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Phillips KM, Bergmark RW, Hoehle LP, Shu ET, Caradonna DS, Gray ST, Sedaghat AR. Differential perception and tolerance of chronic rhinosinusitis symptoms as a confounder of gender‐disparate disease burden. Int Forum Allergy Rhinol 2019; 9:1119-1124. [DOI: 10.1002/alr.22390] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/23/2019] [Accepted: 07/04/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Katie M. Phillips
- Department of OtolaryngologyHarvard Medical School Boston MA
- Department of OtolaryngologyMassachusetts Eye and Ear Infirmary Boston MA
| | - Regan W. Bergmark
- Department of OtolaryngologyHarvard Medical School Boston MA
- Division of Otolaryngology‒Head and Neck SurgeryBrigham and Women's Hospital and Dana Farber Cancer Institute Boston MA
| | | | - Edina T. Shu
- Department of OtolaryngologyHarvard Medical School Boston MA
- Department of OtolaryngologyMassachusetts Eye and Ear Infirmary Boston MA
| | - David S. Caradonna
- Department of OtolaryngologyHarvard Medical School Boston MA
- Division of OtolaryngologyBeth Israel Deaconess Medical Center Boston MA
| | - Stacey T. Gray
- Department of OtolaryngologyHarvard Medical School Boston MA
- Department of OtolaryngologyMassachusetts Eye and Ear Infirmary Boston MA
| | - Ahmad R. Sedaghat
- Department of Otolaryngology‒Head & Neck SurgeryUniversity of Cincinnati College of Medicine Cincinnati OH
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Acosta-Reyes J, Navarro-Lechuga E, Benitez JC, Bravo E, Goenaga E, Galindo JI, Walteros-Acero DM. Health-Related Quality of Life of an adult population sample in Barranquilla, Colombia. Rev Salud Publica (Bogota) 2019; 21:70-76. [PMID: 33206929 DOI: 10.15446/rsap.v21n1.77725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/30/2018] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this study was to estimate values of health-related quality of life (HRQOL) by focusing on the physical and mental health of an adult population sample in the city of Barranquilla, Colombia.Materials and Methods Cross-sectional study with 368 adults representing an adult population. The questionnaires included the health-related quality of life “CDC-Healthy Days”, the Zung Self-Rating Depression Scale, and the Overall Disability Sum Score. The prevalence of fair or poor health status (FPH), frequent physical distress (FPD), frequent mental distress (FMD), and frequent activity limitation (FAL) was estimated according to socio-demographic characteristics, presence of depression, and physical disability.Results The mean age of 368 adults was 45.6 ± 18.3 years; 55.7% were males. Only 21% of this population considered their general health to be fair or poor. The prevalence of FPH, FPD, FMD and FAL was higher in women than in men, and increased with greater severity of depression and higher physical disability. Moreover, 12% of the population presented with mild depression, 3.8% with moderate depression, and less than 1% with severe depression. 94% of this population did not have an arms or legs disability.Discussion This study provides HRQOL values for an adult sample of the population of Barranquilla, Colombia. Overall, the HRQOL of this population, with subtle differences, is similar to other reports from Colombia. In general, women and people with depression and physical disabilities had a worse quality of life.
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Affiliation(s)
- Jorge Acosta-Reyes
- JA: MD. M.Sc Clinical Epidemiology. Department of Public Health, Universidad del Norte. Barranquilla, Colombia.
| | - Edgar Navarro-Lechuga
- EN: MD. M.Sc Epidemiology. Department of Public Health, Universidad del Norte. Barranquilla, Colombia.
| | - Juan C Benitez
- JCB: Psicología, M.Sc Epidemiology. Universidad del Norte. Barranquilla, Colombia.
| | - Elsa Bravo
- EB: Bacteriology, Epidemiology Specialist. Secretaría de Salud de Barranquilla. Barranquilla, Colombia.
| | - Eloina Goenaga
- EG: MD. M.Sc Epidemiology. Secretaría de Salud de Barranquilla. Barranquilla, Colombia.
| | - José I Galindo
- JIG: Dentistry. M.Sc Epidemiology, Ph. D. Epidemiology and Public Health Interventions Network TEPHINET, Institute for Global Health. Georgia, USA.
| | - Diana M Walteros-Acero
- DW: MD. M.Sc Epidemiology. Field Epidemiology Training Program (FETP). Instituto Nacional de Salud. Bogotá, Colombia.
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Acosta-Reyes J, Navarro Lechuga E, Benitez JC, Bravo E, Goenaga E, Galindo JI, Walteros-Acero DM. Health-Related Quality of Life of an adult population sample in Barranquilla, Colombia. Rev Salud Publica (Bogota) 2018. [DOI: 10.15446/rsap.v20n6.77725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective The aim of this study was to estimate values of health-related quality of life (HRQOL) by focusing on the physical and mental health of an adult population sample in the city of Barranquilla, Colombia.Materials and methods Cross-sectional study with 368 adults representing an adult population. The questionnaires included the health-related quality of life “CDC-Healthy Days”, the Zung Self-Rating Depression Scale, and the Overall Disability Sum Score. The prevalence of fair or poor health status (FPH), frequent physical distress (FPD), frequent mental distress (FMD), and frequent activity limitation (FAL) was estimated according to socio-demographic characteristics, presence of depression, and physical disability.Results The mean age of 368 adults was 45.6 ± 18.3 years; 55.7% were males. Only 21% of this population considered their general health to be fair or poor. The prevalence of FPH, FPD, FMD and FAL was higher in women than in men, and increased with greater severity of depression and higher physical disability. Moreover, 12% of the population presented with mild depression, 3.8% with moderate depression, and less than 1% with severe depression. 94% of this population did not have an arms or legs disability.Discussion This study provides HRQOL values for an adult sample of the population of Barranquilla, Colombia. Overall, the HRQOL of this population, with subtle differences, is similar to other reports from Colombia. In general, women and people with depression and physical disabilities had a worse quality of life.
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Kastor A, Shrestha KP. Reassessing the gender differences in type and place of health care utilisation in India: does the gender gap no longer exist? J Public Health (Oxf) 2018; 26:361-371. [DOI: 10.1007/s10389-017-0862-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Elovainio M, Hakulinen C, Pulkki-Råback L, Juonala M, Raitakari OT. A network approach to the analysis of psychosocial risk factors and their association with health. J Health Psychol 2018; 25:1587-1600. [PMID: 29607696 DOI: 10.1177/1359105318765624] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We modeled early psychosocial risks as a network of interconnected variables to study their associations with later depressive symptoms and cardiometabolic outcomes. The participants were a nationally representative sample of 2580 men and women aged 3-18 years in 1980. Their parents reported the psychosocial risks in 1980, including the following: (1) child-specific life events, (2) parental health behavior, (3) parental socioeconomic status, and (4) parental psychological problems. Adulthood depressive symptoms and cardiometabolic outcomes were measured in 2007-2012. The most central risks (most number of connections to other risks) were socioeconomic risks that also predicted health outcomes more consistently than others.
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Affiliation(s)
- Marko Elovainio
- University of Helsinki, Finland.,The National Institute for Health and Welfare, Finland
| | - Christian Hakulinen
- University of Helsinki, Finland.,The National Institute for Health and Welfare, Finland
| | | | - Markus Juonala
- University of Turku, Finland.,Turku University Hospital, Finland
| | - Olli T Raitakari
- University of Turku, Finland.,Turku University Hospital, Finland
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Volken T, Wieber F, Rüesch P, Huber M, Crawford RJ. Temporal change to self-rated health in the Swiss population from 1997 to 2012: the roles of age, gender, and education. Public Health 2017; 150:152-165. [PMID: 28802181 DOI: 10.1016/j.puhe.2017.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/19/2017] [Accepted: 07/07/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Our study aimed to describe the temporal changes in self-rated health status (SRH) from 1997 to 2012 in adults aged 25 to 84 residing in Switzerland, with a view to identifying groups at risk for declining health. STUDY DESIGN Secondary analysis of population-based cross-sectional health surveys. METHODS Data were collected from the cross-sectional, population-based, five-year Swiss Health Survey, from 1997, 2002, 2007 and 2012. A total of 63,861 individuals' data were included. Multilevel mixed-effect logistic regression analysis was employed to estimate the probability of very good and good health within the framework of a hierarchical cross-classified age-period-cohort model (HAPC), adjusting for education level, gender, civil status, smoking status and body mass index. RESULTS Individuals with higher education were substantially more likely than those with primary education to report good SRH (OR = 2.12; 95% CI = 1.93-2.33 for secondary education and OR = 3.79; 95% CI = 3.39-4.23 for tertiary education). The education effect depended on birth cohort and age: higher proportions of good SRH were reported by secondary (8%-17%) and tertiary (10%-22%) compared with primary educated individuals from the 1940 birth cohort onward; the proportion of secondary/tertiary (compared to primary) educated people reporting good SRH increased with age (by 10/11% at 45-50 years and 25/36% at 80-84 years). Gender health equality was achieved by the 1955 (primary educated) and 1960 (secondary educated) birth cohorts, while these women overtook men in reporting good SRH from the 1975 birth cohort onward. Tertiary educated younger women were significantly less likely to report good SRH than men but parity was achieved at around pension age. Similarly, gender inequality in those with primary and secondary education reduced in the younger ages to not be significant at around age 55, with women overtaking men from age 65. CONCLUSIONS Younger birth cohorts with lower education levels appear most vulnerable in terms of their SRH. The education effect cumulatively increases when attaining incrementally higher education levels. While women report lower health than men, gender inequality in SRH has declined and even reversed over time and is substantially linked to differences in educational status. Swiss public health strategies should particularly target the younger adults with only primary school education of both genders; for women, to combat health burdens in their early life, and men, to mitigate issues in their later life.
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Affiliation(s)
- T Volken
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland.
| | - F Wieber
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland; Department of Psychology, University of Konstanz, Konstanz, Germany
| | - P Rüesch
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - M Huber
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - R J Crawford
- Institue for Health Sciences, Zurich University of Applied Sciences, Winterthur, Switzerland; Faculty of Health Professions, Curtin University, Perth, Australia
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Ormond G, Murphy R. An investigation into the effect of alcohol consumption on health status and health care utilization in Ireland. Alcohol 2017; 59:53-67. [PMID: 28262187 DOI: 10.1016/j.alcohol.2017.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 11/25/2022]
Abstract
This paper presents a study of the effect of alcohol consumption on individual health status and health care utilization in Ireland using the 2007 Slán National Health and Lifestyle Survey, while accounting for the endogenous relationship between alcohol and health. Drinkers are categorized as those who never drank, non-drinkers, moderate drinkers, or heavy drinkers, based on national recommended weekly drinking levels in Ireland. The drinking-status equation is estimated using an ordered probit model. Predicted values for the inverse mills ratio are generated, which are then included in the health and health-care utilization equations. Differences in health status for each category of drinker are examined, and the relationship between both alcohol consumption and health with a host of other personal and socio-economic variables is also identified. Given that the measure of health status available is self-assessed, the effect of alcohol consumption on health-care utilization is also analyzed as an alternative measure of health. Findings show that in Ireland, moderate drinkers enjoy the best health status. More moderate drinkers report having very good or excellent health compared with heavy drinkers, non-drinkers, or those who never drank. While heavy drinkers do not report having as good a health status as moderate drinkers, they are better off in terms of health when compared with non-drinkers and those who are lifetime abstainers.
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Abstract
The role of social norms in accounting for the different attitudes of men and women with respect to health is still an open issue. In this research, we investigate the role of social norms associated with specific gender environments in the workplace in accounting for differences in health-reporting behaviours across men and women. Using the 2010 European Working Conditions Survey, we build a database containing 30,124 observations. We first replicate the standard result that women report worse health than men, whatever the health outcome we consider. We then proxy social norms by the gender structure of the workplace environment and study how the latter affects self-reported health for men and women separately. Our findings indicate that individuals in workplaces where women are a majority tend to report worse health than individuals employed in male-dominated work environments, be they men or women. These results are robust to controlling for a large array of working condition indicators, which allows us to rule out that the poorer health status reported by individuals working in female-dominated environments could be due to worse job quality. This evidence suggests that social norms associated with specific gender environments play an important role in explaining differences in health-reporting behaviours across gender, at least in the workplace.
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Affiliation(s)
- Eve Caroli
- PSL, University Paris Dauphine, LEDa-LEGOS, Paris School of Economics and IZA, France.
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Abstract
Women have a life-expectancy advantage over men, but a marked disadvantage with regards to morbidity. This is known as the female–male health-survival paradox in disciplines such as medicine, medical sociology, and epidemiology. Individual differences in physical and mental health are further notably explained by the degree of stress individuals endure, with women being more affected by stressors than men. Here, we briefly examine the literature on women’s disadvantage in health and stress. Beyond biological considerations, we follow with socio-cognitive explanations of gender differences in health and stress. We show that gender roles and traits (masculinity in particular) explain part of the gender differences in stress, notably cognitive appraisal and coping. Stress in turn degrades health. Implications are discussed. In conclusion, traditional socialization is advantageous for men in terms of health.
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Affiliation(s)
- Eric Mayor
- Institut de Psychologie du Travail et des Organisations, Université de Neuchâtel , Neuchâtel, Switzerland
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Abstract
Objective: This research examined gender differences in self-rated health (SRH) using the differential exposure and differential vulnerability explanations of gender differences in health. Method: Trajectories of SRH were estimated using data that spanned 12 years (1992-2004) from the Health and Retirement Study. Results: There was no gender difference in SRH at baseline, but SRH declined faster for males over time. Factors that mediated the gender difference included changes in employment status, smoking behavior, and the onset of health conditions. Moreover, were it not for gender differences in various structural and health status factors, females would have better SRH at baseline and over time. Discussion: Our results differ from previous research, which often shows a female disadvantage that is reduced or disappears at older ages. Furthermore, gender differences in the predictors of SRH (exposure) contribute more to understanding gender differences in SRH than different responses to the predictors (vulnerability).
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Affiliation(s)
- Leah S. Rohlfsen
- Department of Sociology, St. Lawrence University, Canton, NY, USA
| | - Jennie Jacobs Kronenfeld
- Sociology Program, Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA
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Brown BT, Bonello R, Fernandez-Caamano R, Eaton S, Graham PL, Green H. Consumer characteristics and perceptions of chiropractic and chiropractic services in Australia: results from a cross-sectional survey. J Manipulative Physiol Ther 2014; 37:219-29. [PMID: 24679644 DOI: 10.1016/j.jmpt.2014.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 01/08/2014] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to describe patient characteristics and summarize their perceptions of chiropractic in Australia. METHODS This study is part of a broader study aiming to extend the knowledge of the role of chiropractic within the current health care environment. A 33-item, paper-based, cross-sectional survey of a sample of patients from 100 systematically sampled chiropractic clinics from all the states and territories of Australia was conducted. The survey focused on patient demographics, socioeconomic status, perceived health status, and perceptions of chiropractic and chiropractic services. RESULTS A total of 486 responses were received (24.3% response rate). Respondents were predominantly female patients (67.1%) of the 45- to 64-year age group. Approximately half of the respondents reported a pretax annual income exceeding $40000. Most patients sought chiropractic services because of musculoskeletal disorders (68.7%) and for general health (21.2%), and personal beliefs motivated most respondents (70.2%) to visit a chiropractor. Most respondents would seek the chiropractic services again (97.5%) and were satisfied with the service received. CONCLUSIONS The results of this study show that the typical chiropractic patient in Australia is a middle-aged woman with a moderate to high income. Although only a small proportion of the Australian population sees a chiropractor, this group seems to be satisfied with the service.
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Affiliation(s)
- Benjamin T Brown
- Associate Lecturer, Department of Chiropractic, Macquarie University, North Ryde, New South Wales, Australia..
| | - Rod Bonello
- Associate Professor, School of Health Professions, Murdoch University, Murdoch, Western Australia, Australia
| | - Ramon Fernandez-Caamano
- Senior Lecturer, Department of Chiropractic, Macquarie University, North Ryde, New South Wales, Australia
| | - Sharyn Eaton
- Senior Lecturer, Department of Chiropractic, Macquarie University, North Ryde, New South Wales, Australia
| | - Petra L Graham
- Senior Lecturer, Department of Statistics, Macquarie University, North Ryde, New South Wales, Australia
| | - Hilary Green
- Lecturer, Department of Statistics, Macquarie University, North Ryde, New South Wales, Australia
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Rohlfsen LS, Kronenfeld JJ. Gender Differences in Functional Health: Latent Curve Analysis Assessing Differential Exposure. J Gerontol B Psychol Sci Soc Sci 2014; 69:590-602. [DOI: 10.1093/geronb/gbu021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perelman J, Fernandes A, Mateus C. Gender disparities in health and healthcare: results from the Portuguese National Health Interview Survey. CAD SAUDE PUBLICA 2013; 28:2339-48. [PMID: 23288066 DOI: 10.1590/s0102-311x2012001400012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 08/17/2012] [Indexed: 11/21/2022] Open
Abstract
Although women experience poorer health conditions during their lives, they live longer than men. The main explanations for this paradox suggest that women's excess of ill-health is limited to minor illnesses and their different attitudes toward health. The authors test these assumptions by investigating disparities between men and women in health and healthcare in Portugal. Data are used from the Portuguese National Health Interview Survey 2005/2006 (N = 33,662). Multivariate regressions showed that women were more likely to report worse self-rated health, more days with disability, higher prevalence of hypertension, chronic pain, cancer, anxiety and depression, and more medical consultations. Heart disease was significantly more prevalent among men, possibly explaining part of the paradox. Women's more frequent use of medical consultations may reflect their heightened awareness of health problems, which may protect them against early death. Gender differences in socioeconomic status explain part of the differences in health, but fail to provide a complete understanding.
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Affiliation(s)
- Julian Perelman
- Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Lisboa, Portugal.
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Ahlsen B, Bondevik H, Mengshoel AM, Solbrække KN. (Un)doing gender in a rehabilitation context: a narrative analysis of gender and self in stories of chronic muscle pain. Disabil Rehabil 2013; 36:359-66. [DOI: 10.3109/09638288.2013.793750] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Pandey A, Ladusingh L. Socioeconomic Correlates of Gender Differential in Poor Health Status Among Older Adults in India. J Appl Gerontol 2013; 34:879-905. [PMID: 24652876 DOI: 10.1177/0733464813481850] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 02/10/2013] [Indexed: 11/17/2022] Open
Abstract
Assessment of the health status of the older adults can go a long way in controlling the disease burden and monitoring the path to healthy aging in India. In the absence of a population-based clinical survey to collect data on morbidities and other health conditions through biomarkers, self-rated health by nationally representative older population is used for understanding factors contributing to the gender differential in health status. Socioeconomic status is the most important factor explaining 59% of the gender gap in self-assessed health among older adults. The vulnerability of older women in terms of educational attainment, occupational status, and economic dependency is responsible for the higher level of poor self-assessed health. The gender gap in self-assessed poor health among older Indian adults, which perpetuates over the life course resulting in severe health disadvantages at old age can be reduced considerably through social empowerment and gender sensitive public policies.
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Affiliation(s)
- Anamika Pandey
- International Institute for Population Sciences, Deonar, Mumbai, India
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Avitsur R, Maayan R, Weizman A. Neonatal stress modulates sickness behavior: role for proinflammatory cytokines. J Neuroimmunol 2013; 257:59-66. [PMID: 23489747 DOI: 10.1016/j.jneuroim.2013.02.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/22/2013] [Accepted: 02/14/2013] [Indexed: 11/30/2022]
Abstract
Neonatal stress increased the duration and augmented symptoms of sickness behavior induced by influenza virus infection or endotoxin challenge in mice. Since proinflammatory cytokines were implicated in sickness behavior, the present study sought to determine the effect of neonatal stress on cytokines-induced sickness behavior and on proinflammatory cytokine secretion. Data indicate that separation of mouse pups from the dams at an early age (maternal separation, MSP) increased the duration and augmented some of the symptoms of sickness behavior induced by proinflammatory cytokines. In addition, MSP partially suppressed cytokine and corticosterone secretion in response to endotoxin administration. These data may suggest that MSP increased sensitivity to the effects of proinflammatory cytokines on sickness behavior following an immune challenge.
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Affiliation(s)
- Ronit Avitsur
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Yaffo, Israel.
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Abstract
Objectives We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care. Methods We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population. Results Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24). Conclusions Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed.
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Affiliation(s)
- Changgyo Yoon
- Preventive Medicine Program, Graduate School of Public Health, Seoul National University, Seoul, Korea
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Chun H, Cho SI, Khang YH, Kang M, Kim IH. Trends in gender-based health inequality in a transitional society: a historical analysis of South Korea. J Prev Med Public Health 2012; 45:113-21. [PMID: 22509452 PMCID: PMC3324714 DOI: 10.3961/jpmph.2012.45.2.113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 02/09/2012] [Indexed: 11/18/2022] Open
Abstract
Objectives This study examined the trends in gender disparity in the self-rated health of people aged 25 to 64 in South Korea, a rapidly changing society, with specific attention to socio-structural inequality. Methods Representative sample data were obtained from six successive, nationwide Social Statistics Surveys of the Korean National Statistical Office performed during 1992 to 2010. Results The results showed a convergent trend in poor self-rated health between genders since 1992, with a sharper decline in gender disparity observed in younger adults (aged 25 to 44) than in older adults (aged 45 to 64). The diminishing gender gap seemed to be attributable to an increase in women's educational attainment levels and to their higher status in the labor market. Conclusions The study indicated the importance of equitable social opportunities for both genders for understanding the historical trends in the gender gap in the self-reported health data from South Korea.
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Affiliation(s)
- Heeran Chun
- Department of Public Administration, Ewha Womans University, Seoul, Korea
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GLAESMER HEIDE, BRÄHLER ELMAR, MARTIN ALEXANDRA, MEWES RICARDA, RIEF WINFRIED. Gender Differences in Healthcare Utilization: The Mediating Effect of Utilization Propensity. Journal of Applied Social Psychology 2011. [DOI: 10.1111/j.1559-1816.2011.00888.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Quail JM, Wolfson C, Lippman A. Unmet need and psychological distress predict emergency department visits in community-dwelling elderly women: a prospective cohort study. BMC Geriatr 2011; 11:86. [PMID: 22182515 PMCID: PMC3297513 DOI: 10.1186/1471-2318-11-86] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Accepted: 12/19/2011] [Indexed: 12/03/2022] Open
Abstract
Background Unmet need to perform activities of daily living (ADL) is associated with increased use of urgent health services by the elderly. However, the reported associations may be confounded by psychological distress. We examine the independent effects of unmet need and psychological distress upon emergency department (ED) visits. Methods We conducted a prospective study of randomly selected community-dwelling adults aged ≥ 75. We report here the results for women only (n = 530). In-person interviews collected data on self-reported unmet need and the 14-item l'Indice de détresse psychologique de Santé Québec psychological distress scale. ED visits were identified from an administrative database. Multivariable logistic regression was used to identify predictors of any ED visit in the 6 months following the baseline interview. Results In multivariable analysis, unmet need in instrumental ADL was associated with subsequent ED visits (odds ratio = 1.57, 95% confidence interval = 1.02-2.41), as was psychological distress (odds rate = 1.30, 95% confidence interval = 1.02-1.67). The magnitude of the association between unmet need and ED visits was overestimated in statistical models that did not adjust for psychological distress. Conclusions Both unmet need and psychological distress were independent predictors of ED visits. Future investigations of unmet need and health services utilization should include psychological distress to control for confounding and improve the internal validity of statistical models.
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Affiliation(s)
- Jacqueline M Quail
- Department of Epidemiology and Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
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Malmusi D, Artazcoz L, Benach J, Borrell C. Perception or real illness? How chronic conditions contribute to gender inequalities in self-rated health. Eur J Public Health 2011; 22:781-6. [DOI: 10.1093/eurpub/ckr184] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Quail JM, Wolfson C, Lippman A. Unmet Need for Assistance to Perform Activities of Daily Living and Psychological Distress in Community-Dwelling Elderly Women. Can J Aging 2011; 30:591-602. [DOI: 10.1017/s0714980811000493] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
RÉSUMÉDe plus en plus, les aînés vivant dans les communautés ont besoin d’une assistance physique pour les activités de la vie quotidienne (AVQ). L’association de ce besoin, que ce soit atteint ou non satisfaits, avec la détresse psychologique est inconnue. Nous avons mené une étude prospective des cohortes sur des résidents vivant dans les communautés âgées de 75 ans et plus à Montreal, au Canada. Nous rapportons les résultats pour les femmes seulement (n = 530). On a utilisé une régression lineaire multivariable pour examiner l’association entre les besoins satisfaits et ceux qui restent insatisfaits dans les activités déterminantes de la vie quotidienne (ADVQ) et les activités personnelles de la vie quotidienne (APVQ) et la détresse psychologique concomitante. Alors que les besoins ADVQ non satisfaits ont été associés à une détresse psychologique élevée, [β = 0.19 (95% CI: 0.06, 0.33)], comme cela a été avec les besoins ADVQ satisfaits [β = 0.42 (95% CI: 0.26, 0.60)], les besoins APVQ satisfaits et non satisfaits ne l’étaient pas. Le modèle complet explique 32,8 pour cent de la variance totale de la détresse psychologique. Recevoir de l’aide pour répondre aux besoins ADVQ est associé à une détresse psychologique élevée. Ne pas recevoir d’aide, cependant, est associé à une détresse encore plus élevée.
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Sekine M, Tatsuse T, Kagamimori S, Chandola T, Cable N, Marmot M, Martikainen P, Lallukka T, Rahkonen O, Lahelma E. Sex inequalities in physical and mental functioning of British, Finnish, and Japanese civil servants: role of job demand, control and work hours. Soc Sci Med 2011; 73:595-603. [PMID: 21782303 DOI: 10.1016/j.socscimed.2011.06.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Revised: 01/25/2011] [Accepted: 06/10/2011] [Indexed: 10/18/2022]
Abstract
In general, women report more physical and mental symptoms than men. International comparisons of countries with different welfare state regimes may provide further understanding of the social determinants of sex inequalities in health. This study aims to evaluate (1) whether there are sex inequalities in health functioning as measured by the Short Form 36 (SF-36), and (2) whether work characteristics contribute to the sex inequalities in health among employees from Britain, Finland, and Japan, representing liberal, social democratic, and conservative welfare state regimes, respectively. The participants were 7340 (5122 men and 2218 women) British employees, 2297 (1638 men and 659 women) Japanese employees, and 8164 (1649 men and 6515 women) Finnish employees. All the participants were civil servants aged 40-60 years. We found that more women than men tended to have disadvantaged work characteristics (i.e. low employment grade, low job control, high job demands, and long work hours) but such sex differences were relatively smaller among employees from Finland, where more gender equal policies exist than Britain and Japan. The age-adjusted odds ratio (OR) of women for poor physical functioning was the largest for British women (OR = 2.08), followed by for Japanese women (OR = 1.72), and then for Finnish women (OR = 1.51). The age-adjusted OR of women for poor mental functioning was the largest for Japanese women (OR = 1.91), followed by for British women (OR = 1.45), and then for Finnish women (OR = 1.07). Thus, sex differences in physical and mental health was the smallest in the Finnish population. The larger the sex differences in work characteristics, the larger the sex differences in health and the reduction in the sex differences in health after adjustment for work characteristics. These results suggest that egalitarian and gender equal policies may contribute to smaller sex differences in health, through smaller differences in disadvantaged work characteristics between men and women.
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Affiliation(s)
- Michikazu Sekine
- Department of Welfare Promotion and Epidemiology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan.
| | - Takashi Tatsuse
- Department of Welfare Promotion and Epidemiology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan
| | - Sadanobu Kagamimori
- Department of Welfare Promotion and Epidemiology, University of Toyama, Graduate School of Medicine and Pharmaceutical Sciences, 2630 Sugitani, Toyama 930-0194, Japan
| | - Tarani Chandola
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Michael Marmot
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
| | - Pekka Martikainen
- Department of Sociology, Population Research Unit, University of Helsinki, P.O. Box 18, FIN-00014 Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland
| | - Eero Lahelma
- Department of Public Health, University of Helsinki, P.O. Box 41, FIN-00014 Helsinki, Finland
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Avitsur R, Mays JW, Sheridan JF. Sex differences in the response to influenza virus infection: modulation by stress. Horm Behav 2011; 59:257-64. [PMID: 21167165 PMCID: PMC3040247 DOI: 10.1016/j.yhbeh.2010.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 12/06/2010] [Accepted: 12/07/2010] [Indexed: 10/18/2022]
Abstract
Influenza virus infection is a significant public health problem; however factors affecting the incidence and severity of disease have not been fully elucidated. The present study sought to examine the role of sex and stress in mediating susceptibility to an influenza viral infection in mice. Male and female mice underwent repeated cycles of restraint (RST) stress, followed by an influenza A/PR8 virus infection. Following these manipulations, levels of circulating corticosterone, lung proinflammatory cytokine gene expression and sickness behavior were examined. The data indicate sex differences in several aspects of the response to the A/PR8 virus infection. The kinetics of lung interleukin-1β mRNA expression were faster in infected males compared to females, while circulating corticosterone levels were elevated in infected females, but not in males. Anorexia and reduced saccharin consumption began earlier and symptoms were more pronounced in infected males than in females. In addition, RST modulated the response to the A/PR8 virus infection. Proinflammatory cytokine gene expression in response to infection was enhanced and sickness behavior was modulated by RST in both males and females. These data suggest that males mount more vigorous immune and behavioral responses to influenza viral infection compared to females, and stress exacerbates the response in both males and females. In conclusion, complex interactions between biological and behavioral factors are involved in mediating individual differences in health and disease. Additional studies may help uncover some of the factors contributing to the individual differences in susceptibility to influenza infection.
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Affiliation(s)
- Ronit Avitsur
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel.
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Suen YT. Do older women or older men report worse health? Questioning the ‘sicker’ older women assumption through a period and cohort analysis. Soc Theory Health 2011; 9:71-86. [DOI: 10.1057/sth.2010.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kokkonen M, Kinnunen T, Pulkkinen L. Direct and Indirect Effects of Adolescent Self-Control of Emotions and Behavioral Expression on Adult Health Outcomes. Psychol Health 2010. [DOI: 10.1080/08870440290025849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kyobutungi C, Egondi T, Ezeh A. The health and well-being of older people in Nairobi's slums. Glob Health Action 2010; 3. [PMID: 20959873 PMCID: PMC2957141 DOI: 10.3402/gha.v3i0.2138] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 06/27/2010] [Accepted: 07/08/2010] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Globally, it is estimated that people aged 60 and over constitute more than 11% of the population, with the corresponding proportion in developing countries being 8%. Rapid urbanisation in sub-Saharan Africa (SSA), fuelled in part by rural-urban migration and a devastating HIV/AIDS epidemic, has altered the status of older people in many SSA societies. Few studies have, however, looked at the health of older people in SSA. This study aims to describe the health and well-being of older people in two Nairobi slums. METHODS Data were collected from residents of the areas covered by the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) aged 50 years and over by 1 October 2006. Health status was assessed using the short SAGE (Study on Global AGEing and Adult Health) form. Mean WHO Quality of Life (WHOQoL) and a composite health score were computed and binary variables generated using the median as the cut-off. Logistic regression was used to determine factors associated with poor quality of life (QoL) and poor health status. RESULTS Out of 2,696 older people resident in the NUHDSS surveillance area during the study period, data were collected on 2,072. The majority of respondents were male, aged 50-60 years. The mean WHOQoL score was 71.3 (SD 6.7) and mean composite health score was 70.6 (SD 13.9). Males had significantly better QoL and health status than females and older respondents had worse outcomes than younger ones. Sex, age, education level and marital status were significantly associated with QoL, while slum of residence was significantly associated with health status. CONCLUSION The study adds to the literature on health and well-being of older people in SSA, especially those in urban informal settlements. Further studies are needed to validate the methods used for assessing health status and to provide comparisons from other settings. Health and Demographic Surveillance Systems have the potential to conduct such studies and to evaluate health and well-being over time.
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Abstract
Self-rated health (SRH) is a multidimensional measure, predictive of morbidity and mortality. Comparative studies of determinants, however, are rare due to a lack of comparable cross-national data. This paper contributes towards filling in this gap, using data for persons aged 50 or higher in 11 European countries from the SHARE study (2004). The analysis aims at identifying key elements composing SRH using multinomial logistic regression models. In addition, the homogeneity of associations across populations is assessed. The findings indicate that education, depression, chronic conditions, mobility difficulties, somatic symptoms and levels of physical activity constitute important components of SRH; ADLs and obesity, on the other hand, are not significant and IADLs are important only in a few countries. All these associations point to the expected direction and are homogeneous across countries. However, demographic factors, age and gender, though significant in many countries have divergent associations. Effects of smoking also differentiate between southern and northern Europe.
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Affiliation(s)
- Georgia Verropoulou
- Department of Statistics and Insurance Science, University of Piraeus, 80, Karaoli & Dimitriou Str, Piraeus, 185 34 Athens Greece
- Centre for Longitudinal Studies, Institute of Education, University of London, London, UK
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Rueda S, Artazcoz L. Gender inequality in health among elderly people in a combined framework of socioeconomic position, family characteristics and social support. Ageing and Society 2009; 29:625-47. [DOI: 10.1017/s0144686x08008349] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTThis study analyses gender inequalities in health among elderly people in Catalonia (Spain) by adopting a conceptual framework that globally considers three dimensions of health determinants: socio-economic position, family characteristics and social support. Data came from the 2006Catalonian Health Survey. For the purposes of this study a sub-sample of people aged 65–85 years with no paid job was selected (1,113 men and 1,484 women). The health outcomes analysed were self-perceived health status, poor mental health status and long-standing limiting illness. Multiple logistic regression models separated by sex were fitted and a hierarchical model was fitted in three steps. Health status among elderly women was poorer than among the men for the three outcomes analysed. Whereas living with disabled people was positively related to the three health outcomes and confidant social support was negatively associated with all of them in both sexes, there were gender differences in other social determinants of health. Our results emphasise the importance of using an integrated approach for the analysis of health inequalities among elderly people, simultaneously considering socio-economic position, family characteristics and social support, as well as different health indicators, in order fully to understand the social determinants of the health status of older men and women.
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Gerritsen AAM, Devillé WL. Gender differences in health and health care utilisation in various ethnic groups in the Netherlands: a cross-sectional study. BMC Public Health 2009; 9:109. [PMID: 19379499 PMCID: PMC2678118 DOI: 10.1186/1471-2458-9-109] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2008] [Accepted: 04/20/2009] [Indexed: 11/25/2022] Open
Abstract
Background To determine gender differences in health and health care utilisation within and between various ethnic groups in the Netherlands. Methods Data from the second Dutch National Survey of General Practice (2000–2002) were used. A total of 7,789 persons from the indigenous population and 1,512 persons from the four largest migrant groups in the Netherlands – Morocco, Netherlands Antilles, Turkey and Surinam – aged 18 years and older were interviewed. Self-reported health outcomes studied were general health status and the presence of acute (past 14 days) and chronic conditions (past 12 months). And self-reported utilisation of the following health care services was analysed: having contacted a general practitioner (past 2 months), a medical specialist, physiotherapist or ambulatory mental health service (past 12 months), hospitalisation (past 12 months) and use of medication (past 14 days). Gender differences in these outcomes were examined within and between the ethnic groups, using logistic regression analyses. Results In general, women showed poorer health than men; the largest differences were found for the Turkish respondents, followed by Moroccans, and Surinamese. Furthermore, women from Morocco and the Netherlands Antilles more often contacted a general practitioner than men from these countries. Women from Turkey were more hospitalised than Turkish men. Women from Morocco more often contacted ambulatory mental health care than men from this country, and women with an indigenous background more often used over the counter medication than men with an indigenous background. Conclusion In general the self-reported health of women is worse compared to that of men, although the size of the gender differences may vary according to the particular health outcome and among the ethnic groups. This information might be helpful to develop policy to improve the health status of specific groups according to gender and ethnicity. In addition, in some ethnic groups, and for some types of health care services, the use by women is higher compared to that by men. More research is needed to explain these differences.
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Alves LC, Leite IDC, Machado CJ. [Health profile of the elderly in Brazil: analysis of the 2003 National Household Sample Survey using the Grade of Membership method]. CAD SAUDE PUBLICA 2009; 24:535-46. [PMID: 18327441 DOI: 10.1590/s0102-311x2008000300007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 09/24/2007] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to identify functional disability and health profiles of the elderly in Brazil, as well as their prevalence rates, based on the National Household Sample Survey for 2003. The sample size was 33,786 elderly individuals. Grade of Membership was used to define the profiles: "healthy elderly" (Profile 1), whose pure types had a lower probability of disability and chronic illness; "elderly with mild functional disability" (Profile 2), whose pure types had mainly hypertension and lower back problems and were independent in activities of daily living, although with high difficulty in mobility; and "elderly with severe disability" (Profile 3), with higher probability of chronic illness, high difficulty with activities of daily living, and high dependency in terms of mobility. In conclusion, the profiles indicate that a consistent approach to functional disability is essential for promoting the health of the elderly.
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Affiliation(s)
- Luciana Correia Alves
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
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Jeon GS, Jang SN, Rhee SJ. The Impact of Socioeconomic Factors on the Gender Differences of Disability and Subjective Health Among Elderly Koreans. J Prev Med Public Health 2009; 42:199-207. [DOI: 10.3961/jpmph.2009.42.3.199] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Gyeong-Suk Jeon
- Department of Nursing, Division of Health Science, Dongseo University, Korea
| | - Soong-Nang Jang
- Institute of Health and Environment, Seoul National University, Korea
- Department of Society, Human Development and Health, Harvard School of Public Health, U.S.A
| | - Seon-Ja Rhee
- Graduate School of Public Health, Seoul National University, Korea
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Abstract
OBJECTIVES This study examines the association between participation in leisure activities and mortality risk among older men and women. METHODS A representative sample of 1,246 men and women ages 65 to 95, interviewed in 1991-1992, were followed for 12 years. Cox regressions analyzed mortality risk. RESULTS Participating in only a few activities doubled mortality risk compared to those with the highest participation levels, even after controlling for age, education, walking ability, and other health indicators. Women had a dose-response relationship between overall participation and survival. Strong associations with survival were found for engagement in organizational activities and study circles among women and hobby activities and gardening among men. DISCUSSION Results suggest gender differences in the association between leisure activities and mortality. Women display a decreasing mortality risk for each additional activity. Social activities have the strongest effects on survival among women, whereas men seem to benefit from solitary activities.
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Affiliation(s)
- Neda Agahi
- Aging Research Center, Karolinska Institutet/Stockholm University, Gävlegatan 16, 113 30 Stockholm, Sweden.
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Quesnel-Vallée A, Luchenski S, Lynch J. Differences between women's and men's socioeconomic inequalities in health: longitudinal analysis of the Canadian population, 1994-2003. J Epidemiol Community Health 2008; 62:1036-44. [PMID: 19008368 PMCID: PMC3765154 DOI: 10.1136/jech.2007.068908] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Socioeconomic inequalities in health are ubiquitous in developed countries; however, whether these inequalities differ between women and men over time is less clear. OBJECTIVE To estimate the potentially different health effects of changes in socioeconomic position (SEP) on changes in health for working-age women and men over a 10-year period. Three main questions were addressed: (1) are there health differences between women and men over time, (2) do changes in SEP lead to health inequalities and (3) do changes in SEP impact health differently for women and men? METHODS Generalised estimating equations models were used to analyse cycles 1-5 of the Canadian National Population Health Survey for four measures of health, number of chronic conditions, self-rated health, functional health and mental distress, and three measures of SEP, income, education and employment status. RESULTS Health inequalities by sex/gender and by changes in SEP were present for all four outcomes in age-adjusted models; however, after controlling for time-dependent social structure, behaviour, and psychosocial factors the relationships persisted only for chronic conditions and psychological distress. There was no evidence that these effects differed, over time, between women and men. CONCLUSIONS Men and women in this nationally representative sample of Canadians do not differentially embody changes in SEP, although both sex/gender and changes in SEP independently impact health.
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Affiliation(s)
- Amélie Quesnel-Vallée
- Department of Sociology, Department of Epidemiology, Biostatistics and Occupational Health, McGill University
| | - Serena Luchenski
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
| | - John Lynch
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
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Chun H, Khang YH, Kim IH, Cho SI. Explaining gender differences in ill-health in South Korea: the roles of socio-structural, psychosocial, and behavioral factors. Soc Sci Med 2008; 67:988-1001. [PMID: 18632197 DOI: 10.1016/j.socscimed.2008.05.034] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2006] [Indexed: 10/21/2022]
Abstract
This study examines and explains the gender disparity in health despite rapid modernization in South Korea where the social structure is still based on traditional gender relations. A nationally representative sample of 2897 men and 3286 women aged 25-64 from the 2001 Korean National Health and Nutrition Examination Survey was analyzed. Health indicators included self rated health and chronic disease. Age-adjusted prevalence was computed according to a gender and odds ratios (OR) derived from logistic regression. Percentage changes in OR by inclusion of determinant variables (socio-structural, psychosocial, and behavioral) into the base logistic regression model were used to estimate the contributions to the gender gap in two morbidity measures. Results showed a substantial female excess in ill-health in both measures, revealing an increasing disparity in the older age group. Group-specific age-adjusted prevalence of ill-health showed an inverse relationship to socioeconomic position. When adjusting for each determinant, employment status, education, and depression contributed the greatest to the gender gap. After adjusting for all suggested determinants, 78% for self rated health and 86% for chronic disease in excess OR could be explained. After stratifying for age, the full model provided a complete explanation for the female excess in chronic illness, but for self rated health a female excess was still evident for the younger age group. Socio-structural factors played a crucial role in accounting for female excess in ill-health. This result calls for greater attention to gender-based health inequality stemming from socio-structural determinants in South Korea. Cross-cultural validation studies are suggested for further discussion of the link between changing gender relations and the gender health gap in morbidity in diverse settings.
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Affiliation(s)
- Heeran Chun
- Institute of Population and Aging Research, Hanyang University, Seoul, Korea.
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Artazcoz L, Borrell C, Cortès I, Escribà-Agüir V, Cascant L. Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research. J Epidemiol Community Health 2008; 61 Suppl 2:ii39-45. [PMID: 18000116 DOI: 10.1136/jech.2007.059774] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To provide a framework for epidemiological research on work and health that combines classic occupational epidemiology and the consideration of work in a structural perspective focused on gender inequalities in health. METHODS Gaps and limitations in classic occupational epidemiology, when considered from a gender perspective, are described. Limitations in research on work related gender inequalities in health are identified. Finally, some recommendations for future research are proposed. RESULTS Classic occupational epidemiology has paid less attention to women's problems than men's. Research into work related gender inequalities in health has rarely considered either social class or the impact of family demands on men's health. In addition, it has rarely taken into account the potential interactions between gender, social class, employment status and family roles and the differences in social determinants of health according to the health indicator analysed. CONCLUSIONS Occupational epidemiology should consider the role of sex and gender in examining exposures and associated health problems. Variables should be used that capture the specific work environments and health conditions of both sexes. The analysis of work and health from a gender perspective should take into account the complex interactions between gender, family roles, employment status and social class.
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Affiliation(s)
- Lucía Artazcoz
- Agància de Salut Pública de Barcelona, Pl Lesseps 1, 08023 Barcelona, Spain.
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Abstract
BACKGROUND Several studies have demonstrated that women with nonobstructive coronary disease have a high rate of subsequent investigations, rehospitalizations for recurrent chest pain, and repeat coronary angiography. The sex specificity of this finding is unclear. We therefore undertook an evaluation of sex differences in rehospitalization for acute coronary syndrome (ACS) or chest pain in patients with "angiographically normal" coronaries. METHODS A retrospective cohort study using prospectively collected angiographic and clinical data on all patients in British Columbia, Canada, presenting for their first cardiac catheterization with suspected ischemic heart disease but angiographically normal coronaries. RESULTS Among 32,856 patients, 7.1% of men versus 23.3% of women were angiographically normal (P < .001). Among angiographically normal patients, women were older and more likely to present with hypertension, prior stroke, chronic obstructive pulmonary disease, and peripheral vascular disease than men, but Canadian Cardiovascular Society class of angina did not vary by sex. Within 1 year, 1.0% died, (19 women, 18 men, P = .27) and 0.6% had a stroke (13 women, 9 men, P = .91). Readmission to hospital for ACS or chest pain requiring catheterization was significantly higher in women compared to men (adjusted OR 4.06; 95% CI 1.15-14.31). CONCLUSIONS In a contemporary, population-based cohort presenting for cardiac catheterization for suspected ischemia, women with angiographically normal coronaries were >4 times more likely to be readmitted to hospital for ACS/chest pain within 180 days compared to men. The observed sex difference has important social and economic implications and suggests that traditional diagnostic methods may not be optimal for women.
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Affiliation(s)
- Karin H Humphries
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada.
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Salonna F, Middel B, Sleskova M, Madarasova Geckova A, Reijneveld SA, Groothoff JW, van Dijk JP. Deterioration is not the only prospect for adolescents' health: improvement in self-reported health status among boys and girls from age 15 to age 19. Croat Med J 2008; 49:66-74. [PMID: 18293459 PMCID: PMC2269253 DOI: 10.3325/cmj.2008.1.66] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Accepted: 11/16/2007] [Indexed: 11/05/2022] Open
Abstract
AIM To assess changes in the mental and physical health of adolescents between the ages of 15 and 19. METHODS The study included a four-year follow-up of 844 students from 31 secondary schools located in Kosice, Slovakia (response rate 45.6%). The 36-item short form (SF-36) scales were used to assess vitality and mental health, self-rated health, long-term well-being, long-standing illness, and the number of perceived health complaints at the age of 15 and four years later. RESULTS Both boys and girls reported significant deterioration in vitality (mean difference boys 5.3; girls 3.3; P=0.001) and mental health (mean difference boys 7.7; girls 5.7; P=0.001), while only boys reported deterioration in self-rated health (P=0.047). The proportion of boys who reported an improvement ranged from 8%-40%, while the proportion of girls who reported an improvement ranged from 8%-45%. Significantly more girls than boys reported an improvement in mental health (27% of boys vs 34% of girls) and vitality (32% of boys vs 39% of girls), while more boys than girls reported a deterioration in vitality(55% of boys vs 48% of girls)). These differences were trivial according to the effect size (Cohen's H<0.20). CONCLUSION Although significant deterioration in mental health and vitality was detected among both genders, with boys deteriorating more substantially in self-rated health than girls, the differences between the proportion of those with improved and those with deteriorated status were trivial in size.
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Affiliation(s)
- Ferdinand Salonna
- Department of Educational Psychology and Health Psychology, Košice Institute for Society and Health, Faculty of Arts, P.J. Safarik University, Košice, Slovakia
| | - Berrie Middel
- Department of Social Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Maria Sleskova
- Department of Educational Psychology and Health Psychology, Košice Institute for Society and Health, Faculty of Arts, P.J. Safarik University, Košice, Slovakia
| | - Andrea Madarasova Geckova
- Department of Educational Psychology and Health Psychology, Košice Institute for Society and Health, Faculty of Arts, P.J. Safarik University, Košice, Slovakia
| | - Sijmen A. Reijneveld
- Department of Social Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Johan W. Groothoff
- Department of Social Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Jitse P. van Dijk
- Department of Educational Psychology and Health Psychology, Košice Institute for Society and Health, Faculty of Arts, P.J. Safarik University, Košice, Slovakia
- Department of Social Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
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Abstract
PURPOSE To investigate mental health in Iranian adolescents, particularly in high school students from urban areas. METHOD A sample of 4599 girls and boys was selected from third year classes from high schools in Tehran by a stratified cluster random sampling method. They were investigated by means of the 12-item General Health Questionnaire (GHQ-12) in a cross-sectional study. Following the recommendations of Goldberg et al, the chosen cut-off point for the differentiation between individuals with and without psychiatric morbidity was a score of 7 because of the high mean score within the population. RESULTS Of the students, 1270 (19.5%) achieved a GHQ-12 score above the threshold. Significantly more girls (34.1%) than boys (23.7%) had GHQ-12 scores indicating some psychiatric morbidity. On average, the 18-year-old adolescents reported a higher level of mental health problems compared with 17-year-old adolescents in the same school year. CONCLUSION A considerable proportion of adolescent high school students experience mental disorders, with girls experiencing such disorders more frequently than boys. Periodic mental health surveys in high schools are proposed to identify students in need of counselling or treatment to improve their coping skills and problem-solving abilities.
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Affiliation(s)
- Habib Emami
- Division of Epidemiology, Tobacco Prevention and Control Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Saevareid HI, Thygesen E, Nygaard HA, Lindstrom TC. Does sense of coherence affect the relationship between self-rated health and health status in a sample of community-dwelling frail elderly people? Aging Ment Health 2007; 11:658-67. [PMID: 18074253 DOI: 10.1080/13607860701368513] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The objective of this study was to examine the association between self-rated health (SRH) and physical, functional, social and mental health measures in community dwelling elderly people needing nursing care. Of special interest was how coping resources (SOC) influenced this relationship. Self-rated health is a good predictor of future health status as measured by mortality and morbidity, decline of functional abilities, use of healthcare, and nursing home placement. The high mean age and the relatively high level of care-dependency in this sample, make this investigation important. METHODS A hierarchical regression analysis was applied in a cross sectional sample of 242 elderly (mean age 84.6 years). RESULTS Subjective health complaints (SHC) in both sexes, and psychological distress (only in men), was associated directly with SRH. Coping resources associated with SRH directly, and indirectly through subjective perceived health (SHC and GHQ) but only in men. The influence of registered illness was mediated through the effects of subjectively perceived health in both women and men. Sex differences moderated the effects of SOC on SRH. CONCLUSION Subjectively perceived health was more important in the perception of SRH than objective health measures. Men, in contrast to women, tend to convert physical illness into emotional distress.
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Affiliation(s)
- H I Saevareid
- Faculty of Health and Sport, Agder University College, Arendal, Norway.
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Gallegos-Carrillo K, García-Peña C, Duran-Muñoz C, Reyes H, Durán-Arenas L. [Self-perceived health status: an approach of the elderly in Mexico]. Rev Saude Publica 2007; 40:792-801. [PMID: 17301900 DOI: 10.1590/s0034-89102006000600008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2005] [Accepted: 06/12/2005] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate health status of the elderly in Mexico through their self-perception and to describe social, organizational and health-related factors. METHODS A study was carried out on secondary data from the 2000 National Health Survey in Mexico. Multiple logistic regression models were used. The dependent variable health status was measured through self-perception. The independent variables included were: sociodemographic characteristics, risk behaviors, accidents, disease diagnosis and clinical measures. RESULTS A total of 7,322 adults aged 60 years and older were studied, which represents 7% of the total population in that age group in Mexico. Of them, 19.8% reported poor or very poor health status. Factors found to be associated to poor health were age, female sex, having no social security, being divorced, homemaker, disabled, unemployed, tobacco consumption, having a health condition, accidents and diagnosed with chronic diseases. CONCLUSIONS The study allowed to identifying factors that may contribute to poor health status in the elderly. These findings could be taken into account in the development of actions and health care programs for this population in Mexico.
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Affiliation(s)
- Katia Gallegos-Carrillo
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, México, DF, México.
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46
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Abstract
Many studies report higher levels of health care utilization among women. Understanding how gender influences health care utilization is still unresolved. We developed a model that could explain these gender-related differences. The possible pathways assumed by this model that relate gender to utilization, can be summarized as follows: (1) utilization may be influenced by somatic morbidity, mental distress, perceived symptoms, poor subjective health and propensity to use services; (2) women have higher levels of these variables than men (mediating effect); and (3) the direct effects of some of these variables on utililization are moderated by gender, i.e. they are stronger for women than for men (moderating effect). Data were drawn from a community-based sample of adult enrollees of a sickness fund in the Netherlands, who had responded to a mailed health survey (N = 8698). This survey contained questions on somatic morbidity, mental distress and other mediating variables. Health care utilization was measured prospectively, using data extracted from a claims database held by the sickness fund that covers all types of general health services except general practitioner consultations. The model was tested using structural equation modelling. Women reported more somatic morbidity and mental distress than men did, as well as elevated levels of other mediating variables, which might explain-at least partly-gender related differences in utilization. Differences in propensity to use services were not found. The expected moderating effect of gender could not be demonstrated. That is, we did not find gender related differences in the strength of the relations between mental distress, other mediating variables and utilization. Mental distress is related to utilization in a way that is not gender specific, however, because women report higher levels of mental distress (as well as somatic morbidity), this results in a greater utilization of somatic health care services.
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Affiliation(s)
- Gerrit T Koopmans
- Department of Health Policy and Management, Erasmus University Medical Center, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
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Abstract
AIMS We studied a population of patients with surgically corrected congenital cardiac disease to determine whether limitations in activity, impaired cardiac performance, and perception of body image have effects on psychological symptoms. METHODS We undertook medical examinations, and carried out standardized interviews, in 361 patients aged between 14 and 45 years with surgically corrected congenital cardiac disease. From this data, findings from 343 patients were suitable for analysis. Subjectively reported limitations in activity were classified according to the system proposed by the New York Heart Association, while cardiopulmonary capacity was used as the indicator of cardiac performance. The Brief Symptom Inventory was used for assessing psychological symptoms, such as somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The Body Image Questionnaire was used to depict attitudes towards body image, which is assessed on the two subscales of rejection of the body and vitality. Multivariate regression analyses were conducted separately for females and males, taking into account age and socio-economic position. RESULTS Impairments of everyday activities had only a few substantial associations with psychological symptoms. No significant effects of cardiac functional capacity as a standardized physiological measure emerged. Psychological symptoms were strongly influenced by perceptions of body image, particularly if they rejected it, this holding particularly for males. There were no gender differences in terms of psychological symptoms. CONCLUSIONS Limitations of activity, and impaired cardiac performance, have only minor effects on psychological symptoms in patients with surgically corrected congenital cardiac disease. The perception of body image was the strongest predictor, especially if patients rejected their body as a result of disfigurement or perceived deficiency.
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Affiliation(s)
- Siegfried Geyer
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany.
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Green CA, Perrin NA, Polen MR. Gender Differences in the Relationships Between Multiple Measures of Alcohol Consumption and Physical and Mental Health. Alcohol Clin Exp Res 2006; 28:754-64. [PMID: 15166650 DOI: 10.1097/01.alc.0000125342.28367.a1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Epidemiological research examining health consequences of alcohol consumption generally relies on average volume consumed, yet examinations of drinking patterns show different dimensions of use associated with different health outcomes. Gender differences in metabolism and body composition may lead to gender-specific consequences of drinking frequency, quantity consumed per occasion, average amount consumed, and drinking pattern. Inconsistent results suggest gender differences are not well understood. METHODS Participants were 3069 male and 2600 female health maintenance organization survey respondents. Gender differences in relationships between alcohol consumption and health were examined using analyses of covariance adjusting for age alone and for age, ethnicity, marital status, body water index, and smoking. Past-year alcohol consumption (frequency, quantity per occasion, average drinks per month, and drinking pattern) and health measures (Short Form-36 general health, physical functioning, mental health subscales) were examined. RESULTS Gender x drinking frequency and drinking quantity interactions were significant in age-adjusted and fully adjusted models of general health and physical functioning. Gender interactions for drinking pattern were significant in the age-adjusted model and marginally significant in the fully adjusted model. No gender x drinking measure interactions were found for mental health. Fully adjusted models attenuated but did not eliminate gender differences for health and magnified relationships for functioning, the latter after adjusting for body water. For both genders, light to moderate consumption and more frequent drinking were associated with better health and functioning; relationships were stronger among women than men. CONCLUSIONS Gender x drinking measure interactions in health outcomes suggest analyses should include such interactions except, possibly, for mental health. Adjusting for potential confounders can attenuate (general health) or magnify (physical functioning) gender differences. Functional status appears a sensitive measure for evaluating gender differences in alcohol's health effects, adjusting for body water. Women's health may benefit proportionally more from moderate drinking than men's.
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Affiliation(s)
- Carla A Green
- Oregon Health & Science University and Kaiser Permanente Center for Health Research, Portland, Oregon.
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Torsheim T, Ravens-Sieberer U, Hetland J, Välimaa R, Danielson M, Overpeck M. Cross-national variation of gender differences in adolescent subjective health in Europe and North America. Soc Sci Med 2006; 62:815-27. [PMID: 16098649 DOI: 10.1016/j.socscimed.2005.06.047] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The cross-national consistency and variation of gender differences in subjective health complaints was examined in a sample of 125732 11- to 15-year-olds from 29 European and North American countries, participating in the WHO collaborative study 'Health behaviour in school-aged children (HBSC) 1997/98'. Health complaints were measured with the Health Behaviour in School-aged Children Symptom Checklist. Gender differences in health complaints were analysed through multilevel logistic regression analysis. The results indicated a very robust pattern of increasing gender differences across age, with 15-year-old girls as a group at increased risk for health complaints across all countries. The magnitude of gender differences varied across countries, with some countries showing a consistently strong gender difference across age group and different health complaints, and other countries showing a consistently weak gender difference. The gender difference in health complaints was stronger in countries with a low gender development index score. The findings underscore the need to incorporate socio-contextual factors in the study of gender health inequalities during adolescence.
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Affiliation(s)
- Torbjørn Torsheim
- Research Centre for Health Promotion, University of Bergen, Christiesgt. 13, N-5015 Bergen, Norway.
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Kull M. Health Inequality Among Estonian Women. Health Care Women Int 2006; 27:112-24. [PMID: 16484156 DOI: 10.1080/07399330500457960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In Eastern Europe, in post-Communist countries, transformations during the past 10 years have considerably affected the life of women. Our aims were to (a) examine health status and socioeconomic inequalities among Estonian women, and (b) study the relationships between women's social roles and health. A group of 659 women, aged 18-45, completed the Health Questionnaire for Adults (HQA) and the General Health Questionnaire (GHQ). Income had the largest effect on self-related health and psychoemotional health ratings. The second important indicator was education. Women's additional social roles (marital status, parental role) were not detrimental to their health in our study.
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Affiliation(s)
- Merike Kull
- Institute of Exercise Biology and Physiotherapy, University of Tartu, Estonia.
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