Jayawardena R; Byrne NM; Soares MJ; Katulanda P; Hills AP
In the G.D.R. asbestos is used at a large industrial scale. The material is of interest for oncologists and industrial hygienists due to its fibrogenic and cancerogenic potencies. Both carcinomas of the respiratory organs and the rare malignant mesotheliomas are accepted as occupational diseases due to asbestos. In a retrospective study 915 cases of malignant mesotheliomas covered by the National Cancer Registry over a period of 6 years - all histologically established - were analysed. 36.7% originated from occupational handling of asbestos, 0.8% by non-occupational asbestos contacts. In another 9.1% of the cases asbestos may have been the underlying cause. 33.7% have had no asbestos contact; for 19.7% the data available were insufficient. Among the asbestos-containing materials used packing and insulating materials were prevailing in 47.7%, asbestos-containing talc in 19.6%. In 6.9% of the cases mesothelioma affection was due to wearing fire protective clothing. Different duration of exposure and especially long latency periods demonstrates difficulties interpretating the results concerning the relation between working conditions and illness. Primary (technical) prevention by reduction of asbestos dust emission, limited use of asbestos and lifelong monitoring of asbestos workers are necessary to reduce the tumour risk.
Konetzke, G.W.; Beck, B.
Objective. To review outcomes after supraglottoplasty for laryngomalacia and identify risk factors for supraglottoplasty failure.Study Design. Case series with chart review.Setting. Tertiary care children's hospital.Subjects and Methods. Retrospective case series evaluating patient outcomes after supraglottoplasty at an academic medical center between 2004 and 2010. Surgical failure was defined as need for revision surgery, tracheostomy tube placement, or gastrostomy tube insertion. Multivariable logistic regression was performed to identify risk factors for failure.Results. The authors identified 95 children who underwent supraglottoplasty. After excluding patients with inadequate follow-up data, 74 patients were included. On the basis of chart review, 12 (16%) of those patients were defined as failures according to the criteria above. Age, history of prematurity (<34 weeks' gestational age), weight, growth curve percentile, neurologic/developmental problems, genetic syndrome, cardiac abnormality, synchronous airway lesions, and surgical technique were considered in risk factor analysis. Multivariable logistic regression was performed, revealing history of prematurity to be the only independent risk factor for failure (odds ratio = 4.85; 95% confidence interval, 1.07-22.1; P = .041).Conclusions. Outcomes after supraglottoplasty were comparable to previous reports in the literature. History of prematurity should be considered a risk factor for surgical failure.
Day KE; Discolo CM; Meier JD; Wolf BJ; Halstead LA; White DR
Objective. To review outcomes after supraglottoplasty for laryngomalacia and identify risk factors for supraglottoplasty failure.Study Design. Case series with chart review.Setting. Tertiary care children's hospital.Subjects and Methods. Retrospective case series evaluating patient outcomes after supraglottoplasty at an academic medical center between 2004 and 2010. Surgical failure was defined as need for revision surgery, tracheostomy tube placement, or gastrostomy tube insertion. Multivariable logistic regression was performed to identify risk factors for failure.Results. The authors identified 95 children who underwent supraglottoplasty. After excluding patients with inadequate follow-up data, 74 patients were included. On the basis of chart review, 12 (16%) of those patients were defined as failures according to the criteria above. Age, history of prematurity (<34 weeks' gestational age), weight, growth curve percentile, neurologic/developmental problems, genetic syndrome, cardiac abnormality, synchronous airway lesions, and surgical technique were considered in risk factor analysis. Multivariable logistic regression was performed, revealing history of prematurity to be the only independent risk factor for failure (odds ratio = 4.85; 95% confidence interval, 1.07-22.1; P = .041).Conclusions. Outcomes after supraglottoplasty were comparable to previous reports in the literature. History of prematurity should be considered a risk factor for surgical failure. PMID:21987654
Day, Kristine E; Discolo, Christopher M; Meier, Jeremy D; Wolf, Bethany J; Halstead, Lucinda A; White, David R
Tick-borne encephalitis (TBE), the most serious widespread vector-borne disease of humans in Europe, increased from 2- to 30-fold in many Central and Eastern European countries from 1992 to 1993, coinciding with independence from Soviet rule. Unemployment and low income have been shown in Latvia to be statistically associated with high-risk behaviour involving harvest of wild foods from tick-infested forests, and also with not being vaccinated against TBE. Archival data for 1970--2005 record major changes in the agricultural and industrial sectors, and consequent changes in the abiotic and biotic environment and socio-economic conditions, which could have increased the abundance of infected ticks and the contact of humans with those ticks. For example, abandoned agricultural fields became suitable for rodent transmission hosts; use of pesticides and emissions of atmospheric industrial pollutants plummeted; wildlife hosts for ticks increased; tick populations appear to have responded; unemployment and inequality increased in all countries. These factors, by acting synergistically but differentially between and within each country, can explain the marked spatio-temporal heterogeneities in TBE epidemiology better than can climate change alone, which is too uniform across wide areas. Different degrees of socio-economic upheaval caused by political transition in Estonia, Latvia, Lithuania, Slovenia and the Czech Republic can apparently explain the marked variation in TBE upsurge. Causal linkage between national socio-economic conditions and epidemiology is strongly indicated by striking correlations across eight countries between the degree of upsurge of TBE and both poverty and household expenditure on food (R2 = 0.533 and 0.716, respectively).
Sumilo D; Bormane A; Asokliene L; Vasilenko V; Golovljova I; Avsic-Zupanc T; Hubalek Z; Randolph SE
Tick-borne encephalitis (TBE), the most serious widespread vector-borne disease of humans in Europe, increased from 2- to 30-fold in many Central and Eastern European countries from 1992 to 1993, coinciding with independence from Soviet rule. Unemployment and low income have been shown in Latvia to be statistically associated with high-risk behaviour involving harvest of wild foods from tick-infested forests, and also with not being vaccinated against TBE. Archival data for 1970--2005 record major changes in the agricultural and industrial sectors, and consequent changes in the abiotic and biotic environment and socio-economic conditions, which could have increased the abundance of infected ticks and the contact of humans with those ticks. For example, abandoned agricultural fields became suitable for rodent transmission hosts; use of pesticides and emissions of atmospheric industrial pollutants plummeted; wildlife hosts for ticks increased; tick populations appear to have responded; unemployment and inequality increased in all countries. These factors, by acting synergistically but differentially between and within each country, can explain the marked spatio-temporal heterogeneities in TBE epidemiology better than can climate change alone, which is too uniform across wide areas. Different degrees of socio-economic upheaval caused by political transition in Estonia, Latvia, Lithuania, Slovenia and the Czech Republic can apparently explain the marked variation in TBE upsurge. Causal linkage between national socio-economic conditions and epidemiology is strongly indicated by striking correlations across eight countries between the degree of upsurge of TBE and both poverty and household expenditure on food (R2 = 0.533 and 0.716, respectively). PMID:18183571
Sumilo, Dana; Bormane, Antra; Asokliene, Loreta; Vasilenko, Veera; Golovljova, Irina; Avsic-Zupanc, Tatjana; Hubalek, Zdenek; Randolph, Sarah E
Full Text Available More than 60 thousand new cases of bladder cancer are diagnosedeach year in the United States, accounting for approximately 13thousand deaths annually. In recent decades, the overall incidenceof bladder cancer seems to be rising and this may be due to thelatent effects of tobacco abuse, other non-occupational risk factors,industrial carcinogens, as well as the overall aging of our population.Cultural and socioeconomic factors also contribute substantially tothe etiology of bladder cancer and may play an even more importantrole than the occupational environment. In this paper, it is reviewedthe main established or proposed non-occupational factors associatedwith bladder cancer development.
Luiz Alexandre Villares da Costa; Marcelo Langer Wroclawski; Marcos Tobias Machado; Antonio Carlos Lima Pompeo; Eric Roger Wroclawski
Full Text Available This paper is an attempt to unravel new factors that contribute to the success of microfinance institutions “MFIs.” We investigate whether countrywide socioeconomic characteristics and financial access can impact MFIs’ performance. Using data on 222 MFIs we find that countrywide socioeconomic characteristics such as fertility, income and education are important determinants of MFIs’ performance. For example, profitability of MFIs is more likely to fall and default on loans is more likely to rise if fertility rate increases. We also find that countrywide financial access indicators have significant impact on MFIs’ performance. For example, access to commercial banks deposit accounts has a significant and positive impact on MFIs’ success. Access to loans and commercial banks outreach appear to have a negative impact on MFIs’ performance. These results are important as they contradict the generally accepted assumption that commercial banks and MFIs operate in two different market segments and, hence, they are not direct competitors. Overall, the results suggest that several socioeconomic characteristics and financial access elements are important ingredients in evaluating MFIs’ performance.
Moh’d Al-Azzam; Karim Mimouni; Mohammed Abu Ali
OBJECTIVES: The prevalence of overweight and obesity has dramatically increased in western societies. This paper examines behavioural, psychosocial and socioeconomic factors associated with overweight and underweight among adolescents in Germany. METHODS: Data from the German part of the 2001/02 Health Behaviour in School-aged Children (HBSC) survey, composed of 5,650 respondents aged 11 to 17 years were analysed. Body mass index (BMI) was calculated based on self-reported weight and height. The overweight category was defined as BMI within or above the 90th percentile of specific BMI values for gender and age in the German national sample. The underweight category was defined as BMI within or below the 10th percentile of this sample. A multinomial logistic regression model was used to investigate the association between behavioural, psychosocial and socioeconomic factors and BMI categories. RESULTS: 9.5% of the boys and 5.4% of the girls were classified as overweight. The prevalence of underweight was 12.6% among boys and 19.1% among girls. Several factors were associated with over- and/or underweight in the bivariate analysis, showing different patterns for gender and BMI categories. In the multivariable model only low family affluence, high sedentary behaviour, and being bullied (for girls only) remained positively associated with being overweight. Being underweight was negatively associated with higher age and low parental occupation; it differed also by region. CONCLUSION: Despite several variables being associated with overweight and underweight in bivariate models, only three factors remained associated with overweight in multivariable analysis. Other considered variables did not have independent associations with the outcome, but still could be included in respective causal pathways. Our results suggest that preventive strategies focussing on students of low socio-economic status and the avoidance of sedentary behaviours could help to address issues of overweight and obesity.
Mikolajczyk RT; Richter M
CONCLUSION: The major risk factors for oral diseases in both the groups with similar socio-economic status were the lack of social security and health insurance, low literacy levels, high tobacco consumption and low levels of dental care utilisation.
Singh A; Purohit BM; Masih N; Kahndelwal PK
Full Text Available OBJETIVO: Analisar a associação entre fatores de risco e a presença do excesso de peso entre adolescentes de diferentes classes socioeconômicas. MÉTODOS: Análise transversal, da qual participaram 888 jovens de ambos os sexos e com idade variando entre 11 e 17 anos. O índice de massa corporal foi calculado por meio dos valores de massa corporal e estatura, e utilizado como indicador do excesso de peso. A atividade física, a ingestão alimentar e a classe socioeconômica (alta e baixa) foram analisadas mediante a aplicação de questionários. Os dados foram analisados estatiscamente por meio dos testes Qui quadrado e regressão logística binária. RESULTADOS: Para os adolescentes de classe socioeconômica baixa, uma inadequada ingestão alimentar (Razão de chance [RC]= 4,59) e o sobrepeso dos pais (RC= 5,33) foram associados à presença do excesso de peso. Entre os adolescentes de classe socioeconômica alta, a escolaridade materna (RC= 0,57), estudar em escola privada (RC= 3,04) e o sobrepeso dos pais (RC= 3,47) foram associados à presença do excesso de peso. CONCLUSÃO: Em ambas as classes socioeconômicas, o sobrepeso dos pais foi um importante fator de risco associado ao excesso de peso. Os outros fatores de risco diferiram entre as classes socioeconômicas.BACKGROUND: To analyze the association between risk factors and presence of overweight in adolescents from different socioeconomic levels. METHODS: A cross-section analysis with 888 youths recruited from both genders with ages ranging from 11 to 17 years was carried out. The body mass index was calculated through body mass and height values, and was used as the overweight indicator. Physical activity, food intake, and socioeconomic levels (high and low) were obtained by questionnaires. Data were analyzed by chi-square test and binary logistic regression. RESULTS: For adolescents in the lower socioeconomic level, both inadequate food intake (Odds Ratio [OR]= 4.59) and parent overweight (OR= 5.33) were associated to overweight. Among adolescents in the higher socioeconomic level, maternal education (OR= 0.57), study in private school (OR= 3.04), and parent overweight (OR= 3.47) were associated to development of overweight. CONCLUSION: In both socioeconomic levels, parent overweight was an important risk factor associated with overweight. The other risk factors were different among the socioeconomic levels.
Rômulo Araújo Fernandes; Juliano Casonatto; Diego Giuliano Destro Christofaro; Enio Ricardo Vaz Ronque; Arli Ramos de Oliveira; Ismael Forte Freitas Júnior
Little is understood about why some youth from low-socioeconomic-status (SES) environments exhibit good health despite adversity. This study tested whether role models and "shift-and-persist" approaches (reframing stressors more benignly while persisting with future optimism) protect low-SES youth from cardiovascular risk. A total of 163 youth, ages 13-16, completed role model interviews and shift-and-persist measures while cholesterol and inflammatory markers, interleukin-6 (IL-6), and C-reactive protein were assessed. Low-SES youth with supportive role models had lower IL-6. Low-SES youth high in shift-and-persist also had lower IL-6. Shift-and-persist partially mediated the interaction of SES and role models on IL-6. Benefits were not found among high-SES youth. Identifying psychological buffers in low-SES youth has implications for health disparities. PMID:23278857
Chen, Edith; Lee, William K; Cavey, Lisa; Ho, Amanda
Little is understood about why some youth from low-socioeconomic-status (SES) environments exhibit good health despite adversity. This study tested whether role models and "shift-and-persist" approaches (reframing stressors more benignly while persisting with future optimism) protect low-SES youth from cardiovascular risk. A total of 163 youth, ages 13-16, completed role model interviews and shift-and-persist measures while cholesterol and inflammatory markers, interleukin-6 (IL-6), and C-reactive protein were assessed. Low-SES youth with supportive role models had lower IL-6. Low-SES youth high in shift-and-persist also had lower IL-6. Shift-and-persist partially mediated the interaction of SES and role models on IL-6. Benefits were not found among high-SES youth. Identifying psychological buffers in low-SES youth has implications for health disparities.
Chen E; Lee WK; Cavey L; Ho A
Over 3000 patients, treated surgically for peptic ulcers, were assigned to a Social Class and Occupation Group using information obtained either from their death certificates or from their hospital notes. An analysis of the relationship of socioeconomic status and occupation with the site of original ulcer and the risk of cancer is reported. The major observations were: (a) an association of gastric ulcer with manual and of duodenal ulcer with non-manual Social Class; (b) an association of gastric cancer with dusty occupation and colorectal cancer with professional and managerial workers; and (c) no association between post-surgery gastric cancer risk and social class. This implies that the early stages of gastric carcinogenesis are related to poor socioeconomic conditions but the progression from the precursor lesion (in this case gastric ulcer) to gastric cancer is not, and is consistent with the multistage hypothesis of gastric carcinogenesis proposed by Correa [Diet and Human Carcinogenesis (Edited by Joosens, J. V., Hill, M. J. and Geboers, J.), pp. 109-115. Excerpta Medica, Amsterdam (1985)].
Caygill CP; Hill MJ; Knowles RL; Kirkham JS; Northfield TC
Full Text Available Objective: To relate cardiovascular risk factor knowledge to lifestyle. Methods: In this cross-sectional study, food consumption and lifestyle characteristics were recorded using mailed questionnaires. The dietary pattern was described using the Mediterranean Diet Score (MDS). An open ended questionnaire without predefined choices or answers was used to capture cardiovascular knowledge. Results: Lack of physical activity, smoking and eating too much fat were the 3 most cited potential cardiovascular risk factors, while being overweight, eating too much salt and a low consumption of fruits and vegetables were the least cited risk factors. Age, Body Mass Index, physical activity, smoking, income and dietary habits were not consistently associated with knowledge of risk factors. A low socioeconomic position as measured by the indicator education was associated with a lower knowledge of established and modifiable cardiovascular risk factors. Conclusions: Risk factor knowledge, an essential step in prevention of CVD, is not systematically associated with a healthier lifestyle. The findings of this study confirm that there is a gap between risk factor knowledge and lifestyle.
Patrick Mullie; Peter Clarys
Full Text Available Objective: Schizophrenia is a serious mental illness that affects the individualin various ways. Many risk factors have been suggested in the emergenceof the illness. The aim of this study is to identify the potential risk factors forschizophrenia considering the characteristics of patients.Methods: The study included 164 patients diagnosed with schizophreniaaccording to Diagnostic and Statistical Manual of Mental Disorders, FourthEdition (DSM-IV) diagnostic criteria and a control group consisting of a matchingnumber of healthy people. The subjects were given questionnaire formson potential risk factors (prenatal and postnatal, sociodemographic, illnessrelatedinformation). Student’s t-test, chi-square test and logistic regressionanalysis were used to evaluate the data.Results: Significant differences were identified between the patient group andhealthy control group in terms of: for the mother- use of medication , history ofinflammatory disease, or a psychical or physical trauma during pregnancy;-for the patient- being born in hospital, prolonged delivery, growth during childhood,relatives with a history of schizophrenia, and school history. Among thesubtypes of schizophrenia, significant differences were identified in terms ofeducational level, birth rank and school history.Conclusion: Identification of the potential risk factors for schizophrenia and ofsubjects at risk will provide important individual and social advantages, such associal health, health expenses and protection of individuals and society from theadverse effects of schizophrenia. (Archives of Neuropsychiatry 2010; 47: 230-6)
Burçin N. AKAL; Orhan DO?AN
Full Text Available The aim of the study was to determine the correlation between risk factors and diabetic retinopathy, which is the leading cause of blindness in developed countries for patients aged 20 to 65.We compared risk factors between patients without retinopathy, with non-proliferate and with proliferate retinopathy (p< 0.05). Duration of diabetes is most important for the development of retinopathy. Hyperglycaemia and high blood pressure are important for progression. Better control of blood sugar and elevated blood pressure can reduce progression of retinopathy and riskof vision loss.
Admira Dizdarevi?; Amila Alikadi?-Husovi?; Vahid Jusufovi?
The high incidence of chromosomal anomalies at birth and the severity of the resulting handicap led to examining their detectability by amniocentesis. With current indications for amniocentesis, the detection rate did not excede 30%. Consequently, it seems necessary to estimate the importance of other known risk factors and to calculate the resulting impact this would have on eventually broadening the indications for amniocentesis. A review of the literature led the authors to discuss the relative importance of each known risk factor and its role in public health.
Ayme S; Mattei JF; Mattei MG; Giraud F
Full Text Available For generations communities in the Western Pacific have employed a range of resource management techniques (including periodic reef closures, gear restrictions, entry limitations, and the protection of spawning aggregations) to limit marine resource use. Localized control over marine resources, commonly known as customary marine tenure (CMT), is the legal and cultural foundation for many of these practices. Because of their perceived potential to meet both conservation and community goals, these traditional resource management techniques are being revitalized by communities, governments, and NGOs as an integral part of national and regional marine conservation plans in the Pacific. However, the viability of conservation strategies built on a foundation of marine tenure may be in question, as it remains unclear whether marine tenure systems will be able to withstand the profound social and economic changes sweeping the Pacific region. Numerous studies have suggested that changes in marine tenure are attributed to social and economic factors, however, specific relationships between socioeconomic conditions and marine tenure are still not well understood. This paper examines the social and economic characteristics of 21 coastal communities in Papua New Guinea and Indonesia, and explores the characteristics of the communities that employ exclusive marine tenure to answer the following questions: Which socioeconomic factors are related to the presence of CMT regimes? How might socioeconomic factors influence the ability of communities to employ or maintain CMT regimes? Distance to market, immigration, dependence on fishing, and conflicts were found to be related to the presence of highly exclusive marine tenure systems. Exploring these relationships will help conservation practitioners better understand how future social changes may influence the foundation of conservation and development projects.
Full Text Available The generation of solid waste has become an increasing environmental and public health problem, especially in developing countries. These problems associated with the generation of solid waste are part of social changes where households play an important role. Invariably, these social changes influence the size, structure and characteristics of given households. This paper presents the findings of a study carried out in Freetown municipal area in Sierra Leone to assess socioeconomic factors affecting household solid waste generation and composition in Freetown, Sierra Leone. Structured questionnaires were administered with respect to these socioeconomic factors in four (4) selected constituencies of the city. These are the most populated constituencies that generated 70% of the total quantity of solid waste in the city. Therefore, they are suitable samples of the study area. The rate of waste generation was determined by using door- to-door approach in five (5) selected households from each constituency through sorting and weighing of solid wastes respectively. The dependent variables were solid waste generation and composition, and the independent variables were family size, education, income levels among others. The data obtained were subjected to statistical analysis to determine relationships between independent variables and dependent variables through correlation. The results showed that the solid waste generation and composition in Freetown was significantly affected by average family size, employment status, monthly income, and number of room(s) occupied by households. In general, the paper adequately suggests new insights concerning the role of socioeconomic factors in affecting the generation and composition of household solid waste.
Foday Pinka Sankoh; Xiangbin Yan; Alhaji Mohamed Hamza Conteh
Full Text Available Abstract Background Our study aims to follow this effort and to explore the association between health, socioeconomic background, school-related factors, social support and adolescents' sense of coherence and educational aspirations among adolescents from different educational tracks and to contribute to the existing body of knowledge on the role of educational aspirations in the social reproduction of health inequalities. We expect that socioeconomic background will contribute to the development of educational aspirations, but this association will be modified by available social and individual resources, which may be particularly favourable for the group of adolescents who are on lower educational tracks, since for them such resources may lead to gaining a higher educational level. Methods We collected data on the socioeconomic background (mother's and father's education and employment status, doubts about affordability of future study), school-related factors (school atmosphere, school conditions, attitudes towards school), perceived social support, sense of coherence (manageability, comprehensibility, meaningfulness) and the self-rated health of a national sample of Slovak adolescents (n = 1992, 53.5% females, mean age 16.9 years). We assessed the association of these factors with educational aspirations, overall and by educational tracks (grammar schools, specialised secondary schools, vocational schools). Results We found statistically significant associations with educational aspirations for the factors parental educational level, father's unemployment, doubts about the affordability of future study, school atmosphere, attitude towards school, social support from the father and a sense of coherence. Social support from the mother and friends was not associated with educational aspiration, nor was self-rated health. Besides affinity towards school, the determinants of educational aspirations differed among adolescents on different educational tracks. Educational aspirations of grammar school students were associated with father's education, while the aspirations of their peers on lower educational tracks had a stronger association with mother's education and perceived social support from father and friends. Moreover, a sense of coherence contributes to the reporting of educational aspiration by students on different educational tracks. Conclusions Characteristics of the school environment, the family and the individual adolescent are all associated with the level of educational aspiration, but in a different way for different educational tracks. Interventions aimed at reducing socioeconomic inequalities in health via the educational system should, therefore, take this variation and the rather pivotal role of the father into account.
Madarasova Geckova Andrea; Tavel Peter; van Dijk Jitse P; Abel Thomas; Reijneveld Sijmen A
In 1982, the US Congress passed the Nuclear Waste Policy Act to initiate the process of choosing a location to permanently store high-level nuclear waste from the designated Yucca Mountain, Nevada, as the only location to be studied as a candidate site for such a repository. The original acts and its amendments had established the grant mechanism by which the state of Nevada could finance an investigation of the potential socioeconomic impacts that could result from the installation and operation of this facility. Over the past three years, the Office of Civilian Radioactive Waste Management (OCRWM or RW) in the US Department of Energy (DOE) has approved grant requests by Nevada to perform this investigation. This report is intended to update and enhance a literature review conducted by the Human Affairs Research Center (HARC) for the Basalt Waste Isolation Project that dealt with the psychological and sociological processes underlying risk perception. It provides addition information on the HARC work, covers a subsequent step in the impact-estimation process, and translates risk perception into decisions and behaviors with economic consequences. It also covers recently developed techniques for assessing the nature and magnitude of impacts caused by environmental changes focusing on those impacts caused by changes in perceived risks.
Full Text Available Abstract Background School is a multi-cultural setting where students need social, material, physical, and mental resources to attain school achievement. But they are often lacking, especially for immigrant students. In an early adolescence context, this study assessed risk for school difficulties among European and non-European immigrants and the roles of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours. Methods This cross-sectional study included 1,559 middle-school adolescents from north-eastern France, who completed a self-administered questionnaire including socioeconomic characteristics (gender, age, family structure, father’s occupation, and family income), WHO-Quality of life (measuring the four dimensions physical health, psychological health, social relationships, and living environment), unhealthy behaviours (last-30-day uses of tobacco, alcohol, cannabis, and other illicit drugs and no regular sports/physical activities), grade repetition, low school performance ( Results Grade repetition affected 14.8% of students, low school performance 8.2%, and school dropout ideation 3.9%. European immigrants had a higher risk for grade repetition only with a gender-age-adjusted odds ratio (OR) of 2.44, vs. French students. This odds ratio decreased to 1.76 (contribution 47%) with further adjustment for all confounders (family structure, father’s occupation, family income, physical health, psychological health, social relationships, living environment, and unhealthy behaviours). Non-European immigrants had a statistically higher risk for all grade repetition, low school performance, and school dropout ideation with ORs of 3.29, 3.02, and 3.42, respectively vs. French students. These odds ratios decreased to 1.76, 1.54, and 1.54, respectively (contributions 66%, 73%, and 78%) with further adjustment for all confounders. Conclusions Compared with French students, European immigrant students were more affected only by grade repetition while non-European immigrant students by all grade repetition, low school performance, and school dropout ideation. The contribution of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours was very high and much higher for non-European than for European immigrant students. Public policy should focus on these factors and services to reduce school difficulties.
Chau Kénora; Baumann Michèle; Kabuth Bernard; Chau Nearkasen
Full Text Available The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES), illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI), use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.
Ughade Suresh; Zodpey Sanjay; Khanolkar Vandana
Objective: The study aimed to examine suicidal behaviour during in-patient care in a psychiatric university hospital.Method: Based upon a psychiatric basic documentation system prevalence and risk factors of in-patient suicides and suicide attempts were investigated (1995 - 2010).Results: A total of 42 in-patient suicides and 166 attempts were found among 16 251 patients. According to the multivariate logistic regression analysis the risk of suicide during hospitalization increases significantly for male patients, with more previous psychiatric hospitalizations and suicidality according to clinical impression at admission or suicide attempt before admission. Patients with affective or schizophrenic disorders were at highest risk. The following risk factors are associated with suicide attempt during stay: female gender, borderline personality disorder (F60.3), more previous psychiatric hospitalizations, shorter duration of disorder, earlier age of onset, suicidality according to clinical impression at admission or suicide attempt before admission.Conclusion: As depressive and schizophrenic patients represent the high-risk group of in-patient suicide, suicide prevention should be a major goal in their treatment. More frequent suicide risk assessment is recommended particularly before granting a leave or an outing.
Lieb M; Palm U; Meyer S; Sarubin N; Mokhtari-Nejad R; Riedel M; Möller HJ; Seemüller F
Recurrent spontaneous abortion (RSA) has various complicated causes, and more and more researches are focused on its etiology. Genetic factors are the most common risk factors of RSA; immune factors, infection factors, male factors and female factors play an important role; environmental pollution and some other unknown factors may also be conspirators. This article presents an overview on the possible risk factors of RSA.
Gu CH; Liang WJ; Fu LL; Zheng LW
Full Text Available Introduction: eating disorders (ED) are characterized by the excessive worry aboutphysical appearance. They have high incidence in young population with more frequencyin women than in men.Objective: to identify the risk factors for ED.Methods: thematic review of publications in which are described and evaluated thedifferent risk factors to develop ED. It was done an electronic search since 1984 to2011, in english and spanish, in which were included all the methods of publications.There were reviewed the summaries to find the complete articles that treated about riskfactors associate with the development of the ED.Results: there were found 48203 about ED. 96 tried specifically about risk factors. 35(36.4%) complete articles were obtained and the review was done with them.Conclusion: principal risk factors are: To be an adolescent, woman, to have distortedperception of the corporal image and the use of diet to lose weight. Rev.cienc.biomed.2012;3(2):300-305
Monterrosa-Castro Álvaro; Ruiz-Martínez Juan José; Cuesta-Fernández Glendys Carolina
In this report the authors have analysed the various risk factors of the laparoscopy cholecystectomy, proving that those are not different from the ones of standard open cholecystectomy. It has been underlined that laparoscopy cholecystectomy offers significant advantages over open cholecystectomy and moreover the possibility to convert laparoscopy cholecystectomy when it is necessary.
Pecorella G; Bracchitta S; Petrolito E; Cacciaguerra B; Blanco F
BACKGROUND/AIMS: An epidemiologic shift of hepatitis A virus (HAV) seroprevalence is expected due to an improvement in socioeconomic status in young adults in Korea. We investigated the age-specific seroprevalence and socioeconomic factors associated with HAV seropositivity in young, healthy Korean adults. METHODS: Between March 2009 and February 2010, a total of 5,051 persons from 20 to 49 years of age presenting for a health check-up were included and responded to a questionaire. The seroprevalence of HAV was investigated by measuring immunoglobulin G (IgG) anti-HAV. A total of 984 pairs of cases and age- and sex-matched controls were analyzed for associated socioeconomic factors. RESULTS: The prevalence of seropositive HAV was 6.2% in the 20 to 29 age range, 33.1% in the 30 to 39 range and 82.4% in the 40 to 49 range (p<0.001). There were no significant differences in any group according to gender. A multivariate analysis for paired cases indicated that HAV seropositivity was significantly higher in the low monthly income (below five million won, approximately 4,300 dollars) group and the Helicobacter pylori (H. pylori)-positive group (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.27-2.14; p<0.001; OR, 1.45; 95% CI, 1.19-1.76; p<0.001, respectively). CONCLUSIONS: HAV seropositivity in young adults presenting for a health checkup appears to be decreasing, and the prevalence was significantly higher in the low monthly income group and the H. pylori-positive group.
Chung GE; Yim JY; Kim D; Lim SH; Park MJ; Kim YS; Yang SY; Yang JI; Cho SH
BACKGROUND: : Reading impairment is the major learning disability in childhood. Most previous studies were done on English-speaking populations. Yet, it has been argued that the English writing system exacerbates phonological deficits because of its exceptionally high inconsistency between spelling and sound. Thus, cross-language studies are needed to explore the universal versus language-specific factors underlying reading impairment. The goal of the present research was to study biological, socioeconomic, cognitive, and behavioral factors underlying poor reading in French-speaking second grade children. METHODS: : A total of 1062 children from 20 different schools in the city of Paris participated in the study. After an initial test phase, children with a suspected impairment in reading acquisition were assessed individually. Subsequently, 100 poor readers and 50 controls were matched for sex, age, school, and neighborhood socioeconomic status (SES). They underwent comprehensive medical, cognitive, and behavioral assessment complemented by individual socioeconomic data. RESULTS: : The average prevalence of reading impairment was around 12% in our sample. It was highly influenced by neighborhood SES, varying from 3.3% in high SES to 24.2% in low SES areas. Among the individual SES variables, low maternal education significantly distinguished poor from typical readers. Multiple regression analyses showed that reading outcome was best predicted by phonological awareness skills and attention deficits. CONCLUSION: : The majority of poor readers come from low SES areas. As in the English literature, the most robust predictor for reading impairment is phonological awareness. In addition, behavioral problems, such as attention deficits, seem to aggravate reading deficits for children with weak phonological awareness skills.
Fluss J; Ziegler JC; Warszawski J; Ducot B; Richard G; Billard C
The paper considers the primary elements in the risk assessment process in mining - hazard identification, risk estimation and hazard control and argues that, in terms of improvements to safety, both hazard identification and hazard control have a more significant role to play than the risk estimation element per se. In essence therefore, the risk assessment approach is one where the process is more important than the procedure, where the method is more important than the methodology. Having examined the primary elements, the paper then goes on to argue that the most important issue in hazard control effectiveness is the human factor using a series of examples taken from studies in both UK and RSA mining operations. 7 refs., 3 figs., 1 tab.
Simpson, G.C. [International Mining Consultants Ltd. (United Kingdom)
BACKGROUND: Body mass index assessment using self-reported height and weight (BMIsr) can encounter refusals and under/over-reporting while for assessment with measured data (BMIm) refusals can be more frequent. This could relate to socioeconomic and health-related factors. We explored these issues by investigating numerous potential factors: gender, age, family structure, father's occupation, income, physical/sports activity, subjective weight perception, school performance, unhealthy behaviours, physical/psychological health, social relationships, living environment, having sustained violence, sexual abuse, and involvement in violence. METHODS: The sample included 1559 adolescents from middle schools in north-eastern France. They completed a questionnaire including socioeconomic and health-related data, self-reported height/weight, measured height/weight, and weight perception (participation rate 94%). Data were analysed using logistic regression models. RESULTS: BMIsr encountered under-reporting (with change in BMI category, 11.8%), over-reporting (6.0%), and reporting refusals (3.6%). BMIm encountered more numerous refusals (7.9%). Reporting refusal was related to living with a single parent, low school performance, lack of physical/sports activity, sustained violence, poor psychological health, and poor social relationships (gender/age-adjusted odds ratios 1.95 to 2.91). Further to these factors, measurement refusal was related to older age, having divorced/separated parents, a father being a manual worker/inactive, insufficient family income, tobacco/cannabis use, involvement in violence, poor physical health, and poor living environment (1.30 to 3.68). Under-reporting was related to male gender, involvement in violence, poor psychological health, and overweight/obesity (as assessed with BMIm) (1.52 to 11). Over-reporting was related to male gender, younger age, alcohol consumption, and underweight (1.30 to 5.35). Weight perception was linked to reporting refusals and under/over-reporting, but slightly linked to measurement refusal. The contributions of socioeconomic and health-related factors to the associations of weight perception with reporting refusal and under/over-reporting ranged from -82% to 44%. There were substantial discrepancies in the associations between socioeconomic/health-related factors and overweight/obesity assessed with BMIsr and BMIm. CONCLUSIONS: BMIsr and BMIm were affected by numerous biases related to vulnerability which were also obesity risk factors. BMIsr encountered under/over-reporting which were related to some socioeconomic and health-related factors, weight perception, and BMIm. BMIm was more affected by refusals than BMIsr due to socioeconomic and health-related factors. Further research is needed.
Chau N; Chau K; Mayet A; Baumann M; Legleye S; Falissard B
INTRODUCTION: The incidence of dengue (serum type I) in the city of S. José do Rio Preto during an epidemic which occurred in the first semester of 1995 is analyzed in terms of geographical areas defined by socioeconomic variables. MATERIAL AND METHOD: The epidemiological method of analysis is the "ecological study" type. To calculate the coefficient of incidence of dengue, all cases both confirmed and reported between January and July, 1995 are considered. The environmental units are defined according to socioeconomic variables based on the IBGE (Brazilian Institute of Geography and Statistics) Census of 1991, through cluster analysis. The linear correlation coefficient between coefficient of incidence and environmental variables is also calculated. RESULTS AND DISCUSSION: Three distinct environmental units are identified and described on the basis of both economic and educational level. The coefficient of incidence of dengue varied in accordance with the environmental unit: in the unit of low standard the coefficient was 2.7 times greater than that of the unit of highest standard, showing that in these units the determining factors of dengue have a differentiating effect. The roles of some of the determining factors such as population density, basic sanitary services and vector density are discussed. The importance of this study for the control of dengue is also emphasized.
da Costa AI; Natal D
Minority melanoma patients have worse survival. In this study, we evaluated the impact of socioeconomic and demographic factors on minority melanoma patients presenting to two different New York City hospitals (one public and one private) managed by the same multidisciplinary team. Sociodemographic and clinicopathologic characteristics were retrieved for melanoma patients presenting to Bellevue Hospital Center (BHC), a public hospital, and the New York University Cancer Institute (NYUCI), a private cancer center. Socioeconomic data was obtained from the United States Census Bureau database. The Kruskal-Wallis and chi-square tests were used to evaluate the associations between race/ethnicity and continuous and categorical variables (e.g. income, stage at presentation), respectively. Minorities comprised 2% (27/1296) of melanoma patients at the NYUCI compared to 42% (50/119) at BHC. Those presenting to the NYUCI were more likely to have a higher median household income (P = 0.05), a higher educational level (P = 0.04), and an earlier stage at presentation (P = 0.02) than those at BHC. NYUCI patients were predominantly covered by commercial insurance (70%), whereas Medicaid (62%) was common among BHC patients. Only 19% of Hispanic patients at BHC chose English as their preferred language. Our data demonstrate that language and health care system factors affect melanoma presentation in minorities.
Wich LG; Ma MW; Price LS; Sidash S; Berman RS; Pavlick AC; Miller G; Sarpel U; Goldberg JD; Osman I
OBJECTIVE: To determine if functional health literacy (FHL) mediates the relationship between socio-economic status, and perception of the risk of lifestyle behaviors for cancer. METHODS: Cross-sectional, random population survey, 2824 people aged ?15 years, September-October 2008, included newest vital sign measure of FHL. RESULTS: Less than adequate FHL occurred in 45.1%. People who perceived behavioral factors (smoking, diet, obesity, alcohol, physical activity) to be not important, or did not know if they were important cancer risks, were more likely to have inadequate FHL. In a logistic regression model adjusted for age, gender, education, income, occupation, country of birth and area of residence, inadequate FHL was associated with 2-3 (OR=1.9; 95% CI: 1.2-3.0) and 4 or more self-reported lifestyle risk factors (OR=2.8; 95% CI: 1.6-5.0). In a structural equation model of the relationship of socio-economic status, perceptions of risk and behaviors there was significant mediation effect of FHL on the path from SES to health perceptions, estimated 29.4% of the total effect. CONCLUSION: A specific focus on the literacy demands made on individuals from health promotion and materials with a view to improving health communication is indicated. PRACTICE IMPLICATIONS: Health literacy is important for health promotion.
Adams RJ; Piantadosi C; Ettridge K; Miller C; Wilson C; Tucker G; Hill CL
ISSUE ADDRESSED: Obesity is at crisis proportions. Individuals of low socio-economic status (SES) are more likely to consume higher energy dense diets than their high socio-economic status counterparts. The contribution of supermarket purchases of energy dense, nutrient poor foods has not been well-researched and has largely depended on unverified self-report. METHODS: We estimated the proportion of supermarket shelf space dedicated to non-core foods in nine supermarkets (in five high and four low SES areas) in metropolitan Sydney. We analysed 204 shoppers' dockets (102 from high and 102 from low SES areas) for purchases of confectionery; sugar sweetened, carbonated beverages and cordials, sweet biscuits and cakes, and crisps and popcorn. RESULTS: After adjusting for the number of people shopped for, low SES shoppers purchased significantly more non-core foods than high SES shoppers (p=0.039), especially chips and sugar sweetened, carbonated beverages and cordials. There was no difference in the shelf space dedicated to non-core foods, or between non-core foods purchased and the proportion of shelf space occupied by them in either low or high SES areas. CONCLUSIONS: Increased purchase of non-core foods by low SES shoppers who are already at higher risk of obesity than high SES shoppers is cause for concern. Further research is required to explore underlying reasons for this association.
Vinkeles Melchers NV; Gomez M; Colagiuri R
Full Text Available This paper analyzes the connection between life expectancy according to sex and numerous factors on which its level depends on. Statistical analysis understood application of correlation and regression analysis for determining the connection strength of life expectancy and researched factors separately and then all factors together, as well as separately groups of health-medical and socio-economic factors. The analysis was carried out for a group of developed countries, medium developed, mixed group and Yugoslavia (now SCG) on available data for the second half of the 20th century. Analysis results for Yugoslavia showed that the greatest influence on life expectancy of all factors together were setting aside funds for social security (p<0.05). If only health-medical factors are observed, then child mortality up to 5 years and tumor mortality are in question. With women, the greatest influence is with child mortality up to five years old among all factors (
Radivojevi? Biljana M.; Veljanovi?-Mora?a Vukica
BACKGROUND: Changes in socioeconomic status, lifestyle and behavioral factors among the urban population in Ethiopia is resulting in a shift in the causes of mortality.We used verbal autopsy data from 2006 to 2009 to measure the association of socioeconomic and behavioral factors with causes of mortality in Addis Ababa, Ethiopia. METHODS: A total of 49,309 deaths from burial surveillance were eligible for verbal autopsy for the years 2006 to 2009. Among these, 10% (4,931) were drawn randomly for verbal autopsy of which 91% (4,494) were adults of age?15 years. Verbal autopsies, used to identify causes of death and frequency of risk factors, were completed for 3,709 (83%) of the drawn sample. RESULTS: According to the results of the verbal autopsy, non-communicable diseases caused 1,915 (51%) of the total adult deaths, while communicable diseases and injuries caused 1,566 (42%) and 233 (6%) of the deaths respectively.Overall, frequent alcohol (12%) and tobacco consumption (7%) were highly prevalent among the deceased individuals; both because of communicable diseases (HIV/AIDS and tuberculosis) as well as due to non-communicable diseases (malignancy, cardiovascular and chronic liver diseases). HIV/AIDS (AOR=2.14, 95% CI [1.52-3.00], p<0.001) and chronic liver diseases (AOR=3.09, 95% CI [1.95-4.89], p<0.001) were significantly associated with frequent alcohol consumption, while tuberculosis was associated with both frequent alcohol (AOR=1.61, 95% CI [1.15-2.24], p=0.005) and tobacco consumption (AOR=1.67, 95% CI [1.13-2.47], p<0.010). Having low educational status, being female and being within the age range of 25 to 44 years were positively associated with HIV/AIDS related mortality. Individuals aged 45 years and above were 3 to 6 times more likely to have died due to cardiovascular diseases compared with those within the 15 to 24 years age group. CONCLUSION: The findings from the analysis suggest that public health interventions targeting HIV/AIDS, tuberculosis, as well as non-communicable diseases need to consider behavioral factors related to alcohol, tobacco and khat consumption. We also recommend large scale national level studies to further assess the specific contributions of these risk factors to the burden of mortality in the country.
Misganaw A; Mariam DH; Araya T
The approaches for vulnerability and risk assessment have found different and often contrasting solutions by various schools of thought. The two most prominent communities in this field are: climate change adaptation (CCA), and disaster risk reduction (DRR). Although those communities have usually in common the aim of reducing socio-economic vulnerability and risk to natural hazards, they have usually referred to different definitions and conceptualizations. For example, the DRR community has always driven more emphasis on the concept of risk and vulnerability is considered as a physical/environmental input for the quantification of risk, while the CCA research stream, mainly under the auspices of the Intergovernmental Panel on Climate Change (IPCC), considered vulnerability as an output deriving from social conditions and processes such as adaptation or maladaptation. Recently, with the publication of the IPCC Special Report on extreme events and disasters (IPCC-SREX), the notions of vulnerability and risk are somehow integrated in order to jointly consider both climate change adaptation and disaster risk management. The IPCC-SREX indeed is expected to significantly contribute to find common language and methodological approaches across disciplines and, therefore, the opportunity emerges for proposing new operational solutions, consistent with the most recent evolution of concepts and terminology. Based on the development of the IPCC Report, the KULTURisk project developed an operational framework to support integrated assessment and decision support through the combination of contributions from diverse disciplinary knowledge, with emphasis on the social and economic dimensions. KIRAF (KULTURisk Integrated Risk Assessment Framework) is specifically aimed at comprehensively evaluate the benefits of risk mitigation measures with consideration of the dynamic context deriving from the consideration of climatic changes and their effects on natural disasters, within the policy framework of climate change adaptation (CCA). Three main innovations are proposed with respect to the current state of the art: (1) to include the social capacities of reducing risk, (2) to go beyond the estimation direct tangible costs, and (3) to provide an operational solution for decision support to assess risks, impacts and the benefits of plausible risk reduction measures, compatible with both the DRR and the CCA literatures. As stated above, the proposed framework is the inclusion of social capacities (adaptive and coping capacities) in the process of translating risk into a comprehensive cost matrix considering not only direct tangible costs (damages), but also the three other components deriving from the combination of tangible/intangible and direct/indirect costs. The proposed KIRAF approach is thus expected to provide: 1) an operational basis for multidisciplinary integration; 2) a flexible reference to deal with heterogeneous case studies and potentially various types of hazards; and 3) a means to support the assessment of alternative risk prevention measures including consideration of social and cultural dimensions.
Giupponi, Carlo; Gain, Animesh; Mojtahed, Vahid; Balbi, Stefano
Schizophrenia is a relatively common pathology with onset at adolescence or early adulthood, more frequent in men than women. By describing distribution of cases in different populations and the factors that influence this distribution, epidemiology contributes to our understanding of the disease. Several risk factors for schizophrenia have been uncovered both genetic and environmental. The environmental factors can act at individual level (obstetric complications, season of birth, urbanicity, childhood trauma, cannabis, migration) or at population/area levels (socio-economic level, social fragmentation and social capital, ethnic density, etc.). An integrative and dynamic model based on the "vulnerability-persistence-impairment" paradigm is useful in integrating the findings about the risk factors and their complex relationships.
Countries of the Persian Gulf region--Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates--have become increasingly modernized, resulting in a transformation of lifestyle based on technology, sedentary activity, lack of sunlight, and unhealthy dietary patterns. These factors have led to a higher prevalence not only of vitamin D undernutrition, but also chronic obesity, insulin resistance, prediabetes, and type 2 diabetes. This review explores the integrative physiologic effects of vitamin D with socioeconomic factors and propose a hypothesis-driven model for their contributions to obesity and diabetes in the Persian Gulf. Further research into these interactions may ultimately lead to novel preventive strategies and therapies for metabolic disorders in this geographic region.
Fields J; Trivedi NJ; Horton E; Mechanick JI
PURPOSE: This study aimed to identify risk factors associated with maternal night blindness in rural South India. METHODS: At delivery, women enrolled in a population-based trial of newborn vitamin A supplementation were asked whether they were night blind at any time during the pregnancy. Multivariate logistic regression was used to identify socioeconomic, demographic, and pregnancy-related factors associated with maternal night blindness. RESULTS: Women reported night blindness in 687 (5.2%) of 13,171 pregnancies. In a multivariate model, having a concrete roof (Odds Ratio (OR): 0.60, 95% Confidence Interval (CI): 0.47, 0.78), religion other than Hindu (OR: 0.46, 95% CI: 0.27, 0.76), maternal literacy (OR: 0.58, 95% CI: 0.49, 0.69), and maternal age from 25 to 29 years (OR: 0.68, 95% CI: 0.50, 0.93) were associated with a lower risk of night blindness in pregnancy. The odds of night blindness were higher for those leasing rather than owning land (OR: 1.78, 95%CI: 1.08, 2.93), parity 6 or more compared to 0 (OR: 2.11, 95% CI: 1.09, 4.08), and with twin pregnancies (OR: 3.23, 95% CI: 1.93, 5.41). Factors not associated with night blindness in the multivariate model were other markers of socioeconomic status such as electricity in the house, radio and television ownership, type of cooking fuel and household transportation, and number of children under 5 years of age in the household. CONCLUSIONS: Maternal night blindness was prevalent in this population. Being pregnant with twins and of higher parity put women at higher risk. Maternal literacy and higher socioeconomic status lowered the risk.
Katz J; Tielsch JM; Thulasiraj RD; Coles C; Sheeladevi S; Yanik EL; Rahmathullah L
Full Text Available Abstract Background Poor mental health has large social and economic consequences both for the individual and society. In Sweden, the prevalence of mental health symptoms has increased since the beginning of the 1990s. There is a need for a better understanding of the area for planning preventive activities and health care. Methods The study is based on a postal survey questionnaire sent to a random sample of men and women aged 18–84 years in 2004. The overall response rate was 64%. The area investigated covers 55 municipalities with about one million inhabitants in central part of Sweden. The study population includes 42,448 respondents. Mental health was measured with self-reported symptoms of anxiety/depression (EQ-5D, 5th question). The association between socio-economic conditions, lifestyle factors and mental health symptoms was investigated using multivariate multinomial logistic regression models. Results About 40% of women and 30% of men reported that they were moderately or extremely anxious or depressed. Younger subjects reported poorer mental health than older subjects, the best mental health was found at ages 65–74 years. Factors that were strongly and independently related to mental health symptoms were poor social support, experiences of being belittled, employment status (receiving a disability pension and unemployment), economic hardship, critical life events, and functional disability. A strong association was also found between how burdensome domestic work was experienced and anxiety/depression. This was true for both men and women. Educational level was not associated with mental health symptoms. Of lifestyle factors, physical inactivity, underweight and risk consumption of alcohol were independently associated with mental health symptoms. Conclusion Our results support the notion that a ground for good mental health includes balance in social relations, in domestic work and in employment as well as in personal economy both among men and women. In addition, physical inactivity, underweight and risk consumption of alcohol are associated with mental health symptoms independent of socio-economic factors.
Molarius Anu; Berglund Kenneth; Eriksson Charli; Eriksson Hans G; Lindén-Boström Margareta; Nordström Eva; Persson Carina; Sahlqvist Lotta; Starrin Bengt; Ydreborg Berit
Full Text Available The authors review environmental and neurodevelopmental risk factors for schizophrenic disorders, with emphasis on minor physical anomalies, particularly craniofacial anomalies and dermatoglyphic variations. The high prevalence of these anomalies among schizophrenic subjects supports the neurodevelopmental theory of the etiology of schizophrenia, since they suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectodermal origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. The precise confirmation of this theory, at least in some cases, will provide further understanding of these illnesses, allowing easy and inexpensive identification of subjects at risk and providing guidelines for the development of new pharmacological interventions for early treatment and even for primary prevention of the illness.
Lobato M.I.; Belmonte-de-Abreu P.; Knijnik D.; Teruchkin B.; Ghisolfi E.; Henriques A.
For more than a decade, the integration of human and environmental risk assessment (RA) has become an attractive vision. At the same time, existing European regulations of chemical substances such as REACH (EC Regulation No. 1907/2006), the Plant Protection Products Regulation (EC regulation 1107/2009) and Biocide Regulation (EC Regulation 528/2012) continue to ask for sector-specific RAs, each of which have their individual information requirements regarding exposure and hazard data, and also use different methodologies for the ultimate risk quantification. In response to this difference between the vision for integration and the current scientific and regulatory practice, the present paper outlines five medium-term opportunities for integrating human and environmental RA, followed by detailed discussions of the associated major components and their state of the art. Current hazard assessment approaches are analyzed in terms of data availability and quality, and covering non-test tools, the integrated testing strategy (ITS) approach, the adverse outcome pathway (AOP) concept, methods for assessing uncertainty, and the issue of explicitly treating mixture toxicity. With respect to exposure, opportunities for integrating exposure assessment are discussed, taking into account the uncertainty, standardization and validation of exposure modeling as well as the availability of exposure data. A further focus is on ways to complement RA by a socio-economic assessment (SEA) in order to better inform about risk management options. In this way, the present analysis, developed as part of the EU FP7 project HEROIC, may contribute to paving the way for integrating, where useful and possible, human and environmental RA in a manner suitable for its coupling with SEA.
Péry AR; Schüürmann G; Ciffroy P; Faust M; Backhaus T; Aicher L; Mombelli E; Tebby C; Cronin MT; Tissot S; Andres S; Brignon JM; Frewer L; Georgiou S; Mattas K; Vergnaud JC; Peijnenburg W; Capri E; Marchis A; Wilks MF
Full Text Available AbstractBackground and purpose: Adolescent girls as future mothers have a very important function to train healthy generation and it is important to focus on their nutrition status. Therefore in this survey the effects of socioeconomic factors on body mass index (BMI) (as a nutrition status indicator) was assessed.Materials and methods : The subjects were 240 adolescent girls , 14 to 18 years of age. Weight and height measurements of samples were assessed; their BMI was obtained and compared with BMI age and sex-specific growth charts from the centers for disease control and prevention (CDC) in 2000. A general questionnaire (about parent education, family economical condition and number of household) for all of the samples was completed.Results : A significant relationship between BMI status and number of household was observed but parent education and family economical condition had no significant effects on BMI status.Conclusion: Populous families could affect the household's BMI status; in addition we need wide epidemiologic studies to prepare a suitable standard for Iran to assess socioeconomic status of people.
S.Jafarirad; SA.Keshavarz; AR.Khalilian
Full Text Available Abstract Introduction One issue that continues to attract the attention of public health researchers is the possible relationship in high-income countries between income, income inequality and infant mortality (IM). The aim of this study was to assess the associations between IM and major socio-economic determinants in Italy. Methods Associations between infant mortality rates in the 20 Italian regions (2006–2008) and the Gini index of income inequality, mean household income, percentage of women with at least 8 years of education, and percentage of unemployed aged 15–64 years were assessed using Pearson correlation coefficients. Univariate linear regression and multiple stepwise linear regression analyses were performed to determine the magnitude and direction of the effect of the four socio-economic variables on IM. Results The Gini index and the total unemployment rate showed a positive strong correlation with IM (r?=?0.70; p?b?=?0.15, p? Conclusions In Italy, a high-income country where health care is universally available, variations in IM were strongly associated with relative and absolute income and unemployment rate. These results suggest that in Italy IM is not only related to income distribution, as demonstrated for other developed countries, but also to economic factors such as absolute income and unemployment. In order to reduce IM and the existing inequalities, the challenge for Italian decision makers is to promote economic growth and enhance employment levels.
Dallolio Laura; Di Gregori Valentina; Lenzi Jacopo; Franchino Giuseppe; Calugi Simona; Domenighetti Gianfranco; Fantini Maria
Full Text Available Dzanga Ndoki is the main National Park located in Dzanga Sangha Complex Protected Area, Central African Republic. This study assesses socioeconomic factors and different NGOs involved in management of the park. A questionnaire survey was used to collect data in 8 villages around the park. Results on socioeconomic study showed that younger people aged of 20-25 (36.55%) and between 25-30 (27. 81%) are more dynamic in the forest than elderly ones (age >35) who represented (5.61%). Better education may help in conservation of the Dzanga Ndoki due to different employment. Admittedly, 39.27% of people had primary education, (6.4%) had secondary level, (1.33%) had higher education and 53.18% were illiterate. Employment and access to market are missing. Participative management has mostly focused on villages of Mossapoula and Yandoumbe. Ba Aka people (60.52%) were not satisfied with the project. In addition, poor conditions of local people let them very dependent to forest resources (illegal hunting and gathering). This project is however unable to provide financial support to national NGOs and associations for local people.
Ngbo-Ngbangbo Louis Maxime; Ge Jiwen; Nahayo Alphonse
BACKGROUND: Actinic prurigo (AP) is an idiopathic photodermatosis that usually onsets during childhood and predominates in women. It is characterized by the symmetrical involvement of sun-exposed areas of the skin, lips, and conjunctiva. OBJECTIVES: This study aimed to analyze the risk factors associated with AP using a case-control design. METHODS: All patients diagnosed with AP during 1990-2006 at Dr. Manuel Gea González General Hospital in Mexico City were included. Respective controls were recruited. Race, demographic, geographic, socioeconomic, environmental, clinical, and nutritional risk factors were assessed. RESULTS: A total of 132 persons were enrolled. These included 44 cases and two control groups comprising, respectively, dermatology and non-dermatology outpatients without AP or any autoimmune disease. Distribution by gender, age, place of birth, place of residence, and economic status did not differ significantly among the three groups. A total of 256 variables were analyzed. Only 19 variables were found to be statistically significant (P < 0.05). These were: use of a boiler; use of firewood; car ownership; use of earthenware; mixed material housing; socioeconomic level 1; sun exposure; use of soap; lemon consumption; use of moisturizing hair cream; living with pets in the house; living with farm animals; age; having a family member with AP; having had surgery; having had trauma; having been hospitalized; use of oral medication; and use of herbal medication. Of 40 macro- and micronutrients analyzed, 11 were found to have statistically significant effects (P < 0.05). CONCLUSIONS: Multiple epidemiologic, geographic, clinical, and immunologic factors are involved in the etiology of AP. This study proposes a clear line for research directed at specific risk factors that refer to an individual's clinical, allergic, health, and socioeconomic status. Further study should also investigate the etiologic role of diet in AP and the molecular mechanisms behind the development of AP to establish whether AP is caused by exposure to polycyclic aromatic hydrocarbons.
Vera Izaguirre DS; Zuloaga Salcedo S; González Sánchez PC; Sánchez Lara K; Chávez Tapia N; Hojyo Tomoka MT; Domínguez Soto L; Cuevas González JC; Rodríguez Lobato E; Vega Memije ME
OBJECTIVE: To study the association between atopy and variables such as weight, length, and socioeconomic level at birth and in young adulthood. METHODS: A total of 2,063 subjects were investigated in a prospective birth cohort study of individuals born in Ribeirão Preto, Brazil, in 1978/1979, and examined at the age of 23-25 years. Skin prick tests (SPT) for eight common allergens in Brazil were performed. Subjects with a wheal reaction ? 3 mm to one or more of the eight allergens tested were considered to be atopic. We used the log-binomial model (generalized linear model) in order to assess the association between atopy and birth or adult variables. RESULTS: The prevalence of positive SPT was 47.6%. Male gender was associated with an increased risk of atopy (relative risk [RR] = 1.18; 95% confidence interval [95%CI] 1.07-1.30). Low level of schooling was a protective factor against atopy, with a RR = 0.74; 95%CI 0.62-0.89. Living with a smoker in childhood was also associated with lower risk of atopy (RR = 0.87; 95%CI 0.79-0.96). Birth weight, length and order, maternal age, and intrauterine growth restriction were not associated with positive SPT. CONCLUSIONS: This study showed that male gender was associated with an increased risk of atopy. Low socioeconomic status, assessed by low level of schooling, was a protective factor against atopy. These data agree with the hygiene hypothesis.
Ferraz E; Garcia CA; Bettiol H; Caldeira RD; Cardoso VC; Arruda LK; Barbieri MA; Vianna EO
BACKGROUND: Mortality of infants and children younger than 5 years is a globally recognized and broad national welfare indicator. Scientific literature has data on the correlation of mortality indicators with macroeconomic indicators. It is important to study the associations between prevalence and mortality indicators and socioeconomic factors, since deaths from congenital anomalies account for approximately 25%-30% of all deaths in infancy. The aim of the study was to analyze the overall trend in mortality of infants and young children aged 0 to 4 years in relation to macroeconomic factors in Latvia and prevalence of congenital anomalies in newborns in relation to socioeconomic factors. MATERIAL AND METHODS: The Newborns' Register and Causes of Death Register were used as data sources; data on specific socioeconomic factors were retrieved from the Central Statistics Office. RESULTS: The results of the study show a strong correlation between mortality in children younger than 5 years and gross domestic product, as well as health budget in LVL per capita and the national unemployment level. The average decrease in infant mortality from congenital anomalies in Latvia was found to be 6.8 cases per 100,000 live births. CONCLUSIONS: There is a strong correlation between child mortality and socioeconomic situation in the country. There is a need to analyze the data on child mortality in a transnational context on a regular basis and studying the correlations between child mortality indicators and socioeconomic indicators and health care management parameters.
Ebela I; Zile I; Zakis A; Folkmanis V; Rumba-Rozenfelde I
Full Text Available Abstract Background Traditionally Nepalese society favors high fertility. Children are a symbol of well-being both socially and economically. Although fertility has been decreasing in Nepal since 1981, it is still high compared to many other developing countries. This paper is an attempt to examine the demographic, socio-economic, and cultural factors for fertility differentials in Nepal. Methods This paper has used data from the Nepal Demographic and Health Survey (NDHS 2006). The analysis is confined to ever married women of reproductive age (8,644). Both bivariate and multivariate analyses have been performed to describe the fertility differentials. The bivariate analysis (one-way ANOVA) was applied to examine the association between children ever born and women's demographic, socio-economic, and cultural characteristics. Besides bivariate analysis, the net effect of each independent variable on the dependent variable after controlling for the effect of other predictors has also been measured through multivariate analysis (multiple linear regressions). Results The mean numbers of children ever born (CEB) among married Nepali women of reproductive age and among women aged 40-49 were three and five children, respectively. There are considerable differentials in the average number of children ever born according to women's demographic, socio-economic, and cultural settings. Regression analysis revealed that age at first marriage, perceived ideal number of children, place of residence, literacy status, religion, mass media exposure, use of family planning methods, household headship, and experience of child death were the most important variables that explained the variance in fertility. Women who considered a higher number of children as ideal (? = 0.03; p Conclusion The average number of children ever born is high among women in Nepal. There are many contributing factors for the high fertility, among which are age at first marriage, perceived ideal number of children, literacy status, mass media exposure, wealth status, and child-death experience by mothers. All of these were strong predictors for CEB. It can be concluded that programs should aim to reduce fertility rates by focusing on these identified factors so that fertility as well as infant and maternal mortality and morbidity will be decreased and the overall well-being of the family maintained and enhanced.
This paper sought to verify the perceptions of hypertensive people in relation to the risk factors and their experience with high blood pressure in a Reference Center for Cardiovascular Diseases in the city of Salvador. Interviews were staged with 33 hypertensive people. This is a descriptive study, of a qualitative nature, supported by the discourse analysis proposed by Foucault. It was observed that risk factors were confused with hypertension complications. Nevertheless, when the approach changed from "risk factors" to "factors that can increase blood pressure," it was seen that the answers were more coherent with the risk factors classified by the VI Brazilian Policies on Hypertension. Furthermore, it was also observed through the discourses that the perception of increase in blood pressure is directly related to experiences. Therefore, it is necessary that the guidance be transmitted as clearly as possible in order for the understanding to become an important facilitator for controlling the illness. This paper enabled the perception of the risk factors in the viewpoint of these people in such a manner as to supply clues for the interdisciplinary health team to promote healthcare based on the experiences and the socio-economic and cultural context in which these people are inserted.
Machado MC; Pires CG; Lobão WM
The study gives a survey of the factors most frequently mentioned in the literature as factors likely to adversely affect a pregnancy. One essential aspect is the discussion of those factors that can be counted among the causes of malformations, as among others, prenatal radiation exposure. The study prepared within the framework of the research project 'Radiobiological environmental monitoring in Bavaria' is intended to serve as a basis for a retrospective and prospective evaluation of infant mortality, perinatal conditions and occurrence of malformations in Bavaria, with the principal idea of drawing up an environment - related health survey. The study therefore, in addition to ionizing radiation also takes into account other detectable risks within the ecologic context, as e.g. industrial installations, refuse incineration plants or waste dumps, or urbanity. (orig./MG).
Full Text Available The aim of the study was to estimate the parameters of the heteroscedastic bivariate Probit model established for the induced abortion and the contraceptive use by using socioeconomic and demographic factors and their effects by eliminating the observed heteroscedasticity. Using a heteroscedastic bivariate Probit model and Turkish Demographic and Health Survey (1998) data on married women aged 15 through 49 years, we estimated the probabilities of their having an induced abortion, if induced abortion have, of their using contraceptive methods. The results of the research show that induced abortion is perceived and used as a contraceptive method among the women in Turkey. This shows that it is the correct way to examine those two variables, induced abortion and contraceptive use, together.
Ozlem Alpu; Gunseli Kurt
BACKGROUND: To compare the survival of glioblastoma multiforme (GBM) patients operated on at public hospital with that of patients operated on at the private hospitals. METHOD: We carried out a retrospective analysis of the patients' medical records, the surgical reports and the pre- and post-operative images of patients with a histopathological confirmed adult supratentorial GBM. Sixty-three patients were treated at public hospital and twenty-one at private hospitals. RESULTS: The present study revealed that the survival of patients treated in private hospitals was statistically superior to that of patients treated in public hospitals (11.9 vs. 7.7). CONCLUSIONS: Our study advances towards the confirmation of the hypothesis that socioeconomic and educational factors influence the Karnofsky Performance Score (KPS) and the performance of radiotherapy treatment, with negative effects over the GBM patients' survival.
Lynch JC; Welling L; Escosteguy C; Pereira AG; Andrade R; Pereira C
Full Text Available Abstract in portuguese Pesquisas sobre saúde geral têm relacionado coesão familiar a fatores socioeconômicos e comportamentais. O objetivo deste estudo foi investigar a associação entre coesão familiar e fatores socioeconômicos, comportamentais e de saúde bucal. Este foi um estudo transversal com amostra por conglomerados em dois estágios. A amostra randomizada de 524 adolescentes era proveniente de escolas públicas da cidade de Piracicaba-SP. As variáveis foram avaliadas por questi (more) onários autoaplicáveis e os dados de saúde bucal, pelos índices CPO e CPI. A coesão familiar percebida pelo adolescente foi avaliada por meio da escala de adaptabilidade e coesão familiar. Análise univariada e regressão logística multinominal mostraram que adolescentes com baixa coesão familiar apresentaram mais chance de terem baixa renda (OR 2,28 IC95% 1,14-4,55), presença de cárie (OR 2,23 IC95% 1,21-4,09) e baixa frequência de escovação diária (OR 1,91 IC95% 1,03-3,54). Adolescentes com alta coesão familiar apresentaram mais chance que adolescentes com média coesão de terem alta renda e fator de proteção contra o hábito de tabagismo. Desta forma, a coesão familiar percebida pelo adolescente associou-se com variáveis comportamentais, socioeconômicas e de saúde bucal, indicando a importância de uma abordagem integral da saúde do paciente. Abstract in english Overall health surveys have related family cohesion to socio-economic status and behavioral factors. The scope of this study was to investigate the association between family cohesion and socio-economic, behavioral and oral health factors. This was a, cross-sectional study with two-stage cluster sampling. The random sample consisted of 524 adolescents attending public schools in the city of Piracicaba-SP. Variables were evaluated by self-applied questionnaires and caries (more) and periodontal disease were assessed by DMF-T and CPI indices. The adolescent's perception of family cohesion was assessed using the family adaptability and cohesion scale. Univariate and multinomial logistic regression shows that adolescents with low family cohesion were more likely than those with medium family cohesion to have low income (OR 2,28 95% CI 1,14- 4,55), presence of caries (OR 2,23 95% CI 1,21-4,09), less than two daily brushings (OR 1,91 95% CI 1,03-3,54). Adolescents with high family cohesion were more likely than those with medium family cohesion to have high income and protective behavior against the habit of smoking. Thus, the data shows that adolescent perception of family cohesion was associated with behavioral, socio-economic and oral health variables, indicating the importance of an integral approach to patient health.
Ferreira, Luale Leão; Brandão, Gustavo Antônio Martins; Garcia, Gustavo; Batista, Marília Jesus; Costa, Ludmila da Silva Tavares; Ambrosano, Gláucia Maria Bovi; Possobon, Rosana de Fátima
Full Text Available The prevalence of smoking during pregnancy in Ribeirão Preto, a rich Brazilian city, was significantly higher (21.4%) than in São Luís (5.9%), a less developed city. To assess which variables explain the difference in prevalence of smoking during pregnancy, data from two birth cohorts were used, including 2846 puerperae from Ribeirão Preto, in 1994, and 2443 puerperae from São Luís, in 1997/98. In multivariable analysis, risk of maternal smoking during pregnancy was higher in São Luís for mothers living in a household with five or more persons (OR = 1.72, 95%CI = 1.12-2.64), aged 35 years or older (OR = 1.98, 95%CI = 0.99-3.96), who had five or more children (OR = 2.10, 95%CI = 1.16-3.81), and whose companion smoked (OR = 2.20, 95%CI = 1.52-3.18). Age of less than 20 years was a protective factor (OR = 0.55, 95%CI = 0.33-0.92). In Ribeirão Preto there was association with maternal low educational level (OR = 2.18, 95%CI = 1.30-3.65) and with a smoking companion (OR = 3.25, 95%CI = 2.52-4.18). Receiving prenatal care was a protective factor (OR = 0.24, 95%CI = 0.11-0.49). Mothers from Ribeirão Preto who worked outside the home were at a higher risk and those aged 35 years or older or who attended five or more prenatal care visits were at lower risk of smoking during pregnancy as compared to mothers from São Luís. Smoking by the companion reduced the difference between smoking rates in the two cities by 10%. The socioeconomic variables in the model did not explain the higher prevalence of smoking during pregnancy in the more developed city.
V.S. Ribeiro; F.P. Figueiredo; A.A.M. Silva; R.L.F. Batista; M.A. Barbieri; F. Lamy Filho; M.T.S.S.B. Alves; A.M. Santos; H. Bettiol
Tornadoes in North and South Carolina on 28 March 1984 caused 252 people to be injured seriously enough to require hospitalization and 59 to be killed. To evaluate risk factors, we gathered information on 238 (94%) of those hospitalized and 46 (78%) of those killed. Those hospitalized or deceased had statistically significantly more deep cuts, concussions, unconsciousness and broken bones than those with them at the time of the tornado who were not hospitalized or killed. People living in mobile homes were more likely to be hospitalized or die than people occupying conventional houses. Other risk factors for hospitalization or death included advanced age (60+ years), no physical protection (not having been covered with a blanket or other object), having been struck by broken window glass or other falling objects, home lifted off its foundation, collapsed ceiling or floor, or walls blown away. More awareness of the tornado risk before it strikes and better adherence to tornado protection guidelines could reduce injuries and deaths in the future.
Eidson M; Lybarger JA; Parsons JE; MacCormack JN; Freeman JI
PURPOSE: A national study found that infants born in low socioeconomic areas had the worst infant mortality rates (IMRs) and the highest racial disparity. Racial disparities in birth outcomes are also evident in the city of Milwaukee, with African American infants at 3 times greater the risk than white infants. This study was conducted to examine the influence of socioeconomic status (SES) and race on birth outcomes in the city of Milwaukee. METHODS: Milwaukee ZIP codes were stratified into lower, middle, and upper SES groups. IMR, low birth weight, and preterm birth rates by race were analyzed by SES group for the years 2003 to 2007. RESULTS: The overall IMR for the lower, middle, and upper SES groups were 12.4, 10.7, and 7.7, respectively. The largest racial disparity in IMR (3.1) was in the middle SES group, versus lower (1.6) and upper (1.8) SES groups. The overall percent of low birth weight infants for the lower, middle, and upper SES groups was 10.9%, 9.5%, and 7.5%, respectively. Racial disparity ratios in low birth weight were 2.0, 1.9, and 1.9 for lower, middle and upper SES groups. The overall percent of preterm birth was 15.4%, 13.2%, and 10.6% of births within the lower, middle, and upper SES groups, respectively, with a disparity ratio of 1.6 across all SES groups. CONCLUSIONS: For all outcomes, African American infants born in the upper SES group fared the same or worse than white infants born in the lower SES group. Although higher SES appeared to have a protective effect for whites in Milwaukee, it did not have the same protective effect for African Americans.
Ward TC; Mori N; Patrick TB; Madsen MK; Cisler RA
Full Text Available Background and Objectives: Recognition of the risk factors of childhood cancer has been important. However, there is little identification about these risk factors. The aim of this study was to determine the risk factors of cancer in children under14 years old.Methods: The present study has been a case-control study of 14-year-old children. 98 childhood cancer cases and 100 controls were matched on age and sex. Data were collected using a questionnaire with some of the known and suspected risk factors of cancer via the parent, and were analyzed with two independent samples t–tests, chi–square and logistic regression models.Results: In this study, low- educational status in mothers and fathers increased risk of childhood cancer (p<0.05). Children lived in low-income families (500000-1500000 Rails per month), and had a significantly higher risk of cancer (Odds ratios=3.08; 95% CI=4-6.00). Fathers smoking during pregnancy (odds ratio=3.00) and living near high voltage power lines (Odds ratios=1.5) were significantly related to an increased risk of cancer in children. In addition, there was a higher risk of cancer particularly among heavy ( 11 cigarettes per days) smokers (odds ratio= 2.7). Conclusions: The results of this study indicated that some risk factors such as living conditions, smoking fathers during pregnancy, parental educational level and financial status were associated with the risk of childhood cancer. Therefore, public health should aim at improving environmental and familial socioeconomic status for all children; efforts should be concentrated on planning preventive and educational campaigns.
Edraki M; Rambod M
Based on the micro-census 2009 this study investigates the relationship between socio-economic status and a combination of the risk factors smoking behaviour and overweight and furthermore the relation between those risk factor combinations and health status. Based on a multinomial logistic regression it is shown that the combined risk factors are strongly related to socio-economic status. Age standardised conditional means show, furthermore, that the relationship between the combination of smoking behaviour and overweight and health status is moderately negative. PMID:23172600
Meyer, S; Schmidtke, K
... health fact sheet Other possible heart disease risk factors Depression, stress, and anxiety Not enough sleep Lower ... More information on other possible heart disease risk factors Read more from womenshealth.gov Heart Disease Fact ...
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Recurrent spontaneous abortion (RSA) has various complicated causes, and more and more researches are focused on its etiology. Genetic factors are the most common risk factors of RSA; immune factors, infection factors, male factors and female factors play an important role; environmental pollution and some other unknown factors may also be conspirators. This article presents an overview on the possible risk factors of RSA. PMID:24010215
Gu, Chun-Hui; Liang, Wen-Jun; Fu, Lu-Lu; Zheng, Lian-Wen
OBJECTIVES: To assess dental caries and use of dental services experience in 5-year-old children attending public kindergartens in Attica, Greece and to examine the influence of certain socioeconomic factors and living conditions as well as dental behaviours and attitudes. METHODS: In this cross-sectional study, a random and stratified sample of 605 Greek children was examined using decayed, missing, filled tooth surfaces and simplified debris indices. The use of dental services was measured by children's dental visits (any dental visit up to the age of 5 years). Care Index was also calculated. Risk indicators were assessed by a questionnaire. Zero-inflated Poisson and Logistic Regression Analysis were generated to test statistical significant associations. RESULTS: The prevalence of dental caries was 16.5%. Care Index was 32% and dental visits were reported for the 84% of the children. Medium Socio-Economic Level (SEL) was associated with no detectable caries. High SEL was related to decreased decayed, missing, filled teeth values, while female gender and rented houses had the opposite effect. The age of the mother (35-39 years) and the higher SEL were related to higher levels of dental services use. CONCLUSIONS: It is suggested that there are differences in the experience of dental caries and use of dental services among preschool children in Attica, which are related to demographic, socioeconomic factors and living conditions. Dental public polices should focus on groups with specific characteristics in order to improve oral health levels of disease-susceptible populations.
Mantonanaki M; Koletsi-Kounari H; Mamai-Homata E; Papaioannou W
The changing epidemiology of inflammatory bowel disease (IBD) across time and geography suggests that environmental factors play a major role in modifying disease expression. Disease emergence in developing nations suggests that epidemiological evolution is related to westernisation of lifestyle and industrialisation. The strongest environmental associations identified are cigarette smoking and appendectomy, although neither alone explains the variation in incidence of IBD worldwide. Urbanisation of societies, associated with changes in diet, antibiotic use, hygiene status, microbial exposures and pollution have been implicated as potential environmental risk factors for IBD. Changes in socioeconomic status might occur differently in different geographical areas and populations and, consequently, it is important to consider the heterogeneity of risk factors applicable to the individual patient. Environmental risk factors of individual, familial, community-based, country-based and regionally based origin may all contribute to the pathogenesis of IBD. The geographical variation of IBD provides clues for researchers to investigate possible environmental aetiological factors. The present review aims to provide an update of the literature exploring geographical variability in IBD and to explore the environmental risk factors that may account for this variability.
Ng SC; Bernstein CN; Vatn MH; Lakatos PL; Loftus EV Jr; Tysk C; O'Morain C; Moum B; Colombel JF
Background: Physical inactivity in transportation is negatively related to many health outcomes. However, little is known about the correlates of this condition among people living in regions of low socioeconomic level. Methods: Cross-sectional study aimed to assess factors associated with physical inactivity in transportation among adults in the Eastern Zone of São Paulo, Brazil. Home-based interviews were conducted between May 2007 and January 2008 on a probabilistic sample of the adult population (?18 years), totaling 368 men and 522 women. Factors associated with physical inactivity in transportation (less than 10 minutes per week of walking or cycling) were assessed using multivariate Poisson regression with hierarchical selection of variables. Results: Physical inactivity in transportation was associated with the presence of vehicles in the household in men (PR = 2.96) and women (PR = 2.42), with linear trend for both sexes (P < .001 and P = .004, respectively), even after adjusting for age, schooling level and chronic diseases (this last factor, only among women). Conclusions: Presence of vehicles in the household was associated positively with physical inactivity in transportation, both for men and for women. This should be taken into consideration in drawing up public policies for promoting physical activity.
Sa TH; Salvador EP; Florindo AA
Full Text Available The study determined socio-economic factors influencing yield of arable crops in Osun State. Primary data were collected from 150 arable crop farmers from 5 cells in each of the three agricultural zones in the state using purposive and random sampling methods. The data were analysed with descriptive statistics and regression techniques. Result of the analysis showed that the mean age of arable crops farmers was 52 years, the mean years of formal education was 9 years with household size of about 11 and mean farm size was about 3.5 ha. The yield of arable crops slightly increased in 1998 to 2000. Multiple regression analysis showed that R and R2 for all the variables investigated was 0.687 and 0.472, respectively. Training and demonstrations attended by farmers with Beta Coefficient of (0.123) was the best factor-influencing yield of arable crop in Osun State. Other factors in descending order are access to agricultural input (0.119); farm size (0.052) and age (0.042) Agricultural policy effort should be directed at increasing agricultural extension activities to farmers and agricultural input should be made available at affordable prices to arable crop farmers to increase their yield.
S.A. Adesoji; A.J. Farinde
Home » Kidney Info » 1 in 9 Adults Risk Factors for CKD When you have a risk factor, it means you are more likely to have a problem than someone who does ... to prevent or delay kidney failure. Kidney Disease Risk Factors You Can Change Diabetes Type 2 diabetes ...
Russia has the lowest life expectancy among industrialised countries, but little is known about other health outcomes and determinants of health in the Russian population. Here we report a cross-sectional study in a national sample of the Russian population of social and psychosocial determinants of two self-reported health indicators: self-rated health (shown to predict mortality in prospective studies) and physical functioning (validated against more objective health measures). A multi-stage sample of the Russian population aged 18 years and more was interviewed (n=1599, response rate 66%). The questionnaire included political attitudes, social and economic circumstances, psychosocial factors, smoking, alcohol consumption, self-rated health and physical functioning (from the SF36 instrument). Scores of perceived control over life and over one's health were calculated from 6 and 3 questions, respectively. Data were analysed in logistic regression for two dichotomised outcomes: poor self-rated health (worse than average) and low physical functioning (less than 60% of maximum). Overall, 25% of subjects rated their health as worse than average; this is substantially more than in western countries. Perceived control over life was strongly related to both outcomes; age- and sex-adjusted OR for 1 standard deviation increase in control were 0.60 (95% CI 0.52-0.69) for poor self-rated health and 0.67 (0.57-0.81) for low physical functioning. Adjustment for a battery of other factors reduced these estimates only slightly. Associations between control over one's health and both outcomes were also significant, but weaker and attenuated in multivariate models. Material deprivation was also strongly related to both outcomes. Education was inversely related to self-rated health, and unmarried men reported poor physical functioning substantially more often. Subjects not approving the economic changes reported poorer health but this association was removed by adjustment for socioeconomic factors and control. Subjects who could not rely on informal social structures when in problems reported worse health; this effect largely persisted in multivariate analyses. These results are consistent with the hypothesis that poor health status in Russia is related to dysfunction of social structures, socioeconomic deprivation, and lack of perceived control. The absence of informal social networks, vital for maintaining general welfare, seems to affect adversely self-rated health. Deprivation and low perceived control may be important mediators between the broad social environment and health in populations undergoing transition and can provide a useful framework for many biological and behavioural factors. Prospective studies are needed to address the issue of temporality and reporting bias, the major problems in interpreting these findings. PMID:9720645
Bobak, M; Pikhart, H; Hertzman, C; Rose, R; Marmot, M
Full Text Available Abstract Background Changes in lifestyles and in the environment over the last decades are probably the most important cause of the overweight epidemic, but the findings are inconsistent among studies. The purpose of this study was to investigate the association of several socio-economic and lifestyle factors with overweight in Flemish adults, using BMI ? 25 kg/m2, waist circumference (WC) ? 94 cm (men) or ? 80 cm (women) and the combination of BMI and WC for identifying overweight. Methods This cross-sectional epidemiological study was conducted by the Flemish Policy Research Centre Sport, Physical Activity and Health between October 2002 and February 2004 in 46 Flemish communities. A total of 4903 Flemish adults (2595 men and 2308 women), aged 18 to 75 years, from a population-based random sample were included in the analysis. Body weight, height and WC were measured, and socio-economic and lifestyle factors were reported by means of validated questionnaires. Results The results of the logistic regressions revealed that age is positively associated with overweight in both genders. Alcohol consumption is associated with overweight only in men. Men smoking in the past and watching TV >11 h/week have significantly higher OR's for overweight, while men who participate in health related sports >4 h/week have significantly lower OR's for overweight. In women, watching TV >9 h/week was positively associated with overweight. Women who are current smokers or participate in health related sports >2.5 h/week or with a higher educational level have significantly lower odds for overweight. Different results are observed between the first (BMI) and the second model (WC) in both genders. In men, the models differ for education and health related sports, while in women they differ for smoking status and leisure time physical activity. Conclusion The present study confirms the contention that overweight is a multifactorial problem. Age and TV viewing are positively associated with overweight, while educational level and health related sports are negatively related to overweight in both genders. In men, alcohol consumption and smoking in the past are also among the lifestyle factors associated with overweight. This study also indicates that BMI and WC do not have the same discriminative function regarding different lifestyle factors.
Duvigneaud Nathalie; Wijndaele Katrien; Matton Lynn; Deriemaeker Peter; Philippaerts Renaat; Lefevre Johan; Thomis Martine; Duquet William
It is not clear what effect socioeconomic factors have on adherence to antiretroviral therapy (ART) among patients in low- and middle-income countries. We performed a systematic review of the association of socioeconomic status (SES) with adherence to treatment of patients with HIV/AIDS in low- and middle-income countries. We searched electronic databases to identify studies concerning SES and HIV/AIDS and collected data on the association between various determinants of SES (income, education, occupation) and adherence to ART in low- and middle-income countries. From 252 potentially-relevant articles initially identified, 62 original studies were reviewed in detail, which contained data evaluating the association between SES and adherence to treatment of patients with HIV/AIDS. Income, level of education, and employment/occupational status were significantly and positively associated with the level of adherence in 15 studies (41.7%), 10 studies (20.4%), and 3 studies (11.1%) respectively out of 36, 49, and 27 studies reviewed. One study for income, four studies for education, and two studies for employment found a negative and significant association with adherence to ART. However, the aforementioned SES determinants were not found to be significantly associated with adherence in relation to 20 income-related (55.6%), 35 education-related (71.4%), 23 employment/occupational status-related (81.5%), and 2 SES-related (100%) studies. The systematic review of the available evidence does not provide conclusive support for the existence of a clear association between SES and adherence to ART among adult patients infected with HIV/ AIDS in low- and middle-income countries. There seems to be a positive trend among components of SES (income, education, employment status) and adherence to antiretroviral therapy in many of the reviewed studies.
Peltzer K; Pengpid S
AIM: To assess the prevalence of dental caries, periodontal diseases, oral pre-malignant and malignant lesions in relation to socioeconomic factors among the municipal employees of Mysore city. SETTINGS AND DESIGN: The study was cross sectional in nature. MATERIALS AND METHODS: All the available employees (1187) during the study period were considered. World Health Organization (WHO) Oral Health Assessment form (1997) and a preformed questionnaire were used to collect the required data. Modified Kuppuswamy scale with readjustment of the per capita income to suit the present levels was used for classifying the individuals into different socioeconomic status (SES) categories. Data were collected by a single, trained and calibrated examiner (dentist) using mouth mirror and community periodontal index (CPI) probe under natural daylight. Data analysis was done using SPSS windows version 10. Quantitative data were analyzed using one-way analysis of variance (ANOVA) with Tukey's post hoc test and qualitative data were analyzed using chi-square or contingency coefficient. RESULTS: The age range of the study population was 19-57 years (mean 40.74 years, standard deviation 9.17). The prevalence of dental caries in the upper SES category was lesser (43.3%) compared to that in lower SES category (78.6%). 16.4% of the subjects in the upper category had a CPI score of 0 (healthy periodontium) and none of the subjects in the lower middle, upper lower and lower SES category had this score. The prevalence of oral pre-malignant and malignant lesions was higher in lower SES category (17.9%) than in upper class (0%). CONCLUSION: There was an inverse relationship between oral health status and SES. The overall treatment need was more in the lower class people than in the upper class.
Chandra Shekar BR; Reddy C
Full Text Available The purpose of this study was to determine those risk factors that may cause running injuries in general, and particularly damage to the muscle mass, and the tendon. Twenty six male and female Galician runners were evaluated about their lower limb flexibility and length, knee Q angle, explosive power and training features such as kilometers and sessions per week, level of competition, shoes, surface, injuries last year, use of insoles, athletic specially, age, weight and height. During next 12 weeks runners continued training as they had been doing regularly and we recorded all injuries that appeared in this period. After that and from the liner regression we obtained different models that explained the variability of general injuries, tendon injuries and damages to the muscle mass. We also find positive correlations between previous injuries and training volume, and these with the dependent variable «injuries in 12 weeks». In regard to tendinopathy and muscle mass injuries, we observed that the synthetic material present in the track is a risk factor for these muscle injuries. Meanwhile, the increasing age and the Q angle, increments the occurrence of tendon injuries.
Francisco Rodal Abal; José Luis García Soidán; Víctor Arufe Giráldez
Full Text Available Colorectal cancer is one of the most common cancers in human population. It causes significant morbidity and mortality in our country. The incidence of colorectal cancer increases in the fifth decade of life. The aim of this study was to evaluate the association between colorectal cancer and potential risk factors. A case-control study of colorectal cancer was carried out between 1998 and 1999 in Clinical Center of Serbia, Center for Digestive Surgery. A total of 100 cases of newly diagnosed patients with colorectal cancer confirmed by histopathology and an equal number of controls, individually matched by gender and age (+/-5 years), were chosen from patients from the same hospital with no history of cancer at all. McNemar test and conditional logistic regression were used in the analysis. According to logistic regression analysis the following risk factors were independently related with the occurrence of colorectal cancer: cigarette smoking, alcohol consumption, and diet rich in red meat and fat promote the carcinogenic process; food rich in vegetables, fruits, grains, vitamin C, physical activity, and oral contraceptive use inhibit the same process. A family history of cancer and long standing inflammatory bowel diseases also have significant role. There is convincing evidence that nutrition affects colorectal carcinogenesis in a complex fashion.
BACKGROUND: Little is known regarding the cardiovascular disease risk factors among Chamorros residing in the United States. METHODS: The Chamorro Directory International and the CDC's Behavioral Risk Factor Surveillance System Questionnaire (BRFSS) were used to assess the health related practices and needs of a random sample of 228 Chamorros. RESULTS: Inactivity, hypertension, elevated cholesterol and diabetes mellitus were more prevalent in this Chamorro sample compared to the US average. Participants who were 50-and-older or unemployed were more likely to report hypertension, diabetes and inactivity, but they were also more likely to consume more fruits and vegetables than their younger and employed counterparts. Women were more likely to report hypertension and diabetes, whereas men were more likely to have elevated BMI and to have never had their blood cholesterol checked. CONCLUSION: The study provides data that will help healthcare providers, public health workers and community leaders identify where to focus their health improvement efforts for Chamorros and create culturally competent programs to promote health in this community.
Chiem B; Nguyen V; Wu PL; Ko CM; Cruz LA; Sadler GR
Little is known about the risk factors of human brucellosis in Jordan. A case-control study was conducted involving 56 Jordanians who had been treated for brucellosis and at least 3 matched controls for each case (n = 247). Matching was for sex, age, locality (the same village) and socioeconomic standard. Univariate and multivariate logistic regression analyses were used. In all, 17 risk factors were examined related to: contact with various livestock, milk and milk product consumption, drinking-water treatment and disease awareness. Most variables were associated with brucellosis in the univariate analysis but the final logistic model included only 4: milking sheep and goats (OR 3.5), consumption of raw feta cheese made from sheep and goat milk (OR 2.8) and consumption of cows' milk (OR 0.4) and boiled feta cheese (OR 0.4). Small ruminant farmers need to be trained in safer milking practices and feta cheese making procedures.
Abo-Shehada MN; Abu-Halaweh M
Little is known about the risk factors of human brucellosis in Jordan. A case-control study was conducted involving 56 Jordanians who had been treated for brucellosis and at least 3 matched controls for each case (n = 247). Matching was for sex, age, locality (the same village) and socioeconomic standard. Univariate and multivariate logistic regression analyses were used. In all, 17 risk factors were examined related to: contact with various livestock, milk and milk product consumption, drinking-water treatment and disease awareness. Most variables were associated with brucellosis in the univariate analysis but the final logistic model included only 4: milking sheep and goats (OR 3.5), consumption of raw feta cheese made from sheep and goat milk (OR 2.8) and consumption of cows' milk (OR 0.4) and boiled feta cheese (OR 0.4). Small ruminant farmers need to be trained in safer milking practices and feta cheese making procedures. PMID:23516823
Abo-Shehada, M N; Abu-Halaweh, M
This article relates to the theory suggesting that there is a prevalence of male homosexuality within the theatrical profession that can be explained through male performers becoming homosexual due to their low socioeconomic position. In a questionnaire-based study, the socioeconomic status (SES) is...
Ivtzan, I; Goodhand, S
Full Text Available The aim of the present study was to investigate caries prevalence and socioeconomic factors in children with sickle cell anemia. This study was conducted in 160 children with sickle cell anemia aged 3 to 12 years attending the Center for Hematology in Recife, Brazil . Data collection included interviews with guardians concerning social factors and oral examinations to determine the caries prevalence. Statistical analyses were performed using the Kruskal-Wallis and Pearson's chi-square tests at a 5% significance level. The caries prevalence was 55.0%. The dmft index was 2.12, and the DMFT index was 1.50. Income significantly influenced dmft; the mean dmft was 4.57 in children whose family income was less than the Brazilian minimum wage (BMW), whereas in children with a family income three times the BMW or higher, the mean dmft was 2.27. No statistically positive association was found between the educational level of parents and guardians and the caries indices. A statistically significant association was found between dental caries prevalence and family income.
Ana Cláudia Alves e Luna; Maria José Rodrigues; Valdenice Aparecida Menezes; Kátia Maria Gonçalves Marques; Fabiano Almeida dos Santos
The aim of the present study was to investigate caries prevalence and socioeconomic factors in children with sickle cell anemia. This study was conducted in 160 children with sickle cell anemia aged 3 to 12 years attending the Center for Hematology in Recife, Brazil. Data collection included interviews with guardians concerning social factors and oral examinations to determine the caries prevalence. Statistical analyses were performed using the Kruskal-Wallis and Pearson's chi-square tests at a 5% significance level. The caries prevalence was 55.0%. The dmft index was 2.12, and the DMFT index was 1.50. Income significantly influenced dmft; the mean dmft was 4.57 in children whose family income was less than the Brazilian minimum wage (BMW), whereas in children with a family income three times the BMW or higher, the mean dmft was 2.27. No statistically positive association was found between the educational level of parents and guardians and the caries indices. A statistically significant association was found between dental caries prevalence and family income. PMID:22344337
Luna, Ana Cláudia Alves E; Rodrigues, Maria José; Menezes, Valdenice Aparecida; Marques, Kátia Maria Gonçalves; Santos, Fabiano Almeida Dos
Full Text Available Abstract in english The aim of the present study was to investigate caries prevalence and socioeconomic factors in children with sickle cell anemia. This study was conducted in 160 children with sickle cell anemia aged 3 to 12 years attending the Center for Hematology in Recife, Brazil . Data collection included interviews with guardians concerning social factors and oral examinations to determine the caries prevalence. Statistical analyses were performed using the Kruskal-Wallis and Pearson (more) 's chi-square tests at a 5% significance level. The caries prevalence was 55.0%. The dmft index was 2.12, and the DMFT index was 1.50. Income significantly influenced dmft; the mean dmft was 4.57 in children whose family income was less than the Brazilian minimum wage (BMW), whereas in children with a family income three times the BMW or higher, the mean dmft was 2.27. No statistically positive association was found between the educational level of parents and guardians and the caries indices. A statistically significant association was found between dental caries prevalence and family income.
Luna, Ana Cláudia Alves e; Rodrigues, Maria José; Menezes, Valdenice Aparecida; Marques, Kátia Maria Gonçalves; Santos, Fabiano Almeida dos
OBJECTIVES: To describe the possible association between demographic, social and economic characteristics of health areas in the autonomous community of Madrid and utilization of public family practice facilities. METHODS: An ecological study was carried out using health areas as the unit of analysis. The information sources were official data on population statistics and the reports of the National Institute of Health for 1996 and 2001. Indicators were income, mean household size, unemployment rate, the percentage of housewives, and the percentage of individuals with university education. The association between these indicators and utilization of public family practice facilities was analyzed using the Spearman correlation coefficient. A multivariate linear regression model was also fitted. RESULTS: The consultation rate in public family practice facilities in Madrid was directly associated with the percentage of housewives (r = 0.44), income (r = -0,697), and the percentage of individuals with university education (r = -0.72). In the multivariate linear regression model, 77% of the varian-ce in utilization was explained by income (48%), the percentage of housewives (19%), and average household size (9%). CONCLUSIONS: The results show the relationship between social and economic factors and utilization of public family practice facilities and suggest the advisability of including demographic and socioeconomic factors in primary care planning.
Pérez MA; Moreno VM; Puerta DR; Martínez YG; Vicario IH; Ceruelo EE; de la Cámara AG
The aim of the present study was to investigate caries prevalence and socioeconomic factors in children with sickle cell anemia. This study was conducted in 160 children with sickle cell anemia aged 3 to 12 years attending the Center for Hematology in Recife, Brazil. Data collection included interviews with guardians concerning social factors and oral examinations to determine the caries prevalence. Statistical analyses were performed using the Kruskal-Wallis and Pearson's chi-square tests at a 5% significance level. The caries prevalence was 55.0%. The dmft index was 2.12, and the DMFT index was 1.50. Income significantly influenced dmft; the mean dmft was 4.57 in children whose family income was less than the Brazilian minimum wage (BMW), whereas in children with a family income three times the BMW or higher, the mean dmft was 2.27. No statistically positive association was found between the educational level of parents and guardians and the caries indices. A statistically significant association was found between dental caries prevalence and family income.
Luna AC; Rodrigues MJ; Menezes VA; Marques KM; Santos FA
Full Text Available The primary purpose of this study was to analyze the internal consistency and construct validity of a classification of bullying outcomes, and to investigate the risk factors associated with bullying behaviour at Pattani primary schools, southern Thailand. A cross-sectional study was conducted with a sample of 1,440 students. Factor analysis, descriptive statistics, Pearson’s chi-squared test, and logistic regression were used for data analysis. The results showed that 20.9% of students in Pattani primary schools reported having bullied others. A four factors structure of bullying was clearly shown; serious, general physical, psychological-maligning parent and psychological-maligning student. Witnessing parental physical abuse was clearly the most strongly associated determinants, and much more strongly linked to bullying others than was the group who had never witnessed parental physical abuse (OR 7.60, 95% CI 5.60-10.31). The students who preferred action cartoons were more often bullies than were those who preferred comedy cartoons (OR 2.87, 95% CI 1.91-430).
Kasetchai Laeheem; Metta Kuning; Nittaya McNeil
BACKGROUND: Traditionally Nepalese society favors high fertility. Children are a symbol of well-being both socially and economically. Although fertility has been decreasing in Nepal since 1981, it is still high compared to many other developing countries. This paper is an attempt to examine the demographic, socio-economic, and cultural factors for fertility differentials in Nepal. METHODS: This paper has used data from the Nepal Demographic and Health Survey (NDHS 2006). The analysis is confined to ever married women of reproductive age (8,644). Both bivariate and multivariate analyses have been performed to describe the fertility differentials. The bivariate analysis (one-way ANOVA) was applied to examine the association between children ever born and women's demographic, socio-economic, and cultural characteristics. Besides bivariate analysis, the net effect of each independent variable on the dependent variable after controlling for the effect of other predictors has also been measured through multivariate analysis (multiple linear regressions). RESULTS: The mean numbers of children ever born (CEB) among married Nepali women of reproductive age and among women aged 40-49 were three and five children, respectively. There are considerable differentials in the average number of children ever born according to women's demographic, socio-economic, and cultural settings. Regression analysis revealed that age at first marriage, perceived ideal number of children, place of residence, literacy status, religion, mass media exposure, use of family planning methods, household headship, and experience of child death were the most important variables that explained the variance in fertility. Women who considered a higher number of children as ideal (beta = 0.03; p < 0.001), those who resided in rural areas (beta = 0.02; p < 0.05), Muslim women (beta = 0.07; p < 0.001), those who had ever used family planning methods (beta = 0.08; p < 0.001), and those who had a child-death experience (beta = 0.31; p < 0.001) were more likely to have a higher number of CEB compared to their counterparts. On the other hand, those who married at a later age (beta = -0.15; p < 0.001), were literate (beta = -0.05; p < 0.001), were exposed to both (radio/TV) mass media (beta = -0.05; p < 0.001), were richest (beta = -0.12; p < 0.001), and were from female-headed households (beta = -0.02; p < 0.05) had a lower number of children ever born than their counterparts. CONCLUSION: The average number of children ever born is high among women in Nepal. There are many contributing factors for the high fertility, among which are age at first marriage, perceived ideal number of children, literacy status, mass media exposure, wealth status, and child-death experience by mothers. All of these were strong predictors for CEB. It can be concluded that programs should aim to reduce fertility rates by focusing on these identified factors so that fertility as well as infant and maternal mortality and morbidity will be decreased and the overall well-being of the family maintained and enhanced.
England has invested in chlamydia screening interventions for young people. It is not known whether young people in poorer socioeconomic circumstances (SEC) are at greater risk of chlamydia and therefore in greater need of screening.
Sheringham, J; Mann, S; Simms, I; Stafford, M; Hart, GJ; Raine, R
Rift Valley fever (RVF) is a major vector-borne zoonosis first identified on the African continent in the early 1900s. In 2000, RVF was reported for the first time in Yemen. In this study, we provide a descriptive analysis of the period 1999-2007 in Yemen, taking into account the environmental and socioeconomic factors likely to have been involved in the emergence of RVF in the country. We characterize each year in the study period by the environmental conditions (linked to vegetation indexes), the festival calendar, and economic data. We then use a principal component analysis to synthesize the different variables, assess whether the year 2000 was atypical compared with other years in the study period, and, if that was the case, in what respect. Our results show that 2000 presented above-normal vegetation index values, which reflect important precipitation, for both the two rainy seasons (the first between March and May; the second between July and October). These environmental conditions, ones favorable to mosquito vector populations, coincided that year with a late (March) starting date of the Eid al-Kabeer festival, which corresponds to a period with high host (cattle, sheep, goats) densities. According to these criteria, 2000 was an atypical year. These conclusions suggest that it is important to consider social variables in addition to environmental ones when assessing the risk of RVF emergence.
Abdo-Salem S; Tran A; Grosbois V; Gerbier G; Al-Qadasi M; Saeed K; Etter E; Thiry E; Roger F; Chevalier V
Abstract Background Data regarding the impact of early risk factors on later involvement in bullying are scarce. We investigated the impact of preschool behaviors, family characteristics (socio-economic status, family breakup) and parental mental health on bullying and victimization...
Jansen Danielle EMC; Veenstra René; Ormel Johan; Verhulst Frank C; Reijneveld Sijmen A
BACKGROUND: Poor social circumstances in childhood are associated with increased risk of coronary heart disease (CHD). In previous studies, social circumstances and risk factors in adulthood have been suggested to explain this association. In the present study, we included potential explanatory factors from childhood and adolescence. METHODS: We investigated the association between childhood socio-economic position (SEP) and CHD in middle age among 49,321 Swedish males, born during 1949-51, who were conscripted for military service at 18-20 years of age. Register-based data on childhood social circumstances, educational attainment and occupational class in adulthood were used in combination with information on cognitive ability, smoking, body mass index and body height in late adolescence obtained from a compulsory conscription examination. Incidence of CHD from 1991 to 2007 (between 40 and 58 years of age) was followed in national registers. RESULTS: We demonstrated an inverse association between childhood SEP and CHD in middle age: among men with the lowest childhood SEP the crude hazard ratio of CHD was 1.47 (95% CI = 1.30-1.67). Adjustment for crowded housing in childhood, body height, cognitive ability, smoking and BMI in late adolescence attenuated relative risks of CHD considerably. Additional adjustment for educational level had a further, although limited, attenuating effect on associations, but additional adjustment for occupational class had no such effect. CONCLUSIONS: Results showed that social, cognitive and behavioural factors evident prior to adulthood may be of greater importance in explaining the association between childhood SEP and CHD later in life than socio-economic indicators in adulthood.
Falkstedt D; Lundberg I; Hemmingsson T
BACKGROUND: Socioeconomic inequalities in health and social determinants of health are important issues in public health and health policy. We investigated associations of cardiovascular risk factors with household expenditure (as an indicator of socioeconomic status) and marital status in Japan. METHODS: We combined data from 2 nationally representative surveys-the Comprehensive Survey of Living Conditions and the National Health and Nutrition Survey, 2003-2007-and analyzed sex-specific associations of household expenditure quartiles and marital status with cardiovascular risk factors, including obesity, hypertension, dyslipidemia, and diabetes, among 6326 Japanese adults (2664 men and 3662 women) aged 40 to 64 years. RESULTS: For men, there was no statistically significant association between household expenditure and cardiovascular risk factors. For women, lower household expenditure was significantly associated with obesity, hypertension, diabetes, and the presence of multiple risk factors: the ORs for the lowest versus the highest quartile ranged from 1.39 to 1.71. In a comparison of married and unmarried participants, the prevalence of cardiovascular risk factors was higher among married women and lower among married men. CONCLUSIONS: Lower socioeconomic status, as indicated by household expenditure, was associated with cardiovascular risk factors in Japanese women. Socioeconomic factors should be considered in health promotion and prevention of cardiovascular disease.
Fukuda Y; Hiyoshi A
Full Text Available The objective of the study was to identify the socio-economic and institutional factors which influence the level of awareness of Clean Development Mechanism (CDM) projects and in so doing to highlight the policy implications for the stakeholders when designing clean development mechanism projects among smallholder farmers. Findings shows that 23% of the farmers were correctly aware of the project and the results of the ordered logit model indicate that age, gender, education level, group membership, existence of tree farming and contact with extension services was found to influence awareness level of smallholder forest Carbon projects. To assist the community to adapt to climate change and produce sufficiently on a sustainable basis and achieve the desired food security under climate change challenges, the study recommends policies to increase awareness of such agro-environmental initiatives and that of extension providers should distinguish their clientele anchored on vital demographic characteristics such as age and gender. If the probability of younger farmers to be aware this initiative is higher, extension communications should be directed to such age group, particularly during initial stages project information dissemination.
Oscar I. Ayuya; Job K. Lagat; John M. Mironga
The reasons for social inequality in breast cancer survival are far from established. Our study aims to study the importance of a range of socioeconomic factors and comorbid disorders on survival after breast cancer surgery in Denmark where the health care system is tax-funded and uniform. All 25,897 Danish women who underwent protocol-based treatment for breast cancer in 1983-1999 were identified in a clinical database and information on socioeconomic variables and both somatic and psychiatric comorbid disorders was obtained from population-based registries. We used Cox proportional hazards models to estimate the association between socioeconomic position and overall survival and further to analyse breast cancer specific deaths in a competing risk set-up regarding all other causes of death as competing risks. The adjusted hazard ratio (HR) for death was reduced in women with higher education (HR, 0.91; 95% confidence interval (CI), 0.85-0.98), with higher income (HR, 0.93; 95% CI, 0.87-0.98) and with larger dwellings (HR, 0.90; 95% CI, 0.85-0.96 for women living in houses larger than 150 m(2)). Presence of comorbid disorders increased the HR. An interaction between income and comorbid disorders resulting in a 15% lower survival 10 year after primary surgery in poor women with low-risk breast cancer having comorbid conditions ( approximately 65%) compared to rich women with similar breast cancer prognosis and comorbid conditions ( approximately 80%) suggests that part of the explanation for the social inequality in survival after breast cancer surgery in Denmark lies in the access to and/or compliance with management of comorbid conditions in poorer women. (c) 2007 Wiley-Liss, Inc.
Dalton, Susanne Oksbjerg; Ross, Lone
STUDY OBJECTIVE: To estimate relative odds ratios and to ascertain the relative contribution of each socioeconomic covariate in explaining racial disparities in self assessed health status (for example, global health perceptions and functional limitations of daily activities). DESIGN: National repre...
Ren, X S; Amick, B C
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The subject of this thesis is the association between socioeconomic status (SES) and cancer detection and outcome in the Netherlands. Both a description of and explanation for variation in incidence, detection, staging, treatment, survival and health-related quality of life of cancer by SES are give...
OBJECTIVE: To identify the dietary, lifestyle and socio-economic factors associated with the intake of whole grains (WG) in Norway, Sweden and Denmark. DESIGN: A cross-sectional study. SETTING: Subsample of the Scandinavian cohort 'HELGA' consisting of three prospective cohorts: The Norwegian Women and Cancer Study; The Northern Sweden Health and Disease Study; and the Danish Diet, Cancer and Health Study. SUBJECTS: A total of 8702 men and women aged 30-65 years. Dietary data are from one 24 h dietary recall and data on socio-economic status and lifestyle factors including anthropometric values are from the baseline collection of data. RESULTS: Vegetables, fruits, dairy products, fish and shellfish, coffee, tea and margarine were directly associated with the intake of WG, whereas red meat, white bread, alcohol and cakes and biscuits were inversely associated. Smoking and BMI were consistently inversely associated with the intake of WG. Furthermore, length of education was directly associated with the intake of WG among women. CONCLUSIONS: The intake of WG was found to be directly associated with healthy diet, lifestyle and socio-economic factors and inversely associated with less healthy factors, suggesting that these factors are important for consideration as potential confounders when studying WG intake and disease associations.
Kyrø C; Skeie G; Dragsted LO; Christensen J; Overvad K; Hallmans G; Johansson I; Lund E; Slimani N; Johnsen NF; Halkjær J; Tjønneland A; Olsen A
OBJECTIVE: To identify the dietary, lifestyle and socio-economic factors associated with the intake of whole grains (WG) in Norway, Sweden and Denmark. DESIGN: A cross-sectional study. SETTING: Subsample of the Scandinavian cohort 'HELGA' consisting of three prospective cohorts: The Norwegian Women and Cancer Study; The Northern Sweden Health and Disease Study; and the Danish Diet, Cancer and Health Study. SUBJECTS: A total of 8702 men and women aged 30-65 years. Dietary data are from one 24 h dietary recall and data on socio-economic status and lifestyle factors including anthropometric values are from the baseline collection of data. RESULTS: Vegetables, fruits, dairy products, fish and shellfish, coffee, tea and margarine were directly associated with the intake of WG, whereas red meat, white bread, alcohol and cakes and biscuits were inversely associated. Smoking and BMI were consistently inversely associated with the intake of WG. Furthermore, length of education was directly associated with the intake of WG among women. CONCLUSIONS: The intake of WG was found to be directly associated with healthy diet, lifestyle and socio-economic factors and inversely associated with less healthy factors, suggesting that these factors are important for consideration as potential confounders when studying WG intake and disease associations.
KyrØ, Cecilie; Skeie, Guri
This study aimed to evaluate the prevalence and factors associated with oral mucosa alterations in patients from Vale do Jequiti-nhonha, Brazil. The sample consisted of 511 patients of both genders. Questionnaires were used to obtain information about patient gender, age, race, systemic disease state, medication use, cigarette use and alcohol consumption. Physical examinations were then performed to identify lesions of the oral mucosa. Descriptive analyses, Chi-squared tests and logistic regressions were then used to analyze the results (p < 0.05, 95% CI). In this population, 84.9% (434/511) of patients were found to have alterations in their oral mucosa. The most common alterations were melanotic maculae (36.0%), linea alba (33.9%), traumatic ulcers (21.5%), Fordyce's granules (20.4%), coated tongue (12.5%) and fissured tongue (10.0%). Melanotic maculae were more frequently observed in black patients, with an odds ration (OR) of 7.51. Being female was a statistically significant predictive factor for having a visible linea alba (OR: 1.90) and a fissured tongue (OR: 2.11). No statistically significant association was found between the presence of oral lesions and systemic disease, medication use, alcohol use and smoking. The high observed prevalence of melanotic maculae and Fordyce's granules suggests that these alterations could be considered typical characteristics of the population of the Vale do Jequitinhonha. Coated tongue may be related to the socioeconomic deprivation in the region. Furthermore, the high prevalence of traumatic ulcers may be associated with the traumatic agents that caused patients to seek dental care.
Vieira-Andrade RG; Zuquim Guimarães Fde F; Vieira Cda S; Freire ST; Ramos-Jorge ML; Fernandes AM
BACKGROUND: The prevalence of latex allergy appears to be substantially higher in certain high risk groups, particularly in children with spina bifida. The source of this increase is presently unknown and may be due either to increased infantile exposure or to an intrinsic predilection for atopy in this condition. OBJECTIVE: We attempted to ascertain the prevalence of latex and tropical fruit allergy in children of lower socioeconomic strata with spina bifida from Caracas, Venezuela, who have limited operative and other medical exposure to latex. METHODS: Ninety-three unselected patients with spina bifida from clinic and hospital populations were prick tested with commercial (Stallergenes-Pasteur) latex extract and crude glove (Baxter-Triflex, 1/5 wt/vol) latex extract as well as with standardized mite and cockroach, 1/10 wt/vol, extracts (Hollister-Stier). An array of tropical fruits were also included in the battery of skin test materials, using the prick by prick method. Careful family and personal history for allergy as well as any reactions to rubber products were noted, placing emphasis on intraoperative anaphylaxis, number of operations and use of bladder catheters. RESULTS: Only four patients of the 93 skin tested (4.3%) were positive to latex. Atopy was not a predisposing factor for latex allergy and neither was the number of surgical interventions. No fruit allergy was found in this population and three of the four skin test-positive patients had facial angioedema when exposed to balloons. CONCLUSIONS: The very low incidence of latex allergy found in our patients with spina bifida could very well be due to a low level of rubber exposure as best exemplified in the use of nonlatex bladder catheters, frequently washed and resterilized surgeon's gloves, and low number of operations per patient. The fact that atopy was no more prevalent in children with spina bifida than in the general population in Venezuela strongly supports exposure level as the major factor determining latex sensitization.
Capriles-Hulett A; Sánchez-Borges M; Von-Scanzoni C; Medina JR
This paper aims to review current knowledge on risk factors leading to burn-out of general practitioners, who are particularly concerned by burn-out, as 50% of them are being more or less affected. This article is based on bibliographic research covering literature between 1975 and 2010, using PUB MED software, medical books and articles. 44 articles were selected as dealing well with the aspects of the burn-out reviewed here. It seems established that stress precedes burnout symptoms. Theories investigating relationships between stress and work are presented. Exogenic stress (load and organization of work, emotional interaction with the patient, constraints, lack of recognition, conflicts between private and professional life) interacts with endogenous stress (idealism, (too much) acute feeling of responsibility, mood disorder, difficulty in collaborating, character, personality). Burn-out symptoms would appear preferentially when these two stresses coexist. Despite the wealth of publications, there is still a lack of knowledge of the causes of burn-out, requiring therefore increased research efforts, in order to improve the implementation of preventive measures, beneficial to the doctors as well as to their patients.
Dagrada H; Verbanck P; Kornreich C
Full Text Available The aim of this study was to investigate the probable risk factors implicated in the aetiology ofCongenital Heart Disease (CHD) in Vellore population, India. CHD is now a most common cause of birthdefects. The burden of CHD in India is enormous due to very high birth rate. This emphasizes the importanceof this group of heart diseases. The cause of 90% of the CHDs is multifactorial, but little is known about theenvironmental risk factors. Thus a matched case control study was conducted in Vellore, India, aiming atinvestigating the risk factors responsible for the causation of CHDs. Descriptive statistics was reported as meanvalue and 95% Confidence Interval (CI). Chi-square (P²) test was used for testing the association between twovariables. Univariate analysis was performed followed by multivariate logistic regression analysis to providethe estimated effect of each risk factor. Thus Chi-square (P²) test showed that significant risk factors that areassociated with CHDs were maternal and paternal age at pregnancy, rural residence, birth order, birth weightof the individual, consanguineous marriages, family history of inherited disorder, maternal drug exposure,maternal illness, maternal infection, socio-economic status of the family. Logistic regression analysis revealedthat only maternal and paternal age at pregnancy, rural residence, birth order and birth weight of the individualwere only found significantly associated in the development of CHDs. This study emphasizes on theaugmenting pre-marital counselling and regular health counselling during pregnancy, extending healtheducation to women of childbearing age and need of occupational health system to monitor the residential areasfor risk of any environmental teratogen.
Anshula Tandon; Sonali Sengupta; Vinayak Shukla; Sumita Danda
Full Text Available Abstract Background The estimated gap in life expectancy (LE) between Indigenous and non-Indigenous Australians was 12 years for men and 10 years for women, whereas the Northern Territory Indigenous LE gap was at least 50% greater than the national figures. This study aims to explain the Indigenous LE gap by common modifiable risk factors. Methods This study covered the period from 1986 to 2005. Unit record death data from the Northern Territory were used to assess the differences in LE at birth between the Indigenous and non-Indigenous populations by socioeconomic disadvantage, smoking, alcohol abuse, obesity, pollution, and intimate partner violence. The population attributable fractions were applied to estimate the numbers of deaths associated with the selected risks. The standard life table and cause decomposition technique was used to examine the individual and joint effects on health inequality. Results The findings from this study indicate that among the selected risk factors, socioeconomic disadvantage was the leading health risk and accounted for one-third to one-half of the Indigenous LE gap. A combination of all six selected risks explained over 60% of the Indigenous LE gap. Conclusions Improving socioeconomic status, smoking cessation, and overweight reduction are critical to closing the Indigenous LE gap. This paper presents a useful way to explain the impact of risk factors of health inequalities, and suggests that reducing poverty should be placed squarely at the centre of the strategies to close the Indigenous LE gap.
Zhao Yuejen; Wright Jo; Begg Stephen; Guthridge Steven
The aim of the present study was to determine the prevalence of oral mucosal conditions and associated factors among 541 preschoolers of low socioeconomic status. A cross-sectional study was carried out. Sociodemographic data and information on harmful oral habits were gathered with the use of a questionnaire. A clinical exam was performed for the determination of oral mucosal conditions, dental caries and level of oral hygiene. Data analysis involved statistical analysis, the Kruskal-Wallis test, Mann-Whitney test, chi-square test, Fisher's exact test and multivariate regression (p < 0.05, 95 % CI). The prevalence of oral mucosal conditions was 40.7 %. The most prevalent oral mucosal conditions were coated tongue (23.4 %), melanotic macules (14.4 %), oral ulcers (11.8 %), Fordyce's spots (8.1 %), angular cheilitis (3.0 %), geographic tongue (2.8 %), linea alba (1.5 %) and fistula (1.3 %). Children between 3 and 5 years of age had a greater chance of exhibiting coated tongue (OR, 2.55; 95 % CI, 1.6-4.1), melanotic macules (OR, 4.07; 95 % CI, 2.3-7.2) and Fordyce's spots (OR, 12.70; 95 % CI, 7.2-28.6). The female gender had a greater chance of exhibiting melanotic macules (OR, 2.23; 95 % CI, 1.3-1.8). Coated tongue was more prevalent among children from low-income families (OR, 2.35; 95 % CI, 1.3-4.3) and those with inadequate oral hygiene (OR, 4.65; 95 % CI, 2.9-7.4). Caries constituted a predictive factor for oral ulcers (OR, 2.15; 95 % CI, 1.2-3.9) and fistula (OR, 12.00; 95 % CI, 1.4-11.3). Bruxism (teeth clenching/grinding) was a predictive factor for angular cheilitis (OR, 5.55; 95 % CI, 1.9-16.3). The determinant factors for oral mucosal conditions were the female gender, age between 3 and 5 years, inadequate oral hygiene, low household income, residence in rural areas and presence of dental caries and bruxism.
Vieira-Andrade RG; Martins-Júnior PA; Corrêa-Faria P; Stella PE; Marinho SA; Marques LS; Ramos-Jorge ML
Psoriasis is an autoimmune disease resulting in plaques of the skin. Similar to atherosclerosis, inflammation is integral to the initiation and propagation of plaque development. Mounting evidence has emerged demonstrating that psoriasis not only is associated with increased prevalence of cardiovascular risk factors, but also is an independent risk factor for the development of cardiovascular disease. Systemic therapies for moderate to severe psoriasis can increase the cardiovascular risk. Despite the evidence that psoriasis is an independent risk factor for cardiovascular disease, current guidelines only address managing traditional risk factors. An interdisciplinary approach is needed to find the necessary steps beyond classic risk reduction and detection of early cardiovascular disease in patients with psoriasis, as well as to develop a cardiovascular disease preventive regimen.
Coumbe AG; Pritzker MR; Duprez DA
Full Text Available Objective: to determine HIV presence and risk behaviors of persons of low socio-economic status in the city of PopayanColombia. Methods: Cross-sectional study; between 2008 and 2009, 363 participants of Popayan signed informed consent and received pre and post HIV test counseling. Socio-demographic characteristics and history of STDs, risk behaviors and previous HIV testing were assessed. Descriptive statistics, correlations and multivariate logistic regression were calculated Results: Mean age 33,5±10,2; 66%women.Frequency of HIV-positive patients was 3.86% (95% CI: 1.87-5.85), greater in men (7.38%; p=0,013). Greater frequency of HIV-positive patients was observed in people age 29-37, those without a stable partner, and those with history of risky alcohol consumption (more than five drinks in 2 hours) . Conclusions: HIV-positive patients frequency in this population was greater than national estimate for general population, aged 15-49 in Colombia, with even greater frequency in men. This study suggests that characteristics associated with low socioeconomic status, in economically active population, without a stable partner and with risky alcohol use, can potentially increase risk of HIV infection
Mueses, Hector Fabio; Pinzón, María Virginiaa; Tello, Inés Constanza; Rincón-Hoyos, Hernan Gilbertoa; Galindo, Jaime
Full Text Available To elucidate the socioeconomic factors influencing lead exposure in elementary school children by gender, 108 children (56 male, 52 female), aged 6–7 years, were randomly selected from 39 elementary state schools in Serpong, Banten, Indonesia. Their parents were interviewed to obtain information on sociodemographic characteristics. Their blood lead (BPb) levels were measured by atomic absorption spectrophotometry. BPb concentrations were significantly higher in males than in females, i.e., 6.8 ± 2.0 (2.9–12.5) µg/dL and 5.9 ± 1.9 (3.1–11.7) µg/dL, respectively (p < 0.05). Lower socioeconomic status and well water use were associated with increased BPb concentrations, especially in females. The proportion of well water use was related to lower socioeconomic status. Lower socioeconomic status linked with well water drinking seemed to be associated with increased lead exposure in children in Serpong. Their exposure levels possibly varied according to gender differences in behavior. An intervention should be instituted among children in Serpong with BPb concentrations of 10 µg/dL or above.
Dewi U. Iriani; Takehisa Matsukawa; Muhammad K. Tadjudin; Hiroaki Itoh; Kazuhito Yokoyama
To elucidate the socioeconomic factors influencing lead exposure in elementary school children by gender, 108 children (56 male, 52 female), aged 6-7 years, were randomly selected from 39 elementary state schools in Serpong, Banten, Indonesia. Their parents were interviewed to obtain information on sociodemographic characteristics. Their blood lead (BPb) levels were measured by atomic absorption spectrophotometry. BPb concentrations were significantly higher in males than in females, i.e., 6.8 ± 2.0 (2.9-12.5) µg/dL and 5.9 ± 1.9 (3.1-11.7) µg/dL, respectively (p < 0.05). Lower socioeconomic status and well water use were associated with increased BPb concentrations, especially in females. The proportion of well water use was related to lower socioeconomic status. Lower socioeconomic status linked with well water drinking seemed to be associated with increased lead exposure in children in Serpong. Their exposure levels possibly varied according to gender differences in behavior. An intervention should be instituted among children in Serpong with BPb concentrations of 10 µg/dL or above.
Iriani DU; Matsukawa T; Tadjudin MK; Itoh H; Yokoyama K
Data from 2,000 Norwegian 16-year-old ninth graders were used to study the importance of socioeconomic factors and sex differences in an educational system with mainstreaming, no ability grouping, little acceleration, and no retention in grade. Analysis illustrates how sex and socioeconomic differences may be mediated in an egalitarian society.…
Undheim, Johan Olav; Nordvik, Hilmar
OBJECTIVES: The prevalence of musculoskeletal pain in European countries varies considerably. We analyzed data from the fifth European Working Conditions Survey (EWCS) to explore the role of personal, occupational, and social risk factors in determining the national prevalence of musculoskeletal pain. METHODS: Over the course of 2010, 43 816 subjects from 34 countries were interviewed. We analyzed the one-year prevalence of back and neck/upper-limb pain. Individual-level risk factors studied included: sex; age; educational level; socioeconomic status; housework or cooking; gardening and repairs; somatizing tendency; job demand-control; six physical occupational exposures; and occupational group. Data on national socioeconomic variables were obtained from Eurostat and were available for 28 countries. We fitted Poisson regression models with random intercept by country. RESULTS: The main analysis comprised 35 550 workers. Among individual-level risk factors, somatizing tendency was the strongest predictor of the symptoms. Major differences were observed by country with back pain more than twice as common in Portugal (63.8%) than Ireland (25.7%), and prevalence rates of neck/upper-limb pain ranging from 26.6% in Ireland to 67.7% in Finland. Adjustment for individual-level risk factors slightly reduced the large variation in prevalence between countries. For back pain, the rates were more homogenous after adjustment for national socioeconomic variables. CONCLUSIONS: Our analysis indicates substantial variation between European countries in the prevalence of back and neck/upper-limb pain. This variation is unexplained by established individual risk factors. It may be attributable in part to socioeconomic differences between countries, with higher prevalence where there is less risk of poverty or social exclusion.
Farioli A; Mattioli S; Quaglieri A; Curti S; Violante FS; Coggon D
Within the last decades severe flooding events occurred in many parts of Europe. Especially in 2002, Upper Austria was seriously affected. Beside the natural variability of precipitation events the increase of losses is strongly connected with socio-economic developments. Especially the increase of settlement areas and the specific values of such modern settlement areas in flood prone areas induced this increase of losses. The presented case study was initiated to analyse different consequences of the currently observed socio-economic trend and further socio-economic projections within the watershed of the so-called Ottnanger Redl in Upper Austria, a watershed which was affected by the event in 2002. The temporal dimension of this change in damage potential is analysed for the 1990s, current conditions and future scenarios (Statistics Austria). Beside the socio-economic development the common structural vulnerability but also the positive effect of legislation and standards concerning flood-adapted constructions are considered. The hydrological-hydraulic is realized based on a scaled scenario approach. Therefore, documented precipitation events at rain gauges are considered for precipitation run-off simulations. To include further events the gauged events are scalled in their intensity. The hydrological loads of these scenarios are considered within different 2D hydraulic simulations; representation of past, current and future settlement structure. Based on the current settlement structure and its transfer in an asset value database, the past structure of the 1990s is reconstructed with remote sensing methods. The future structure (different pragmatic scenarios) in contrast is estimated on the basis of the current situation, socio-economic projections of Statistics Austria, land-use planes and local development concepts of the individual communities and in cooperation with the Regional Government of Upper Austria. The monetary evaluation is conducted with visualized verified building footprints, high resolved building characteristics on address level, building cross cubature analyses based on LiDAR data and monetary evaluation guidelines for different sectors and building functionalities of the Oberösterreichische Versicherung (regional insurance companies). Furthermore, this monetary evaluation approach is crosschecked with further approaches. First, to analyse the flood risk situation under past, current and future socio-economic situations for the different hydraulic loads without any measures to reduce current vulnerability, common flood vulnerability approaches (loss ratio) are considered. In a next step, the introduced legislation and standards in Upper Austria concerning flood adapted constructions is implemented within the applied vulnerability approaches. Thus, the effect of flood adapted construction measures as well as different settlement scenarios on the risk situation can be analysed. The stochastic nature of flood events is furthermore considered within a Monte-Carlo based evaluation routine. The results of the study show exemplarily the positive effect of object-based measures to reduce the susceptibility of the elements at risk and, furthermore, demonstrate the consequences of different settlement scenarios on the flood risk situation within the study area. As the project is still in progress, the contribution will introduce the general framework and highlight some first results.
Huttenlau, Matthias; Reiss, Julia; Achleitner, Stefan; Plörer, Manuel; Hofer, Michael; Weingraber, Felix
OBJECTIVES: To assess the impact of oral health on quality of life in elderly Brazilians and to evaluate its association with clinical oral health measures and socioeconomic and general health factors. DESIGN: Cross-sectional study. SETTING: Population-based cohort study on health, well-being, and aging. PARTICIPANTS: Eight hundred fifty-seven participants representing 588,384 community-dwelling elderly adults from the city of São Paulo, Brazil. MEASUREMENTS: Self-perceived impact of oral health on quality of life was measured using the Geriatric Oral Health Assessment Index (GOHAI), with scores categorized as good, moderate, or poor, indicating low, moderate, and high degrees of negative impact on quality of life, respectively. RESULTS: Nearly half of the individuals had good GOHAI scores (44.7% of overall sample, 45.9% of dentate participants, and 43.4% of edentulous participants). In the overall sample, those with poor self-rated general health and a need for dental prostheses were more likely to have poor and moderate GOHAI scores. Individuals with depression were significantly more likely to have poor GOHAI scores. No socioeconomic variables were related to the outcome, except self-perception of sufficient income, which was a protective factor against a poor GOHAI score in dentate participants. CONCLUSION: Moderate and high degrees of negative impact of oral health on quality of life were associated with general health and clinical oral health measures, independent of socioeconomic factors.
de Andrade FB; Lebrão ML; Santos JL; da Cruz Teixeira DS; de Oliveira Duarte YA
Background and Purpose Black/white disparities in stroke incidence are well-documented, but few studies have assessed the contributions to the disparity. Here we assess the contribution of “traditional” risk factors. Methods 25,714 black and white men and women, aged 45+ and stroke-free at baseline were followed for an average of 4.4 years to detect stroke. Mediation analysis employing proportional hazards analysis assessed the contribution of “traditional” risk factors to racial disparities. Results At age 45, incident stroke risk was 2.90 (95% CI: 1.72 – 4.89) times more likely in blacks than whites, and 1.66 (95% CI: 1.34 – 2.07) times at age 65. Adjustment for risk factors attenuated these excesses by 40% and 45%, respectively, resulting in relative risks of 2.14 (95% CI: 1.25 – 3.67) and 1.35 (95% CI: 1.08 – 1.71). Approximately one-half of this mediation is attributable to systolic blood pressure. Further adjustment for socioeconomic factors resulted in total mediation of 47% and 53% to relative risks of 2.01 (95% CI: 1.16 – 3.47) and 1.30 (1.03 – 1.65) respectively. Conclusions Between ages 45 to 65 years, approximately half of the racial disparity in stroke risk is attributable to traditional risk factors (primarily systolic blood pressure) and socioeconomic factors, suggesting a critical need to understand the disparity in the development of these traditional risk factors. Because half of the excess stroke risk in blacks is not attributable to traditional risk factors and socioeconomic factors, differential racial susceptibility to risk factors, residual confounding or non-traditional risk factors may also play a role.
Howard, George; Cushman, Mary; Kissela, Brett M.; Kleindorfer, Dawn O.; McClure, Leslie A.; Safford, Monika M.; Rhodes, J. David; Soliman, Elsayed Z.; Moy, Claudia S.; Judd, Suzanne E.; Howard, Virginia J.
Full Text Available Abstract Background Malaria is a leading cause of disease burden in Uganda, although surprisingly few contemporary, age-stratified data exist on malaria epidemiology in the country. This report presents results from a total population survey of malaria infection and intervention coverage in a rural area of eastern Uganda, with a specific focus on how risk factors differ between demographic groups in this population. Methods In 2008, a cross-sectional survey was conducted in four contiguous villages in Mulanda, sub-county in Tororo district, eastern Uganda, to investigate the epidemiology and risk factors of Plasmodium species infection. All permanent residents were invited to participate, with blood smears collected from 1,844 individuals aged between six months and 88 years (representing 78% of the population). Demographic, household and socio-economic characteristics were combined with environmental data using a Geographical Information System. Hierarchical models were used to explore patterns of malaria infection and identify individual, household and environmental risk factors. Results Overall, 709 individuals were infected with Plasmodium, with prevalence highest among 5-9 year olds (63.5%). Thin films from a random sample of 20% of parasite positive participants showed that 94.0% of infections were Plasmodium falciparum and 6.0% were P. malariae; no other species or mixed infections were seen. In total, 68% of households owned at least one mosquito although only 27% of school-aged children reported sleeping under a net the previous night. In multivariate analysis, infection risk was highest amongst children aged 5-9 years and remained high in older children. Risk of infection was lower for those that reported sleeping under a bed net the previous night and living more than 750 m from a rice-growing area. After accounting for clustering within compounds, there was no evidence for an association between infection prevalence and socio-economic status, and no evidence for spatial clustering. Conclusion These findings demonstrate that mosquito net usage remains inadequate and is strongly associated with risk of malaria among school-aged children. Infection risk amongst adults is influenced by proximity to potential mosquito breeding grounds. Taken together, these findings emphasize the importance of increasing net coverage, especially among school-aged children.
Pullan Rachel L; Bukirwa Hasifa; Staedke Sarah G; Snow Robert W; Brooker Simon
OBJECTIVE: To describe the influence of socioeconomic characteristics on the choice of the contraceptive method used among women in Spain in 2006. METHODS: This is a cross-sectional study of women aged 15-49 who reported the contraceptive method used during the first sexual intercourse (n = 3352) and during the 4 weeks prior to the interview (n = 2672). Data were analyzed taking into account women's socioeconomic characteristics. RESULTS: The mostly used method during the first sexual intercourse was the condom. Women from developing countries more frequently used the pill than native-born Spanish women. The condom was also the most commonly used method in the 4 weeks prior to the interview. The use of other contraceptive methods increased with age. Being older and having children were both associated with an increased use of permanent methods. CONCLUSIONS: The choice of a specific contraceptive method seems to be more strongly influenced by women's stage of life than by socioeconomic characteristics.
Ruiz-Muñoz D; Pérez G
Risk management is an important step in project success. It is the process of identifying, classifying, analysing and assessing of inherent risks in a project. Due to the nature of the construction projects which consists of many related and none-related operations, many risk factors will contribute...
The relationship between socioeconomic factors and mortality for lung cancer is investigated. To identify the proper lag time between socioeconomic factors and lung cancer mortality, a space-time hierarchical Bayesian model with time-dependent covariates is adopted. A real example on lung cancer mortality, males, in Tuscany (Italy) during the period 1971-1999, is provided. Results confirm the presence of an association between mortality for lung cancer and socioeconomic factors with a temporal lag (latency time) of at least 10 years. PMID:15724269
Dreassi, Emanuela; Biggeri, Annibale; Catelan, Dolores
The four risk factors controlling for the market, size, value, and momentum effect have become a state-of-the-art framework for various applications in financial markets research. However, previous work shows that these broadly recognized risk factors are country-specific. For these reasons, this pa...
Manuel Ammann; Michael Steiner
A study involving 64 Australian sex offenders and 33 non-sex offenders found childhood emotional abuse and family dysfunction, childhood behavior problems, and childhood sexual abuse were developmental risk factors for paraphilia. Emotional abuse and family dysfunction was found to be a risk factor for pedophilia, exhibitionism, rape, or multiple…
Lee, Joseph K. P.; Jackson, Henry J.; Pattison, Pip; Ward, Tony
The aim of this study was to analyze the prevalence of Toxocara spp. antibodies in children from two different socioeconomic classes in the Presidente Prudente municipality, São Paulo State, Brazil, and the protective and risk factors associated with toxocariasis. One hundred and twenty-six middle-class (MC) and 126 disadvantaged children (DC) were included in this study. Anti-Toxocara ELISA test was performed in order to evaluate seroprevalence. A survey was applied to the children's guardians/parents in order to analyze the protective and risk factors. The overall prevalence was 11.1%, and of 9.5% (12/126) and 12.7% (16/126) for MC and DC subgroups, respectively. Toxocara seropositivity was inversely proportional to the family income. A high household income was considered a protective factor for toxocariasis in the total population and in both MC and DC subgroups. Being a girl was considered a protective factor for the total population and for both subgroups. Whilst being an owner of cat was a risk factor for children belonging to the total and for both MC and DC subgroups, having dog was considered as a risk factor for only the MC. Epidemiologic protective/factor risks can be distinct depending on the strata of the same population. Thus, it is relevant to evaluate these factors independently for different socioeconomic classes in order to design future investigations and programs for preventing the infection of human beings by Toxocara spp. and other geohelminths.
Santarém VA; Leli FN; Rubinsky-Elefant G; Giuffrida R
INTRODUCTION: The aim of this review is to update and divulge the main constitutional risk factors involved in the etiopathology of prostate cancer. MATERIALS AND METHODS: Bibliographic review of the scientific literature on the constitutional risk factors associated with prostate cancer between 1985 and 2010, obtained from MedLine, CancerLit, Science Citation Index and Embase. The search profiles were Risk Factors, Genetic Factors, Genetic Polymorphisms, Genomics, Etiology, Epidemiology, Hormonal Factors, Endocrinology, Primary Prevention and Prostate Cancer. RESULTS: The principal constitutional risk factors are: age (before the age of 50 years at least 0.7% of these neoplasms are diagnosed and between 75-85% are diagnosed after the age of 65 years), ethnic-racial and geographic (African Americans present the highest incidence rates, and the lowest are found in South East Asia), genetic, family and hereditary (family syndromes cover 13-26% of all prostate cancers, of which 5% are of autosomal dominant inheritance), hormonal (it is a hormone-dependent tumour), anthropometric (obesity increases the risk), perinatal, arterial hypertension and type 2 diabetes. CONCLUSIONS: Constitutional risk factors play a very important role in the etiopathology of prostate cancer, especially age, ethnic-racial-geographic factors and genetic-family factors. We cannot know what percentage of these neoplasms are a result of constitutional factors, because our knowledge of these factors is currently lacking.
Ferrís-i-Tortajada J; García-i-Castell J; Berbel-Tornero O; Ortega-García JA
Full Text Available Abstract Background Traditional birth attendants (TBAs) are likely to deliver lower quality maternity care compared to professional health workers. It is important to characterize women who are assisted by TBAs in order to design interventions specific to such groups. We thus conducted a study to assess if socio-economic status and demographic factors are associated with having childbirth supervised by traditional birth attendants in Iraq. Methods Iraqi Multiple Indicator Cluster Survey (MICS) data for 2000 were used. We estimated frequencies and proportions of having been delivered by a traditional birth attendant and other social characteristics. Logistic regression analysis was used to assess the association between having been delivered by a TBA and wealth, area of residence (urban versus rural), parity, maternal education and age. Results Altogether 22,980 women participated in the survey, and of these women, 2873 had delivery information and whether they were assisted by traditional birth attendants (TBAs) or not during delivery. About 1 in 5 women (26.9%) had been assisted by TBAs. Compared to women of age 35 years or more, women of age 25–34 years were 22% (AOR = 1.22, 95%CI [1.08, 1.39]) more likely to be assisted by TBAs during delivery. Women who had no formal education were 42% (AOR = 1.42, 95%CI [1.22, 1.65]) more likely to be delivered by TBAs compared to those who had attained secondary or higher level of education. Women in the poorest wealth quintile were 2.52 (AOR = 2.52, 95%CI [2.14, 2.98]) more likely to be delivered by TBAs compared to those in the richest quintile. Compared to women who had 7 or more children, those who had 1 or 2 were 28% (AOR = 0.72, 95%CI [0.59, 0.87]) less likely to be delivered by TBAs. Conclusion Findings from this study indicate that having delivery supervised by traditional birth attendants was associated with young maternal age, low education, and being poor. Meanwhile women having 1 or 2 children were less likely to be delivered by TBAs. These factors should be considered in the design of interventions to reduce the rate of deliveries assisted by TBAs in favour of professional midwives, and consequently reduce maternal and neonatal mortality rates and other adverse events.
Siziya Seter; Muula Adamson S; Rudatsikira Emmanuel
AIM: To investigate the association between life-style and socioeconomic factors and coping strategies in a community sample in Iran. METHOD: As part of a community-based study called Isfahan Healthy Heart Program, we studied 17593 individuals older than 19 living in the central part of Iran. Demographic and socioeconomic factors (age, sex, occupation status, marital status, and educational level) and lifestyle variables (smoking status, leisure time physical activity, and psychological distress), and coping strategy were recorded. Data were analyzed by Pearson correlation and multiple linear regression. RESULTS: Not smoking (women beta=-11.293, P<0.001; men beta=-3.418, P=0.007), having leisure time physical activity (women beta=0.017, P=0.046; men beta=0.005, P=0.043), and higher educational level (women beta=0.344, P=0.015; men beta=0.406, P=0.008) were predictors of adaptive coping strategies, while smoking (women beta=11.849, P<0.001; men beta=9.336, P<0.001), high stress level (women beta=1.588, P=0.000; men beta=1.358, P<0.001), and lower educational level (women beta=-0.443, P=0.013; men beta=-0.427, P=0.013) were predictors of maladaptive coping strategies in both sexes. Non-manual work was a positive predictor of adaptive (beta=4.983, P<0.001) and negative predictor of maladaptive (beta=-3.355, P=0.023) coping skills in men. CONCLUSION: Coping strategies of the population in central Iran were highly influenced by socioeconomic status and life-style factors. Programs aimed at improving healthy life-styles and increasing the socioeconomic status could increase adaptive coping skills and decrease maladaptive ones and consequently lead to a more healthy society.
Roohafza H; Sadeghi M; Shirani S; Bahonar A; Mackie M; Sarafzadegan N
Full Text Available Abstract Background Malaria is endemic in the Rajasthali region of the Chittagong Hill Tracts in Bangladesh and the Rajasthali region is the most endemic area of Bangladesh. Quantifying the role of environmental and socio-economic factors in the local spatial patterns of malaria endemicity can contribute to successful malaria control and elimination. This study aimed to investigate the role of environmental factors on malaria risk in Rajasthali and to quantify the geographical clustering in malaria risk unaccounted by these factors. Method A total of 4,200 (78.9%; N = 5,322) households were targeted in Rajasthali in July, 2009, and 1,400 individuals were screened using a rapid diagnostic test (Falci-vax). These data were linked to environmental and socio-economic data in a geographical information system. To describe the association between environmental factors and malaria risk, a generalized linear mixed model approach was utilized. The study investigated the role of environmental factors on malaria risk by calculating their population-attributable fractions (PAF), and used residual semivariograms to quantify the geographical clustering in malaria risk unaccounted by these factors. Results Overall malaria prevalence was 11.7%. Out of 5,322 households, 44.12% households were living in areas with malaria prevalence of ? 10%. The results from statistical analysis showed that age, ethnicity, proximity to forest, household density, and elevation were significantly and positively correlated with the malaria risk and PAF estimation. The highest PAF of malaria prevalence was 47.7% for third tertile (n = 467) of forest cover, 17.6% for second tertile (n = 467) of forest cover and 19.9% for household density >1,000. Conclusion Targeting of malaria health interventions at small spatial scales in Bangladesh should consider the social and socio-economic risk factors identified as well as alternative methods for improving equity of access to interventions across whole communities.
Haque Ubydul; Soares Magalhães Ricardo J; Mitra Dipak; Kolivras Korine N; Schmidt Wolf-Peter; Haque Rashidul; Glass Gregory E
OBJECTIVES: We examined effects of socio-economic status (SES) factors on diet quality and fruits and vegetables intake among US adults and effect modification by nutrition knowledge and beliefs. METHODS: We used national cross-sectional data (Continuing Survey of Food Intake by Individuals) on 4356 US adults, aged 20-65 years, collected in 1994-1996. Socio-economic factors considered were education and poverty income ratio. Nutrition knowledge and belief score was measured by principal components analysis of 11 question responses. We considered three binary and two continuous outcomes related to United States Department of Agriculture recommended intake of fruits and vegetables and overall diet quality through Healthy Eating Index and alternate Mediterranean Diet Score. RESULTS: Multivariate analyses indicated that better SES independently improved likelihood of adequate fruits and vegetables intake and overall diet quality. In several cases, nutrition knowledge and beliefs acted as an effect modifier. In particular, education showed no association with diet quality among subjects in the lowest nutrition knowledge and belief tertile, while the association was consistently stronger in the highest tertile (Education x Nutrition knowledge and beliefs interaction term P<0.10 for Healthy Eating Index and both fruits and vegetables guidelines). A similar interaction was noted for poverty income ratio. CONCLUSION: For improvement in overall diet quality, socio-economic interventions must be coupled with health education programs targeting all segments of the US population.
Beydoun MA; Wang Y
BACKGROUND: Taking into account our rapidly ageing population, older people are of particular interest in studying health inequalities. Most studies of older persons only include measures of current socioeconomic status (SES) and do not take into account data from earlier stages of life. In addition, only classic SES measures are used, while alternative measures, such as car ownership and house ownership, might equally well predict health. The present study aims to examine the effect of midlife socioeconomic factors on mobility limitation and depressed mood three decades later. METHODS: Data were from 4,809 men and women aged 33-65 years who participated in the Reykjavik Study (1967-1992) and who were re-examined in old age in the Age, Gene/Environment Susceptibility (AGES) -Reykjavik Study (2002-2006). RESULTS: Education and occupation predicted mobility limitation and depressed mood. Independently, home and car ownership and the availability of housing features predicted mobility limitation. Shortages of food in childhood and lack of a car in midlife predicted depressed mood. CONCLUSION: Socioeconomic factors from midlife and from childhood affect mobility limitation and depressed mood in old age. Prevention of health problems in old age should begin as early as midlife.
Groffen DA; Koster A; Bosma H; van den Akker M; Aspelund T; Siggeirsdóttir K; Kempen GI; van Eijk JT; Eiriksdottir G; Jónsson PV; Launer LJ; Gudnason V; Harris TB
OBJECTIVES: To determine the prevalence of overweight and obesity and their effects on cardiometabolic risk factors in a representative sample of urban population in Eastern India. MATERIALS AND METHODS: A population-based survey was conducted among a randomly selected study population aged 20-80 years in an urban population of Berhampur city of Eastern India. Both anthropometric and biochemical information were collected, in addition to detailed information on classical cardiometabolic risk factors. Both descriptive and inferential statistical analyses were performed. Obesity and overweight were defined based on the revised Asian-Pacific population criteria (Body mass index [BMI] ?25 kg/m(2) and ?23 kg/m(2), respectively). RESULTS: The age-standardized rates of obesity and overweight are 36.8% (Males: 33.2%; Females: 40.8%) and 17.6%, (Males: 20.4%; Females: 15.1%) respectively, i.e., over half are either obese or overweight in this study population. Compared to the World Health Organization (WHO) standard cutoff criteria of overweight [BMI ?25 kg/m(2)] and obesity [BMI >30 kg/m(2)], the cardiometabolic risk factors studied showed a significant incremental rise even with the lower cutoffs of the revised Asia-Pacific criteria. Older age, female gender, family history of diabetes, being hypertensive, hypertriglyceridemia, hypercholesterolemia, physical inactivity and middle to higher socioeconomic status significantly contributed to increased obesity risk among this urban population. CONCLUSION: One-third of the urban populations are obese in Eastern India - an underestimate compared to the standard BMI cutoff criteria. Nevertheless, significant associations of the classical cardiometabolic risk factors with obesity were observed using the revised Asia-Pacific criteria clearly indicating a more aggressive cardiovascular prevention strategy for Asian Indians.
Prasad DS; Kabir Z; Dash AK; Das BC
BACKGROUND: Patients with borderline personality disorder (BPD) show a high prevalence of early adversity, such as childhood trauma. It has also been reported that prenatal adverse conditions, such as prenatal maternal stress, drug taking, tobacco smoking or medical complications, may be associated with an increased risk of mental disorders in the offspring. Prenatal adversity is investigated here for the first time as a potential risk factor in the diagnosis of BPD. Method A total of 100 patients with a DSM-IV diagnosis of BPD and 100 matched healthy controls underwent semi-structured interviews about the course of pregnancy, maternal stressors, birth complications and childhood trauma. Further information was obtained from the participants' mothers and from prenatal medical records. RESULTS: Borderline patients were significantly more often exposed to adverse intrauterine conditions, such as prenatal tobacco exposure (p=0.004), medical complications (p=0.008), prenatal maternal traumatic stress (p=0.015), familial conflicts (p=0.004), low social support (p=0.004) and partnership problems during pregnancy (p=0.014). Logistic regression analyses revealed that the reported prenatal risk factors accounted for 25.7% of the variance in BPD. Prenatal tobacco exposure [odds ratio (OR) 3.37, 95% confidence interval (CI) 1.49-7.65, p=0.004] and medical complications (OR 2.87, 95% CI 1.29-6.38, p=0.010) emerged as important predictors. After controlling for childhood adversity and parental socio-economic status (SES), prenatal risk factors predicted relevant borderline subdomains, such as impulsivity, affective instability, identity disturbance, dissociation and severity of borderline symptoms. CONCLUSIONS: This study provides evidence of an association between prenatal adversity and the diagnosis of BPD. Our findings suggest that prenatal adversity may constitute a potential risk factor in the pathogenesis of BPD.
Schwarze CE; Mobascher A; Pallasch B; Hoppe G; Kurz M; Hellhammer DH; Lieb K
The purpose of the present prospective study was to compare different risk factors in head injuries with one known risk factor, the level of consciousness at admission. The series includes 1,120 head-injured patients admitted to hospitals in Trøndelag, Norway, in 1979 and 1980. In addition to the level of consciousness at admission, the following factors seemed to be important for the outcome: age, pupillary light reactions, intracranial haematomata, associated extracranial injuries and skull fracture.
Relación entre el Nivel Socioeconómico y Hábitos de Vida, con el Fibrinógeno y el Factor von Willebrand en Venezolanos Sanos y con Cardiopatía Isquémica/ Relation between Socioeconomic Levels and Life Style with Fibrinogen and von Willebrand Factor in Venezuela.
Full Text Available Abstract in spanish Estudios epidemiológicos en Europa, EEUU y Japón, han revelado una relación inversa entre la concentración de fibrinógeno y del factor von Willebrand con el nivel socioeconómico. En este trabajo se presentan los resultados de la relación entre el fibrinógeno y el factor von Willebrand con el nivel socioeconómico, los hábitos tabáquicos, alcohólicos, actividad física y la edad, en una población venezolana aparentemente sana de 978 hombres y 968 mujeres (grupo (more) control), y en 172 hombres y 78 mujeres con Enfermedad Cardiovascular Isquémica. Se consideró factor de riesgo comportamiento para niveles altos de fibrinógeno y factor von Willebrand, la presencia de uno o más de los siguientes hábitos: ser fumador o ex-fumador de menos de 5 años, no ingerir alcohol o ingerirlo en exceso, y el tener una actividad física muy limitada. En los controles, la edad tuvo un efecto significativo y positivo sobre las dos variables hemostáticas, en ambos sexos. En relación al efecto del nivel socioeconómico, se observó una tendencia en ambas variables de mostrar las concentraciones más altas en los niveles más bajos, sólo significativa en las mujeres. En cambio, el factor de riesgo comportamiento no tuvo un efecto significativo sobre ninguna de las dos variables. En los pacientes, la edad no tuvo efecto sobre ninguna de las variables, el factor de riesgo comportamiento tuvo un efecto significativo positivo sólo sobre el fibrinógeno de los hombres, y el nivel socioeconómico sólo tuvo efectos significativos en la concentración de fibrinógeno de las mujeres: valores altos en niveles socioeconómicos bajos. Se recomienda continuar con estos estudios para entender mejor la relación entre el nivel socioeconómico, las variables hemostáticas y la incidencia de Enfermedad Cardiovascular Isquémica. Abstract in english Previous studies in Europe, USA and Japan have revealed an inverse relationship between socioeconomic levels and fibrinogen concentration. Similar results have been reported in a smaller number of studies for concentrations of von Willebrand factor. In this opportunity we present results on the relationship between smoking, drinking, physical activity, age and socioeconomic level on fibrinogen and von Willebrand factor concentrations in a Venezuelan sample. The Control po (more) pulation consisted of 978 men and 968 women. Patients with Coronary Heart Disease were 172 males and 78 females. The presence of one or more of the following conditions: smoking or less than 5 years of having quit, non drinkers or drinking in excess, and a reduced physical activity, was considered a health related risk factor for high levels of these two haemostatic variables. Our results indicate that in Controls, the socioeconomic level had a significant effect on fibrinogen and von Willebrand factor levels, only in women: those of lower socioeconomic levels had the highest concentrations. This difference was maintained when age was taken into account. Health related behaviors had no significant effect on either variable. In Patients, age had no effect on either variable. The health behavior risk factor had a significant effect only on fibrinogen of male patients, and socioeconomic level had a significant effect only on the fibrinogen of female patients. More studies in Venezuela are recommended, in order to increase our knowledge on the relationship between socioeconomic levels, haemostatic markers and the occurrence of Coronary Heart Disease.
Rodríguez-Larralde, Álvaro; Mijares, Mercedes E; Nagy, Elena; Espinosa, Raul; Ryde, Elena; Diez-Ewald, María P.; Torres, Enrique; Coll-Sangrona, Enriqueta; Rodríguez- Roa, Elsy; Carvajal, Zoila; Lundberg, Ulf; Campos, Gilberto; Gi, Amparo; Arocha-Piñango, Carmen L; en nombre del Grupo FRICVE
Relación entre el Nivel Socioeconómico y Hábitos de Vida, con el Fibrinógeno y el Factor von Willebrand en Venezolanos Sanos y con Cardiopatía Isquémica Relation between Socioeconomic Levels and Life Style with Fibrinogen and von Willebrand Factor in Venezuela.
Full Text Available Estudios epidemiológicos en Europa, EEUU y Japón, han revelado una relación inversa entre la concentración de fibrinógeno y del factor von Willebrand con el nivel socioeconómico. En este trabajo se presentan los resultados de la relación entre el fibrinógeno y el factor von Willebrand con el nivel socioeconómico, los hábitos tabáquicos, alcohólicos, actividad física y la edad, en una población venezolana aparentemente sana de 978 hombres y 968 mujeres (grupo control), y en 172 hombres y 78 mujeres con Enfermedad Cardiovascular Isquémica. Se consideró factor de riesgo comportamiento para niveles altos de fibrinógeno y factor von Willebrand, la presencia de uno o más de los siguientes hábitos: ser fumador o ex-fumador de menos de 5 años, no ingerir alcohol o ingerirlo en exceso, y el tener una actividad física muy limitada. En los controles, la edad tuvo un efecto significativo y positivo sobre las dos variables hemostáticas, en ambos sexos. En relación al efecto del nivel socioeconómico, se observó una tendencia en ambas variables de mostrar las concentraciones más altas en los niveles más bajos, sólo significativa en las mujeres. En cambio, el factor de riesgo comportamiento no tuvo un efecto significativo sobre ninguna de las dos variables. En los pacientes, la edad no tuvo efecto sobre ninguna de las variables, el factor de riesgo comportamiento tuvo un efecto significativo positivo sólo sobre el fibrinógeno de los hombres, y el nivel socioeconómico sólo tuvo efectos significativos en la concentración de fibrinógeno de las mujeres: valores altos en niveles socioeconómicos bajos. Se recomienda continuar con estos estudios para entender mejor la relación entre el nivel socioeconómico, las variables hemostáticas y la incidencia de Enfermedad Cardiovascular Isquémica.Previous studies in Europe, USA and Japan have revealed an inverse relationship between socioeconomic levels and fibrinogen concentration. Similar results have been reported in a smaller number of studies for concentrations of von Willebrand factor. In this opportunity we present results on the relationship between smoking, drinking, physical activity, age and socioeconomic level on fibrinogen and von Willebrand factor concentrations in a Venezuelan sample. The Control population consisted of 978 men and 968 women. Patients with Coronary Heart Disease were 172 males and 78 females. The presence of one or more of the following conditions: smoking or less than 5 years of having quit, non drinkers or drinking in excess, and a reduced physical activity, was considered a health related risk factor for high levels of these two haemostatic variables. Our results indicate that in Controls, the socioeconomic level had a significant effect on fibrinogen and von Willebrand factor levels, only in women: those of lower socioeconomic levels had the highest concentrations. This difference was maintained when age was taken into account. Health related behaviors had no significant effect on either variable. In Patients, age had no effect on either variable. The health behavior risk factor had a significant effect only on fibrinogen of male patients, and socioeconomic level had a significant effect only on the fibrinogen of female patients. More studies in Venezuela are recommended, in order to increase our knowledge on the relationship between socioeconomic levels, haemostatic markers and the occurrence of Coronary Heart Disease.
Álvaro Rodríguez-Larralde; Mercedes E Mijares; Elena Nagy; Raul Espinosa; Elena Ryde; María P. Diez-Ewald; Enrique Torres; Enriqueta Coll-Sangrona; Elsy Rodríguez- Roa; Zoila Carvajal; Ulf Lundberg; Gilberto Campos; Amparo Gi; Carmen L Arocha-Piñango
Full Text Available OBJECTIVE: The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women. METHODS: This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth > 4 mm and an attachment loss > 3 mm at the same site in four or more teeth. A logistic regression analysis was also performed. RESULTS: The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque. CONCLUSION: The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.
Maria Dilma Bezerra de Vasconcellos Piscoya; Ricardo Arraes de Alencar Ximenes; Genivaldo Moura da Silva; Sílvia Regina Jamelli; Sonia Bechara Coutinho
Full Text Available Abstract in english OBJECTIVE: The main objective of this study was to investigate the risk factors associated with p