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Gao Q, Muniz Terrera G, Mayston R, Prina M. Multistate survival modelling of multimorbidity and transitions across health needs states and death in an ageing population. J Epidemiol Community Health 2024; 78:212-219. [PMID: 38212107 PMCID: PMC10958265 DOI: 10.1136/jech-2023-220570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 12/23/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Unmet health needs have the potential to capture health inequality. Nevertheless, the course of healthcare needs fulfilment, and the role of multimorbidity in this process remains unclear. This study assessed the bidirectional transitions between met and unmet health needs and the transition to death and examined the effect of multimorbidity on transitions. METHODS This study was based on the China Health and Retirement Longitudinal Study, a nationally representative survey in 2011-2015 among 18 075 participants aged 45 and above (average age 61.1; SD 9.9). We applied a multistate survival model to estimate the probabilities and the instantaneous risk of state transitions, and Gompertz hazard models were fitted to estimate the total, marginal and state-specific life expectancies (LEs). RESULTS Living with physical multimorbidity (HR=1.85, 95% CI 1.58 to 2.15) or physical-mental multimorbidity (HR=1.45, 95% CI 1.15 to 1.82) was associated with an increased risk of transitioning into unmet healthcare needs compared with no multimorbidity. Conversely, multimorbidity groups had a decreased risk of transitioning out of unmet needs. Multimorbidity was also associated with shortened total life expectancy (TLEs), and the proportion of marginal LE for having unmet needs was more than two times higher than no multimorbidity. CONCLUSION Multimorbidity aggravates the risk of transitioning into having unmet healthcare needs in the middle and later life, leading to a notable reduction in TLEs, with longer times spent with unmet needs. Policy inputs on developing integrated person-centred services and specifically scaling up to target the complex health needs of ageing populations need to be in place.
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Affiliation(s)
- Qian Gao
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
- Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Rosie Mayston
- Global Health & Social Medicine & King's Global Health Institute, Social Science & Public Policy, King's College London, London, UK
| | - Matthew Prina
- Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Sperlich S, Beller J, Epping J, Geyer S, Tetzlaff J. Trends of healthy and unhealthy working life expectancy in Germany between 2001 and 2020 at ages 50 and 60: a question of educational level? J Epidemiol Community Health 2023; 77:430-439. [PMID: 37193584 PMCID: PMC10314014 DOI: 10.1136/jech-2023-220345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/17/2023] [Accepted: 04/29/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Extending the number of active working years is an important goal both for maintaining individual quality of life and safeguarding social security systems. Against this background, we examined the development of healthy and unhealthy working life expectancy (HWLE/UHWLE) in the general population and for different educational groups. METHODS The study is based on data from the German Socio-Economic Panel study, including 88 966 women and 85 585 men aged 50-64 years and covering four time periods (2001-05, 2006-2010, 2011-2015 and 2016-2020). Estimates of HWLE and UHWLE in terms of self-rated health (SRH) were calculated using the Sullivan's method. We adjusted for hours worked and stratified by gender and educational level. RESULTS Working-hours adjusted HWLE at age 50 increased in women and men from 4.52 years (95% CI 4.42 to 4.62) in 2001-2005 to 6.88 years (95% CI 6.78 to 6.98) in 2016-2020 and from 7.54 years (95% CI 7.43 to 7.65) to 9.36 years (95% CI 9.25 to 9.46), respectively. Moreover, UHWLE also rose with the proportion of working life spent in good SRH (health ratio) remaining largely stable. At age 50, educational differences in HWLE between the lowest and highest educational groups increased over time in women and in men from 3.72 to 4.99 years and from 4.06 to 4.40 years, respectively. CONCLUSIONS We found evidence for an overall increase but also for substantial educational differences in working-hours adjusted HWLE, which widened between the lowest and highest educational group over time. Our findings suggest that policies and health prevention measures at workplace should be more focused on workers with low levels of education in order to extend their HWLE.
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Affiliation(s)
| | - Johannes Beller
- Medical Sociology, Hannover Medical School, Hannover, Germany
| | - Jelena Epping
- Medical Sociology, Hannover Medical School, Hannover, Germany
| | - Siegfried Geyer
- Medical Sociology, Hannover Medical School, Hannover, Germany
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Selvamani Y, Elgar F. Food insecurity and its association with health and well-being in middle-aged and older adults in India. J Epidemiol Community Health 2023; 77:252-257. [PMID: 36754599 DOI: 10.1136/jech-2022-219721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/23/2022] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
AIM Food insecurity is a global public health concern; however, there is limited knowledge about its health impacts in India. We examined the associations of food insecurity with socioeconomic conditions, chronic disease and various domains of health and well-being in a community sample of middle-aged and older adults (45+ years) in India. METHODS Cross-sectional nationally representative data were collected in wave 1 (2017-2018) of the Longitudinal Ageing Study in India. Food insecurity was measured by questions of access and availability of food. We used logistic regression analyses to examine associations of food insecurity with poor self-rated health, limitations in activities of daily living (ADLs), instrumental ADLs, low life satisfaction, depression, sleep problems and low body mass. RESULTS Food insecurity related to all seven indicators of poor health and well-being, even after controlling for material wealth and the presence of multimorbidity (which food insecurity also predicted). Associations with mental health were stronger for those for physical health. For instance, food insecurity related to a threefold increase in probable depression (OR=2.9, 95% CI=2.4 to 3.4) and low life satisfaction (OR=3.4, 95% CI=2.9 to 3.8). CONCLUSIONS Food insecurity is a powerful social determinant of poor health among older adults in India. Policy measures to improve population health and well-being should closely follow trends in food insecurity, particularly among those living in poverty and with multiple health conditions.
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Affiliation(s)
- Y Selvamani
- School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Frank Elgar
- Institute for Health and Social Policy, McGill University, Montreal, Québec, Canada
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Steinkirchner AB, Zimmermann ME, Donhauser FJ, Dietl A, Brandl C, Koller M, Loss J, Heid IM, Stark KJ. Self-report of chronic diseases in old-aged individuals: extent of agreement with general practitioner medical records in the German AugUR study. J Epidemiol Community Health 2022; 76:jech-2022-219096. [PMID: 36028306 PMCID: PMC9554083 DOI: 10.1136/jech-2022-219096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND To estimate prevalence and incidence of diseases through self-reports in observational studies, it is important to understand the accuracy of participant reports. We aimed to quantify the agreement of self-reported and general practitioner-reported diseases in an old-aged population and to identify socio-demographic determinants of agreement. METHODS This analysis was conducted as part of the AugUR study (n=2449), a prospective population-based cohort study in individuals aged 70-95 years, including 2321 participants with consent to contact physicians. Self-reported chronic diseases of participants were compared with medical data provided by their respective general practitioners (n=589, response rate=25.4%). We derived overall agreement, over-reporting/under-reporting, and Cohen's kappa and used logistic regression to evaluate the dependency of agreement on participants' sociodemographic characteristics. RESULTS Among the 589 participants (53.1% women), 96.9% reported at least one of the evaluated chronic diseases. Overall agreement was >80% for hypertension, diabetes, myocardial infarction, stroke, cancer, asthma, bronchitis/chronic obstructive pulmonary disease and rheumatoid arthritis, but lower for heart failure, kidney disease and arthrosis. Cohen's kappa was highest for diabetes and cancer and lowest for heart failure, musculoskeletal, kidney and lung diseases. Sex was the primary determinant of agreement on stroke, kidney disease, cancer and rheumatoid arthritis. Agreement for myocardial infarction and stroke was most compromised by older age and for cancer by lower educational level. CONCLUSION Self-reports may be an effective tool to assess diabetes and cancer in observational studies in the old and very old aged. In contrast, self-reports on heart failure, musculoskeletal, kidney or lung diseases may be substantially imprecise.
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Affiliation(s)
- Anna B Steinkirchner
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Martina E Zimmermann
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | | | - Alexander Dietl
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Caroline Brandl
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
- Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Julika Loss
- Department for Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Iris M Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | - Klaus J Stark
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
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Pickard R, Goulao B, Carnell S, Shen J, MacLennan G, Norrie J, Breckons M, Vale L, Whybrow P, Rapley T, Forbes R, Currer S, Forrest M, Wilkinson J, McColl E, Andrich D, Barclay S, Cook J, Mundy A, N'Dow J, Payne S, Watkin N. Open urethroplasty versus endoscopic urethrotomy for recurrent urethral stricture in men: the OPEN RCT. Health Technol Assess 2020; 24:1-110. [PMID: 33228846 PMCID: PMC7750862 DOI: 10.3310/hta24610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Men who suffer recurrence of bulbar urethral stricture have to decide between endoscopic urethrotomy and open urethroplasty to manage their urinary symptoms. Evidence of relative clinical effectiveness and cost-effectiveness is lacking. OBJECTIVES To assess benefit, harms and cost-effectiveness of open urethroplasty compared with endoscopic urethrotomy as treatment for recurrent urethral stricture in men. DESIGN Parallel-group, open-label, patient-randomised trial of allocated intervention with 6-monthly follow-ups over 24 months. Target sample size was 210 participants providing outcome data. Participants, clinicians and local research staff could not be blinded to allocation. Central trial staff were blinded when needed. SETTING UK NHS with recruitment from 38 hospital sites. PARTICIPANTS A total of 222 men requiring operative treatment for recurrence of bulbar urethral stricture who had received at least one previous intervention for stricture. INTERVENTIONS A centralised randomisation system using random blocks allocated participants 1 : 1 to open urethroplasty (experimental group) or endoscopic urethrotomy (control group). MAIN OUTCOME MEASURES The primary clinical outcome was control of urinary symptoms. Cost-effectiveness was assessed by cost per quality-adjusted life-year (QALY) gained over 24 months. The main secondary outcome was the need for reintervention for stricture recurrence. RESULTS The mean difference in the area under the curve of repeated measurement of voiding symptoms scored from 0 (no symptoms) to 24 (severe symptoms) between the two groups was -0.36 [95% confidence interval (CI) -1.78 to 1.02; p = 0.6]. Mean voiding symptom scores improved between baseline and 24 months after randomisation from 13.4 [standard deviation (SD) 4.5] to 6 (SD 5.5) for urethroplasty group and from 13.2 (SD 4.7) to 6.4 (SD 5.3) for urethrotomy. Reintervention was less frequent and occurred earlier in the urethroplasty group (hazard ratio 0.52, 95% CI 0.31 to 0.89; p = 0.02). There were two postoperative complications requiring reinterventions in the group that received urethroplasty and five, including one death from pulmonary embolism, in the group that received urethrotomy. Over 24 months, urethroplasty cost on average more than urethrotomy (cost difference £2148, 95% CI £689 to £3606) and resulted in a similar number of QALYs (QALY difference -0.01, 95% CI -0.17 to 0.14). Therefore, based on current evidence, urethrotomy is considered to be cost-effective. LIMITATIONS We were able to include only 69 (63%) of the 109 men allocated to urethroplasty and 90 (80%) of the 113 men allocated to urethrotomy in the primary complete-case intention-to-treat analysis. CONCLUSIONS The similar magnitude of symptom improvement seen for the two procedures over 24 months of follow-up shows that both provide effective symptom control. The lower likelihood of further intervention favours urethroplasty, but this had a higher cost over the 24 months of follow-up and was unlikely to be considered cost-effective. FUTURE WORK Formulate methods to incorporate short-term disutility data into cost-effectiveness analysis. Survey pathways of care for men with urethral stricture, including the use of enhanced recovery after urethroplasty. Establish a pragmatic follow-up schedule to allow national audit of outcomes following urethral surgery with linkage to NHS Hospital Episode Statistics. TRIAL REGISTRATION Current Controlled Trials ISRCTN98009168. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 61. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Robert Pickard
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Beatriz Goulao
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Sonya Carnell
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Jing Shen
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Graeme MacLennan
- Centre for Healthcare and Randomised Trials, University of Aberdeen, Aberdeen, UK
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Matt Breckons
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Tim Rapley
- Social Work, Education & Community Wellbeing, University of Northumbria, Newcastle upon Tyne, UK
| | - Rebecca Forbes
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Stephanie Currer
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Mark Forrest
- Centre for Healthcare and Randomised Trials, University of Aberdeen, Aberdeen, UK
| | - Jennifer Wilkinson
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Elaine McColl
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Daniela Andrich
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Jonathan Cook
- Oxford Clinical Trials Research Unit, Oxford University, Oxford, UK
| | - Anthony Mundy
- University College London Hospitals NHS Foundation Trust, London, UK
| | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - Stephen Payne
- Central Manchester Hospitals NHS Foundation Trust, Manchester, UK
| | - Nick Watkin
- St George's University Hospitals NHS Foundation Trust, London, UK
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Chiu M, Rahman F, Kurdyak P, Cairney J, Jembere N, Vigod S. Self-rated health and mental health of lone fathers compared with lone mothers and partnered fathers: a population-based cross-sectional study. J Epidemiol Community Health 2017. [PMID: 27923873 DOI: 10.11136/jech-2016-208005] [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] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND Lone parenthood is associated with poorer health; however, the vast majority of previous studies have examined lone mothers and only a few have focused on lone fathers. We aimed to examine the self-rated health and mental health status among a large population-based cross-sectional sample of Canadian lone fathers compared with both partnered fathers and lone mothers. METHODS We investigated differences in self-rated health and mental health among 1058 lone fathers compared with 20 692 partnered fathers and 5725 lone mothers using the Ontario component of the Canadian Community Health Survey (2001-2013). Multivariable logistic regression was used to compare the odds of poor/fair self-rated health and mental health between the study groups while adjusting for a comprehensive list of sociodemographic factors, stressors and lifestyle factors. RESULTS Lone fathers and lone mothers showed similar prevalence of poor/fair self-rated health (11.6% and 12.5%, respectively) and mental health (6.2% and 8.4%, respectively); the odds were similar even after multivariable adjustment. Lone fathers showed higher odds of poor/fair self-rated health (OR 1.53, 95% CI 1.07 to 2.17) and mental health (OR 2.09, 95% CI 1.26 to 3.46) than partnered fathers after adjustment for sociodemographic factors; however, these differences were no longer significant after accounting for stressors, including low income and unemployment. CONCLUSIONS In this large population-based study, lone fathers had worse self-rated health and mental health than partnered fathers and similarly poor self-rated health and mental health as lone mothers. Interventions, supports and social policies designed for single parents should also recognise the needs of lone fathers.
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Affiliation(s)
- Maria Chiu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Faculty of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Farah Rahman
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Faculty of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - John Cairney
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Simone Vigod
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Faculty of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Women's College Hospital and Women's College Research Institute, Toronto, Ontario, Canada
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Di Gessa G, Corna LM, Platts LG, Worts D, McDonough P, Sacker A, Price D, Glaser K. Is being in paid work beyond state pension age beneficial for health? Evidence from England using a life-course approach. J Epidemiol Community Health 2016; 71:431-438. [PMID: 27940656 PMCID: PMC5484027 DOI: 10.1136/jech-2016-208086] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 07/14/2016] [Accepted: 11/14/2016] [Indexed: 11/20/2022]
Abstract
Background Given the current policy emphasis in many Western societies on extending working lives, we investigated the health effects of being in paid work beyond state pension age (SPA). Until now, work has largely focused on the health of those who exit the labour force early. Methods Our data come from waves 2–4 of the English Longitudinal Study of Ageing, including the life history interview at wave 3. Using logistic and linear regression models, we assessed the longitudinal associations between being in paid work beyond SPA and 3 measures of health (depression, a latent measure of somatic health and sleep disturbance) among men aged 65–74 and women aged 60–69. Our analyses controlled for baseline health and socioeconomic characteristics, as well as for work histories and health in adulthood and childhood. Results Approximately a quarter of women and 15% of men were in paid work beyond SPA. Descriptive bivariate analyses suggested that men and women in paid work were more likely to report better health at follow-up. However, once baseline socioeconomic characteristics as well as adulthood and baseline health and labour market histories were accounted for, the health benefits of working beyond SPA were no longer significant. Conclusions Potential health benefits of working beyond SPA need to be considered in the light of the fact that those who report good health and are more socioeconomically advantaged are more likely to be working beyond SPA to begin with.
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Affiliation(s)
- Giorgio Di Gessa
- Department of Social Policy, The London School of Economics and Political Science, London, UK
| | - Laurie M Corna
- Institute of Gerontology, Department of Global Health and Social Medicine, King's College London, London, UK
| | - Loretta G Platts
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Diana Worts
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Peggy McDonough
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Amanda Sacker
- Institute of Epidemiology & Health, University College London, London, UK
| | - Debora Price
- School of Social Sciences, University of Manchester, Manchester, UK
| | - Karen Glaser
- Institute of Gerontology, Department of Global Health and Social Medicine, King's College London, London, UK
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8
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Peters S, Ota S, Bolous E, Reich E, Chait S, Feldman BM. The Responsiveness of the Modified Childhood Health Assessment Questionnaire. J Rheumatol 2016; 43:1904-1908. [PMID: 27481906 DOI: 10.3899/jrheum.151139] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the ability of the revised version of the Childhood Health Assessment Questionnaire (CHAQ), the VASCHAQ, to detect clinical change over time in pediatric patients with juvenile idiopathic arthritis (JIA). We studied the relative responsiveness of the VASCHAQ as compared to the original CHAQ-30 and revised CHAQ-38, as well as the parent-patient, physician-patient, and physician-parent concordance. METHODS The CHAQ-38 and VASCHAQ were administered to 30 parents and patients (if older than 8 years) with any subtype of JIA before and after the start of a new treatment. The standardized response means (SRM) were calculated for the VASCHAQ, the original CHAQ-30, and the CHAQ-38. Comparisons of SRM were made using the relative SRM. Parent-patient, physician-patient, and physician-parent concordances were assessed by calculating a series of intraclass correlation coefficients. RESULTS Twenty-seven parents and 21 patients completed questionnaires at both visits. All questionnaires demonstrated large responsiveness; however, the VASCHAQ was found to be about 25% more responsive than both the original CHAQ-30 and CHAQ-38. CONCLUSION The VASCHAQ was moderately more responsive than the CHAQ-30 and CHAQ-38 in both parent and patient groups and should be considered for use in studies evaluating change in function over time.
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Affiliation(s)
- Shannon Peters
- From the Child Health Evaluative Sciences, and the Division of Rheumatology, The Hospital for Sick Children; Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; Department of Pediatrics, Faculty of Medicine, and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.S. Peters, BS, School of Medicine and Medical Sciences, University College Dublin; S. Ota, MHSc, Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; E. Bolous, MD, Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; E. Reich, MD, CCFP, Child Health Evaluative Sciences, The Hospital for Sick Children; S. Chait, HBMSc, Child Health Evaluative Sciences, The Hospital for Sick Children; B.M. Feldman, MD, MSc, FRCPC, Professor, Department of Pediatrics, Faculty of Medicine and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, and Child Health Evaluative Sciences, Division of Rheumatology, The Hospital for Sick Children
| | - Sylvia Ota
- From the Child Health Evaluative Sciences, and the Division of Rheumatology, The Hospital for Sick Children; Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; Department of Pediatrics, Faculty of Medicine, and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.S. Peters, BS, School of Medicine and Medical Sciences, University College Dublin; S. Ota, MHSc, Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; E. Bolous, MD, Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; E. Reich, MD, CCFP, Child Health Evaluative Sciences, The Hospital for Sick Children; S. Chait, HBMSc, Child Health Evaluative Sciences, The Hospital for Sick Children; B.M. Feldman, MD, MSc, FRCPC, Professor, Department of Pediatrics, Faculty of Medicine and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, and Child Health Evaluative Sciences, Division of Rheumatology, The Hospital for Sick Children
| | - Emily Bolous
- From the Child Health Evaluative Sciences, and the Division of Rheumatology, The Hospital for Sick Children; Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; Department of Pediatrics, Faculty of Medicine, and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.S. Peters, BS, School of Medicine and Medical Sciences, University College Dublin; S. Ota, MHSc, Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; E. Bolous, MD, Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; E. Reich, MD, CCFP, Child Health Evaluative Sciences, The Hospital for Sick Children; S. Chait, HBMSc, Child Health Evaluative Sciences, The Hospital for Sick Children; B.M. Feldman, MD, MSc, FRCPC, Professor, Department of Pediatrics, Faculty of Medicine and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, and Child Health Evaluative Sciences, Division of Rheumatology, The Hospital for Sick Children
| | - Erin Reich
- From the Child Health Evaluative Sciences, and the Division of Rheumatology, The Hospital for Sick Children; Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; Department of Pediatrics, Faculty of Medicine, and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.S. Peters, BS, School of Medicine and Medical Sciences, University College Dublin; S. Ota, MHSc, Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; E. Bolous, MD, Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; E. Reich, MD, CCFP, Child Health Evaluative Sciences, The Hospital for Sick Children; S. Chait, HBMSc, Child Health Evaluative Sciences, The Hospital for Sick Children; B.M. Feldman, MD, MSc, FRCPC, Professor, Department of Pediatrics, Faculty of Medicine and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, and Child Health Evaluative Sciences, Division of Rheumatology, The Hospital for Sick Children
| | - Samantha Chait
- From the Child Health Evaluative Sciences, and the Division of Rheumatology, The Hospital for Sick Children; Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; Department of Pediatrics, Faculty of Medicine, and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.S. Peters, BS, School of Medicine and Medical Sciences, University College Dublin; S. Ota, MHSc, Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; E. Bolous, MD, Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; E. Reich, MD, CCFP, Child Health Evaluative Sciences, The Hospital for Sick Children; S. Chait, HBMSc, Child Health Evaluative Sciences, The Hospital for Sick Children; B.M. Feldman, MD, MSc, FRCPC, Professor, Department of Pediatrics, Faculty of Medicine and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, and Child Health Evaluative Sciences, Division of Rheumatology, The Hospital for Sick Children
| | - Brian M Feldman
- From the Child Health Evaluative Sciences, and the Division of Rheumatology, The Hospital for Sick Children; Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; Department of Pediatrics, Faculty of Medicine, and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.S. Peters, BS, School of Medicine and Medical Sciences, University College Dublin; S. Ota, MHSc, Communicable Disease Surveillance Unit, Communicable Disease Control, Toronto Public Health; E. Bolous, MD, Department of Medical Imaging, University of Toronto, Diagnostic Radiology residency program; E. Reich, MD, CCFP, Child Health Evaluative Sciences, The Hospital for Sick Children; S. Chait, HBMSc, Child Health Evaluative Sciences, The Hospital for Sick Children; B.M. Feldman, MD, MSc, FRCPC, Professor, Department of Pediatrics, Faculty of Medicine and the Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, and Child Health Evaluative Sciences, Division of Rheumatology, The Hospital for Sick Children.
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Hinds AM, Bechtel B, Distasio J, Roos LL, Lix LM. Health and social predictors of applications to public housing: a population-based analysis. J Epidemiol Community Health 2016; 70:1229-1235. [PMID: 27225679 DOI: 10.1136/jech-2015-206845] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 10/20/2015] [Revised: 04/28/2016] [Accepted: 05/07/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Residents of public housing are often in poor health. However, it is unclear whether poor health precedes residency in public housing. We compared the health of people who applied to public housing to people who did not apply and had similar socioeconomic characteristics. METHODS Population-based administrative databases from Manitoba, Canada, containing health, housing and income assistance information were used to identify a cohort of individuals who applied to public housing and a matched cohort from the general population. Conditional logistic regression was used to test the association between a public housing application and health status and health service use, after controlling for income. RESULTS There were 10 324 individuals in each of the public housing applicant and matched cohorts; the majority were women, young, urban residents, and received income assistance. A higher per cent of the public housing cohort had physician-diagnosed physical and mental health conditions compared to the matched cohort. Physical health, mental health and health service use were significantly associated with applying to public housing, after controlling for individual and area-level income. CONCLUSIONS Applicants to public housing were in poorer health compared to people of the same income level who did not apply to public housing. These health issues may affect the long-term stability of their tenancy if appropriate services and supports are not provided. Additionally, preventing ill health, better management of mental health and additional supports may reduce the need for public housing, which, in turn, would alleviate the pressure on governments to provide this form of housing.
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Affiliation(s)
- Aynslie M Hinds
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brian Bechtel
- Program Policy Integration, Interagency Council on Homelessness, Family Violence Prevention and Homeless Supports, Alberta Human Services, Edmonton, Alberta, Canada
| | | | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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10
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Berger N, Robine JM, Ojima T, Madans J, Van Oyen H. Harmonising summary measures of population health using global survey instruments. J Epidemiol Community Health 2016; 70:1039-44. [PMID: 27165845 PMCID: PMC5036208 DOI: 10.1136/jech-2015-206870] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 04/13/2016] [Indexed: 11/12/2022]
Abstract
Summary measures of population health—health expectancies in particular—have become a standard for quantifying and monitoring population health. To date, cross-national comparability of health expectancies is limited, except within the European Union (EU). To advance international comparability, the European Joint Action on Healthy Life Years (JA: EHLEIS) set up an international working group. The working group discussed the conceptual basis of summary measures of population health and made suggestions for the development of comparable health expectancies to be used across the EU and Organisation for Economic Co-operation and Development (OECD) members. In this paper, which summarises the main results, we argue that harmonised health data needed for health expectancy calculation can best be obtained from ‘global’ survey measures, which provide a snapshot of the health situation using 1 or a few survey questions. We claim that 2 global measures of health should be pursued for their high policy relevance: a global measure of participation restriction and a global measure of functional limitation. We finally provide a blueprint for the future development and implementation of the 2 global measures. The blueprint sets the basis for subsequent international collaboration, having as a core group Member States of the EU, the USA and Japan. Other countries, in particular OECD members, are invited to join the initiative.
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Affiliation(s)
- Nicolas Berger
- Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jean-Marie Robine
- French Institute of Health and Medical Research (INSERM), Montpellier, France École Pratique des Hautes Études, Paris, France
| | | | | | - Herman Van Oyen
- Public Health and Surveillance, Scientific Institute of Public Health, Brussels, Belgium
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11
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Rubanzana W, Hedt-Gauthier BL, Ntaganira J, Freeman MD. Exposure to genocide and risk of suicide in Rwanda: a population-based case-control study. J Epidemiol Community Health 2014; 69:117-22. [PMID: 25488977 PMCID: PMC4316837 DOI: 10.1136/jech-2014-204307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background In Rwanda, an estimated one million people were killed during the 1994 genocide, leaving the country shattered and social fabric destroyed. Large-scale traumatic events such as wars and genocides have been linked to endemic post-traumatic stress disorder, depression and suicidality. The study objective was to investigate whether the 1994 genocide exposure is associated with suicide in Rwanda. Methods We conducted a population-based case–control study. Suicide victims were matched to three living controls for sex, age and residential location. Exposure was defined as being a genocide survivor, having suffered physical/sexual abuse in the genocide, losing a first-degree relative in the genocide, having been convicted for genocide crimes or having a first-degree relative convicted for genocide. From May 2011 to May 2013, 162 cases and 486 controls were enrolled countrywide. Information was collected from the police, local village administrators and family members. Results After adjusting for potential confounders, having been convicted for genocide crimes was a significant predictor for suicide (OR=17.3, 95% CI 3.4 to 88.1). Being a survivor, having been physically or sexually abused during the genocide, and having lost a first-degree family member to genocide were not significantly associated with suicide. Conclusions These findings demonstrate that individuals convicted for genocide crimes are experiencing continued psychological disturbances that affect their social reintegration into the community even 20 years after the event. Given the large number of genocide perpetrators reintegrated after criminal courts and Gacaca traditional reconciling trials, suicide could become a serious public health burden if preventive remedial action is not identified.
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Affiliation(s)
- Wilson Rubanzana
- Department of Epidemiology and Biostatistics, University of Rwanda College of Medicine and Health Sciences, School of Public Health, Kigali, Rwanda Rwanda National Police, Directorate of Medical Service, Kigali, Rwanda
| | - Bethany L Hedt-Gauthier
- Department of Epidemiology and Biostatistics, University of Rwanda College of Medicine and Health Sciences, School of Public Health, Kigali, Rwanda Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA
| | - Joseph Ntaganira
- Department of Epidemiology and Biostatistics, University of Rwanda College of Medicine and Health Sciences, School of Public Health, Kigali, Rwanda
| | - Michael D Freeman
- Oregon Health & Science University, School of Medicine, Portland, Oregon, USA Faculty of Medicine, Section of Forensic Medicine, Umeå University, Umeå, Sweden Faculty of Health Sciences, Department of Forensic Medicine, Aarhus University, Aarhus, Denmark
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12
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Hinchcliff ME, Beaumont JL, Carns MA, Podlusky S, Thavarajah K, Varga J, Cella D, Chang RW. Longitudinal evaluation of PROMIS-29 and FACIT-dyspnea short forms in systemic sclerosis. J Rheumatol 2014; 42:64-72. [PMID: 25362656 DOI: 10.3899/jrheum.140143] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [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: 11/22/2022]
Abstract
OBJECTIVE To assess the sensitivity of the Patient-Reported Outcomes Measurement Information System 29-item Health Profile (PROMIS-29) and the Functional Assessment of Chronic Illness Therapy-Dyspnea 10-item short form (FACIT-Dyspnea) for measuring change in health status and dyspnea in systemic sclerosis (SSc). METHODS One hundred patients with SSc completed the PROMIS-29, FACIT-Dyspnea, and traditional instruments [Medical Research Council Dyspnea Score, St. George's Respiratory Questionnaire (SGRQ), Health Assessment Questionnaire-Disability Index (HAQ-DI), and Medical Outcomes Study Short Form-36 (SF-36)] at baseline and 1-year visits. PROMIS-29, FACIT-Dyspnea, and traditional instrument change scores were compared across composite modified Medsger Disease Severity and modified Rodnan Skin score (mRSS) change groups. RESULTS Moderately high Spearman correlation coefficients were observed between FACIT-Dyspnea and SGRQ (r = 0.57), FACIT-Dyspnea functional limitations and SF-36 physical component summary (PCS; r = 0.51), PROMIS-29 physical functioning and HAQ-DI (r = 0.50), and SF-36 PCS (r = 0.52) change scores. In most validity comparisons, PROMIS-29, FACIT-Dyspnea, HAQ-DI, and SF-36 scores performed similarly. While PROMIS-29 covers more content areas than SF-36 (e.g., sleep), it may do so at the expense of responsiveness of its 4-item physical function scale as compared to the multiitem-derived SF-36 PCS. Statistically significant increases in SF-36 role physical (p = 0.01) and physical component scale (p = 0.016), but not PROMIS-29, were observed in patients with mRSS improvement. CONCLUSION PROMIS-29 and FACIT-Dyspnea are valid instruments to measure health status and dyspnea in patients with SSc. In physical function assessment, longer PROMIS short forms or computer adaptive testing should be considered to improve responsiveness to the effect of skin disease changes on physical function in patients with SSc.
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Affiliation(s)
- Monique E Hinchcliff
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine.
| | - Jennifer L Beaumont
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
| | - Mary A Carns
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
| | - Sofia Podlusky
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
| | - Krishna Thavarajah
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
| | - John Varga
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
| | - David Cella
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
| | - Rowland W Chang
- From the Department of Medicine, Division of Rheumatology, Department of Medical Social Sciences, and the Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine, Chicago, Illinois; Center for Lung Health, Henry Ford Hospital, Detroit, Michigan, USA.M.E. Hinchcliff, MD, MS, Assistant Professor of Medicine; M.A. Carns, MS; S. Podlusky, BA, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; J.L. Beaumont, MS, Statistical Analyst/Programmer, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; K. Thavarajah, MD, MS, Clinical Assistant Professor of Medicine, Center for Lung Health, Henry Ford Hospital; J. Varga, MD, Professor of Medicine, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine; D. Cella, PhD, Professor of Medicine, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine; R.W. Chang, MD, MPH, Professor of Medicine, Department of Medicine, Division of Rheumatology, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, and the Institute for Public Health and Medicine
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Curl A, Kearns A, Mason P, Egan M, Tannahill C, Ellaway A. Physical and mental health outcomes following housing improvements: evidence from the GoWell study. J Epidemiol Community Health 2014; 69:12-9. [PMID: 25205160 DOI: 10.1136/jech-2014-204064] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [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: 11/03/2022]
Abstract
BACKGROUND Existing research points towards physical and mental health gains from housing improvements, but findings are inconsistent and often not statistically significant. The detailed characteristics and variability of housing improvement works are problematic and studies are often small, not experimental, with short follow-up times. METHODS A quasi-experimental design was used to assess the impact on physical health and mental health (using SF-12v2 Physical and Mental health component summary scales) of four types of housing improvement works-central heating, 'Secured By Design' front doors, fabric works, kitchens and bathrooms-both singly and in pairwise combinations. A longitudinal sample of 1933 residents from 15 deprived communities in Glasgow, UK was constructed from surveys carried out in 2006, 2008 and 2011. Sociodemographic characteristics and changes in employment status were taken into account. RESULTS Fabric works had positive associations with physical health (+2.09, 95% CI 0.13 to 4.04) and mental health (+1.84, 95% CI 0.04 to 3.65) in 1-2 years. Kitchens and bathrooms had a positive association with mental health in 1-2 years (+2.58, 95% CI 0.79 to 4.36). Central heating had a negative association with physical health (-2.21, 95% CI -3.74 to -0.68). New front doors had a positive association with mental health in <1 year (+5.89, 95% CI 0.65 to 11.14) and when provided alongside kitchens and bathrooms (+4.25, 95% CI 1.71 to 6.80). Gaining employment had strong associations with physical health (+7.14, 95% CI 4.72 to 9.55) as well as mental health (+5.50, 95% CI 3.27 to 7.73). CONCLUSIONS Fabric works may provide insulation benefits and visual amenity benefits to residents. Front doors may provide important security benefits in deprived communities. Economic regeneration is important alongside property-led regeneration.
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Affiliation(s)
- Angela Curl
- Urban Studies, University of Glasgow, Glasgow, UK
| | - Ade Kearns
- Urban Studies, University of Glasgow, Glasgow, UK
| | - Phil Mason
- Urban Studies, University of Glasgow, Glasgow, UK
| | - Matthew Egan
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Anne Ellaway
- MRC Social & Public Health Sciences Unit, Glasgow, UK
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Iparraguirre J. Physical Functioning in work and retirement: commentary on age-related trajectories of physical functioning in work and retirement --the role of sociodemographic factors, lifestyle and disease by Stenholm et al. J Epidemiol Community Health 2014; 68:493-9. [PMID: 24696090 DOI: 10.1136/jech-2014-203945] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Ul-Haq Z, Mackay DF, Martin D, Smith DJ, Gill JMR, Nicholl BI, Cullen B, Evans J, Roberts B, Deary IJ, Gallacher J, Hotopf M, Craddock N, Pell JP. Heaviness, health and happiness: a cross-sectional study of 163066 UK Biobank participants. J Epidemiol Community Health 2013; 68:340-8. [PMID: 24336235 DOI: 10.1136/jech-2013-203077] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Obesity is known to increase the risk of many diseases and reduce overall quality of life. This study examines the relationship with self-reported health (SRH) and happiness. METHODS We conducted a cross-sectional study of the 163 066 UK Biobank participants who completed the happiness rating. The association between adiposity and SRH and happiness was examined using logistic regression. SRH was defined as good (excellent, good), or poor (fair, poor). Self-reported happiness was defined as happy (extremely, very, moderately) or unhappy (moderately, very, extremely). RESULTS Poor health was reported by 44 457 (27.3%) participants. The adjusted ORs for poor health were 3.86, 2.92, 2.60 and 6.41 for the highest, compared with lowest, deciles of Body Mass Index, waist circumference, waist to hip ratio and body fat percent, respectively. The associations were stronger in men (p<0.001). Overall, 7511 (4.6%) participants felt unhappy, and only class III obese participants were more likely to feel unhappy (adjusted OR 1.33, 95% CI 1.15 to 1.53, p<0.001) but the associations differed by sex (p<0.001). Among women, there was a significant association between unhappiness and all levels of obesity. By contrast, only class III obese men had significantly increased risk and overweight and class I obese men were less likely to be unhappy. CONCLUSIONS Obesity impacts adversely on happiness as well as health, but the association with unhappiness disappeared after adjustment for self-reported health, indicating this may be mediated by health. Compared with obese men, obese women are less likely to report poor health, but more likely to feel unhappy.
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