The association of health-related fitness with indicators of academic performance in Texas schools.

PubMed

Welk, Gregory J; Jackson, Allen W; Morrow, James R; Haskell, William H; Meredith, Marilu D; Cooper, Kenneth H

2010-09-01

This study examined the associations between indicators of health-related physical fitness (cardiovascular fitness and body mass index) and academic performance (Texas Assessment of Knowledge and Skills). Partial correlations were generally stronger for cardiovascular fitness than body mass index and consistently stronger in the middle school grades. Mixed-model regression analyses revealed modest associations between fitness and academic achievement after controlling for potentially confounding variables. The effects of fitness on academic achievement were positive but small. A separate logistic regression analysis indicated that higher fitness rates increased the odds of schools achieving exemplary/recognized school status within the state. School fitness attainment is an indicator of higher performing schools. Direction of causality cannot be inferred due to the cross-sectional nature of the data.

Relationship between transitions in self-rated health and health indicators in Japanese workers.

PubMed

Tsurugano, Shinobu; Takahashi, Eiko; Negami, Masako; Otsuka, Hiroki; Moriyama, Kengo

2012-12-20

Self-rated health (SRH) reflects lifestyle habits, chronic disease, and psychosocial conditions. The aim of this study was to examine the relationship between transitions in SRH and health indicators among Japanese white-collar workers. Three-year medical examination data from an occupational field was used. The distribution of data related to SRH, lifestyle habits, treatment of chronic disease, laboratory data abnormalities, job stress, and sickness absences were compared using ridit analysis, and the odds ratios and 95% confidence intervals were calculated using the first year of observation as a reference. During the observation period, the proportion of workers with poor SRH, self-rated lifestyle habits, sleep, dietary habits, and body mass index increased. Particularly, high job stress (heavy job burden and low job control) and few sickness absences were strongly related to poor SRH. Unfavorable lifestyles and work-related conditions worsened as SRH declined among workers. The results suggest that health indicators related to SRH are different according to the population. Tracking changes in SRH using indices related to SRH is useful for evaluating the health status in a target group.

Relative performance of three stream bed stability indices as indicators of stream health.

PubMed

Kusnierz, Paul C; Holbrook, Christopher M

2017-10-16

Bed stability is an important stream habitat attribute because it affects geomorphology and biotic communities. Natural resource managers desire indices of bed stability that can be used under a wide range of geomorphic conditions, are biologically meaningful, and are easily incorporated into sampling protocols. To eliminate potential bias due to presence of instream wood and increase precision of stability values, we modified a stream bed instability index (ISI) to include measurements of bankfull depth (d bf ) and median particle diameter (D 50 ) only in riffles and increased the pebble count to decrease variability (i.e., increase precision) in D 50 . The new riffle-based instability index (RISI) was compared to two established indices: ISI and the riffle stability index (RSI). RISI and ISI were strongly associated with each other but neither was closely associated with RSI. RISI and ISI were closely associated with both a diatom- and two macrovertebrate-based stream health indices, but RSI was only weakly associated with the macroinvertebrate indices. Unexpectedly, precision of D 50 did not differ between RISI and ISI. Results suggest that RISI is a viable alternative to both ISI and RSI for evaluating bed stability in multiple stream types. With few data requirements and a simple protocol, RISI may also better conform to riffle-based sampling methods used by some water quality practitioners.

Relative performance of three stream bed stability indices as indicators of stream health

USGS Publications Warehouse

Kusnierz, Paul C; Holbrook, Christopher

2017-01-01

Bed stability is an important stream habitat attribute because it affects geomorphology and biotic communities. Natural resource managers desire indices of bed stability that can be used under a wide range of geomorphic conditions, are biologically meaningful, and are easily incorporated into sampling protocols. To eliminate potential bias due to presence of instream wood and increase precision of stability values, we modified a stream bed instability index (ISI) to include measurements of bankfull depth (dbf) and median particle diameter (D50) only in riffles and increased the pebble count to decrease variability (i.e., increase precision) in D50.The new riffle-based instability index (RISI) was compared to two established indices: ISI and the riffle stability index (RSI). RISI and ISI were strongly associated with each other but neither was closely associated with RSI. RISI and ISI were closely associated with both a diatom- and two macrovertebrate-based stream health indices, but RSI was only weakly associated with the macroinvertebrate indices. Unexpectedly, precision of D50 did not differ between RISI and ISI. Results suggest that RISI is a viable alternative to both ISI and RSI for evaluating bed stability in multiple stream types. With few data requirements and a simple protocol, RISI may also better conform to riffle-based sampling methods used by some water quality practitioners.

Health Care Indicators

PubMed Central

Donham, Carolyn S.; Letsch, Suzanne W.; Maple, Brenda T.; Singer, Naphtale; Cowan, Cathy A.

1991-01-01

Contained in this regular feature of the journal is a section on each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they provide indicators of the direction and magnitude of health care costs prior to the availability of more comprehensive data. PMID:10112766

The use of remote sensors to relate biological and physical indicators to environmental and public health problems

NASA Technical Reports Server (NTRS)

1972-01-01

Relationships between biological, ecological and botanical structures, and disease organisms and their vectors which might be detected and measured by remote sensing are determined. In addition to the use of trees as indicators of disease or potential disease, an attempt is made to identify environmental factors such as soil moisture and soil and water temperatures as they relate to disease or health problems and may be detected by remote sensing. The following three diseases and one major health problem are examined: Malaria, Rocky Mountain spotted fever, Encephalitis and Red Tide. It is shown that no single species of vascular plant nor any one environmental factor can be used as the indicator of disease or health problems. Entire vegetation types, successional stages and combinations of factors must be used.

Health expectancy indicators.

PubMed Central

Robine, J. M.; Romieu, I.; Cambois, E.

1999-01-01

An outline is presented of progress in the development of health expectancy indicators, which are growing in importance as a means of assessing the health status of populations and determining public health priorities. PMID:10083720

Functioning: the third health indicator in the health system and the key indicator for rehabilitation.

PubMed

Stucki, Gerold; Bickenbach, Jerome

2017-02-01

In this methodological note on applying the ICF in rehabilitation, we introduce functioning as the third health indicator complementing the established indicators mortality and morbidity. Together, these three provide a complete set of indicators for monitoring the performance of health strategies in health systems. When applying functioning as the third health indicator across the five health strategies, it is fundamental to distinguish between biological health and lived health. For rehabilitation, functioning is the key indicator. Since we can now code mortality and morbidity data with the ICD, and functioning data with the ICF, and since given current plans to including functioning properties in the proposed ICD-11 revision, we should in the future be able to report on all three health indicators.

Socio-medical indicators of health in South Africa.

PubMed

Jinabhai, C C; Coovadia, H M; Abdool-Karim, S S

1986-01-01

Socio-medical indicators developed by WHO for monitoring progress towards Health-for-All have been adapted to reveal, clearly and objectively, the devastating impact of state planning based on an outmoded immoral and unscientific philosophy of race superiority in South Africa on the health of the disenfranchised majority within the context of social and economic discrimination; Health policy indicators confirm that the government is committed to three options (Bantustans, A New Constitution, and A Health Services Facilities Plan) all of which are inconsistent with the attainment of Health-for-All; Social and economic indicators reveal gross disparities between African, Coloured, Indian, and White living and working conditions; Provision of health care indicators show the overwhelming dominance of high technology curative medical care consuming about 97 percent of the health budget with only minor shifts towards community-based comprehensive care; and Health status indicators illustrate the close nexus between privilege, dispossession and disease with Whites falling prey to health problems related to affluence and lifestyle, while Africans, Coloureds, and Indians suffer from disease due to poverty. All four categories of the indicator system reveal discrepancies which exist between Black and White, rich and poor, urban and rural. To achieve the social goal of Health-for-All requires a greater measure of political commitment from the state. We conclude that it is debatable whether a system which maintains race discrimination and exploitation can in fact be adapted to provide Health-for-All.

Relative foraminiferan abundance as an indicator of seagrass sediment health:

NASA Astrophysics Data System (ADS)

Cajandig, P.; Quiros, A.; Nolan, H.; Tallman, R.; Cooper, N.; Ayala, J.; Courtier, C.

2013-12-01

Authors: Patrick Cajandig*, Jose Ayala**, Nathaniel Cooper**, Catherine Courtier**, Hannah Nolan**, Rachelle Tallman**, T.E. Angela L. Quiros** * Davis High-School CA, **University of California Santa Cruz, Ecology and Evolutionary Biology Department Seagrasses are a key component in coastal ecosystems. Found in shallow marine environments, they make a large contribution to coastal ecosystem health by sustaining water quality, stabilizing the sea bottom, and providing habitat as well as food for other organisms. Seagrasses accumulate tiny grains of sediment, increasing water clarity. Just like barren hills are prone to erosion compared to vegetated, rooted down hills, we find a similar situation in the ocean. Seagrasses have broad roots that extend vertically and horizontally to help stabilize the seabed. Seagrasses support a whole ecosystem, because some organisms feed off of the seagrass alone, while others feed off the inhabitants of the seagrass. The quality of sediment is a vital part of seagrass health, just like nutrient rich soils are important to land plants. But what in seagrass sediment is a good indication of health? We hypothesize that seagrass health measures such as percent cover and seagrass species diversity are related to the abundance of foraminiferans relative to other seagrass sediment components. My mentor, T. E. Angela L. Quiros, from the University of California, Santa Cruz (UCSC), collected the sediment samples from seagrass beds in the Philippines. Samples were dried and brought to UCSC for sediment sieving. We used different sized sieves to sort the sediment. These sieves ranged from coarse to very fine sieves (Phi -2.0 (coarse) through +3.0 (fine) going in 0.5 intervals on a log scale). We weighed the sediment that was caught in each tray and separated them into bags of different size classes. To analyze each sample, we subsampled four size classes (Phi's -2.0, -1.5,-1.0, 0.0), and used a dissecting scope to identify and then weigh the

Air quality as respiratory health indicator: a critical review.

PubMed

Moshammer, Hanns; Wallner, Peter

2011-09-01

As part of the European Public Health project IMCA II validity and practicability of "air pollution" as a respiratory health indicator were analyzed. The definitions of air quality as an indicator proposed by the WHO project ECOEHIS and by IMCA I were compared. The public availability of the necessary data was checked through access to web-based data-bases. Practicability and interpretation of the indicator were discussed with project partners and external experts. Air quality serves as a kind of benchmark for the good health-related environmental policy. In this sense, it is a relevant health indicator. Although air quality is not directly in the responsibility of health policy, its vital importance for the population's health should not be neglected. In principle, data is available to calculate this IMCA indicator for any chosen area in Europe. The indicator is relevant and informative, but calculation and interpretation need input from local expert knowledge. The European health policy is well advised to take air quality into account. To that end, an interdisciplinary approach is warranted. The proposed definition of air quality as a (respiratory) health indicator is workable, but correct interpretation depends on expert and local knowledge.

Income-related inequality in health and health-related behaviour: exploring the equalisation hypothesis.

PubMed

Vallejo-Torres, Laura; Hale, Daniel; Morris, Stephen; Viner, Russell M

2014-07-01

Previous studies have found the socioeconomic gradient in health among adolescents to be lower than that observed during childhood and adulthood. The aim of this study was to examine income-related inequalities in health and health-related behaviour across the lifespan in England to explore 'equalisation' in adolescence. We used five years of data (2006-2010) from the Health Survey for England to explore inequalities in six indicators: self-assessed general health, longstanding illness, limiting longstanding illness, psychosocial wellbeing, obesity and smoking status. We ran separate analyses by age/gender groups. Inequality was measured using concentration indices. Our findings for longstanding illnesses, psychosocial wellbeing and obesity were consistent with the equalisation hypothesis. For these indicators, the extent of income-related inequality was lower among late adolescents (16-19 years) and young adults (20-24 years) compared to children and young adolescents (under 15 years), mid- and late-adults (25-44 and 45-64 years) and the elderly (65+ years). The remaining indicators showed lower inequality among adolescents compared to adults, but higher inequality when compared with children. Our work shows that inequalities occur across the life-course but that for some health issues there may be a period of equalisation in late adolescence and early adulthood. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

OECD Health Care Quality Indicator Project. The expert panel on primary care prevention and health promotion.

PubMed

Marshall, Martin; Klazinga, Niek; Leatherman, Sheila; Hardy, Charlie; Bergmann, Eckhard; Pisco, Luis; Mattke, Soeren; Mainz, Jan

2006-09-01

This article describes a project undertaken as part of the Organization for Economic Co-operation and Development (OECD)'s Healthcare Quality Indicator (HCQI) Project, which aimed to develop a set of quality indicators representing the domains of primary care, prevention and health promotion, and which could be used to assess the performance of primary care systems. Existing quality indicators from around the world were mapped to an organizing framework which related primary care, prevention, and health promotion. The indicators were judged against the US Institute of Medicine's assessment criteria of importance and scientific soundness, and only those which met these criteria and were likely to be feasible were included. An initial large set of indicators was reduced by the primary care expert panel using a modified Delphi process. A set of 27 indicators was produced. Six of them were related to health promotion, covering health-related behaviours that are typically targeted by health education and outreach campaigns, 13 to preventive care with a focus on prenatal care and immunizations and eight to primary clinical care mainly addressing activities related to risk reduction. The indicators selected placed a strong emphasis on the public health aspects of primary care. This project represents an important but preliminary step towards a set of measures to evaluate and compare primary care quality. Further work is required to assess the operational feasibility of the indicators and the validity of any benchmarking data drawn from international comparisons. A conceptual framework needs to be developed that comprehensively captures the complex construct of primary care as a basis for the selection of additional indicators.

[Pitfalls in international comparisons of health data and indices].

PubMed

Rotstein, Z; Shani, M

1991-05-01

Comparison of published data and health indices from different countries with different health systems is subject to many pitfalls. Comparison of national expenditure for health care based on purchasing power of the currency may be misleading if the purchasing power of the health services is ignored. Comparisons may also be misleading if they ignore national geographic and demographic structures. Government and health authorities often quote different sets of data and use different terminology and definitions. This article stresses the disparity in the definition of medical manpower and points out differences relating to ratios of manpower to population and to per capita spending. Also addressed is the importance of the qualitative and value aspects of health systems not usually involved in comparison of international health indices. In conclusion, safety measures and precautions such as choosing the right index for the right purpose, adjustment of indices to the purchasing power parity of health, demographics, etc., should be used when conducting health care analyses.

Health Care Indicators

PubMed Central

Donham, Carolyn S.; Sensenig, Arthur L.

1994-01-01

This regular feature of the journal includes a discussion of each of the following four topics: community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. These statistics are valuable in their own right for understanding the relationship between the health care sector and the overall economy. In addition, they allow us to anticipate the direction and magnitude of health care cost changes prior to the availability of more comprehensive data. PMID:10142373

Flourishing in New Zealand Workers: Associations With Lifestyle Behaviors, Physical Health, Psychosocial, and Work-Related Indicators.

PubMed

Hone, Lucy C; Jarden, Aaron; Duncan, Scott; Schofield, Grant M

2015-09-01

To investigate the prevalence and associations of flourishing among a large sample of New Zealand workers. A categorical diagnosis of flourishing was applied to data from the Sovereign Wellbeing Index, a nationally representative sample of adults in paid employment (n = 5549) containing various lifestyle, physical, psychosocial, and work-related indicators. One in four New Zealand workers were categorized as flourishing. Being older and married, reporting greater income, financial security, physical health, autonomy, strengths awareness and use, work-life balance, job satisfaction, participation in the Five Ways to Well-being, volunteering, and feeling appreciated by others were all positively associated with worker flourishing independent of sociodemographics. Flourishing is a useful additional indicator for evaluating the prevalence, and identifying the drivers, of employee well-being. Employers may benefit from promoting these indicators among staff.

[Contextual indicators to assess social determinants of health and the Spanish economic recession].

PubMed

Cabrera-León, Andrés; Daponte Codina, Antonio; Mateo, Inmaculada; Arroyo-Borrell, Elena; Bartoll, Xavier; Bravo, María José; Domínguez-Berjón, María Felicitas; Renart, Gemma; Álvarez-Dardet, Carlos; Marí-Dell'Olmo, Marc; Bolívar Muñoz, Julia; Saez, Marc; Escribà-Agüir, Vicenta; Palència, Laia; López, María José; Saurina, Carme; Puig, Vanessa; Martín, Unai; Gotsens, Mercè; Borrell, Carme; Serra Saurina, Laura; Sordo, Luis; Bacigalupe, Amaia; Rodríguez-Sanz, Maica; Pérez, Glòria; Espelt, Albert; Ruiz, Miguel; Bernal, Mariola

To provide indicators to assess the impact on health, its social determinants and health inequalities from a social context and the recent economic recession in Spain and its autonomous regions. Based on the Spanish conceptual framework for determinants of social inequalities in health, we identified indicators sequentially from key documents, Web of Science, and organisations with official statistics. The information collected resulted in a large directory of indicators which was reviewed by an expert panel. We then selected a set of these indicators according to geographical (availability of data according to autonomous regions) and temporal (from at least 2006 to 2012) criteria. We identified 203 contextual indicators related to social determinants of health and selected 96 (47%) based on the above criteria; 16% of the identified indicators did not satisfy the geographical criteria and 35% did not satisfy the temporal criteria. At least 80% of the indicators related to dependence and healthcare services were excluded. The final selection of indicators covered all areas for social determinants of health, and 62% of these were not available on the Internet. Around 40% of the indicators were extracted from sources related to the Spanish Statistics Institute. We have provided an extensive directory of contextual indicators on social determinants of health and a database to facilitate assessment of the impact of the economic recession on health and health inequalities in Spain and its autonomous regions. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Can health indicators help policy-makers? Experience from European system of urban health indicators (EURO-URHIS).

PubMed

Torun, Perihan; Heller, Richard F; Harrison, Annie; Verma, Arpana

2017-05-01

This paper proposes that Population Impact Measures (PIMs), the Population Impact Number of Eliminating a Risk Factor over a time period (PIN-ER-t) and the number of events prevented in your population (NEPP), can assist in policy making as they include relevant information which describes the impact or benefits to the population of risk factors and interventions. In this study, we explore the utilization of the indicators from European System of Urban Health Indicators System to produce the two PIMs. We identified from the indicators list the health determinants, health status and health interventions which can be linked, and searched Medline for evidence of association. We then investigated whether the type of frequency measure available for the indicator match with the measure used in PIMs, and explored data availability for the City of Manchester (UK) as an urban area. Of the 39 indicators relevant to socio-economic factors, health determinants and health status, it was possible to calculate the population impact of a risk factor, i.e. the PIN-ER-t, for only six associations, and the population impact of health interventions, i.e. NEPP, for only one out of the three listed indicators, as the relevant health conditions were not included. The results of this study suggest that if an indicator system is intended to play a part in the policy making process, then the method of presentation to policy-makers should be decided before setting up the system, as it is likely that some indicators which would be essential might not be available. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health and labour force participation of older people in Europe: what do objective health indicators add to the analysis?

PubMed

Kalwij, Adriaan; Vermeulen, Frederic

2008-05-01

This paper studies labour force participation of older individuals in 11 European countries. The data are drawn from the new Survey of Health, Ageing and Retirement in Europe (SHARE). We examine the value added of objective health indicators in relation to potentially endogenous self-reported health. We approach the endogeneity of self-reported health as an omitted variables problem. In line with the literature on the reliability of self-reported health ambiguous results are obtained. In some countries self-reported health does a fairly good job and controlling for objective health indicators does not add much to the analysis. In other countries, however, the results show that objective health indicators add significantly to the analysis and that self-reported health is endogenous due to omitted objective health indicators. These latter results illustrate the multi-dimensional nature of health and the need to control for objective health indicators when analysing the relation between health status and labour force participation. This makes an instrumental variables approach to deal with the endogeneity of self-reported health less appropriate.

Development of Mental Health Indicators in Korea

PubMed Central

Han, Hyeree; Ahn, Dong Hyun; Song, Jinhee; Hwang, Tae Yeon

2012-01-01

Objective Promoting mental health and preventing mental health problems are important tasks for international organizations and nations. Such goals entail the establishment of active information networks and effective systems and indicators to assess the mental health of populations. This being said, there is a need in Korea develop ways to measure the state of mental health in Korea. Methods This paper reviews the mental health indicator development policies and practices of seven organizations, countries, and regions: WHO, OECD, EU, United States, Australia, UK, and Scotland. Using Delphi method, we conducted two surveys of mental health indicators for experts in the field of mental health. The survey questionnaire included 5 domains: mental health status, mental health factor, mental health system, mental health service, and quality of mental health services. We considered 124 potential mental health indicators out of more than 600 from indicators of international organizations and foreign countries. Results We obtained the top 30 mental health indicators from the surveys. Among them, 10 indicators belong to the mental health system. The most important five mental health indicators are suicide rate, rate of increase in mental disorder treatment, burden caused by mental disorders, adequacy of identifying problems of mental health projects and deriving solutions, and annual prevalence of mental disorders. Conclusion Our study provides information about the process for indicator development and the use of survey results to measure the mental health status of the Korean population. The aim of mental health indicator development is to improve the mental health system by better grasping the current situation. We suggest these mental health indicators can monitor progress in efforts to implement reform policies, provide community services, and involve users, families and other stakeholders in mental health promotion, prevention, care and rehabilitation. PMID:23251193

Social media indicators of the food environment and state health outcomes.

PubMed

Nguyen, Q C; Meng, H; Li, D; Kath, S; McCullough, M; Paul, D; Kanokvimankul, P; Nguyen, T X; Li, F

2017-07-01

Contextual factors can influence health through exposures to health-promoting and risk-inducing factors. The aim of this study was to (1) build, from geotagged Twitter and Yelp data, a national food environment database and (2) to test associations between state food environment indicators and health outcomes. This is a cross-sectional study based upon secondary analyses of publicly available data. Using Twitter's Streaming Application Programming Interface (API), we collected and processed 4,041,521 food-related, geotagged tweets between April 2015 and March 2016. Using Yelp's Search API, we collected data on 505,554 unique food-related businesses. In linear regression models, we examined associations between food environment characteristics and state-level health outcomes, controlling for state-level differences in age, percent non-Hispanic white, and median household income. A one standard deviation increase in caloric density of food tweets was related to higher all-cause mortality (+46.50 per 100,000), diabetes (+0.75%), obesity (+1.78%), high cholesterol (+1.40%), and fair/poor self-rated health (2.01%). More burger Yelp listings were related to higher prevalence of diabetes (+0.55%), obesity (1.35%), and fair/poor self-rated health (1.12%). More alcohol tweets and Yelp bars and pub listings were related to higher state-level binge drinking and heavy drinking, but lower mortality and lower percent reporting fair/poor self-rated health. Supplemental analyses with county-level social media indicators and county health outcomes resulted in finding similar but slightly attenuated associations compared to those found at the state level. Social media can be utilized to create indicators of the food environment that are associated with area-level mortality, health behaviors, and chronic conditions. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Children's Environmental Health Indicators in Australia.

PubMed

Sly, J Leith; Moore, Sophie E; Gore, Fiona; Brune, Marie Noel; Neira, Maria; Jagals, Paul; Sly, Peter D

2016-01-01

Adverse environmental exposures in early life increase the risk of chronic disease but do not attract the attention nor receive the public health priority warranted. A safe and healthy environment is essential for children's health and development, yet absent in many countries. A framework that aids in understanding the link between environmental exposures and adverse health outcomes are environmental health indicators-numerical estimates of hazards and outcomes that can be applied at a population level. The World Health Organization (WHO) has developed a set of children's environmental health indicators (CEHI) for physical injuries, insect-borne disease, diarrheal diseases, perinatal diseases, and respiratory diseases; however, uptake of steps necessary to apply these indicators across the WHO regions has been incomplete. A first indication of such uptake is the management of data required to measure CEHI. The present study was undertaken to determine whether Australia has accurate up-to-date, publicly available, and readily accessible data on each CEHI for indigenous and nonindigenous Australian children. Data were not readily accessible for many of the exposure indicators, and much of the available data were not child specific or were only available for Australia's indigenous population. Readily accessible data were available for all but one of the outcome indicators and generally for both indigenous and nonindigenous children. Although Australia regularly collects data on key national indicators of child health, development, and well-being in several domains mostly thought to be of more relevance to Australians and Australian policy makers, these differ substantially from the WHO CEHI. The present study suggests that the majority of these WHO exposure and outcome indicators are relevant and important for monitoring Australian children's environmental health and establishing public health interventions at a local and national level and collection of appropriate

ENVIRONMENTAL PUBLIC HEALTH INDICATORS

EPA Science Inventory

Environmental Public Health Indicators (EPHIs), quantitative measures of health factors and environmental influences tracked over time, can be used to identify specific areas and populations for intervention and prevention efforts and to evaluate the outcomes of implemented polic...

Health indicators 1991.

PubMed

Dawson, N

1991-01-01

This is the second edition of a database developed by the Canadian Centre for Health Information (CCHI). It features 49 health indicators, under one cover containing the most recent data available from a variety of national surveys. This information may be used to establish health goals for the population and to offer objective measures of their success. The database can be accessed through CANSIM, Statistics Canada's socio-economic electronic database and retrieval system, or through a personal computer package which enables the user to retrieve and analyze the 1.2 million data points in the system.

Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal

PubMed Central

Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

2017-01-01

Background Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide. Anticoagulant-related adverse events and the quality of anticoagulation management should thus be routinely assessed to improve patient safety in vulnerable older inpatients. Objective This project aims to develop and validate a set of outcome and process indicators based on linked administrative health data (ie, insurance claims data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients. Methods GPSIs will measure cumulative incidences of thromboembolic and bleeding adverse events based on hospital discharge data linked to insurance claims data. Using linked administrative health data will improve GPSI risk adjustment on patients’ conditions that are present at admission and will capture in-hospital and postdischarge adverse events. GQIs will estimate the proportion of index hospital stays resulting in recommended anticoagulation at discharge and up to various time frames based on the same electronic health data. The GPSI and GQI development and validation process will comprise 6 stages: (1) selection and specification of candidate indicators, (2

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

PubMed Central

van Zon, Sander K. R.; Bültmann, Ute; Mendes de Leon, Carlos F.; Reijneveld, Sijmen A.

2015-01-01

Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. Methods The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Results Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Conclusions Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of

Health Information–Seeking Behaviors, Health Indicators, and Health Risks

PubMed Central

Mays, Darren; Weaver, Stephanie Sargent; Hopkins, Gary L.; Eroğlu, Doğan; Bernhardt, Jay M.

2010-01-01

Objectives. We examined how different types of health information–seeking behaviors (HISBs)—no use, illness information only, wellness information only, and illness and wellness information combined—are associated with health risk factors and health indicators to determine possible motives for health information seeking. Methods. A sample of 559 Seattle–Tacoma area adults completed an Internet-based survey in summer 2006. The survey assessed types of HISB, physical and mental health indicators, health risks, and several covariates. Covariate-adjusted linear and logistic regression models were computed. Results. Almost half (49.4%) of the sample reported HISBs. Most HISBs (40.6%) involved seeking a combination of illness and wellness information, but both illness-only (28.6%) and wellness-only (30.8%) HISBs were also widespread. Wellness-only information seekers reported the most positive health assessments and the lowest occurrence of health risk factors. An opposite pattern emerged for illness-only information seekers. Conclusions. Our findings reveal a unique pattern of linkages between the type of health information sought (wellness, illness, and so on) and health self-assessment among adult Internet users in western Washington State. These associations suggest that distinct health motives may underlie HISB, a phenomenon frequently overlooked in previous research. PMID:20558794

A reduced factor structure for the PROQOL-HIV questionnaire provided reliable indicators of health-related quality of life.

PubMed

Lalanne, Christophe; Chassany, Olivier; Carrieri, Patrizia; Marcellin, Fabienne; Armstrong, Andrew R; Lert, France; Spire, Bruno; Dray-Spira, Rosemary; Duracinsky, Martin

2016-04-01

To identify a simplified factor structure for the PROQOL-human immunodeficiency virus (HIV) questionnaire to improve the measurement of the health-related quality of life (HRQL) of HIV-positive patients in clinical care and research settings. HRQL data were collected using the eight-dimension PROQOL-HIV questionnaire from 2,537 patients (VESPA2 study). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) validated a simpler four-factor structure and assessed measurement invariance (MI). Multigroup analysis assessed the effect of sex, age, and antiretroviral therapy (ART) on the resulting factor scores. Correlations with symptom and Short Form (SF)-12 self-reports assessed convergent validity. Item analysis, EFA, and CFAs confirmed the validity [comparative fit index (CFI), 0.948; root mean square error of approximation, 0.064] and reliability (α's ≥ 0.8) of four dimensions: physical health and symptoms, health concerns and mental distress, social and intimate relationships, and treatment-related impact. Strong MI was demonstrated across sex and age (decrease in CFI <0.01). A multiple-cause multiple-indicator model indicated that HRQL correlated as expected with sex, age, and the ART status. Correlations of HRQL, symptom reports, and SF-12 scores evidenced convergent validity criterion. The simplified factor structure and scoring scheme for PROQOL-HIV will allow clinicians to monitor with greater reliability the HRQL of patients in clinical care and research settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Indicators of accuracy of consumer health information on the Internet: a study of indicators relating to information for managing fever in children in the home.

PubMed

Fallis, Don; Frické, Martin

2002-01-01

To identify indicators of accuracy for consumer health information on the Internet. The results will help lay people distinguish accurate from inaccurate health information on the Internet. Several popular search engines (Yahoo, AltaVista, and Google) were used to find Web pages on the treatment of fever in children. The accuracy and completeness of these Web pages was determined by comparing their content with that of an instrument developed from authoritative sources on treating fever in children. The presence on these Web pages of a number of proposed indicators of accuracy, taken from published guidelines for evaluating the quality of health information on the Internet, was noted. Correlation between the accuracy of Web pages on treating fever in children and the presence of proposed indicators of accuracy on these pages. Likelihood ratios for the presence (and absence) of these proposed indicators. One hundred Web pages were identified and characterized as "more accurate" or "less accurate." Three indicators correlated with accuracy: displaying the HONcode logo, having an organization domain, and displaying a copyright. Many proposed indicators taken from published guidelines did not correlate with accuracy (e.g., the author being identified and the author having medical credentials) or inaccuracy (e.g., lack of currency and advertising). This method provides a systematic way of identifying indicators that are correlated with the accuracy (or inaccuracy) of health information on the Internet. Three such indicators have been identified in this study. Identifying such indicators and informing the providers and consumers of health information about them would be valuable for public health care.

Environmental Health Problems and Indicators in Tabriz, Iran

PubMed Central

Ghozikali, Mohammad Ghanbari; Mosaferi, Mohammad; Naddafi, Kazem

2013-01-01

Background: Environmental Health Indicators (EHIs) are the most important criteria for evaluation of efficiency and effectiveness of the activities of the health sector. The operations and situation of the health system can be analyzed through surveying the indicators and comparing them during different times. The present study aimed to study the EHIs of Tabriz, using the common environmental health processes and national EHIs of the Ministry of Health. Method: The required information for determination of EHIs was collected from different sources, including mainly the Environmental Health Department of the Health Center of East Azerbaijan Province, Iran and other organizations. Results: We found some important desirable and undesirable EHIs in Tabriz,including high percentage of households with access to safe and reliable drinking water, high safety in microbiological and chemical quality of drinking water, acceptable level of BOD5 and COD in the effluent of wastewater treatment plants (WTP), lack of complete municipal wastewater collection and treatment, relatively poor sanitation and health of food markets and public places, undesirable collection,transportation and disposal of municipal solid waste, low EHIs of some school classrooms, unacceptable disposal of medical waste in some hospitals, and finally high level of noise pollution in the city. Conclusion: Considering the poor condition of some EHIs of Tabriz, implementing proper actions for promotion of the indicators especially development of municipal wastewater collection, improvement of solid waste management,environmental health of some schools and mosques, and finally the noise pollution level of the city is recommended. PMID:24688959

Geriatric Patient Safety Indicators Based on Linked Administrative Health Data to Assess Anticoagulant-Related Thromboembolic and Hemorrhagic Adverse Events in Older Inpatients: A Study Proposal.

PubMed

Le Pogam, Marie-Annick; Quantin, Catherine; Reich, Oliver; Tuppin, Philippe; Fagot-Campagna, Anne; Paccaud, Fred; Peytremann-Bridevaux, Isabelle; Burnand, Bernard

2017-05-11

Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this population and their substantial risk of toxicity and inefficacy have therefore become an important patient safety and public health concern worldwide. Anticoagulant-related adverse events and the quality of anticoagulation management should thus be routinely assessed to improve patient safety in vulnerable older inpatients. This project aims to develop and validate a set of outcome and process indicators based on linked administrative health data (ie, insurance claims data linked to hospital discharge data) assessing older inpatient safety related to anticoagulation in both Switzerland and France, and enabling comparisons across time and among hospitals, health territories, and countries. Geriatric patient safety indicators (GPSIs) will assess anticoagulant-related adverse events. Geriatric quality indicators (GQIs) will evaluate the management of anticoagulants for the prevention and treatment of arterial or venous thromboembolism in older inpatients. GPSIs will measure cumulative incidences of thromboembolic and bleeding adverse events based on hospital discharge data linked to insurance claims data. Using linked administrative health data will improve GPSI risk adjustment on patients' conditions that are present at admission and will capture in-hospital and postdischarge adverse events. GQIs will estimate the proportion of index hospital stays resulting in recommended anticoagulation at discharge and up to various time frames based on the same electronic health data. The GPSI and GQI development and validation process will comprise 6 stages: (1) selection and specification of candidate indicators, (2) definition of administrative data

Monitoring socioeconomic inequity in maternal health indicators in Egypt: 1995-2005

PubMed Central

2009-01-01

Background Egypt's longstanding commitment to safe motherhood and maternal health has paid off in substantial declines in maternal mortality ratio and significant improvement in the levels of many maternal health indicators. The current study aims to monitor trends of maternal health indicators and their socioeconomic inequities among Egyptian women over ten-year period (1995-2005). It poses the question "to what extent have the recent maternal health improvements been shared among the various socioeconomic categories of women?" Methods The current paper uses data on maternal health available in three consecutive Demographic and Health Surveys (1995-2000-2005). Concentration index is used to assess the levels of health inequity over the ten year period. Results Although previous efforts in maternal health have contributed to substantial improvements in the general levels of maternal health indicators, these improvements were not enjoyed equally by women in various social groups. Indicators that have long been the focus of health policy such as fertility and contraceptive use showed some declines in disparities but they are far behind from achieving equity. Other indicators which relate to unmet need, prenatal care, delivery, postnatal care still loaded with high levels of inequity and call for more comprehensive policy interventions. PMID:19895706

Indigenous community health and climate change: integrating biophysical and social science indicators

USGS Publications Warehouse

Donatuto, Jamie; Grossman, Eric E.; Konovsky, John; Grossman, Sarah; Campbell, Larry W.

2014-01-01

This article describes a pilot study evaluating the sensitivity of Indigenous community health to climate change impacts on Salish Sea shorelines (Washington State, United States and British Columbia, Canada). Current climate change assessments omit key community health concerns, which are vital to successful adaptation plans, particularly for Indigenous communities. Descriptive scaling techniques, employed in facilitated workshops with two Indigenous communities, tested the efficacy of ranking six key indicators of community health in relation to projected impacts to shellfish habitat and shoreline archaeological sites stemming from changes in the biophysical environment. Findings demonstrate that: when shellfish habitat and archaeological resources are impacted, so is Indigenous community health; not all community health indicators are equally impacted; and, the community health indicators of highest concern are not necessarily the same indicators most likely to be impacted. Based on the findings and feedback from community participants, exploratory trials were successful; Indigenous-specific health indicators may be useful to Indigenous communities who are assessing climate change sensitivities and creating adaptation plans.

The Relational Health Indices for Youth: An Examination of Reliability and Validity Aspects

ERIC Educational Resources Information Center

Liang, Belle; Tracy, Allison J.; Kenny, Maureen E.; Brogan, Deirdre; Gatha, Ravi

2010-01-01

Relational health, a termed coined by Liang et al. (2001) to reflect Relational-Cultural Theory concepts, is the presence of growth-fostering characteristics in significant relationships. Although growth-fostering relationships have been conceptualized as relevant across the lifespan, existing research has mainly explored the experiences of…

Healthy People 2020: Leading Health Indicators

MedlinePlus

... Environmental Quality Injury and Violence Maternal, Infant, and Child Health Mental Health Nutrition, Physical Activity, and Obesity Oral Health Reproductive and Sexual Health Social Determinants Substance Abuse Tobacco Leading Health Indicators Healthy People 2020 provides ...

Comparing two survey methods of measuring health-related indicators: Lot Quality Assurance Sampling and Demographic Health Surveys.

PubMed

Anoke, Sarah C; Mwai, Paul; Jeffery, Caroline; Valadez, Joseph J; Pagano, Marcello

2015-12-01

Two common methods used to measure indicators for health programme monitoring and evaluation are the demographic and health surveys (DHS) and lot quality assurance sampling (LQAS); each one has different strengths. We report on both methods when utilised in comparable situations. We compared 24 indicators in south-west Uganda, where data for prevalence estimations were collected independently for the two methods in 2011 (LQAS: n = 8876; DHS: n = 1200). Data were stratified (e.g. gender and age) resulting in 37 comparisons. We used a two-sample two-sided Z-test of proportions to compare both methods. The average difference between LQAS and DHS for 37 estimates was 0.062 (SD = 0.093; median = 0.039). The average difference among the 21 failures to reject equality of proportions was 0.010 (SD = 0.041; median = 0.009); among the 16 rejections, it was 0.130 (SD = 0.010, median = 0.118). Seven of the 16 rejections exhibited absolute differences of <0.10, which are clinically (or managerially) not significant; 5 had differences >0.10 and <0.20 (mean = 0.137, SD = 0.031) and four differences were >0.20 (mean = 0.261, SD = 0.083). There is 75.7% agreement across the two surveys. Both methods yield regional results, but only LQAS provides information at less granular levels (e.g. the district level) where managerial action is taken. The cost advantage and localisation make LQAS feasible to conduct more frequently, and provides the possibility for real-time health outcomes monitoring. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Health indicators and social gradient in adolescent immigrants' health risk and healthcare experiences.

PubMed

Zlotnick, Cheryl; Birenbaum-Carmeli, Daphna; Goldblatt, Hadass; Dishon, Yael; Taychaw, Omer; Shadmi, Efrat

2018-02-01

Few studies have assessed healthcare experiences in apparently healthy adolescents, or whether healthcare attitudes are linked to the two leading adolescent health indicators, smoking and obesity. Even fewer have examined these relationships in adolescent immigrant groups or made comparisons to adolescent non-immigrants. Using a cross-sectional study, healthcare experiences were compared among three groups of adolescents (n = 589) including Russian immigrants (n = 154), Ethiopian immigrants (n = 54), and non-immigrants (n = 381). Bootstrap estimates indicated positive healthcare experiences were less common among Russian adolescent immigrants (OR = 0.38, CI = 0.17, 0.86) compared to non-immigrants, unless the Russian adolescent immigrants reported above average socioeconomic status, in which case they were more likely than non-immigrant adolescents to report positive healthcare experiences (OR = 3.22, CI = 1.05, 9.85). Positive healthcare experiences were less likely among adolescents who were smokers (OR = 0.50, CI = 0.27, 0.91), and more likely for adolescents with a normal or low BMI (OR = 3.16, CI = 1.56, 6.40) and for those relying on parents for health information (OR = 1.97, CI = 1.05, 3.70). Findings suggest a social gradient in which positive healthcare experiences were more common among adolescence with higher socioeconomic status for some immigrants (Russian adolescents) but not for others. The two leading health indicators were related to healthcare experiences, but as adolescent smokers were less likely to have positive healthcare experiences, proactive efforts are needed to engage this group. What is Known: • Health indicators (such as obesity) and healthcare attitudes are linked to healthcare service use among adolescents sampled from outpatient and inpatient populations. What is New: • A social gradient involving socioeconomic status and being an adolescent immigrant was found regarding

Levels, Trends and Disparities in Public-Health-Related Indicators among Reproductive-Age Women in Bangladesh by Urban-Rural and Richest-Poorest Groups, 1993-2011

PubMed Central

Khan, Md. Mobarak Hossain; Zanuzdana, Arina; Kraemer, Alexander

2013-01-01

Background And Objectives Although Bangladesh has already achieved noticeable progress in the field of development and health, disparities in public health indicators for several markers are still reported. To assess public health development in Bangladesh during the last two decades, firstly, we analysed levels, trends and disparities in public-health-related indicators by rural versus urban as well as by the richest versus poorest group of women who have ever been married. Secondly, using the most recent data set we performed multiple analyses to check whether urban-rural and richest-poorest disparities were still significant. Methods The analysis was based on six nationally representative data sets from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 1993-94 (n=9,640), 1996-1997 (n=9,127), 1999-2000 (n=10,544), 2004 (n=11,440), 2007 (n=10,996) and 2011 (n=17,749). The outcome variables were six selected public-health-related indicators. We performed various types of analyses, including multiple logistic regressions. Results The trend of all indicators except being overweight (1993-2011) displayed gradual improvements for both markers. However, the urban and richest groups revealed a better situation than their counterparts in both simple and multiple analyses. Disparities between richest-poorest groups were more pronounced than urban-rural disparities. For instance, the prevalence of delivery at any healthcare facility in 2011 was 20.4% in rural areas and 46.5% in urban areas, whereas it was 9.1% in the poorest group and 57.6% in the richest group. Conclusion The public health sector in Bangladesh has achieved some successes over the last two decades. However, urban-rural and richest-poorest disparities are still considerable and therefore more public health strategies and efforts are clearly needed for the rural and poorest groups of women in order to reduce these gaps further. PMID:24086485

An Approach to Developing Local Climate Change Environmental Public Health Indicators in a Rural District.

PubMed

Houghton, Adele; Austin, Jessica; Beerman, Abby; Horton, Clayton

2017-01-01

Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network's framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as "high vulnerability." Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment.

Screen-based media use clusters are related to other activity behaviours and health indicators in adolescents

PubMed Central

2013-01-01

Background Screen-based media (SBM) occupy a considerable portion of young peoples’ discretionary leisure time. The aim of this paper was to investigate whether distinct clusters of SBM use exist, and if so, to examine the relationship of any identified clusters with other activity/sedentary behaviours and physical and mental health indicators. Methods The data for this study come from 643 adolescents, aged 14 years, who were participating in the longitudinal Western Australian Pregnancy Cohort (Raine) Study through May 2003 to June 2006. Time spent on SBM, phone use and reading was assessed using the Multimedia Activity Recall for Children and Adults. Height, weight, muscle strength were measured at a clinic visit and the adolescents also completed questionnaires on their physical activity and psychosocial health. Latent class analysis (LCA) was used to analyse groupings of SBM use. Results Three clusters of SBM use were found; C1 ‘instrumental computer users’ (high email use, general computer use), C2 ‘multi-modal e-gamers’ (both high console and computer game use) and C3 ‘computer e-gamers’ (high computer game use only). Television viewing was moderately high amongst all the clusters. C2 males took fewer steps than their male peers in C1 and C3 (-13,787/week, 95% CI: -4619 to -22957, p = 0.003 and -14,806, 95% CI: -5,306 to -24,305, p = 0.002) and recorded less MVPA than the C1 males (-3.5 h, 95% CI: -1.0 to -5.9, p = 0.005). There was no difference in activity levels between females in clusters C1 and C3. Conclusion SBM use by adolescents did cluster and these clusters related differently to activity/sedentary behaviours and both physical and psychosocial health indicators. It is clear that SBM use is not a single construct and future research needs to take consideration of this if it intends to understand the impact SBM has on health. PMID:24330626

Indicators for Environment Health Risk Assessment in the Jiangsu Province of China

PubMed Central

Zhang, Shujie; Wei, Zhengzheng; Liu, Wenliang; Yao, Ling; Suo, Wenyu; Xing, Jingjing; Huang, Bingzhao; Jin, Di; Wang, Jiansheng

2015-01-01

According to the framework of “Pressure-State-Response”, this study established an indicator system which can reflect comprehensive risk of environment and health for an area at large scale. This indicator system includes 17 specific indicators covering social and economic development, pollution emission intensity, air pollution exposure, population vulnerability, living standards, medical and public health, culture and education. A corresponding weight was given to each indicator through Analytical Hierarchy Process (AHP) method. Comprehensive risk assessment of the environment and health of 58 counties was conducted in the Jiangsu province, China, and the assessment result was divided into four types according to risk level. Higher-risk counties are all located in the economically developed southern region of Jiangsu province and relatively high-risk counties are located along the Yangtze River and Xuzhou County and its surrounding areas. The spatial distribution of relatively low-risk counties is dispersive, and lower-risk counties mainly located in the middle region where the economy is somewhat weaker in the province. The assessment results provide reasonable and scientific basis for Jiangsu province Government in formulating environment and health policy. Moreover, it also provides a method reference for the comprehensive risk assessment of environment and health within a large area (provinces, regions and countries). PMID:26371016

Indicators for Environment Health Risk Assessment in the Jiangsu Province of China.

PubMed

Zhang, Shujie; Wei, Zhengzheng; Liu, Wenliang; Yao, Ling; Suo, Wenyu; Xing, Jingjing; Huang, Bingzhao; Jin, Di; Wang, Jiansheng

2015-09-07

According to the framework of "Pressure-State-Response", this study established an indicator system which can reflect comprehensive risk of environment and health for an area at large scale. This indicator system includes 17 specific indicators covering social and economic development, pollution emission intensity, air pollution exposure, population vulnerability, living standards, medical and public health, culture and education. A corresponding weight was given to each indicator through Analytical Hierarchy Process (AHP) method. Comprehensive risk assessment of the environment and health of 58 counties was conducted in the Jiangsu province, China, and the assessment result was divided into four types according to risk level. Higher-risk counties are all located in the economically developed southern region of Jiangsu province and relatively high-risk counties are located along the Yangtze River and Xuzhou County and its surrounding areas. The spatial distribution of relatively low-risk counties is dispersive, and lower-risk counties mainly located in the middle region where the economy is somewhat weaker in the province. The assessment results provide reasonable and scientific basis for Jiangsu province Government in formulating environment and health policy. Moreover, it also provides a method reference for the comprehensive risk assessment of environment and health within a large area (provinces, regions and countries).

[Health for All-Italia: an indicator system on health].

PubMed

Burgio, Alessandra; Crialesi, Roberta; Loghi, Marzia

2003-01-01

The Health for All - Italia information system collects health data from several sources. It is intended to be a cornerstone for the achievement of an overview about health in Italy. Health is analyzed at different levels, ranging from health services, health needs, lifestyles, demographic, social, economic and environmental contexts. The database associated software allows to pin down statistical data into graphs and tables, and to carry out simple statistical analysis. It is therefore possible to view the indicators' time series, make simple projections and compare the various indicators over the years for each territorial unit. This is possible by means of tables, graphs (histograms, line graphs, frequencies, linear regression with calculation of correlation coefficients, etc) and maps. These charts can be exported to other programs (i.e. Word, Excel, Power Point), or they can be directly printed in color or black and white.

An Approach to Developing Local Climate Change Environmental Public Health Indicators in a Rural District

PubMed Central

2017-01-01

Climate change represents a significant and growing threat to population health. Rural areas face unique challenges, such as high rates of vulnerable populations; economic uncertainty due to their reliance on industries that are vulnerable to climate change; less resilient infrastructure; and lower levels of access to community and emergency services than urban areas. This article fills a gap in public health practice by developing climate and health environmental public health indicators for a local public health department in a rural area. We adapted the National Environmental Public Health Tracking Network's framework for climate and health indicators to a seven-county health department in Western Kentucky. Using a three-step review process, we identified primary climate-related environmental public health hazards for the region (extreme heat, drought, and flooding) and a suite of related exposure, health outcome, population vulnerability, and environmental vulnerability indicators. Indicators that performed more poorly at the county level than at the state and national level were defined as “high vulnerability.” Six to eight high vulnerability indicators were identified for each county. The local health department plans to use the results to enhance three key areas of existing services: epidemiology, public health preparedness, and community health assessment. PMID:28352286

Income-related health inequalities across regions in Korea

PubMed Central

2011-01-01

Introduction In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. This study measures income-related health inequalities within and between regions and assesses the possibility of convergence of socioeconomic inequalities in health as regional incomes converge. Methods We considered a total of 45,233 subjects (≥ 19 years) drawn from the four waves of the Korean National Health and Nutrition Examination Survey (KNHANES). We considered true health as a latent variable following a lognormal distribution. We obtained ill-health scores by matching self-rated health (SRH) to its distribution and used the Gini Coefficient (GC) and an income-related ill-health Concentration Index (CI) to examine inequalities in income and health, respectively. Results The GC estimates were 0.3763 and 0.0657 for overall and spatial inequalities, respectively. The overall CI was -0.1309, and the spatial CI was -0.0473. The spatial GC and CI estimates were smaller than their counterparts, indicating substantial inequalities in income (from 0.3199 in Daejeon to 0.4233 Chungnam) and income-related health inequalities (from -0.1596 in Jeju and -0.0844 in Ulsan) within regions. The results indicate a positive relationship between the GC and the average ill-health and a negative relationship between the CI and the average ill-health. Those regions with a low level of health tended to show an unequal distribution of income and health. In addition, there was a negative relationship between the GC and the CI, that is, the larger the income inequalities, the larger the health inequalities were. The GC was negatively related to the average regional income, indicating that an increase in a region's average income reduced income inequalities in the region. On the other hand, the CI showed a positive relationship, indicating that an increase in a region's average income reduced health inequalities in the

Food shopping habits, physical activity and health-related indicators among adults aged ≥70 years.

PubMed

Thompson, Janice L; Bentley, Georgina; Davis, Mark; Coulson, Jo; Stathi, Afroditi; Fox, Kenneth R

2011-09-01

To investigate the food shopping habits of older adults in the UK and explore their potential associations with selected health-related indicators. A cross-sectional study including objectively measured physical activity levels, BMI, physical function and self-reported health status and dietary intake. Bristol, UK. A total of 240 older adults aged ≥70 years living independently. Mean age was 78·1 (sd 5·7) years; 66·7 % were overweight or obese and 4 % were underweight. Most (80·0 %) carried out their own food shopping; 53·3 % shopped at least once weekly. Women were more likely to shop alone (P < 0·001) and men more likely to shop with their spouse (P < 0·001). Men were more likely than women to drive to food shopping (P < 0·001), with women more likely to take the bus or be driven (P < 0·001). Most reported ease in purchasing fruit and vegetables (72·9 %) and low-fat products (67·5 %); 19·2 % reported low fibre intakes and 16·2 % reported high fat intakes. Higher levels of physical function and physical activity and better general health were significantly correlated with the ease of purchasing fresh fruit, vegetables and low-fat products. Shopping more often was associated with higher fat intake (P = 0·03); higher levels of deprivation were associated with lower fibre intake (P = 0·019). These findings suggest a pattern of food shopping carried out primarily by car at least once weekly at large supermarket chains, with most finding high-quality fruit, vegetables and low-fat products easily accessible. Higher levels of physical function and physical activity and better self-reported health are important in supporting food shopping and maintaining independence.

[Evaluating the activity of the Italian Mental Health Services inpatient and residential facilities: the PRISM (Process Indicator System for Mental health) indicators].

PubMed

Picardi, Angelo; Tarolla, Emanuele; de Girolamo, Giovanni; Gigantesco, Antonella; Neri, Giovanni; Rossi, Elisabetta; Biondi, Massimo

2014-01-01

This article describes the activities of a project aimed at developing a system of process and process/outcome indicators suitable to monitor over time the quality of psychiatric care of Italian inpatient and residential psychiatric facilities. This system, named PRISM (Process Indicator System for Mental health), was developed by means of a standardized evaluation made by a panel of experts and a consecutive pilot study in 17 inpatient and 13 residential psychiatric facilities. A total of 28 indicators were selected from a set of 251 candidate indicators developed by the most relevant and qualified Italian and international authorities. These indicators are derived by data from medical records and information about characteristics of facilities, and they cover processes of care, operational equipment of facilities, staff training and working, relationships with external agencies, and sentinel events. The procedure followed for the development of the indicator system was reliable and innovative. The data collected from the pilot study suggested a favourable benefit-cost ratio between the workload associated with regular use of the indicators into the context of daily clinical activities and the advantages related to the information gathered through regular use of the indicators. CONCLUSIONS.:The PRISM system provides additional information about the healthcare processes with respect to the information gathered via routine information systems, and it might prove useful for both continuous quality improvement programs and health services research.

Iran's Health Reform Plan: Measuring Changes in Equity Indices.

PubMed

Assari Arani, Abbas; Atashbar, Tohid; Antoun, Joseph; Bossert, Thomas

2018-03-01

Two years after the implementation of the Health Sector Evolution Plan (HSEP), this study evaluated the effects of the plan on health equity indices. The main indices assessed by the study were the Out-of-Pocket (OOP) health expenditures, the Fairness in Financial Contribution (FFC) to the health system index, the index of households' Catastrophic Health Expenditure (CHE) and the headcount ratio of Impoverishing Health Expenditure (IHE). The per capita share of costs for total health services has been decreased. The lowered costs have been more felt in rural areas, generally due to sharp decrease in inpatient costs. Per capita pay for outpatient services is almost constant or has slightly increased. The reform plan has managed to improve households' Catastrophic Health Expenditure (CHE) index from an average of 2.9% before the implementation of the plan to 2.3% after the plan. The Fairness in Financial Contribution (FFC) to the health system index has worsened from 0.79 to 0.76, and the headcount ratio of Impoverishing Health Expenditure (IHE) index deteriorated after the implementation of plan from 0.34 to 0.50. Considerable improvement, in decreasing the burden of catastrophic hospital costs in low income strata which is about 26% relative to the time before the implementation of the plan can be regarded as the main achievement of the plan, whereas the worsening in the headcount ratio of IHE and FFC are the equity bottlenecks of the plan.

Spatial and temporal dynamics of lake whitefish (Coregonus clupeaformis) health indicators: linking individual-based indicators to a management-relevant endpoint

USGS Publications Warehouse

Wagner, Tyler; Jones, Michael L.; Ebener, Mark P.; Arts, Michael T.; Brenden, Travis O.; Honeyfield, Dale C.; Wright, Gregory M.; Faisal, Mohamed

2010-01-01

We examined the spatial and temporal dynamics of health indicators in four lake whitefish (Coregonus clupeaformis) stocks located in northern lakes Michigan and Huron from 2003 to 2006. The specific objectives were to (1) quantify spatial and temporal variability in health indicators; (2) examine relationships among nutritional indicators and stock-specific spatial and temporal dynamics of pathogen prevalence and intensity of infection; and (3) examine relationships between indicators measured on individual fish and stock-specific estimates of natural mortality. The percent of the total variation attributed to spatial and temporal sources varied greatly depending on the health indicator examined. The most notable pattern was a downward trend in the concentration of highly unsaturated fatty acids (HUFAs), observed in all stocks, in the polar lipid fraction of lake whitefish dorsal muscle tissue over the three study years. Variation among stocks and years for some indicators were correlated with the prevalence and intensity of the swimbladder nematode Cystidicola farionis, suggesting that our measures of fish health were related, at some level, with disease dynamics. We did not find relationships between spatial patterns in fish health indicators and estimates of natural mortality rates for the stocks. Our research highlights the complexity of the interactions between fish nutritional status, disease dynamics, and natural mortality in wild fish populations. Additional research that identifies thresholds of health indicators, below (or above) which survival may be reduced, will greatly help in understanding the relationship between indicators measured on individual fish and potential population-level effects.

Belgian health-related data in three international databases

PubMed Central

2011-01-01

Aims of the study This study wants to examine the availability of Belgian healthcare data in the three main international health databases: the World Health Organization European Health for All Database (WHO-HFA), the Organisation for Economic Co-operation and Development Health Data 2009 and EUROSTAT. Methods For the indicators present in the three databases, the availability of Belgian data and the source of these data were checked. Main findings The most important problem concerning the availability of Belgian health-related data in the three major international databases is the lack of recent data. Recent data are available for 27% of the indicators of the WHO-HFA database, 73% of the OECD Health Data, and for half of the Eurostat indicators. Especially recent data about health status (including mortality-based indicators) are lacking. Discussion Only the availability of the health-related data is studied in this article. The quality of the Belgian data is however also important to examine. The main problem concerning the availability of health data is the timeliness. One of the causes of this lack of (especially mortality) data is the reform of the Belgian State. Nowadays mortality data are provided by the communities. This results in a delay in the delivery of national mortality data. However several efforts are made to catch up. PMID:22958554

Workload, mental health and burnout indicators among female physicians.

PubMed

Győrffy, Zsuzsa; Dweik, Diana; Girasek, Edmond

2016-04-01

Female doctors in Hungary have worse indicators of physical and mental health compared with other professional women. We aimed to cast light on possible indicators of mental health, workload, and burnout of female physicians. Two time-points (T) were compared, in 2003 (T1 n = 408) and 2013 (T2 n = 2414), based on two nationally representative surveys of female doctors, and comparison made with data from other professional control groups. Independent samples t test or chi-squared test was used both for the two time-point comparison and the comparison between the index and the control groups. The background factors of sleep disorders and burnout were assessed by binary logistic regression analysis. No significant differences in the rates of depressive symptoms and suicidal thoughts and attempts were detected between the 2003 and 2013 cohorts, but the prevalence of sleep disorders increased. The workload increased, and there was less job satisfaction in 2013 than in 2003, coupled to more stressful or difficult work-related situations. The personal accomplishment component of burnout significantly decreased in line with the declining work-related satisfaction. Compared to the professional control groups, the prevalence of depressive symptoms, suicide attempts, and sleep disorders was higher among female physicians at both time-points. The number of workplaces, frequency of work-related stressful situations, and intensive role conflict was associated with sleep disorders and decreased personal accomplishment. In comparison with the other professional groups, female doctors had worse mental health indicators with regard to depression, suicidal ideas, and sleep disorders both in 2003 and 2013 while within professional strata the changes seemed to be less. Increasing workload had a clear impact on sleep disorders and the personal accomplishment dimension of burnout.

Parental functional health literacy relates to skip pattern questionnaire error and to child oral health.

PubMed

Garrett, Gail M; Citi, Alicia M; Gansky, Stuart A

2012-05-01

The study's purpose was to determine if parental dental functional health literacy related to child oral health. A secondary aim was to assess if errors in completing the questionnaire related to FHL and child oral health. Parents of pediatric clinic children (N = 101) completed questionnaires and dental caries indices were recorded. Higher FHL was negatively correlated with worse child caries (r = -0.23), but not subjective oral health. Mean FHL seemed to differ by skip pattern (p = 0.087), indicating it may be a potential FHL proxy.

An assessment of key health indicators among emergency medical services professionals.

PubMed

Studnek, Jonathan R; Bentley, Melissa; Crawford, J Mac; Fernandez, Antonio R

2010-01-01

were 3,394 (17.0%) individuals classified as current smokers. Finally, logistic regression analysis indicated that when controlling for work-life characteristics and age, BMI and level of physical fitness were associated with preexisting health conditions. This study was the first known baseline assessment of EMS professionals regarding the key health indicators identified by Healthy People 2010. Investigations regarding the impact of health and wellness in relation to workforce stability should be undertaken. Further research should also be conducted to identify strategies to improve the health of the EMS workforce.

Health-Related Quality of Life in Bereaved HIV-Positive Adults: Relationships between HIV Symptoms, Grief, Social Support, and Axis II Indication

PubMed Central

Hansen, Nathan B.; Vaughan, Ellen L.; Cavanaugh, Courtenay E.; Connell, Christian M.; Sikkema, Kathleen J.

2008-01-01

Objective This study evaluated a model of the impact of borderline and antisocial personality disorder indications on HIV symptoms and health-related quality of life (HRQoL) in AIDS-bereaved adults, accounting for grief severity, social support and years since HIV diagnosis. Design Structural Equation modeling was used to test the proposed model in a sample of 268 HIV-seropositive adults enrolled in an intervention for coping with AIDS-related bereavement. Main Outcome Measures Functional Assessment of HIV Infection, HIV symptoms. Results The proposed model demonstrated excellent fit with study data and all hypothesized paths were supported. Personality disorder indication was directly related to HIV symptoms and HRQoL, and indirectly related through both social support and grief severity. Social support was negatively related to HIV symptoms and positively related to HRQoL, while grief severity was positively related to HIV symptoms and negatively related to HRQoL. Finally, HIV symptoms had a direct negative relationship with HRQoL. Conclusion Personality disorders have a direct negative effect on HIV symptoms and HRQoL, and indirect effects through grief severity and social support. PMID:19290717

A Health 'Kuznets' Curve'? Cross-Sectional and Longitudinal Evidence on Concentration Indices'.

PubMed

Costa-Font, Joan; Hernandez-Quevedo, Cristina; Sato, Azusa

2018-01-01

The distribution of income related health inequalities appears to exhibit changing patterns when both developing countries and developed countries are examined. This paper tests for the existence of a health Kuznets' curve; that is, an inverse U-shape pattern between economic developments (as measured by GDP per capita) and income-related health inequalities (as measured by concentration indices). We draw upon both cross sectional (the World Health Survey) and a long longitudinal (the European Community Household Panel survey) dataset. Our results suggest evidence of a health Kuznets' curve on per capita income. We find a polynomial association where inequalities decline when GDP per capita reaches a magnitude ranging between $26,000 and $38,700. That is, income-related health inequalities rise with GDP per capita, but tail off once a threshold level of economic development has been attained.

Quality of working life indicators in Canadian health care organizations: a tool for healthy, health care workplaces?

PubMed

Cole, Donald C; Robson, Lynda S; Lemieux-Charles, Louise; McGuire, Wendy; Sicotte, Claude; Champagne, Francois

2005-01-01

Quality-of-work-life (QWL) includes broad aspects of the work environment that affect employee learning and health. Canadian health care organizations (HCOs) are being encouraged to monitor QWL, expanding existing occupational health surveillance capacities. To investigate the understanding, collection, diffusion and use of QWL indicators in Canadian HCOs. We obtained cooperation from six diverse public HCOs managing 41 sites. We reviewed documentation relevant to QWL and conducted 58 focus groups/team interviews with strategic, support and programme teams. Group interviews were taped, reviewed and analysed for themes using qualitative data techniques. Indicators were classified by purpose and HCO level. QWL indicators, as such, were relatively new to most HCOs yet the data managed by human resource and occupational health and safety support teams were highly relevant to monitoring of employee well-being (119 of 209 mentioned indicators), e.g. sickness absence. Monitoring of working conditions (62/209) was also important, e.g. indicators of employee workload. Uncommon were indicators of biomechanical and psychosocial hazards at work, despite their being important causes of morbidity among HCO employees. Although imprecision in the definition of QWL indicators, limited links with other HCO performance measures and inadequate HCO resources for implementation were common, most HCOs cited ways in which QWL indicators had influenced planning and evaluation of prevention efforts. Increase in targeted HCO resources, inclusion of other QWL indicators and greater integration with HCO management systems could all improve HCO decision-makers' access to information relevant to employee health.

Income-related children's health inequality and health achievement in China.

PubMed

Chen, Lu; Wu, Ya; Coyte, Peter C

2014-10-29

This study assessed income-related health inequality and health achievement in children in China, and additionally, examined province-level variations in health achievement. Longitudinal data on 19,801 children under 18 years of age were derived from the China Health and Nutrition Survey. Income-related health inequality and health achievement were measured by the Health Concentration and Health Achievement Indices, respectively. Panel data with a fixed effect multiple regression model was employed to examine province-level variations in health achievement. A growing trend was towards greater health inequality among Chinese children over the last two decades. Although health achievement was getting better over time, the pro-rich inequality component has lessened the associated gain in achievement. Health achievement was positively impacted by middle school enrollments, the urbanization rate, inflation-adjusted per capita gross domestic product, and per capita public health spending. This study has provided evidence that average health status of Chinese children has improved, but inequality has widened. Widening inequality slowed the growth in health achievement for children over time. There were wide variations in health achievement throughout China.

The role of health-related behaviors in the socioeconomic disparities in oral health.

PubMed

Sabbah, Wael; Tsakos, Georgios; Sheiham, Aubrey; Watt, Richard G

2009-01-01

This study aimed to examine the socioeconomic disparities in health-related behaviors and to assess if behaviors eliminate socioeconomic disparities in oral health in a nationally representative sample of adult Americans. Data are from the US Third National Health and Nutrition Examination Survey (1988-1994). Behaviors were indicated by smoking, dental visits, frequency of eating fresh fruits and vegetables and extent of calculus, used as a marker for oral hygiene. Oral health outcomes were gingival bleeding, loss of periodontal attachment, tooth loss and perceived oral health. Education and income indicated socioeconomic position. Sex, age, ethnicity, dental insurance and diabetes were adjusted for in the regression analysis. Regression analysis was used to assess socioeconomic disparities in behaviors. Regression models adjusting and not adjusting for behaviors were compared to assess the change in socioeconomic disparities in oral health. The results showed clear socioeconomic disparities in all behaviors. After adjusting for behaviors, the association between oral health and socioeconomic indicators attenuated but did not disappear. These findings imply that improvement in health-related behaviors may lessen, but not eliminate socioeconomic disparities in oral health, and suggest the presence of more complex determinants of these disparities which should be addressed by oral health preventive policies.

[Healthy life years (HLY) comprehensive indicator of health situation--recommended by European Union].

PubMed

Gromulska, Lucyna; Wysocki, Mirosław J; Goryński, Paweł

2008-01-01

This article presents Healthy Life Years (HLY) indicator of functional health status, its application in the field of public health research and monitoring, method of calculation, idea of its construction and relation of HLY to other health status indicators e.g. life expectancy, quality adjusted life years. Current data on HLY in the EU member states are also presented. HLY indicator is one of structural indicators, recommended by European Council to deliver information on the progress of implementation of the Lisbon Strategy resolutions, which main principle is development of knowledge-based economy characterised by growth, social cohesion and respect for environment. HLY shifts the focus from quantity of years of life to its quality, full-productivity health of the population, thus conveying information not only on health status but also referring to the fields--other than medicine or social sciences--such as: finances, economy, politics, development.

[Health indicators in the time of crisis in Italy].

PubMed

Costa, Giuseppe; Marra, Michele; Salmaso, Stefania

2012-01-01

to estimate for the first time in Italy the consequences of the national current economic crisis on health and on social determinants of health, assessing its impact on a set of distal determinants (development and economic wellbeing, labour and environment) and of prossimal ones (material, psychosocial, professional, environmental and behavioural risk factors) on health care performance and on health outcomes normally related to economic trends, as self-perceived health, depression, number of suicides attempts, road traffic incidents and work injuries. The analysis is therefore aimed at identifying the most promising entry points in order to plan and implement either health care and other policies to tackle the negative effects of crisis on health. using the main international and national references on the measure of wellbeing and on the role of social determinants, this paper draws a conceptual framework of all the connections between recession and health. For each mechanism identified, it examines the value of the main available indicators before and during the crisis in order to measure its impact, adjusting if possible for the trend observed in the previous years. Indicators have been selected according to their availability in the main Italian national informative sources and, when not possible, circumscribing the analysis to the regional or local level. regarding the short term impact, results have shown an association between the recession and the raise of mental health related problems (measured in terms of number of suicides, depression and substance misuse), especially on the most disadvantaged groups because of their higher job and financial insecurity. A first ex-ante impact assessment on long term effects allows to attribute almost two hundred deaths a year due to the increase of unemployment rate. Regarding the budget cuts on public expenditure of the health care sector, significant reductions have been shown in specialist care and in drug

Parental Functional Health Literacy Relates to Skip Pattern Questionnaire Error and to Child Oral Health

PubMed Central

Garrett, Gail M.; Citi, Alicia M.; Gansky, Stuart A.

2012-01-01

The study's purpose was to determine if parental dental functional-health-literacy (FHL) related to child oral health; a secondary aim was to assess if errors in completing the questionnaire related to FHL and child oral health. Parents of pediatric clinic children (N=101) completed questionnaires; dental caries indices were recorded. Higher FHL was negatively correlated with worse child caries (r=-0.23), but not subjective oral health. Mean FHL seemed to differ by skip pattern (p=0.087), indicating it may be a potential FHL proxy. PMID:22685950

Development of key indicators to quantify the health impacts of climate change on Canadians.

PubMed

Cheng, June J; Berry, Peter

2013-10-01

This study aimed at developing a list of key human health indicators for quantifying the health impacts of climate change in Canada. A literature review was conducted in OVID Medline to identify health morbidity and mortality indicators currently used to quantify climate change impacts. Public health frameworks and other studies of climate change indicators were reviewed to identify criteria with which to evaluate the list of proposed key indicators and a rating scale was developed. Total scores for each indicator were calculated based on the rating scale. A total of 77 health indicators were identified from the literature. After evaluation using the chosen criteria, 8 indicators were identified as the best for use. They include excess daily all-cause mortality due to heat, premature deaths due to air pollution (ozone and particulate matter 2.5), preventable deaths from climate change, disability-adjusted life years lost from climate change, daily all-cause mortality, daily non-accidental mortality, West Nile Disease incidence, and Lyme borreliosis incidence. There is need for further data and research related to health effect quantification in the area of climate change.

Stakeholder driven indicators for eHealth performance management.

PubMed

Vedlūga, Tomas; Mikulskienė, Birutė

2017-08-01

The goal of the present article is to compile a corpus of indicators of eHealth development evaluation that would essentially reflect stakeholder approaches and complement technical indicators of assessment of an eHealth system. Consequently, the assessment of the development of an eHealth system would reflect stakeholder approaches and become an innovative solution in attempting to improve productivity of IT projects in the field of health care. The compiled minimum set of indicators will be designed to monitor implementation of the national eHealth information system. To ensure reliability of the quality research, the respondents were grouped in accordance to the geographical distribution and diversity of the levels and types of the represented jobs and institutions. The applied analysis implies several managerial insights on the hierarchy of eHealth indicators. These insights may be helpful in recommending priority activities in implementation of an eHealth data system on the national or international level. The research is practically useful as it is the first to deal with the topic in Lithuania and its theoretical and practical aspect are particularly relevant in implementation of an eHealth data system in Lithuania. The eHealth assessment indicators presented in the article may be practically useful in two aspects: (1) as key implementation guidelines facilitating the general course of eHealth system development and (2) as a means to evaluate eHealth outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Marital-role quality and stress-related psychobiological indicators.

PubMed

Barnett, Rosalind Chait; Steptoe, Andrew; Gareis, Karen C

2005-08-01

The quality of one's marital relationship is gaining recognition as a potential stressor associated with negative health outcomes. In this study, we estimated the relationship between marital-role quality and three psychobiological stress indicators (self-reported stress, cortisol levels, and ambulatory blood pressure). Participants were 105 middle-age adults (67 men, 38 women) who had previously taken part in the Whitehall psychobiology study. Ambulatory monitoring and saliva sampling were carried out over a working day, and marital relationships were assessed with the Marital/Partner Role Quality scales. We found that marital-role concerns (but not marital-role rewards) were related to all three psychobiological stress indicators; results did not vary by gender. Specifically, participants with more marital concerns reported greater stress throughout the day (p=.014), showed an attenuated cortisol increase following waking (p=.042) and a flatter cortisol slope over the day (p=.010), and had elevated ambulatory diastolic blood pressure over the middle of the workday (p=.004), with a similar trend in systolic pressure (p=.069). The results suggest that in addition to the carryover of work stress into domestic life that has been evident for many years, there are also influences of domestic strain on biological function over the working day and evening. Previous research suggests that a possible mechanism linking troubled marriages to health outcomes is depressed immune functioning. This study suggests a second mechanism-poorer stress-related biological response.

Sexual Minority Stress, Coping, and Physical Health Indicators.

PubMed

Flenar, Delphia J; Tucker, Carolyn M; Williams, Jaime L

2017-12-01

Sexual minorities experience higher rates of several physical health problems compared to their heterosexual counterparts. The present study uses Meyer's Minority Stress Model (Psychological Bulletin, 129(5): 674-697, 2003) to examine physical health indicators among 250 adults who identified as sexual minorities. Study hypotheses include that sexual minority stress is predictive of two physical health indicators (i.e., engagement in a health-promoting lifestyle and number of physical health problems) and that planning (i.e., problem-focused) and social support coping will partially mediate the relationship between sexual minority stress and each physical health indicator. Results showed that as level of sexual minority stress increased, engagement in a health-promoting lifestyle decreased and the number of physical health problems increased. Planning and social support coping did not mediate these relationships; however, as levels of coping increased, engagement in a health-promoting lifestyle increased. These findings have implications for researchers and healthcare professionals in their efforts to promote the physical health of sexual minorities.

Urban Health Indicator Tools of the Physical Environment: a Systematic Review.

PubMed

Pineo, Helen; Glonti, Ketevan; Rutter, Harry; Zimmermann, Nici; Wilkinson, Paul; Davies, Michael

2018-04-16

Urban health indicator (UHI) tools provide evidence about the health impacts of the physical urban environment which can be used in built environment policy and decision-making. Where UHI tools provide data at the neighborhood (and lower) scale they can provide valuable information about health inequalities and environmental deprivation. This review performs a census of UHI tools and explores their nature and characteristics (including how they represent, simplify or address complex systems) to increase understanding of their potential use by municipal built environment policy and decision-makers. We searched seven bibliographic databases, four key journals and six practitioner websites and conducted Google searches between January 27, 2016 and February 24, 2016 for UHI tools. We extracted data from primary studies and online indicator systems. We included 198 documents which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy. Our taxonomy classifies the significant diversity of UHI tools with respect to topic, spatial scale, format, scope and purpose. The proportions of UHI tools which measure data at the neighborhood and lower scale, and present data via interactive maps, have both increased over time. This is particularly relevant to built environment policy and decision-makers, reflects growing analytical capability and offers the potential for improved understanding of the complexity of influences on urban health (an aspect noted as a particular challenge by some indicator producers). The relation between urban health indicators and health impacts attributable to modifiable environmental characteristics is often indirect. Furthermore, the use of UHI tools in policy and decision-making appears to be limited, thus raising questions about the continued development of such tools by multiple organisations duplicating scarce resources. Further research is needed to understand the requirements of built environment policy and

Towards good practice for health statistics: lessons from the Millennium Development Goal health indicators.

PubMed

Murray, Christopher J L

2007-03-10

Health statistics are at the centre of an increasing number of worldwide health controversies. Several factors are sharpening the tension between the supply and demand for high quality health information, and the health-related Millennium Development Goals (MDGs) provide a high-profile example. With thousands of indicators recommended but few measured well, the worldwide health community needs to focus its efforts on improving measurement of a small set of priority areas. Priority indicators should be selected on the basis of public-health significance and several dimensions of measurability. Health statistics can be divided into three types: crude, corrected, and predicted. Health statistics are necessary inputs to planning and strategic decision making, programme implementation, monitoring progress towards targets, and assessment of what works and what does not. Crude statistics that are biased have no role in any of these steps; corrected statistics are preferred. For strategic decision making, when corrected statistics are unavailable, predicted statistics can play an important part. For monitoring progress towards agreed targets and assessment of what works and what does not, however, predicted statistics should not be used. Perhaps the most effective method to decrease controversy over health statistics and to encourage better primary data collection and the development of better analytical methods is a strong commitment to provision of an explicit data audit trail. This initiative would make available the primary data, all post-data collection adjustments, models including covariates used for farcasting and forecasting, and necessary documentation to the public.

Health-Related Decision-Making in HIV Disease

PubMed Central

Doyle, Katie L.; Woods, Steven Paul; Morgan, Erin E.; Iudicello, Jennifer E.; Cameron, Marizela V.; Gilbert, Paul E.; Beltran, Jessica

2016-01-01

Individuals living with HIV show moderate decision-making deficits, though no prior studies have evaluated the ability to make optimal health-related decisions across the HIV healthcare continuum. Forty-three HIV+ individuals with HIV−associated neurocognitive disorders (HAND+), 50 HIV+ individuals without HAND (HAND−), and 42 HIV− participants were administered two measures of health-related decision-making as part of a comprehensive neuropsychological battery: 1) The Decisional Conflict Scale (DCS), and 2) The Modified UCSD Brief Assessment for Capacity to Consent (UBACC-T). Multiple regression analyses revealed that HAND was an independent predictor of both the DCS and the UBACC-T, such that the HAND+ sample evidenced significantly poorer scores relative to comparison groups. Within the HIV+ sample, poorer health-related decision-making was associated with worse performance on tests of episodic memory, risky decision-making, and health literacy. Findings indicate that individuals with HAND evidence moderate deficits in effectively comprehending and evaluating various health-related choices. PMID:26946300

Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study

PubMed Central

Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin

2017-01-01

Background To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. Methods A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. Results The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). Conclusions The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion. PMID:28746400

Associations between health culture, health behaviors, and health-related outcomes: A cross-sectional study.

PubMed

Jia, Yingnan; Gao, Junling; Dai, Junming; Zheng, Pinpin; Fu, Hua

2017-01-01

To examine the associations between demographic characteristics, health behaviors, workplace health culture, and health-related outcomes in Chinese workplaces. A total of 1508 employees from 10 administrative offices and 6 enterprises were recruited for a cross-sectional survey. Self-administered questionnaires mainly addressed demographic characteristics, health behaviors, workplace health culture, and health-related outcomes including self-rated health, mental health, and happiness. The proportion of participants who reported good health-related outcomes was significantly higher in those working in administrative offices than those working in enterprises. The result of the potential factors related to self-rated health (SRH), mental health, and happiness by logistic regression analyses showed that age and income were associated with SRH; type of workplace, age, smoking, and health culture at the workplace level were associated with mental health; and beneficial health effects of direct leadership was positively associated with happiness. Moreover, there were some similar results among 3 multivariate regression models. Firstly, good SRH (Odds Ratio (OR) = 1.744), mental health (OR = 1.891), and happiness (OR = 1.736) were more common among highly physically active participants compared with those physical inactive. Furthermore, passive smoking was negatively correlated with SRH (OR = 0.686), mental health (OR = 0.678), and happiness (OR = 0.616), while health culture at the individual level was positively correlated with SRH (OR = 1.478), mental health (OR = 1.654), and happiness (OR = 2.916). The present study indicated that workplace health culture, health behaviors, and demographic characteristics were associated with health-related outcomes. Furthermore, individual health culture, physical activity, and passive smoking might play a critical role in workplace health promotion.

Effects of the 2008 Global Economic Crisis on National Health Indicators: Results from the Korean National Health and Nutrition Examination Survey

PubMed Central

Shin, Jung-Hyun; Lee, Gyeongsil; Kim, Jun-Suk; Oh, Hyung-Seok; Lee, Keun-Seung; Hur, Yong

2015-01-01

Background The relationship between economics and health has been of great interest throughout the years. The accumulated data is not sufficient enough to carry out long-term studies from the viewpoint of morbidity, although Korea National Health and Nutrition Examination Survey (KNHANES) was carried out yearly since 1998 in Korea. Thus, we investigated the effect of the 2008 global economic crisis on health indicators of Korea. Methods Health indicators were selected by paired t-test based on 2007 and 2009 KNHANES data. Age, gender, body mass index (BMI), smoking, drinking, exercise, education, income, working status, and stress were used as confounding factors, which were analyzed with logistic and probit analyses. Validation was done by comparing gross domestic product (GDP) growth rates and probit analyses results of 2007-2012 KNHANES data. Results Among several health indicators, the prevalence of hypertension and stress perception was higher after the economic crisis. Factors related with higher hypertension prevalence include older age, male gender, higher BMI, no current tobacco use, recent drinking, lower education levels, and stress perception. Factors related with more stress perception were younger age, female gender, current smoking, lower education levels, and lower income. GDP growth rates, a macroeconomic indicator, are inversely associated with hypertension prevalence with a one-year lag, and also inversely associated with stress perception without time lag. Conclusion The economic crisis increased the prevalence of hypertension and stress perception. In the case of GDP growth rate change, hypertension was an inversely lagging indicator and stress perception was an inversely-related coincident indicator. PMID:26217479

Effects of the 2008 Global Economic Crisis on National Health Indicators: Results from the Korean National Health and Nutrition Examination Survey.

PubMed

Shin, Jung-Hyun; Lee, Gyeongsil; Kim, Jun-Suk; Oh, Hyung-Seok; Lee, Keun-Seung; Hur, Yong; Cho, Be-Long

2015-07-01

The relationship between economics and health has been of great interest throughout the years. The accumulated data is not sufficient enough to carry out long-term studies from the viewpoint of morbidity, although Korea National Health and Nutrition Examination Survey (KNHANES) was carried out yearly since 1998 in Korea. Thus, we investigated the effect of the 2008 global economic crisis on health indicators of Korea. Health indicators were selected by paired t-test based on 2007 and 2009 KNHANES data. Age, gender, body mass index (BMI), smoking, drinking, exercise, education, income, working status, and stress were used as confounding factors, which were analyzed with logistic and probit analyses. Validation was done by comparing gross domestic product (GDP) growth rates and probit analyses results of 2007-2012 KNHANES data. Among several health indicators, the prevalence of hypertension and stress perception was higher after the economic crisis. Factors related with higher hypertension prevalence include older age, male gender, higher BMI, no current tobacco use, recent drinking, lower education levels, and stress perception. Factors related with more stress perception were younger age, female gender, current smoking, lower education levels, and lower income. GDP growth rates, a macroeconomic indicator, are inversely associated with hypertension prevalence with a one-year lag, and also inversely associated with stress perception without time lag. The economic crisis increased the prevalence of hypertension and stress perception. In the case of GDP growth rate change, hypertension was an inversely lagging indicator and stress perception was an inversely-related coincident indicator.

National Estimates of Marijuana Use and Related Indicators - National Survey on Drug Use and Health, United States, 2002-2014.

PubMed

Azofeifa, Alejandro; Mattson, Margaret E; Schauer, Gillian; McAfee, Tim; Grant, Althea; Lyerla, Rob

2016-09-02

In the United States, marijuana is the most commonly used illicit drug. In 2013, 7.5% (19.8 million) of the U.S. population aged ≥12 years reported using marijuana during the preceding month. Because of certain state-level policies that have legalized marijuana for medical or recreational use, population-based data on marijuana use and other related indicators are needed to help monitor behavioral health changes in the United States. 2002-2014. The National Survey on Drug Use and Health (NSDUH) is a national- and state-level survey of a representative sample of the civilian, noninstitutionalized U.S. population aged ≥12 years. NSDUH collects information about the use of illicit drugs, alcohol, and tobacco; initiation of substance use; frequency of substance use; substance dependence and abuse; perception of substance harm risk or no risk; and other related behavioral health indicators. This report describes national trends for selected marijuana use and related indicators, including prevalence of marijuana use; initiation; perception of harm risk, approval, and attitudes; perception of availability and mode of acquisition; dependence and abuse; and perception of legal penalty for marijuana possession. In 2014, a total of 2.5 million persons aged ≥12 years had used marijuana for the first time during the preceding 12 months, an average of approximately 7,000 new users each day. During 2002-2014, the prevalence of marijuana use during the past month, past year, and daily or almost daily increased among persons aged ≥18 years, but not among those aged 12-17 years. Among persons aged ≥12 years, the prevalence of perceived great risk from smoking marijuana once or twice a week and once a month decreased and the prevalence of perceived no risk increased. The prevalence of past year marijuana dependence and abuse decreased, except among persons aged ≥26 years. Among persons aged ≥12 years, the percentage reporting that marijuana was fairly easy or very easy

Analysis of Health Indicators in Two Rural Communities on the Colombian Caribbean Coast: Poor Water Supply and Education Level Are Associated with Water-Related Diseases.

PubMed

Ruiz-Díaz, María Stephany; Mora-García, Gustavo José; Salguedo-Madrid, Germán Israel; Alario, Ángelo; Gómez-Camargo, Doris Esther

2017-11-01

Water-related diseases are closely linked with drinking water, sanitation, and hygiene (WASH) indicators, socioeconomic status, education level, or dwelling's conditions. Developing countries exhibit a particular vulnerability to these diseases, especially rural areas and urban slums. This study assessed socioeconomic features, WASH indicators, and water-related diseases in two rural areas of the Colombian Caribbean coast. Most of this population did not finish basic education (72.3%, N = 159). Only one of the communities had a water supply (aqueduct), whereas the other received water via an adapted tanker ship. No respondents reported sewage services; 92.7% ( N = 204) had garbage service. Reported cases of diarrhea were associated with low education levels ( P = 2.37 × 10 -9 ) and an unimproved drinking water supply ( P = 0.035). At least one fever episode was reported in 20% ( N = 44) of dwellings, but the cases were not related to any indicator. The Aedes/ House index (percentage of houses that tested positive for Aedes larvae and/or pupae) was 69%, the container index (percentage of water-holding containers positive for Aedes larvae or pupae) 29.4%, and the Breteau index (number of positive containers per 100 houses in a specific location) was three positive containers per 100 inspected houses. The presence of positive containers was associated with the absence of a drinking water supply ( P = 0.04). The community with poorer health indicators showed greater health vulnerability conditions for acquisition of water-related diseases. In summary, water supply and educational level were the main factors associated with the presence of water-related diseases in both communities.

Evaluation of Geographic Indices Describing Health Care Utilization.

PubMed

Kim, Agnus M; Park, Jong Heon; Kang, Sungchan; Kim, Yoon

2017-01-01

The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.

Evaluation of Geographic Indices Describing Health Care Utilization

PubMed Central

Park, Jong Heon

2017-01-01

Objectives The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. Methods We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. Results In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. Conclusions Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit. PMID:28173689

Patterns of Adolescent Physical Activity, Screen-Based Media Use and Positive and Negative Health Indicators in the U.S. and Canada

PubMed Central

Iannotti, Ronald J.; Kogan, Michael D.; Janssen, Ian; Boyce, William F.

2008-01-01

Purpose To examine: 1) how adolescent physical activity (PA) and screen-based media use (SBM) relate to physical and social health indicators, and 2) cross-national differences in these relationships. Methods Essentially identical questions and methodologies were used in the Health Behavior in School-Aged Children cross-sectional surveys of nationally-representative samples of American (N = 14,818) and Canadian (N = 7,266) students in grades 6 to 10. Items included questions about frequency of PA, SBM, positive health indicators (health status, self-image, quality of life, and quality of family and peer relationships), and negative health indicators (health complaints, physical aggression, smoking, drinking, and marijuana use). Results In regression analyses controlling for age and gender, positive health indicators were uniformly positively related to PA while two negative health indicators were negatively related to PA. However, PA was positively related to physical aggression. The pattern for SBM was generally the opposite; SBM was negatively related to most positive health indices and positively related to several of the negative health indicators. The notable exception was that SBM was positively related to the quality of peer relationships. Although there were cross-national differences in the strength of some relationships, these patterns were essentially replicated in both countries. Conclusions Surveys of nationally representative samples of youth in two countries provide evidence of positive physical and social concomitants of PA and negative concomitants of SBM. These findings suggest potential positive consequences of increasing PA and decreasing SBM in adolescents and provide further justification for such efforts. PMID:19380098

Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013-2014.

PubMed

Dragon, Christina N; Laffan, Alison M; Erdem, Erkan; Cahill, Sean R; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C

2017-12-01

Advances in lesbian, gay, and bisexual (sexual minority [SM]) acceptance and equality have been made in the past decade. However, certain SM subgroups continue to be disadvantaged due to lack of data and, thus, lack of knowledge about these populations. Data for older sexual minorities are especially lacking and will be increasingly important as more sexual minorities enter older age. This research explores results from a nationally representative health survey to elucidate some health indicators for older sexual minorities. Data from the 2013 and 2014 National Health Interview Surveys (NHIS) were pooled for increased sample size, and established research methods were followed as recommended by prior NHIS sexual orientation studies. We conducted descriptive analyses on the differences between SM and heterosexual groups, aged 65 years and older, for 12 health indicators. Four out of the 12 health indicators were significantly different for sexual minorities, and three out of those four indicated positive health outcomes or behaviors when compared with heterosexuals. Sexual minorities were more than three times as likely to receive HIV testing as heterosexual peers. Sexual minorities were more likely to receive an influenza vaccination, and much more likely to report excellent or very good health, than their heterosexual peers. Sexual minorities were more than twice as likely to report binge drinking, which is consistent with prior research for adult sexual minorities. This analysis is the first to examine national data on health indicators for sexual minorities, aged 65 years and older, using NHIS data. As more surveys begin to collect SMdata and more years of data are collected by NHIS, a clearer picture of the health of older adult sexual minorities should emerge.

Community/hospital indicators in South African public sector mental health services.

PubMed

Lund, Crick; Flisher, Alan J

2003-12-01

The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

Internet Searches for Affect-Related Terms: An Indicator of Subjective Well-Being and Predictor of Health Outcomes across US States and Metro Areas.

PubMed

Ford, Michael T; Jebb, Andrew T; Tay, Louis; Diener, Ed

2018-03-01

The present study explored the potential for internet search data to serve as indicators of subjective well-being (SWB) and predictors of health at the state and metro area levels. We propose that searches for positive and negative affect-related terms represent information-seeking behavior of individuals who are experiencing emotions and seeking information about them. Data on the frequency of Google searches for 15 affect terms were collected from Google's Trends website (trends.google.com). These were paired with data on health, self-reported emotions, psychological well-being, personality, and Twitter postings at the state and metro area levels. Several internet search scores correlated with indicators of cardiovascular health and depression. Some search term scores also correlated strongly with self-reported emotions, well-being metrics, neuroticism, per capita income, and Twitter postings at the state or metro area level. Multiple regression analyses suggest that affect searches predict depression rates at the metro area level beyond the effects of income and other well-being measures. The results highlight the promise and challenges of using internet search data at the aggregate level for physical and mental health assessment and surveillance. © 2018 The International Association of Applied Psychology.

Workgroup Report: Developing Environmental Health Indicators for European Children: World Health Organization Working Group

PubMed Central

Pond, Kathy; Kim, Rokho; Carroquino, Maria-Jose; Pirard, Philippe; Gore, Fiona; Cucu, Alexandra; Nemer, Leda; MacKay, Morag; Smedje, Greta; Georgellis, Antonis; Dalbokova, Dafina; Krzyzanowski, Michal

2007-01-01

A working group coordinated by the World Health Organization developed a set of indicators to protect children’s health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children’s Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children’s Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002. PMID:17805431

Workgroup report: developing environmental health indicators for European children: World Health Organization Working Group.

PubMed

Pond, Kathy; Kim, Rokho; Carroquino, Maria-Jose; Pirard, Philippe; Gore, Fiona; Cucu, Alexandra; Nemer, Leda; MacKay, Morag; Smedje, Greta; Georgellis, Antonis; Dalbokova, Dafina; Krzyzanowski, Michal

2007-09-01

A working group coordinated by the World Health Organization developed a set of indicators to protect children's health from environmental risks and to support current and future European policy needs. On the basis of identified policy needs, the group developed a core set of 29 indicators for implementation plus an extended set of eight additional indicators for future development, focusing on exposure, health effects, and action. As far as possible, the indicators were designed to use existing information and are flexible enough to be developed further to meet the needs of policy makers and changing health priorities. These indicators cover most of the priority topic areas specified in the Children's Environment and Health Action Plan for Europe (CEHAPE) as adopted in the Fourth Ministerial Conference on Health and Environment in 2004, and will be used to monitor the implementation of CEHAPE. This effort can be viewed as an integral part of the Global Initiative on Children's Environmental Health Indicators, launched at the World Summit on Sustainable Development in 2002.

Indicators related to the rational use of medicines and its associated factors

PubMed Central

Lima, Marina Guimarães; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Guibu, Ione Aquemi; Soeiro, Orlando Mario; Leite, Silvana Nair; Karnikowski, Margô Gomes de Oliveira; Costa, Karen Sarmento; Acurcio, Francisco de Assis

2017-01-01

ABSTRACT OBJECTIVE To evaluate indicators related to the rational use of medicines and its associated factors in Basic Health Units. METHOD This is a cross-sectional study carried out in a representative sample of Brazilian cities included in the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). The data were collected by interviews with users, medicine dispensing professionals, and prescribers; and described by prescription, dispensing, and health services indicators. We analyzed the association between human resources characteristics of pharmaceutical services and dispensing indicators. RESULTS At national level, the average number of medicines prescribed was 2.4. Among the users, 5.8% had antibiotic prescription, 74.8% received guidance on how to use the medicines at the pharmacy and, for 45.1% of users, all prescribed medicines were from the national list of essential medicines. All the indicators presented statistically significant differences between the regions of Brazil. The dispensing professionals that reported the presence of a pharmacist in the unit with a working load of 40 hours or more per week presented 1.82 more chance of transmitting information on the way of using the medicines in the dispensing process. CONCLUSION The analysis of prescription, dispensing, and health services indicators in the basic health units showed an unsatisfactory proportion of essential medicines prescription and limitations in the correct identification of the medicine, orientation to the patients on medicines, and availability of therapeutic protocols in the health services. PMID:29160461

Introducing version 5 of Interpreting Indicators of Rangeland Health

USDA-ARS?s Scientific Manuscript database

Interpreting Indicators of Rangeland Health was initiated in 1994 as a qualitative, rapid assessment technique to evaluate rangeland health. Seventeen field indicators are used to rate three attributes of rangeland health: 1) soil/site stability, 2) hydrologic function, and 3) biotic integrity. The ...

Sensitivity of health sector indicators' response to climate change in Ghana.

PubMed

Dovie, Delali B K; Dzodzomenyo, Mawuli; Ogunseitan, Oladele A

2017-01-01

There is accumulating evidence that the emerging burden of global climate change threatens the fidelity of routine indicators for disease detection and management of risks to public health. The threat partially reflects the conservative character of the health sector and the reluctance to adopt new indicators, despite the growing awareness that existing environmental health indicators were developed to respond to risks that may no longer be relevant, and are too simplistic to also act as indicators for newer global-scale risk factors. This study sought to understand the scope of existing health indicators, while aiming to discover new indicators for building resilience against three climate sensitive diseases (cerebro spinal meningitis, malaria and diarrhea). Therefore, new potential indicators derived from human and biophysical origins were developed to complement existing health indicators, thereby creating climate-sensitive battery of robust composite indices of resilience in health planning. Using Ghana's health sector as a case study systematic international literature review, national expert consultation, and focus group outcomes yielded insights into the relevance, sensitivity and impacts of 45 indicators in 11 categories in responding to climate change. In total, 65% of the indicators were sensitive to health impacts of climate change; 24% acted directly; 31% synergistically; and 45% indirectly, with indicator relevance strongly associated with type of health response. Epidemiological indicators (e.g. morbidity) and health demographic indicators (e.g. population structure) require adjustments with external indicators (e.g. biophysical, policy) to be resilient to climate change. Therefore, selective integration of social and ecological indicators with existing public health indicators improves the fidelity of the health sector to adopt more robust planning of interdependent systems to build resilience. The study highlights growing uncertainties in

Integration of Health Protection and Health Promotion: Rationale, Indicators, and Metrics

PubMed Central

Sorensen, Glorian; McLellan, Deborah; Dennerlein, Jack T.; Pronk, Nicolaas P.; Allen, Jennifer D.; Boden, Leslie I.; Okechukwu, Cassandra A.; Hashimoto, Dean; Stoddard, Anne; Wagner, Gregory R

2014-01-01

Objective To offer a definition of an “integrated” approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization. Methods Guided by the question, “How will we know it when we see it?” we reviewed relevant literature to identify available definitions and metrics, and used a modified-Delphi process to review and refine indicators and measures of integrated approaches. Results A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers and workers. Conclusions A shared understanding of what is meant by integrated approaches to protect and promote worker health has the potential to improve dialogue among researchers and facilitate the research-to-practice process. PMID:24284762

[Inequalities on indicators of chronic conditions among adults in Mexico: analysis of three health surveys].

PubMed

Gutiérrez, Juan Pablo; García-Saisó, Sebastián; Espinosa-de la Peña, Rodrigo; Balandrán, Dulce Alejandra

2016-01-01

To analyze trends from 2000 to 2012 in socioeconomic inequalities in health related to diabetes and hypertension indicators in Mexico. Cross-sectional analysis of three national health surveys (2000, 2006 and 2012), measuring inequality using absolute and relative gaps as well as the Slope Index of Inequality for diabetes and hypertension indicators. From 2000 to 2012, there is a reduction in the gap related to the prevalence of diagnosed diabetes and hypertension, with a parallel reduction in the inequality related to care for those conditions, while an inequality gradient on diabetes care remains. While there is an evident progress in the reduction of inequalities for diabetes and hypertension diagnostic and care in Mexico, some inequalities remain. Given the contribution of these conditions to the burden of disease in the country, there is a need to strength the quality of health services that will promote effective access.

The ECHI project: health indicators for the European Community.

PubMed

Kramers, Pieter G N

2003-09-01

Within the EU Health Monitoring Programme (HMP), the ECHI project has proposed a comprehensive list of 'European Community Health Indicators'. In the design of the indicator set, a set of explicit criteria was applied. These included: i) be comprehensive and coherent, i.e. cover all domains of the public health field; ii) take account of earlier work, especially that by WHO-Europe, OECD and Eurostat; and iii) cover the priority areas that Member States and Community health policies currently pursue. Flexibility is an important characteristic of the present proposal. In ECHI, this has been emphasized by the definition of 'user-windows'. These are subsets from the overall indicator list, each of which should reflect a specific user's requirement or interest. The proposed indicators are, in most cases, defined as generic indicators, i.e. their actual operational definitions have not yet been attempted. This work has been, and is being carried out to a large part by other projects financed under the HMP, which cover specific areas of public health or areas of data collection. Apart from indicators covered by regularly available data, indicators (or issues) have been proposed for which data are currently difficult to collect but which from a policy point of view would be needed. All this points to the fact that establishing an indicator list which is actually used by Member States is a continuously developing process. This process is now continued by the first strand of the new EU Public Health Action Programme.

State-level variations in income-related inequality in health and health achievement in the US.

PubMed

Xu, Ke Tom

2006-07-01

The objective of this study was to examine state-level variations in income-related inequality in health and overall health achievement in the US. Data that were representative of the US and each state in 2001 were extracted from the Current Population Survey 2001. Income-related inequality in health and health achievement were measured by Health Concentration and Health Achievement Indices, respectively. Significant variations were found across states in income-related inequality in health and health achievement. In particular, states in the south and east regions, on average, experienced a higher degree of health inequality and lower health achievement. About 80% of the state-level variation in health achievement could be explained by demographics, economic structure and performance, and state and local government spending and burden. In contrast, medical care resource indicators were not found to contribute to health achievement in states. States with better health achievement were more urbanized, had lower proportions of minority groups, females and the elderly, fewer individuals below the poverty line, larger primary industry, and lower unemployment rates. Also, per capita state and local government spending, particularly the proportion spent on public health, was positively associated with better health achievement. Because of the direct implications of health level and distribution in resource allocation and social norms, states with a lower level of health achievement need to prioritize efforts in increasing and reallocating resources to diminish health inequality and to improve population health.

Interactive visualization of public health indicators to support policymaking: An exploratory study

PubMed Central

Zakkar, Moutasem; Sedig, Kamran

2017-01-01

Purpose The purpose of this study is to examine the use of interactive visualizations to represent data/information related to social determinants of health and public health indicators, and to investigate the benefits of such visualizations for health policymaking. Methods: The study developed a prototype for an online interactive visualization tool that represents the social determinants of health. The study participants explored and used the tool. The tool was evaluated using the informal user experience evaluation method. This method involves the prospective users of a tool to use and play with it and their feedback to be collected through interviews. Results: Using visualizations to represent and interact with health indicators has advantages over traditional representation techniques that do not allow users to interact with the information. Communicating healthcare indicators to policymakers is a complex task because of the complexity of the indicators, diversity of audiences, and different audience needs. This complexity can lead to information misinterpretation, which occurs when users of the health data ignore or do not know why, where, and how the data has been produced, or where and how it can be used. Conclusions: Public health policymaking is a complex process, and data is only one element among others needed in this complex process. Researchers and healthcare organizations should conduct a strategic evaluation to assess the usability of interactive visualizations and decision support tools before investing in these tools. Such evaluation should take into consideration the cost, ease of use, learnability, and efficiency of those tools, and the factors that influence policymaking. PMID:29026455

49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 2 2011-10-01 2011-10-01 false Requirements relating to transport indices and... Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices..., transport and unloading are to be supervised by persons qualified in the transport of radioactive material...

49 CFR 176.704 - Requirements relating to transport indices and criticality safety indices.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 2 2010-10-01 2010-10-01 false Requirements relating to transport indices and... Requirements relating to transport indices and criticality safety indices. (a) The sum of the transport indices..., transport and unloading are to be supervised by persons qualified in the transport of radioactive material...

Are mental health problems associated with use of Accident and Emergency and health-related harm?

PubMed

Keene, J; Rodriguez, J

2007-08-01

Previous findings indicate that mental health problems are common in Emergency departments; however, there are few studies of the extent of health-related problems and emergency service use in mental health populations as a whole. Record linkage methods were used to map the association between mental health, age, gender, and health-related harm across total health and mental health care populations in one geographical area, over three years. By examining patterns of health-related harm, an accurate profile of mentally ill Emergency patients was generated enabling identification of factors that increased vulnerability to harm. Of the total population of 625 964 individuals, 10.7% contacted Accident and Emergency (A&E) over three years, this proportion rose to 28.6% among the total secondary care mental health population. Young men and older women were more likely to contact A&E, both overall and within mental health populations and were also more likely to be frequent attendees at A&E. Four distinct groups (typologies) of mental health patients attending A&E emerged: young, male frequent attendees with self-inflicted and other traumatic injuries; young females also presenting with self-harm; older patients with multiple medical conditions; and very old patients with cardiac conditions and fractures. The study indicates increased A+E service use and unmet health-related need within a total mental health population. It identifies specific 'care populations' particularly vulnerable to accidents and self-harm and highlights the need for targeted services for mentally ill groups who may not access traditional health and social care services effectively.

Insights about health-related quality of life in cancer patients indicate demands for better pharmaceutical care.

PubMed

Ibrahim, Nagwa A; Björnsdottir, Ingunn; Al Alwan, Ashraf S; Honore, Per Hartvig

2014-08-01

To highlight the health-related quality of life scale scores for Saudi patients with different types of cancer, to get understanding and foundation for improvements. To suggest suitable plans for quality of life improvement based on study outcome. The role of oncology pharmacy will be stressed. A cross-sectional descriptive study was conducted at a tertiary regional hospital using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire. Attendees were patients diagnosed with any type of cancer and eligible for active anticancer treatment and/or palliative care. Quality of life was evaluated for 87 participants. Most of patients were aged between 51 and 60 years; and 50% had active treatment with chemotherapy. Patients seemed to perform well with respect to average scores in both the symptoms and the functional health status scales. The mean score for the global quality of life scale was 47.2 ± 27.1, while the range of mean scores for the five function subscales was 59.0 ± 27.1 to 81.6 ± 13.8, indicating average level of general wellbeing with above average to high level of functional health status, while >50% of the patients met the operational criterion having less severe symptoms. Outpatients generally had somewhat higher scores as compared to hospitalized patients. The general quality of life seemed satisfactory, but there is still need to improve care. Based on results from other studies, oncology pharmacists' roles are essential to improve quality of life through treatment counseling, follow-up on drug support therapy, stress on patient's education through specific programs, review and update the local guidelines, and conduct more research. © Prince Sultan Military Medical City, Saudi Arabia 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

[Quality Indicators of Primary Health Care Facilities in Austria].

PubMed

Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea

2017-07-11

Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.

Serum 25-Hydroxyvitamin D Concentrations and Indicators of Mental Health: An Analysis of the Canadian Health Measures Survey.

PubMed

Chu, Filmer; Ohinmaa, Arto; Klarenbach, Scott; Wong, Zing-Wae; Veugelers, Paul

2017-10-13

The main function of vitamin D is calcium homeostasis. However, emerging evidence has correlated adequate serum 25-hydroxyvitamin D (25(OH)D) concentrations with better mental health. The objective of this study is to investigate the association of serum 25(OH)D concentrations with indicators of mental health such as depression, anxiety, and stress. Associations of serum 25(OH)D concentrations with four indicators of mental health were examined using ordered logistic regression models with increasing specificity that account for demographics, socio-economic status, and health. Margin effects are used to determine the probability of the average adult Canadian being in the best mental health state by groupings of serum 25(OH)D concentrations. A robust association between serum 25(OH)D concentrations and the indicators of mental health were observed. In the fully adjusted ordered logistic model, an average Canadian appeared more likely to experience better mental health when serum 25(OH)D concentrations were higher. This study adds to the weight of the existence of an association between vitamin D status and mental health, but, as this study is cross sectional, it does not establish causality. Due to the low risk of harm from toxicity and the relative modest costs of vitamin D supplements, more research to establish the effectiveness and causality of this relationship is recommended.

Health Care Indicators for the United States

PubMed Central

Donham, Carolyn S.; Maple, Brenda T.; Levit, Katharine R.

1992-01-01

Contained in this regular feature of the journal is a section on each of the following four topics community hospital statistics; employment, hours, and earnings in the private health sector; health care prices; and national economic indicators. PMID:10122005

Towards a unified taxonomy of health indicators: academic health centers and communities working together to improve population health.

PubMed

Aguilar-Gaxiola, Sergio; Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton Mickey; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B; Strelnick, A Hal; Wallerstein, Nina

2014-04-01

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public's health and reducing health disparities, the CTSA Consortium's Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators.The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy's application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health.

Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

PubMed Central

Ahmed, Syed; Franco, Zeno; Kissack, Anne; Gabriel, Davera; Hurd, Thelma; Ziegahn, Linda; Bates, Nancy J.; Calhoun, Karen; Carter-Edwards, Lori; Corbie-Smith, Giselle; Eder, Milton “Mickey”; Ferrans, Carol; Hacker, Karen; Rumala, Bernice B.; Strelnick, A. Hal; Wallerstein, Nina

2014-01-01

The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

Stress management standards: a warning indicator for employee health.

PubMed

Kazi, A; Haslam, C O

2013-07-01

Psychological stress is a major cause of lost working days in the UK. The Health & Safety Executive (HSE) has developed management standards (MS) to help organizations to assess work-related stress. To investigate the relationships between the MS indicator tool and employee health, job attitudes, work performance and environmental outcomes. The first phase involved a survey employing the MS indicator tool, General Health Questionnaire-12 (GHQ-12), job attitudes, work performance and environmental measures in a call centre from a large utility company. The second phase comprised six focus groups to investigate what employees believed contributed to their perceived stress. Three hundred and four call centre employees responded with a response rate of 85%. Significant negative correlations were found between GHQ-12 and two MS dimensions; demands (Rho = -0.211, P < 0.001) and relationships (Rho= -0.134, P < 0.05). Other dimensions showed no significant relationship with GHQ-12. Higher levels of stress were associated with reduced job performance, job motivation and increased intention to quit but low stress levels were associated with reduced job satisfaction. Lack of management support, recognition and development opportunities were identified as sources of stress. The findings support the utility of the MS as a measure of employee attitudes and performance.

Indicators of Range Health

USDA-ARS?s Scientific Manuscript database

Science-based grassland management requires an understanding of the current status of the land relative to its potential. Rangeland health assessments help increase the cost-effectiveness of management by identifying where a change in management may be required, and the types of ecological processes...

Racial/Ethnic Differences in Knowledge of Personal and Target Levels of Cardiovascular Health Indicators.

PubMed

Ma, Mindy; Ma, Alyson

2015-10-01

This study aimed to examine ethnic differences in knowledge of personal and target levels of cardiovascular health indicators between non-Hispanic whites and African Americans. A secondary objective was to evaluate the associations between knowledge of cardiovascular health indicators and health promotion behaviors. Participants (66.7% female) consisted of 265 whites and 428 African Americans, ages 18 and older recruited from primary care clinics and churches. Respondents completed a brief survey on blood pressure (BP), total cholesterol, blood glucose, body mass index (BMI), diet, and physical activity. Whites were more likely than African Americans to report knowing their personal and target levels of cardiovascular health indicators. Knowledge of personal BP and/or BMI was positively associated with actual physical activity, and awareness of personal blood glucose was positively associated with healthy dietary practices for participants in both groups. Among whites, awareness of personal BP and knowledge of target levels for BP, total cholesterol, and BMI were also associated with healthy diet. Results suggest there are racial/ethnic disparities in knowledge of personal and ideal levels of cardiovascular health indicators, and that this knowledge is related to health promotion behaviors. Targeted educational efforts are warranted to enhance knowledge of personal risk indicators among African Americans.

Heavy Metal Phytoremediation: Microbial Indicators of Soil Health for the Assessment of Remediation Efficiency

NASA Astrophysics Data System (ADS)

Epelde, Lur; Ma Becerril, José; Alkorta, Itziar; Garbisu, Carlos

Phytoremediation is an effective, non-intrusive, inexpensive, aesthetically pleasing, socially accepted, promising phytotechnology for the remediation of polluted soils. The objective of any soil remediation process must be not only to remove the contaminant(s) from the soil but, most importantly, to restore the continued capacity of the soil to perform or function according to its potential (i.e., to recover soil health). Hence, indicators of soil health are needed to properly assess the efficiency of a phytoremediation process. Biological indicators of soil health, especially those related to the size, activity and diversity of the soil microbial communities, are becoming increasingly used, due to their sensitivity and capacity to provide information that integrates many environmental factors. In particular, microbial indicators of soil health are valid tools to evaluate the success of metal phytoremediation procedures such as phytoextraction and phytostabilization processes.

Indicators for evaluating European population health: a Delphi selection process.

PubMed

Freitas, Ângela; Santana, Paula; Oliveira, Mónica D; Almendra, Ricardo; Bana E Costa, João C; Bana E Costa, Carlos A

2018-04-27

Indicators are essential instruments for monitoring and evaluating population health. The selection of a multidimensional set of indicators should not only reflect the scientific evidence on health outcomes and health determinants, but also the views of health experts and stakeholders. The aim of this study is to describe the Delphi selection process designed to promote agreement on indicators considered relevant to evaluate population health at the European regional level. Indicators were selected in a Delphi survey conducted using a web-platform designed to implement and monitor participatory processes. It involved a panel of 51 experts and 30 stakeholders from different areas of knowledge and geographies. In three consecutive rounds the panel indicated their level of agreement or disagreement with indicator's relevance for evaluating population health in Europe. Inferential statistics were applied to draw conclusions on observed level of agreement (Scott's Pi interrater reliability coefficient) and opinion change (McNemar Chi-square test). Multivariate analysis of variance was conducted to check if the field of expertise influenced the panellist responses (Wilk's Lambda test). The panel participated extensively in the study (overall response rate: 80%). Eighty indicators reached group agreement for selection in the areas of: economic and social environment (12); demographic change (5); lifestyle and health behaviours (8); physical environment (6); built environment (12); healthcare services (11) and health outcomes (26). Higher convergence of group opinion towards agreement on the relevance of indicators was seen for lifestyle and health behaviours, healthcare services, and health outcomes. The panellists' field of expertise influenced responses: statistically significant differences were found for economic and social environment (p < 0.05 in round 1 and 2), physical environment (p < 0.01 in round 1) and health outcomes (p < 0.01 in round 3). The

Health indicators and human development in the Arab region

PubMed Central

Boutayeb, Abdesslam; Serghini, Mansour

2006-01-01

Background The present paper deals with the relationship between health indicators and human development in the Arab region. Beyond descriptive analysis showing geographic similarities and disparities inter countries, the main purpose is to point out health deficiencies and to propose pragmatic strategies susceptible to improve health conditions and consequently enhance human development in the Arab world. Methods Data analysis using Principal Components Analysis is used to compare the achievements of the Arab countries in terms of direct and indirect health indicators. The variables (indicators) are seen to be well represented on the circle of correlation, allowing for interesting interpretation and analysis. The 19 countries are projected on the first and second plane respectively. Results The results given by the present analysis give a good panorama of the Arab countries with their geographic similarities and disparities. The high correlation between health indicators and human development is well illustrated and consequently, countries are classified by groups having similar human development. The analysis shows clearly how health deficits are impeding human development in the majority of Arab countries and allows us to formulate suggestions to improve health conditions and enhance human development in the Arab World. Discussion The discussion is based on the link between different direct and indirect health indicators and the relationship between these indicators and human development index. Without including the GDP indicator, our analysis has shown that the 19 Arab countries may be classified, independently of their geographic proximity, in three different groups according to their global human development level (Low, Medium and High). Consequently, while identifying health deficiencies in each group, the focus was made on the countries presenting a high potential of improvement in health indicators. In particular, maternal mortality and infant mortality

School-performance indicators and subjective health complaints: are there gender differences?

PubMed

Brolin Låftman, Sara; Modin, Bitte

2012-05-01

Although boys and girls are generally located in the same physical school environment, it may be experienced differently by, and have varying implications for, boys and girls. Girls like school more and achieve higher school marks, but they also perceive more school-related pressure. Based on a total sample of 8456 ninth grade pupils in Stockholm in 2004, this study uses multilevel linear regression to analyse differences between boys and girls with regard to a number of school-performance indicators (demands, motivation, teacher support and school marks) and their association with subjective health complaints. Results showed that girls perceive more demands, show greater academic motivation, perform better in school and report more emotional support from teachers than boys. In contrast, instrumental and appraisal support from teachers are more commonly reported by boys. Associations between school-performance indicators and subjective health complaints were slightly stronger for girls than for boys. Contextual variation in health complaints, especially between classes, was found only for girls. High achievement motivation and emotional teacher support in the school class was associated with better pupil health, suggesting that a positive climate in terms of motivation and support favours class health as a whole. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Relevance of gender-sensitive policies and general health indicators to compare the status of South Asian women's health.

PubMed

Gill, Roopan; Stewart, Donna E

2011-01-01

despite goals for gender equity in South Asia, the relationship between gender-sensitive policies and the empowerment of women is complex and requires an analysis of how policies align with a broad set of social, cultural, political, and economic indicators that relate to women's health. through a review of four documents under the umbrella of the World Health Organization and the United Nations, a list of 17 gender-sensitive policy and 17 general health indicators was generated with a focus on health, education, economic, and political empowerment and violence against women. A series of policy documents and international and national databases that are accessible in the public domain were the major tools used to find supporting documentation to address women's health outcomes in Bangladesh, India, Nepal, Pakistan, and Sri Lanka. all five South Asian countries had several gender-sensitive policies that were measurable by indicators that contribute to health. Examination of political and economic status, birth sex ratios, human trafficking, illiteracy rates, maternal mortality rates, contraception prevalence, fertility rates, knowledge of HIV/AIDS prevention, access to skilled birth attendants, and microfinance show that large gender inequities still prevail despite the presence of gender-sensitive policies. in many cases, the presence of gender-sensitive policies did not reflect the realization of gender equity over a wide range of indicators. Although the economic, political, social, and cultural climates of the five countries may differ, the integration of women's needs into the formulation, implementation, and monitoring of policies is a universal necessity to achieve positive outcomes. 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc.

Building sustainability indicators in the health dimension for solid waste management 1

PubMed Central

Veiga, Tatiane Bonametti; Coutinho, Silvano da Silva; Andre, Silvia Carla Silva; Mendes, Adriana Aparecida; Takayanagui, Angela Maria Magosso

2016-01-01

ABSTRACT Objective: to prepare a list of sustainability indicators in the health dimension, for urban solid waste management. Methods: a descriptive and exploratory study performed jointly with 52 solid waste specialists, using a three-steps Delphi technique, and a scale measuring the degree of importance for agreement among the researchers in this area. Results: the subjects under study were 92,3% PhD's concentrated in the age group from 30 to 40 years old (32,7%) and 51% were men. At the end of the 3rd step of the Delphi process, the average and standard deviation of all the proposed indicators varied from 4,22 (±0,79) to 4,72 (±0,64), in a scale of scores for each indicator from 1 to 5 (from "dispensable" to "very important"). Results showed the level of correspondence among the participants ranging from 82% to 94% related to those indicators. Conclusion: the proposed indicators may be helpful not only for the identification of data that is updated in this area, but also to enlarge the field of debates of the environmental health policies, directed not only for urban solid waste but for the achievement of better health conditions for the Brazilian context. PMID:27508905

Use of social media in health promotion: purposes, key performance indicators, and evaluation metrics.

PubMed

Neiger, Brad L; Thackeray, Rosemary; Van Wagenen, Sarah A; Hanson, Carl L; West, Joshua H; Barnes, Michael D; Fagen, Michael C

2012-03-01

Despite the expanding use of social media, little has been published about its appropriate role in health promotion, and even less has been written about evaluation. The purpose of this article is threefold: (a) outline purposes for social media in health promotion, (b) identify potential key performance indicators associated with these purposes, and (c) propose evaluation metrics for social media related to the key performance indicators. Process evaluation is presented in this article as an overarching evaluation strategy for social media.

Is the political system really related to health?

PubMed

Klomp, Jeroen; de Haan, Jakob

2009-07-01

We analyze whether the political system and its stability are related to cross-country differences in health. We apply factor analysis on various national health indicators for a large sample of countries over the period 2000-2005 and use the outcomes of the factor analysis to construct two new health measures, i.e., the health of individuals and the quality of the health care sector. Using a cross-country structural equation model with various economic and demographic control variables, we examine the relationship between the type of regime and political stability on the one hand and health on the other. The political variables and the control variables are measured as averages over the period 1980-1999. Our results suggest that democracy has a positive relationship with the health of individuals, while regime instability has a negative relationship with the health of individuals. Government instability is negatively related to individual health via its link with the quality of the health care sector, while democracy is positively related with individual health through its link with income. Our main findings are confirmed by the results of a panel model and various sensitivity tests.

Health-and-environment indicators in the context of sustainable development.

PubMed

von Schirnding, Yasmin E

2002-01-01

This paper gives a broad overview of issues relevant to the development and use of health-and-environment indicators in the broader context of sustainable development. Criteria for the construction of indicators are given, and their key characteristics are highlighted. Selected international indicator initiatives are discussed, as well as the concept and use of core indicators in policy and planning. Finally, an organizational framework for the consideration of health-environment-development linkages is presented, which can be used in the development of health-and-environment indicators in various contexts. This framework is the Driving forces-Pressures-State-Exposures-Health Effects-Actions framework (DPSEEA) of the World Health Organization (WHO). It is a descriptive representation of the way in which various driving forces generate pressures which affect the state of the environment, and ultimately human health through the various exposure pathways by which people come into contact with the environment. Throughout the paper, emphasis is placed on work done within the UN system, in particular that of the WHO, and examples of suites of indicators developed and in use are provided.

Health Indicators for Older Sexual Minorities: National Health Interview Survey, 2013–2014

PubMed Central

Laffan, Alison M.; Erdem, Erkan; Cahill, Sean R.; Kenefick, Daniel; Ye, Jiahui; Haffer, Samuel C.

2017-01-01

Abstract Purpose: Advances in lesbian, gay, and bisexual (sexual minority [SM]) acceptance and equality have been made in the past decade. However, certain SM subgroups continue to be disadvantaged due to lack of data and, thus, lack of knowledge about these populations. Data for older sexual minorities are especially lacking and will be increasingly important as more sexual minorities enter older age. This research explores results from a nationally representative health survey to elucidate some health indicators for older sexual minorities. Methods: Data from the 2013 and 2014 National Health Interview Surveys (NHIS) were pooled for increased sample size, and established research methods were followed as recommended by prior NHIS sexual orientation studies. We conducted descriptive analyses on the differences between SM and heterosexual groups, aged 65 years and older, for 12 health indicators. Results: Four out of the 12 health indicators were significantly different for sexual minorities, and three out of those four indicated positive health outcomes or behaviors when compared with heterosexuals. Sexual minorities were more than three times as likely to receive HIV testing as heterosexual peers. Sexual minorities were more likely to receive an influenza vaccination, and much more likely to report excellent or very good health, than their heterosexual peers. Sexual minorities were more than twice as likely to report binge drinking, which is consistent with prior research for adult sexual minorities. Conclusion: This analysis is the first to examine national data on health indicators for sexual minorities, aged 65 years and older, using NHIS data. As more surveys begin to collect SMdata and more years of data are collected by NHIS, a clearer picture of the health of older adult sexual minorities should emerge. PMID:29028455

The Effects of Traumatic Stressors and HIV-Related Trauma Symptoms on Health and Health Related Quality of Life

PubMed Central

Sher, Tamara G.; Mattson, Melissa; Thilges, Sarah; Hansen, Nathan B.

2012-01-01

The study identified relations among traumatic stressors, HIV-related trauma symptoms, comorbid medical conditions, and health related quality of life (HRQL) in individuals with HIV. Participants (N = 118) completed a structured clinical interview on HIV as a traumatic stressor and other severe traumatic stressors and completed the Impact of Event Scale to assess HIV-related trauma symptoms and the Medical Outcomes Study 36-item Short Form (SF-36) to assess HRQL. Medical chart reviews determined comorbid conditions. Path analysis findings indicated participants with prior severe traumatic stressors experienced their HIV diagnosis as traumatic and in turn were more likely to have current HIV-related trauma symptoms which were negatively related to HRQL. HIV as a traumatic stressor was related to coronary artery diseases and HRQL. Traumatic stressors and HIV-related trauma symptoms impact health in individuals with HIV and highlight the need for psychological interventions prior to diagnosis and throughout treatment. PMID:21667297

Relationship Between Marital Transitions, Health Behaviors, and Health Indicators of Postmenopausal Women: Results from the Women's Health Initiative

PubMed Central

Kutob, Randa M.; Yuan, Nicole P.; Wertheim, Betsy C.; Sbarra, David A.; Loucks, Eric B.; Nassir, Rami; Bareh, Gihan; Kim, Mimi M.; Snetselaar, Linda G.

2017-01-01

Abstract Background: Historically, marital status has been associated with lower mortality and transitions into marriage were generally accompanied by improved health status. Conversely, divorce has been associated with increased mortality, possibly mediated by changes in health behaviors. Methods: This study uses data from a prospective cohort of 79,094 postmenopausal women participating in the Women's Health Initiative Observational Study (WHI-OS) to examine the relationship between marital transition and health indicators (blood pressure, waist circumference, body mass index [BMI]) as well as health behaviors (diet pattern, alcohol use, physical activity, and smoking) in a sample of relatively healthy and employed women. Linear and logistic regression modeling were used to test associations, controlling for confounding factors. Results: Women's transitions into marriage/marriage-like relationship after menopause were associated with greater increase in BMI (β = 0.22; confidence interval (95% CI), 0.11–0.33) and alcohol intake (β = 0.08; 95% CI, 0.04–0.11) relative to remaining unmarried. Divorce/separation was associated with a reduction in BMI and waist circumference, changes that were accompanied by improvements in diet quality (β = 0.78, 95% CI, 0.10–1.47) and physical activity (β = 0.98, 95% CI, 0.12–1.85), relative to women who remained married. Conclusion: Contrary to earlier literature, these findings among well-educated, predominantly non-Hispanic white women suggest that marital transitions after menopause are accompanied by modifiable health outcomes/behaviors that are more favorable for women experiencing divorce/separation than those entering a new marriage. PMID:28072926

Active Video Games and Health Indicators in Children and Youth: A Systematic Review

PubMed Central

McFarlane, Allison; Colley, Rachel C.; Thivel, David; Biddle, Stuart J. H.; Maddison, Ralph; Leatherdale, Scott T.; Tremblay, Mark S.

2013-01-01

Background Active video games (AVGs) have gained interest as a way to increase physical activity in children and youth. The effect of AVGs on acute energy expenditure (EE) has previously been reported; however, the influence of AVGs on other health-related lifestyle indicators remains unclear. Objective This systematic review aimed to explain the relationship between AVGs and nine health and behavioural indicators in the pediatric population (aged 0–17 years). Data sources Online databases (MEDLINE, EMBASE, psycINFO, SPORTDiscus and Cochrane Central Database) and personal libraries were searched and content experts were consulted for additional material. Data selection Included articles were required to have a measure of AVG and at least one relevant health or behaviour indicator: EE (both habitual and acute), adherence and appeal (i.e., participation and enjoyment), opportunity cost (both time and financial considerations, and adverse events), adiposity, cardiometabolic health, energy intake, adaptation (effects of continued play), learning and rehabilitation, and video game evolution (i.e., sustainability of AVG technology). Results 51 unique studies, represented in 52 articles were included in the review. Data were available from 1992 participants, aged 3–17 years, from 8 countries, and published from 2006–2012. Overall, AVGs are associated with acute increases in EE, but effects on habitual physical activity are not clear. Further, AVGs show promise when used for learning and rehabilitation within special populations. Evidence related to other indicators was limited and inconclusive. Conclusions Controlled studies show that AVGs acutely increase light- to moderate-intensity physical activity; however, the findings about if or how AVG lead to increases in habitual physical activity or decreases in sedentary behaviour are less clear. Although AVGs may elicit some health benefits in special populations, there is not sufficient evidence to recommend AVGs as a

Active video games and health indicators in children and youth: a systematic review.

PubMed

LeBlanc, Allana G; Chaput, Jean-Philippe; McFarlane, Allison; Colley, Rachel C; Thivel, David; Biddle, Stuart J H; Maddison, Ralph; Leatherdale, Scott T; Tremblay, Mark S

2013-01-01

Active video games (AVGs) have gained interest as a way to increase physical activity in children and youth. The effect of AVGs on acute energy expenditure (EE) has previously been reported; however, the influence of AVGs on other health-related lifestyle indicators remains unclear. This systematic review aimed to explain the relationship between AVGs and nine health and behavioural indicators in the pediatric population (aged 0-17 years). Online databases (MEDLINE, EMBASE, psycINFO, SPORTDiscus and Cochrane Central Database) and personal libraries were searched and content experts were consulted for additional material. Included articles were required to have a measure of AVG and at least one relevant health or behaviour indicator: EE (both habitual and acute), adherence and appeal (i.e., participation and enjoyment), opportunity cost (both time and financial considerations, and adverse events), adiposity, cardiometabolic health, energy intake, adaptation (effects of continued play), learning and rehabilitation, and video game evolution (i.e., sustainability of AVG technology). 51 unique studies, represented in 52 articles were included in the review. Data were available from 1992 participants, aged 3-17 years, from 8 countries, and published from 2006-2012. Overall, AVGs are associated with acute increases in EE, but effects on habitual physical activity are not clear. Further, AVGs show promise when used for learning and rehabilitation within special populations. Evidence related to other indicators was limited and inconclusive. Controlled studies show that AVGs acutely increase light- to moderate-intensity physical activity; however, the findings about if or how AVG lead to increases in habitual physical activity or decreases in sedentary behaviour are less clear. Although AVGs may elicit some health benefits in special populations, there is not sufficient evidence to recommend AVGs as a means of increasing daily physical activity.

The evaluation of reproductive health PhD program in Iran: The input indicators analysis.

PubMed

AbdiShahshahani, Mahshid; Ehsanpour, Soheila; Yamani, Nikoo; Kohan, Shahnaz

2014-11-01

Appropriate quality achievement of a PhD program requires frequent assessment and discovering the shortcomings in the program. Inputs, which are important elements of the curriculum, are frequently missed in evaluations. The purpose of this study was to evaluate the input indicators of reproductive health PhD program in Iran based on the Context, Input, Process, and Product (CIPP) evaluation model. This is a descriptive and evaluative study based on the CIPP evaluation model. It was conducted in 2013 in four Iranian schools of nursing and midwifery of medical sciences universities. Statistical population consisted of four groups: heads of departments (n = 5), faculty members (n = 18), graduates (n = 12), and PhD students of reproductive health (n = 54). Data collection tools were five separate questionnaires including 37 indicators that were developed by the researcher. Content and face validity were evaluated based on the experts' indications. The Cronbach's alpha coefficient was calculated in order to obtain the reliability of the questionnaires. Collected data were analyzed by SPSS software. Data were analyzed by descriptive statistics (mean, frequency, percentage, and standard deviation), and one-way analysis of variance (ANOVA) and least significant difference (LSD) post hoc tests to compare means between groups. The results of the study indicated that the highest percentage of the heads of departments (80%), graduates (66.7%), and students (68.5%) evaluated the status of input indicators of reproductive health PhD program as relatively appropriate, while most of the faculties (66.7%) evaluated that as appropriate. It is suggested to explore the reasons for relatively appropriate evaluation of input indicators by further academic researches and improve the reproductive health PhD program accordingly.

The dynamics of income-related health inequality among American children.

PubMed

Chatterji, Pinka; Lahiri, Kajal; Song, Jingya

2013-05-01

We estimate and decompose income-related inequality in child health in the USA and analyze its dynamics using the recently introduced health mobility index. Data come from the 1997, 2002, and 2007 waves of the Child Development Supplement of the Panel Study of Income Dynamics. The findings show that income-related child health inequality remains stable as children grow up and enter adolescence. The main factor underlying income-related child health inequality is income itself, although other factors, such as maternal education, also play a role. Decomposition of income-related health mobility indicates that health changes over time are more favorable to children with lower initial family incomes versus children with higher initial family incomes. However, offsetting this effect, our findings also suggest that changes in income ranking over time are positively related to children's subsequent health status. Copyright © 2012 John Wiley & Sons, Ltd.

Adequate sleep among adolescents is positively associated with health status and health-related behaviors.

PubMed

Chen, Mei-Yen; Wang, Edward K; Jeng, Yi-Jong

2006-03-08

Amount of sleep is an important indicator of health and well-being in children and adolescents. Adequate sleep (AS: adequate sleep is defined as 6-8 hours per night regularly) is a critical factor in adolescent health and health-related behaviors. The present study was based on a health promotion project previously conducted on adolescents in Tao-Yuan County, Taiwan. The aim was to examine the relationship between AS during schooldays and excessive body weight, frequency of visiting doctors and health-related behaviors among Taiwanese adolescents. A cross-sectional study design, categorical and multivariate data analyses were used. The hypotheses investigated were: high frequency of AS is positively associated with lack of obesity and less frequent visits to doctors; and high frequency AS is positively associated with health-related behavior. A total of 656 boys (53.2%) and girls (46.8%), ranging in age from 13-18 years were studied between January and June 2004. Three hundred and fifty seven subjects (54%) reported that they slept less than the suggested 6-8 hours on schooldays. A significant negative association was found between low sleep and of the following health-related behaviors: (1) life appreciation; (2) taking responsibility for health; (3) adopting healthy diet; (4) effective stress management; (5) regular exercise; and (6) total AHP score. High frequency AS was associated with low frequencies of obesity after potential confounding factors were controlled. Junior high school adolescents reported significantly higher frequencies of AS than high school participants. Gender, family structure, home location and frequency of television watching or computer use were not significantly associated with AS. These findings support the proposition that AS is associated with good health status and high-frequency adoption of health-related behavior. Furthermore, these findings suggest that inadequate sleep may be a screening indicator for an unhealthy lifestyle and

Applying ethological and health indicators to practical animal welfare assessment.

PubMed

Wemelsfelder, F; Mullan, S

2014-04-01

There is a growing effort worldwide to develop objective indicators for animal welfare assessment, which provide information on an animal's quality of life, are scientifically trustworthy, and can readily be used in practice by professionals. Animals are sentient beings capable of positive and negative emotion, and so these indicators should be sensitive not only to their physical health, but also to their experience of the conditions in which they live. This paper provides an outline of ethological research aimed at developing practical welfare assessment protocols. The first section focuses on the development and validation of welfare indicators generally, in terms of their relevance to animal well-being, their interobserver reliability, and the confidence with which the prevalence of described features can be estimated. Challenges in this work include accounting for the ways in which welfare measures may fluctuate over time, and identifying measures suited to monitoring positive welfare states. The second section focuses more specifically on qualitative welfare indicators, which assess the 'whole animal' and describe the expressive qualities of its demeanour (e.g. anxious, content). Such indicators must be validated in the same way as other health and behaviour indicators, with the added challenge of finding appropriate methods of measurement. The potential contribution of qualitative indicators, however, is to disclose an emotional richness in animals that helps to interpret information provided by other indicators, thus enhancing the validity of welfare assessment protocols. In conclusion, the paper emphasises the importance of integrating such different perspectives, showing that new knowledge of animals and new ways of relating to animals are both needed for the successful development of practical welfare assessment tools.

Use of geographic indicators of healthcare, environment and socioeconomic factors to characterize environmental health disparities.

PubMed

Padilla, Cindy M; Kihal-Talantikit, Wahida; Perez, Sandra; Deguen, Severine

2016-07-22

An environmental health inequality is a major public health concern in Europe. However just few studies take into account a large set of characteristics to analyze this problematic. The aim of this study was to identify and describe how socioeconomic, health accessibility and exposure factors accumulate and interact in small areas in a French urban context, to assess environmental health inequalities related to infant and neonatal mortality. Environmental indicators on deprivation index, proximity to high-traffic roads, green space, and healthcare accessibility were created using the Geographical Information System. Cases were collected from death certificates in the city hall of each municipality in the Nice metropolitan area. Using the parental addresses, cases were geocoded to their census block of residence. A classification using a Multiple Component Analysis following by a Hierarchical Clustering allow us to characterize the census blocks in terms of level of socioeconomic, environmental and accessibility to healthcare, which are very diverse definition by nature. Relation between infant and neonatal mortality rate and the three environmental patterns which categorize the census blocks after the classification was performed using a standard Poisson regression model for count data after checking the assumption of dispersion. Based on geographic indicators, three environmental patterns were identified. We found environmental inequalities and social health inequalities in Nice metropolitan area. Moreover these inequalities are counterbalance by the close proximity of deprived census blocks to healthcare facilities related to mother and newborn. So therefore we demonstrate no environmental health inequalities related to infant and neonatal mortality. Examination of patterns of social, environmental and in relation with healthcare access is useful to identify census blocks with needs and their effects on health. Similar analyzes could be implemented and considered

Indicators of ocean health and human health: developing a research and monitoring framework.

PubMed Central

Knap, Anthony; Dewailly, Eric; Furgal, Chris; Galvin, Jennifer; Baden, Dan; Bowen, Robert E; Depledge, Michael; Duguay, Linda; Fleming, Lora E; Ford, Tim; Moser, Fredricka; Owen, Richard; Suk, William A; Unluata, Umit

2002-01-01

We need to critically assess the present quality of the marine ecosystem, especially the connection between ecosystem change and threats to human health. In this article we review the current state of indicators to link changes in marine organisms with eventual effects to human health, identify research opportunities in the use of indicators of ocean and human health, and discuss how to establish collaborations between national and international governmental and private sector groups. We present a synthesis of the present state of understanding of the connection between ocean health and human health, a discussion of areas where resources are required, and a discussion of critical research needs and a template for future work in this field. To understand fully the interactions between ocean health and human health, programs should be organized around a "models-based" approach focusing on critical themes and attributes of marine environmental and public health risks. Given the extent and complex nature of ocean and human health issues, a program networking across geographic and disciplinary boundaries is essential. The overall goal of this approach would be the early detection of potential marine-based contaminants, the protection of marine ecosystems, the prevention of associated human illness, and by implication, the development of products to enhance human well-being. The tight connection between research and monitoring is essential to develop such an indicator-based effort. PMID:12204815

Relationship between diet-related indicators and overweight and obesity in older adults in rural Japan.

PubMed

Ishikawa, M; Moriya, S; Yokoyama, T

2017-01-01

To identify the relationship between diet-related indicators and overweight and obesity in older adults in rural Japan. Cross-sectional survey. Obira, Hokkaido, Japan. Local residents aged between 65 and 74 years, except for those with poor health, were included. A health- and diet-related questionnaire was applied to participants house-to-house by trained health professionals. The following indicators were examined: number of meals, number of balanced meals, food diversity, food group diversity, chewing ability, alcohol intake habit, smoking habit, instrumental activities of daily living scores, age, and residing alone or with family. Of 550 residents, 317 residents completely responded to the questionnaire. Of these, 41 were had low body mass index (BMI≤20) and were excluded. This resulted in a sample of 307 subjects comprising 117 men and 190 women; 37.6% and 46.8% of men and women were classified as obese (BMI≥25), respectively. Women with a normal BMI (20related indicators compared with women with high BMI. The mean number of meals per day of normal men was significantly higher than of obese men. Using logistic regression analysis (stepwise), it was found that the number of meals per day was associated with obesity in men (OR=3.02; 95% CI 0.91-9.98; P=0.071), and food diversity was significantly associated with obesity in women (OR=1.95; 95% CI 1.12-3.38; P=0.018). The associations between dietary indicators and obesity differed by sex. Food diversity may be a potential indicator to measure nutritional status in women.

Prevalence of rape-related pregnancy as an indication for abortion at two urban family planning clinics.

PubMed

Perry, Rachel; Zimmerman, Lindsay; Al-Saden, Iman; Fatima, Aisha; Cowett, Allison; Patel, Ashlesha

2015-05-01

We sought to estimate the prevalence of rape-related pregnancy as an indication for abortion at two public Chicago facilities and to describe demographic and clinical correlates of women who terminated rape-related pregnancies. We performed a cross-sectional study of women obtaining abortion at the Center for Reproductive Health (CRH) at University of Illinois Health Sciences Center and Reproductive Health Services (RHS) at John H. Stroger, Jr. Hospital between August 2009 and August 2013. Gestational age limits at CRH and RHS were 23+6 and 13+6weeks, respectively. We estimated the prevalence of rape-related pregnancy based on billing code (CRH) or data from an administrative database (RHS), and examined relationships between rape-related pregnancy and demographic and clinical variables. Included were 19,465 visits for abortion. The majority of patients were Black (85.6%). Prevalence of abortion for rape-related pregnancy was 1.9%, and was higher at CRH (6.9%) than RHS (1.5%). Later gestational age was associated with abortion for rape-related pregnancy (median 12days, p<.001). Younger age and Black race were associated with abortion for rape-related pregnancy at CRH only (p<.001 for both). Chlamydia and gonorrhea infection were no more prevalent among women terminating rape-related pregnancy than among those terminating for other indications. Rape-related pregnancy as an indication for abortion had a low, but clinically significant prevalence at two urban Chicago family planning centers. Later gestational age was associated with abortion for rape-related pregnancy. Rape-related pregnancy may occur with higher prevalence among some subgroups of women seeking abortion than others. Efforts to address rape-related pregnancy in the abortion care setting are needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Fine-Scale Environmental Indicators of Public Health and Well ...

EPA Pesticide Factsheets

Urban ecosystem services contribute to public health and well-being by buffering natural and man-made hazards, and by promoting healthful lifestyles that include physical activity, social interaction, and engagement with nature. As part of the EnviroAtlas online mapping tool, EPA and its research partners have identified urban environmental features that have been linked in the scientific literature to specific aspects of public health and well-being. Examples of these features include tree cover along walkable roads, overall neighborhood green space, green window views, and proximity to parks. Associated aspects of health and well-being include physical fitness, social capital, school performance, and longevity. In many previous studies, stronger associations were observed in disproportionately vulnerable populations such as children, the elderly, and those of lower socioeconomic status.EnviroAtlas researchers have estimated and mapped a suite of urban environmental features by synthesizing newly-generated one-meter resolution landcover data, downscaled census population data, and existing datasets such as roads and waterways. Resulting geospatial metrics represent health-related indicators of urban ecosystem services supply and demand at the census block-group and finer. They have been developed using consistent methods to facilitate comparisons between neighborhoods and across multiple U.S. communities. Demographic overlays, also available in EnviroAtl

Birth risk indicators for maternal and neonatal health: Songkla Center Hospital perspective.

PubMed

Kaewsuksai, Peeranan; Chandeying, Verapol

2012-02-01

The aim of the present study was to examine the maternal and neonatal birth risk indicator and their relationship with the outcome of pregnancy. This retrospective descriptive study was conducted in a selective month of 2008, 2009, and 2010. The birth risk indicators of maternal and neonatal health were collected from the medical records. There were 385, 349 and 334 deliveries in a selective month of 2008, 2009, and 2010. There was neither maternal mortality, nor cardiovascular failure in the present study period. Three main indication of inductions of labor were premature rupture of membrane (up to 4.0%), diabetes mellitus (up to 2.0%), and postdate (up to 1.3%). The first two conditions had statistical significance in September 2009 (p = 0.0334 and 0.0053 respectively). Whereas, the three major indications of cesarean section were previous cesarean section (12.5 to 21.9%), failure to progress due to protracted/arrest of labor pattern with/without rupture of membrane and augmented labor (2.4 to 7.5%), and fetal distress (1.1 to 4.2%). The rates of low birth weight, less than 2,500 grams, were varied from 5.2 to 6.9%. The respiratory distress syndrome (RDS) related to repeat cesarean section was encountered up to 3.6%, as well as the RDS related to induction of labor was up to 1.6%. The birth risk indicators reflect the outcome of pregnancy, however the development of additional key indicators for perinatal health care outcome are required.

Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment.

PubMed

Turner, Lyle R; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-03-22

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks.

Health-related outcomes of war in Nicaragua.

PubMed Central

Garfield, R M; Frieden, T; Vermund, S H

1987-01-01

Since 1983, war in Nicaragua has slowed improvements in health which had developed rapidly from 1979-82. The rate of war-related deaths among Nicaraguans now exceeds that of the United States citizens in either the Vietnam War or World War II. Forty-two of the 84 documented war-related casualties among Nicaraguan health workers have been deaths. This high case fatality rate reflects the targeting of health workers by contra troops. The number of staff and services of the public medical system decreased by approximately 10 per cent from 1983 to 1985. Population movements, the establishment of new settlements, and war-related destruction of the primary health infrastructure are associated with recent epidemics of malaria, dengue, measles, and leishmaniasis. The estimated rate of infant mortality in Nicaragua, which had declined from 120 per 1,000 in 1978 to 76/1,000 live births in 1983, has since shown no further decline. Internationally mandated protections enjoyed by civilians and health workers during times of war do not appear to operate in this so-called "low intensity" conflict. Further declines in infant mortality, prevention of epidemics, and improvement in other health indicators will likely await the cessation of military hostilities. PMID:3565659

Accessibility to health care facilities in Montreal Island: an application of relative accessibility indicators from the perspective of senior and non-senior residents.

PubMed

Paez, Antonio; Mercado, Ruben G; Farber, Steven; Morency, Catherine; Roorda, Matthew

2010-10-25

. The combination of average trip length estimates with the spatial distribution of health care facilities indicates that despite being more mobile, suburban residents tend to have lower levels of accessibility compared to central city residents. The effect is more marked for seniors. Furthermore, the results indicate that accessibility calculated using a fixed bandwidth would produce patterns of exposure to health care facilities that would be difficult to achieve for suburban seniors given actual mobility patterns. The analysis shows large disparities in accessibility between seniors and non-seniors, between urban and suburban seniors, and between vehicle owning and non-owning seniors. This research was concerned with potential accessibility levels. Follow up research could consider the results reported here to select case studies of actual access and usage of health care facilities, and related health outcomes.

Indicators of Accuracy of Consumer Health Information on the Internet

PubMed Central

Fallis, Don; Frické, Martin

2002-01-01

Objectives: To identify indicators of accuracy for consumer health information on the Internet. The results will help lay people distinguish accurate from inaccurate health information on the Internet. Design: Several popular search engines (Yahoo, AltaVista, and Google) were used to find Web pages on the treatment of fever in children. The accuracy and completeness of these Web pages was determined by comparing their content with that of an instrument developed from authoritative sources on treating fever in children. The presence on these Web pages of a number of proposed indicators of accuracy, taken from published guidelines for evaluating the quality of health information on the Internet, was noted. Main Outcome Measures: Correlation between the accuracy of Web pages on treating fever in children and the presence of proposed indicators of accuracy on these pages. Likelihood ratios for the presence (and absence) of these proposed indicators. Results: One hundred Web pages were identified and characterized as “more accurate” or “less accurate.” Three indicators correlated with accuracy: displaying the HONcode logo, having an organization domain, and displaying a copyright. Many proposed indicators taken from published guidelines did not correlate with accuracy (e.g., the author being identified and the author having medical credentials) or inaccuracy (e.g., lack of currency and advertising). Conclusions: This method provides a systematic way of identifying indicators that are correlated with the accuracy (or inaccuracy) of health information on the Internet. Three such indicators have been identified in this study. Identifying such indicators and informing the providers and consumers of health information about them would be valuable for public health care. PMID:11751805

Health-related parental indicators and their association with healthy weight and overweight/obese children's physical activity.

PubMed

Sigmund, E; Sigmundová, D; Badura, P; Madarasová Gecková, A

2018-05-31

Although it is accepted that parents play a key role in forming children's health behaviours, differences in parent-child physical activity (PA) have not previously been analysed simultaneously in random samples of families with non-overweight and overweight to obese preschool and school-aged children. This study answers the question which of the health-related parental indicators (daily step count (SC), screen time (ST), and weight status and participation in organized leisure-time PA) help their children achieve the step count recommendations. A nationally representative sample comprising 834 families including 1564 parent-child dyads who wore the Yamax Digiwalker SW-200 pedometer for at least 8 h a day on at least four weekdays and both weekend days and completed a family log book (anthropometric parameters, SC, and ST). Logistic regression analyses were used to investigate whether parental achievement of the daily SC recommendation (10,000 SC/day), non-excessive ST (< 2 h/day), weight status, and active participation in organized PA were associated with children's achievement of their daily SC (11,500 SC/day for pre-schoolers and 13,000/11,000 SC/day for school-aged boys/girls). While living in a family with non-overweight parents helps children achieve the daily SC recommendation (mothers in the model: OR = 3.50, 95% CI = 2.29-5.34, p < 0.001; fathers in the model: OR = 2.41, 95% CI = 1.37-4.26, p < 0.01) regardless of their age category, gender, or ST, for families with overweight/obese children, only the mother's achievement of the SC recommendations and non-excessive ST significantly (p < 0.05) increase the odds of their children reaching the daily SC recommendation. The active participation of children in organized leisure-time PA increases the odds of all children achieving the daily SC recommendations (OR = 1.80-2.85); however, for overweight/obese children this remains non-significant. The participation of parents in

Moralized Health-Related Persuasion Undermines Social Cohesion

PubMed Central

Täuber, Susanne

2018-01-01

Integrating theory and research on persuasion, moralization, and intergroup relations, the present research aims to highlight the far-reaching impact of health-related persuasion on society. I propose that governments’ health-related persuasion leads to the emergence of new social norms, and in particular moral norms. Importantly, moral norms provide strong behavioral imperatives and are seen as binding for group members. This suggests that moralized persuasion has a strong potential to divide society along the lines of citizens who conform to and citizens who deviate from health-related moral norms. Thus, departing from the traditional focus on targets of persuasion, the present research focuses on those holding a moralized view on health and lifestyle. Key aspects of social cohesion as defined by the OECD (2011) have been tested across four studies. The main hypothesis tested is that those conforming to the norm (e.g., non-smokers, normal weight people, people with healthy lifestyles) will stigmatize those deviating from the norm (e.g., smokers, overweight people, people with unhealthy lifestyles). Flowing from stigmatization, less inclusion, lower solidarity with and greater endorsement of unequal treatment of those deviating from the moral norm are predicted. Four survey studies (total N = 1568) examining the proposed associations among non-smokers, normal weight people, and employees with healthy lifestyles are presented. The studies provide unanimous support for the hypothesis, with meta-analysis providing further support for the reliability of the findings. Consistent across studies, social cohesion indicators were negatively affected by health moralization through stigmatization of those deviating from health-related moral norms. Findings highlight an under-acknowledged potential of moralized health-related persuasion to divide society, thereby undermining cohesion and the achievement of important societal goals. In the discussion, limitations and

Are differential consumption patterns in health-related behaviours an explanation for persistent and widening social inequalities in health in England?

PubMed

Stait, Emma; Calnan, Michael

2016-10-18

During the last two decades, differential consumption patterns in health-related behaviours have increasingly been highlighted as playing an important role in explaining persistent and widening health inequalities. This period has also seen government public health policies in England place a greater emphasis on changing 'lifestyle' behaviours, in an attempt to tackle social inequalities in health. The aim of this study was to empirically examine the variation in health-related behaviour in relation to socio-economic position, in the English adult population, to determine the nature of this relationship and whether it has changed over time. The study population was derived from the Health Survey for England between 2001 and 2012 (n = 56,468). The relationships between health-related behaviour (smoking, fruit and vegetable intake, alcohol consumption and physical activity) and three socioeconomic indicators (educational level, occupational social class and equivilised household income) were analysed using log bi-nomial regression. The study found that each of the three socio-economic indicators were statistically related to smoking, fruit and vegetable consumption and alcohol intake, with the strongest relationship found for smoking. For physical activity, no relationship was found in 2003 by education or income and in 2008 by occupation. Statistical analysis showed that the difference between those at the highest and lowest end of the socio-economic indicators had widened in relation to smoking, as measured by educational level, occupation and household income. A similar trend was also found for physical activity as measured by educational level and household income. However, for fruit and vegetable intake and alcohol consumption, the relationship between health-related behaviour and socio-economic position had narrowed over time as measured by education and income. The findings provided only partial support for the thesis that socio-economic variations in

New approaches to ranking countries for the allocation of development assistance for health: choices, indicators and implications

PubMed Central

Ottersen, Trygve; Grépin, Karen A; Henderson, Klara; Pinkstaff, Crossley Beth; Norheim, Ole Frithjof; Røttingen, John-Arne

2018-01-01

Abstract The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise approach to the design and assessment of country classification frameworks for the allocation of DAH, with emphasis on critical value choices. We devised 25 frameworks, all which combined GNIpc and at least one other indicator into an index. Indicators were selected and assessed based on relevance, salience, validity, consistency, and availability and timeliness, where relevance concerned the extent to which the indicator represented country’s health needs, domestic capacity, the expected impact of DAH, or equity. We assessed how the use of the different frameworks changed the rankings of low- and middle-income countries relative to a country’s ranking based on GNIpc alone. We found that stakeholders generally considered needs to be the most important concern to be captured by classification frameworks, followed by inequality, expected impact and domestic capacity. We further found that integrating a health-needs indicator with GNIpc makes a significant difference for many countries and country categories—and especially middle-income countries with high burden of unmet health needs—while the choice of specific indicator makes less difference. This together with assessments of relevance, salience, validity, consistency, and availability and timeliness suggest that donors have reasons to include a health-needs indicator in the initial classification of countries. It specifically suggests that life expectancy and disability-adjusted life year rate are indicators worth considering. Indicators related to other

Remote Sensing of Forest Health Indicators for Assessing Change in Forest Health

Treesearch

Michael K. Crosby; Zhaofei Fan; Martin A. Spetich; Theodor D. Leininger

2012-01-01

Oak decline poses a substantial threat to forest health in the Ozark Highlands of northern Arkansas and southern Missouri, where coupled with diseases and insect infestations, it has damaged large tracts of forest lands. Forest Health Monitoring (FHM) crown health indicators (e.g. crown dieback, etc.), collected by the U.S. Forest Service’s Forest Inventory and...

Network Indicators of the Social Ecology of Adolescents in Relative and Non-Relative Foster Households

PubMed Central

Kothari, Brianne H.; McBeath, Bowen; Sorenson, Paul; Bank, Lew

2016-01-01

Though the presence, composition, and quality of social relationships—particularly as found in family networks—has an important influence on adolescent well-being, little is known about the social ecology of youth in foster care. This study examined the social networks of foster youth participating in a large RCT of an intervention for siblings in foster care. Youth reported on the people they lived with and the relatives they were in contact with, which provided indicators of network size, composition, and relationship quality. Cluster analysis was used to identify five family network profiles for youth living in foster homes. Two identified subgroups reflected robust family networks where youth were living with relative caregiver(s) and related youth, and also reported multiple family ties outside the household, including with biological parents. The remaining three profiles reflected youth reports of fewer family connections within or beyond the foster household, with distinctions by whether they lived with siblings and/or reported having positive relationships with their mothers and/or fathers. The identified network profiles were validated using youth- and caregiver-reported measures of mental health functioning, with increased caregiver report of post-traumatic stress symptoms indicated for the three subgroups that were not characterized by a robust family network. PMID:28736465

Motivators and Barriers to Incorporating Climate Change-Related Health Risks in Environmental Health Impact Assessment

PubMed Central

Turner, Lyle R.; Alderman, Katarzyna; Connell, Des; Tong, Shilu

2013-01-01

Climate change presents risks to health that must be addressed by both decision-makers and public health researchers. Within the application of Environmental Health Impact Assessment (EHIA), there have been few attempts to incorporate climate change-related health risks as an input to the framework. This study used a focus group design to examine the perceptions of government, industry and academic specialists about the suitability of assessing the health consequences of climate change within an EHIA framework. Practitioners expressed concern over a number of factors relating to the current EHIA methodology and the inclusion of climate change-related health risks. These concerns related to the broad scope of issues that would need to be considered, problems with identifying appropriate health indicators, the lack of relevant qualitative information that is currently incorporated in assessment and persistent issues surrounding stakeholder participation. It was suggested that improvements are needed in data collection processes, particularly in terms of adequate communication between environmental and health practitioners. Concerns were raised surrounding data privacy and usage, and how these could impact on the assessment process. These findings may provide guidance for government and industry bodies to improve the assessment of climate change-related health risks. PMID:23525029

Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: A recipe for good practice

PubMed Central

Erreygers, Guido; Van Ourti, Tom

2011-01-01

The tools to be used and other choices to be made when measuring socioeconomic inequalities with rank-dependent inequality indices have recently been debated in this journal. This paper adds to this debate by stressing the importance of the measurement scale, by providing formal proofs of several issues in the debate, and by lifting the curtain on the confusing debate between adherents of absolute versus relative health differences. We end this paper with a ‘matrix’ that provides guidelines on the usefulness of several rank-dependent inequality indices under varying circumstances. PMID:21683462

Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

PubMed

Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

2015-01-01

New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

Assessing the cost of electronic health records: a review of cost indicators.

PubMed

Gallego, Ana Isabel; Gagnon, Marie-Pierre; Desmartis, Marie

2010-11-01

We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

Macroinvertebrates as Indicators of Stream Health.

ERIC Educational Resources Information Center

McDonald, Brook S.; And Others

1991-01-01

Describes Ohio's Scenic Rivers Monitoring Program that uses benthic macroinvertebrates, such as the stonefly, mayfly, and water penny beetle larva, as key indicators of water quality and stream health. Presents a three-category scheme for invertebrates based upon their tolerance to pollution. Students can collect samples of these organisms,…

Correlation of sex ratio at birth with health and socioeconomic indicators.

PubMed

Grech, Victor

2018-03-01

The sex ratio at birth (male divided by total live births: M/T) has been mooted as a potential sentinel health indicator. Several metrics indicate individual countries' health and socioeconomic status. In this study, in all available countries (where such data was accessible), M/T and these indicators were compared in order to ascertain whether better (vis-à-vis health and socioeconomic status) levels of these indicators were associated with higher M/T in available countries. The following were obtained (by country) from various sources: M/T, infant mortality rate, under 5 years mortality rate, fertility rate, Human Development Index, gross domestic product per capita, life expectancy for both sexes, females, males, as well as both sexes Health Adjusted Life Expectancy (HALE). Pearson correlation was performed comparing M/T and these indicators. Despite weak correlation values, all except for the Human Development Index (HDI) correlated with M/T at statistically significant levels. A decrease in mortality and an increase in life expectancy and GDP/capita are indicators of socioeconomic wellbeing. In this study, mortality was negatively correlated with M/T. Life expectancy and GDP/capita were both positively correlated with M/T, indicating that M/T may also serve as a surrogate health indicator, and incidentally, also supporting the Trivers-Willard hypothesis. Improving economies lead to increasing education, which in turns tends to lower fertility rate in association with a declining M/T. In conclusion, the global correlation of health and socioeconomic indicators with M/T suggests that M/T may be a useful sentinel health indicator. Copyright © 2018 Elsevier B.V. All rights reserved.

Changes in relative fit of human heat stress indices to cardiovascular, respiratory, and renal hospitalizations across five Australian urban populations

NASA Astrophysics Data System (ADS)

Goldie, James; Alexander, Lisa; Lewis, Sophie C.; Sherwood, Steven C.; Bambrick, Hilary

2018-03-01

Various human heat stress indices have been developed to relate atmospheric measures of extreme heat to human health impacts, but the usefulness of different indices across various health impacts and in different populations is poorly understood. This paper determines which heat stress indices best fit hospital admissions for sets of cardiovascular, respiratory, and renal diseases across five Australian cities. We hypothesized that the best indices would be largely dependent on location. We fit parent models to these counts in the summers (November-March) between 2001 and 2013 using negative binomial regression. We then added 15 heat stress indices to these models, ranking their goodness of fit using the Akaike information criterion. Admissions for each health outcome were nearly always higher in hot or humid conditions. Contrary to our hypothesis that location would determine the best-fitting heat stress index, we found that the best indices were related largely by health outcome of interest, rather than location as hypothesized. In particular, heatwave and temperature indices had the best fit to cardiovascular admissions, humidity indices had the best fit to respiratory admissions, and combined heat-humidity indices had the best fit to renal admissions. With a few exceptions, the results were similar across all five cities. The best-fitting heat stress indices appear to be useful across several Australian cities with differing climates, but they may have varying usefulness depending on the outcome of interest. These findings suggest that future research on heat and health impacts, and in particular hospital demand modeling, could better reflect reality if it avoided "all-cause" health outcomes and used heat stress indices appropriate to specific diseases and disease groups.

Changes in relative fit of human heat stress indices to cardiovascular, respiratory, and renal hospitalizations across five Australian urban populations.

PubMed

Goldie, James; Alexander, Lisa; Lewis, Sophie C; Sherwood, Steven C; Bambrick, Hilary

2018-03-01

Various human heat stress indices have been developed to relate atmospheric measures of extreme heat to human health impacts, but the usefulness of different indices across various health impacts and in different populations is poorly understood. This paper determines which heat stress indices best fit hospital admissions for sets of cardiovascular, respiratory, and renal diseases across five Australian cities. We hypothesized that the best indices would be largely dependent on location. We fit parent models to these counts in the summers (November-March) between 2001 and 2013 using negative binomial regression. We then added 15 heat stress indices to these models, ranking their goodness of fit using the Akaike information criterion. Admissions for each health outcome were nearly always higher in hot or humid conditions. Contrary to our hypothesis that location would determine the best-fitting heat stress index, we found that the best indices were related largely by health outcome of interest, rather than location as hypothesized. In particular, heatwave and temperature indices had the best fit to cardiovascular admissions, humidity indices had the best fit to respiratory admissions, and combined heat-humidity indices had the best fit to renal admissions. With a few exceptions, the results were similar across all five cities. The best-fitting heat stress indices appear to be useful across several Australian cities with differing climates, but they may have varying usefulness depending on the outcome of interest. These findings suggest that future research on heat and health impacts, and in particular hospital demand modeling, could better reflect reality if it avoided "all-cause" health outcomes and used heat stress indices appropriate to specific diseases and disease groups.

Use of Electronic Health-Related Datasets in Nursing and Health-Related Research.

PubMed

Al-Rawajfah, Omar M; Aloush, Sami; Hewitt, Jeanne Beauchamp

2015-07-01

Datasets of gigabyte size are common in medical sciences. There is increasing consensus that significant untapped knowledge lies hidden in these large datasets. This review article aims to discuss Electronic Health-Related Datasets (EHRDs) in terms of types, features, advantages, limitations, and possible use in nursing and health-related research. Major scientific databases, MEDLINE, ScienceDirect, and Scopus, were searched for studies or review articles regarding using EHRDs in research. A total number of 442 articles were located. After application of study inclusion criteria, 113 articles were included in the final review. EHRDs were categorized into Electronic Administrative Health-Related Datasets and Electronic Clinical Health-Related Datasets. Subcategories of each major category were identified. EHRDs are invaluable assets for nursing the health-related research. Advanced research skills such as using analytical softwares, advanced statistical procedures, dealing with missing data and missing variables will maximize the efficient utilization of EHRDs in research. © The Author(s) 2014.

[Assessing work-related stress: an Italian adaptation of the HSE Management Standards Work-Related Stress Indicator Tool].

PubMed

Marcatto, Francesco; D'Errico, Giuseppe; Di Blas, Lisa; Ferrante, Donatella

2011-01-01

The aim of this paper is to present a preliminary validation of an Italian adaptation of the HSE Management Standards Work-Related Stress Indicator Tool (IT), an instrument for assessing work-related stress at the organizational level, originally developed in Britain by the Health and Safety Executive. A scale that assesses the physical work environment has been added to the original version of the IT. 190 employees of the University of Trieste have been enrolled in the study. A confirmatory analysis showed a satisfactory fit of the eight-factors structure of the instrument. Further psychometric analysis showed adequate internal consistency of the IT scales and good criterion validity, as evidenced by the correlations with self-perception of stress, work satisfaction and motivation. In conclusion, the Indicator Tool proved to be a valid and reliable instrument for the assessment of work-related stress at the organizational level, and it is also compatible with the instructions provided by the Ministry of Labour and Social Policy (Circular letter 18/11/2010).

Deprivation Indices, Population Health and Geography: An Evaluation of the Spatial Effectiveness of Indices at Multiple Scales

PubMed Central

Bell, Nathaniel; Dunn, James R.; Oliver, Lisa

2007-01-01

Area-based deprivation indices (ABDIs) have become a common tool with which to investigate the patterns and magnitude of socioeconomic inequalities in health. ABDIs are also used as a proxy for individual socioeconomic status. Despite their widespread use, comparably less attention has been focused on their geographic variability and practical concerns surrounding the Modifiable Area Unit Problem (MAUP) than on the individual attributes that make up the indices. Although scale is increasingly recognized as an important factor in interpreting mapped results among population health researchers, less attention has been paid specifically to ABDI and scale. In this paper, we highlight the effect of scale on indices by mapping ABDIs at multiple census scales in an urban area. In addition, we compare self-rated health data from the Canadian Community Health Survey with ABDIs at two census scales. The results of our analysis confirm the influence of spatial extent and scale on mapping population health—with potential implications for health policy implementation and resource distribution. PMID:17447145

Developing Responsive Indicators of Indigenous Community Health

PubMed Central

Donatuto, Jamie; Campbell, Larry; Gregory, Robin

2016-01-01

How health is defined and assessed is a priority concern for Indigenous peoples due to considerable health risks faced from environmental impacts to homelands, and because what is “at risk” is often determined without their input or approval. Many health assessments by government agencies, industry, and researchers from outside the communities fail to include Indigenous definitions of health and omit basic methodological guidance on how to evaluate Indigenous health, thus compromising the quality and consistency of results. Native Coast Salish communities (Washington State, USA) developed and pilot-tested a set of Indigenous Health Indicators (IHI) that reflect non-physiological aspects of health (community connection, natural resources security, cultural use, education, self-determination, resilience) on a community scale, using constructed measures that allow for concerns and priorities to be clearly articulated without releasing proprietary knowledge. Based on initial results from pilot-tests of the IHI with the Swinomish Indian Tribal Community (Washington State, USA), we argue that incorporation of IHIs into health assessments will provide a more comprehensive understanding of Indigenous health concerns, and assist Indigenous peoples to control their own health evaluations. PMID:27618086

Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study.

PubMed

Busch, Vincent; Van Stel, Henk F; Schrijvers, Augustinus J P; de Leeuw, Johannes R J

2013-12-04

Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial and physical health. These findings have

Clustering of health-related behaviors, health outcomes and demographics in Dutch adolescents: a cross-sectional study

PubMed Central

2013-01-01

Background Recent studies show several health-related behaviors to cluster in adolescents. This has important implications for public health. Interrelated behaviors have been shown to be most effectively targeted by multimodal interventions addressing wider-ranging improvements in lifestyle instead of via separate interventions targeting individual behaviors. However, few previous studies have taken into account a broad, multi-disciplinary range of health-related behaviors and connected these behavioral patterns to health-related outcomes. This paper presents an analysis of the clustering of a broad range of health-related behaviors with relevant demographic factors and several health-related outcomes in adolescents. Methods Self-report questionnaire data were collected from a sample of 2,690 Dutch high school adolescents. Behavioral patterns were deducted via Principal Components Analysis. Subsequently a Two-Step Cluster Analysis was used to identify groups of adolescents with similar behavioral patterns and health-related outcomes. Results Four distinct behavioral patterns describe the analyzed individual behaviors: 1- risk-prone behavior, 2- bully behavior, 3- problematic screen time use, and 4- sedentary behavior. Subsequent cluster analysis identified four clusters of adolescents. Multi-problem behavior was associated with problematic physical and psychosocial health outcomes, as opposed to those exerting relatively few unhealthy behaviors. These associations were relatively independent of demographics such as ethnicity, gender and socio-economic status. Conclusions The results show that health-related behaviors tend to cluster, indicating that specific behavioral patterns underlie individual health behaviors. In addition, specific patterns of health-related behaviors were associated with specific health outcomes and demographic factors. In general, unhealthy behavior on account of multiple health-related behaviors was associated with both poor psychosocial

Disparities in Health Indicators for Latinas in California.

ERIC Educational Resources Information Center

Baezconde-Garbanati, Lourdes; Portillo, Carmen J.; Garbanati, James Allen

1999-01-01

Analyzes health indicators for Latinas in rural and urban California. Discusses Latina demographics; causes of death; life expectancy; and profiles for breast cancer, cervical cancer, heart disease, diabetes, and AIDS. Examines Latina risk factors: poverty, high dropout rates, lack of health insurance, obesity, physical inactivity, low levels of…

Assessing the public health impact of cannabis legalization in Canada: core outcome indicators towards an 'index' for monitoring and evaluation.

PubMed

Fischer, Benedikt; Russell, Cayley; Rehm, Jürgen; Leece, Pamela

2018-05-30

The legalization of non-medical cannabis use and supply is impending in Canada. This constitutes a major policy change with the declared objective of improving public health outcomes, which requires rigorous monitoring and evaluation. While numerous different aspects associated with legalization will be examined, a focused perspective is required for effective policy evaluation purposes. To these ends, we have identified a set of 10 core indicators associated with cannabis-related risk/harm outcomes-based on current best evidence-that are expected to measure the primary impacts of legalization on public health outcomes. We briefly review these indicators, and their respective data availability in Canada. As ideally an integrated outcome assessment of cannabis legalization's impact on public health will be available, we further propose options to merge the individual indicators into an integrated, weighted 'index', considering their expected relative impact for public health. One possible approach to undertake this is 'multi-criteria decision analysis' as a method to weight the relative indicator impact on public health; alternative approaches are proposed. The integrated 'public health index' for cannabis legalization will allow for scientifically comprehensive, while focused, monitoring and evaluation of the effects of legalization in Canada for the benefits of science and evidence-based policy alike.

[Quality criteria and indicators of women's health care].

PubMed

Mandú, Edir Nei Teixeira

2005-04-01

In this article, quality criteria and indicators of the basic care of the woman's health are presented with emphasis on the sexual and reproductive health that can be used in the management of supervision practices. In its elaboration, formulations regarding the evaluating practice, the managerial work, the full care to the woman's health (sexual and reproductive) are taken into consideration, besides proposals of the Health Ministry for monitoring the attention to this specific group. It focuses mainly on care and vigilance actions as to the women's health and on organizational and managerial aspects of such care.

An empirical exploration of the relations between the health components of the International Classification of Functioning, Disability and Health (ICF).

PubMed

Perenboom, Rom J M; Wijlhuizen, Gert Jan; Garre, Francisca Galindo; Heerkens, Yvonne F; van Meeteren, Nico L U

2012-01-01

The aim of this study was to investigate the relations between the ICF components from a subjective perspective. Data on health condition and perceived functioning were collected among 2941 individuals with at least one chronic disease or disorder. Path analysis was used with perceived level of participation as the final denominator. Three models were tested: one with the number of chronic diseases and disorders as an indicator of health condition, one with perceived health as indicator of health condition, and one with perceived health as part of the personal factors. Although all models showed a good fit, the model with the best fit was that with perceived health as an indicator of health condition. From a patient's perspective, components of the ICF scheme appear to be associated with each other, with perceived health being the best indicator of the health condition.

Physical fitness and health indices in children, adolescents and adults with high or low motor competence.

PubMed

Cantell, Marja; Crawford, Susan G; Tish Doyle-Baker, P K

2008-04-01

The overall purpose of the study was to examine if individuals with low motor competence achieve age-adequate fitness and health. A group of 149 children, adolescents, and adults with low or high motor competence participated in motor, fitness, and health assessments. Individuals with low motor competence did not differ on their basic physiological health parameters, but they had less optimal levels of overall health and fitness indices than those with high motor competence. As a function of age, musculoskeletal fitness was significantly compromised for the low motor competence group. The metabolic indices suggested that the low motor competence group had significantly higher BMI's compared to the high motor competence group. Motor skills and static balance were significant predictors of the BMI. Exercise intensity differed between children in the low and high motor competence group. The findings suggest that individuals with low motor competence have compromised health-related fitness. In order to discriminate between individuals with high and low motor competence, fitness assessment should include at least back extension, curl ups, and sit and reach. In addition, health-related fitness measurements such as BMI, waist circumference, blood lipid profile and bone mineral density are also recommended.

Impact of traffic-related air pollution on health.

PubMed

Jakubiak-Lasocka, J; Lasocki, J; Siekmeier, R; Chłopek, Z

2015-01-01

Road transport contributes significantly to air quality problems through vehicle emissions, which have various detrimental impacts on public health and the environment. The aim of this study was to assess the impact of traffic-related air pollution on health of Warsaw citizens, following the basics of the Health Impact Assessment (HIA) method, and evaluate its social cost. PM10 was chosen as an indicator of traffic-related air pollution. Exposure-response functions between air pollution and health impacts were employed. The value of statistical life (VSL) approach was used for the estimation of the cost of mortality attributable to traffic-related air pollution. Costs of hospitalizations and restricted activity days were assessed basing on the cost of illness (COI) method. According to the calculations, about 827 Warsaw citizens die in a year as a result of traffic-related air pollution. Also, about 566 and 250 hospital admissions due to cardiovascular and respiratory diseases, respectively, and more than 128,453 restricted activity days can be attributed to the traffic emissions. From the social perspective, these losses generate the cost of 1,604 million PLN (1 EUR-approx. 4.2 PLN). This cost is very high and, therefore, more attention should be paid for the integrated environmental health policy.

The Association of Sexual Orientation Measures With Young Adults’ Health-Related Outcomes

PubMed Central

Walsemann, Katrina M.; Carter, Jarvis W.

2012-01-01

Objectives. We examined associations among 3 dimensions of sexual orientation (identity, behavior, and attraction) and key health-related indicators commonly studied among sexual minority populations: depressive symptoms, perceived stress, smoking, binge drinking, and victimization. Methods. We analyzed data from the National Longitudinal Study of Adolescent Health, Wave IV (2007–2008) when respondents were aged 24 to 32 years (n = 14 412). We used multivariate linear and logistic regressions to examine consistency of associations between sexual orientation measures and health-related indicators. Results. Strength of associations differed by gender and sexual orientation measure. Among women, being attracted to both sexes, identifying as “mostly straight” or “bisexual,” and having mostly opposite-sex sexual partners was associated with greater risk for all indicators. Among men, sexual attraction was unrelated to health indicators. Men who were “mostly straight” were at greater risk for some, but not all, indicators. Men who had sexual partners of the same-sex or both sexes were at lower risk for binge drinking. Conclusions. Using all 3 dimensions of sexual orientation provides a more complete picture of the association between sexual orientation and health among young adults than does using any 1 dimension alone. PMID:22021310

Evaluating area-based socioeconomic status indicators for monitoring disparities within health care systems: results from a primary care network.

PubMed

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-04-01

To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. © Health Research and Educational Trust.

Relative residential property value as a socio-economic status indicator for health research

PubMed Central

2013-01-01

Background Residential property is reported as the most valuable asset people will own and therefore provides the potential to be used as a socio-economic status (SES) measure. Location is generally recognised as the most important determinant of residential property value. Extending the well-established relationship between poor health and socio-economic disadvantage and the role of residential property in the overall wealth of individuals, this study tested the predictive value of the Relative Location Factor (RLF), a SES measure designed to reflect the relationship between location and residential property value, and six cardiometabolic disease risk factors, central obesity, hypertriglyceridemia, reduced high density lipoprotein (HDL), hypertension, impaired fasting glucose, and high low density lipoprotein (LDL). These risk factors were also summed and expressed as a cumulative cardiometabolic risk (CMR) score. Methods RLF was calculated using a global hedonic regression model from residential property sales transaction data based upon several residential property characteristics, but deliberately blind to location, to predict the selling price of the property. The predicted selling price was divided by the actual selling price and the results interpolated across the study area and classified as tertiles. The measures used to calculate CMR were collected via clinic visits from a population-based cohort study. Models with individual risk factors and the cumulative cardiometabolic risk (CMR) score as dependent variables were respectively tested using log binomial and Poisson generalised linear models. Results A statistically significant relationship was found between RLF, the cumulative CMR score and all but one of the risk factors. In all cases, participants in the most advantaged and intermediate group had a lower risk for cardio-metabolic diseases. For the CMR score the RR for the most advantaged was 19% lower (RR = 0.81; CI 0.76-0.86; p <0.0001) and the

Rangeland health attributes and indicators for qualitative assessment

USGS Publications Warehouse

Pyke, David A.; Herrick, J.E.; Pellant, Mike

2002-01-01

Panels of experts from the Society for Range Management and the National Research Council proposed that status of rangeland ecosystems could be ascertained by evaluating an ecological site's potential to conserve soil resources and by a series of indicators for ecosystem processes and site stability. Using these recommendations as a starting point, we developed a rapid, qualitative method for assessing a moment-in-time status of rangelands. Evaluators rate 17 indicators to assess 3 ecosystem attributes (soil and site stability, hydrologic function, and biotic integrity) for a given location. Indicators include rills, water flow patterns, pedestals and terracettes, bare ground, gullies, wind scour and depositional areas, litter movement, soil resistance to erosion, soil surface loss or degradation, plant composition relative to infiltration, soil compaction, plant functional/structural groups, plant mortality, litter amount, annual production, invasive plants, and reproductive capability. In this paper, we detail the development and evolution of the technique and introduce a modified ecological reference worksheet that documents the expected presence and amount of each indicator on the ecological site. In addition, we review the intended applications for this technique and clarify the differences between assessment and monitoring that lead us to recommend this technique be used for moment-in-time assessments and not be used for temporal monitoring of rangeland status. Lastly, we propose a mechanism for adapting and modifying this technique to reflect improvements in understanding of ecosystem processes. We support the need for quantitative measures for monitoring rangeland health and propose some measures that we believe may address some of the 17 indicators.

Development of measurable indicators to enhance public health evidence-informed policy-making.

PubMed

Tudisca, Valentina; Valente, Adriana; Castellani, Tommaso; Stahl, Timo; Sandu, Petru; Dulf, Diana; Spitters, Hilde; Van de Goor, Ien; Radl-Karimi, Christina; Syed, Mohamed Ahmed; Loncarevic, Natasa; Lau, Cathrine Juel; Roelofs, Susan; Bertram, Maja; Edwards, Nancy; Aro, Arja R

2018-05-31

Ensuring health policies are informed by evidence still remains a challenge despite efforts devoted to this aim. Several tools and approaches aimed at fostering evidence-informed policy-making (EIPM) have been developed, yet there is a lack of availability of indicators specifically devoted to assess and support EIPM. The present study aims to overcome this by building a set of measurable indicators for EIPM intended to infer if and to what extent health-related policies are, or are expected to be, evidence-informed for the purposes of policy planning as well as formative and summative evaluations. The indicators for EIPM were developed and validated at international level by means of a two-round internet-based Delphi study conducted within the European project 'REsearch into POlicy to enhance Physical Activity' (REPOPA). A total of 82 researchers and policy-makers from the six European countries (Denmark, Finland, Italy, the Netherlands, Romania, the United Kingdom) involved in the project and international organisations were asked to evaluate the relevance and feasibility of an initial set of 23 indicators developed by REPOPA researchers on the basis of literature and knowledge gathered from the previous phases of the project, and to propose new indicators. The first Delphi round led to the validation of 14 initial indicators and to the development of 8 additional indicators based on panellists' suggestions; the second round led to the validation of a further 11 indicators, including 6 proposed by panellists, and to the rejection of 6 indicators. A total of 25 indicators were validated, covering EIPM issues related to human resources, documentation, participation and monitoring, and stressing different levels of knowledge exchange and involvement of researchers and other stakeholders in policy development and evaluation. The study overcame the lack of availability of indicators to assess if and to what extent policies are realised in an evidence-informed manner

Usability Evaluation and Implementation of a Health Information Technology Dashboard of Evidence-Based Quality Indicators.

PubMed

Schall, Mark Christopher; Cullen, Laura; Pennathur, Priyadarshini; Chen, Howard; Burrell, Keith; Matthews, Grace

2017-06-01

Health information technology dashboards that integrate evidence-based quality indicators can efficiently and accurately display patient risk information to promote early intervention and improve overall quality of patient care. We describe the process of developing, evaluating, and implementing a dashboard designed to promote quality care through display of evidence-based quality indicators within an electronic health record. Clinician feedback was sought throughout the process. Usability evaluations were provided by three nurse pairs and one physician from medical-surgical areas. Task completion times, error rates, and ratings of system usability were collected to compare the use of quality indicators displayed on the dashboard to the indicators displayed in a conventional electronic health record across eight experimental scenarios. Participants rated the dashboard as "highly usable" following System Usability Scale (mean, 87.5 [SD, 9.6]) and Poststudy System Usability Questionnaire (mean, 1.7 [SD, 0.5]) criteria. Use of the dashboard led to reduced task completion times and error rates in comparison to the conventional electronic health record for quality indicator-related tasks. Clinician responses to the dashboard display capabilities were positive, and a multifaceted implementation plan has been used. Results suggest application of the dashboard in the care environment may lead to improved patient care.

Measuring socioeconomic inequality in health, health care and health financing by means of rank-dependent indices: a recipe for good practice.

PubMed

Erreygers, Guido; Van Ourti, Tom

2011-07-01

The tools to be used and other choices to be made when measuring socioeconomic inequalities with rank-dependent inequality indices have recently been debated in this journal. This paper adds to this debate by stressing the importance of the measurement scale, by providing formal proofs of several issues in the debate, and by lifting the curtain on the confusing debate between adherents of absolute versus relative health differences. We end this paper with a 'matrix' that provides guidelines on the usefulness of several rank-dependent inequality indices under varying circumstances. Copyright © 2011 Elsevier B.V. All rights reserved.

Indicators of deprivation, voting patterns, and health status at area level in the Republic of Ireland.

PubMed

Kelleher, C; Timoney, A; Friel, S; McKeown, D

2002-01-01

To determine what relation, if any, exists between mortality patterns, indicators of deprivation, general lifestyle and social attitudes, as exemplified by general election voting pattern, in the Republic of Ireland. A relation has been demonstrated previously between voting and mortality patterns in the United Kingdom. Cross sectional ecological study using three data sources. Standardised mortality ratios (SMR) were based on mortality rates at county level and 1996 census data from the Central Statistics Office, 1997 general election first preference voting data in all 41 constituencies were aggregated to county level. Selected reported measures of health status, lifestyle and social circumstances are from the first ever National survey on lifestyles, attitudes and nutrition (SLAN). This study comprised adults over 18 years sampled by post using the electoral register from 273 representative district electoral divisions. Univariate inter-relations were examined at individual level for the dataset as a whole, adjusting for age and at aggregated level for 26 county borough areas, which included the two largest cities and for 22 county areas, which afforded correlation with voting pattern, using the method of Pearson's correlation coefficient. 1,806,932 votes were cast nationally at the 1997 general election, representing a voter turnout of 65.92 %. There was an overall response rate of 62% to SLAN comprising 6539 adults (47% male). The demographic pattern of survey respondents was consistent with that of the general population over 18 years. At individual level there was a large number of highly significant inter-relations between indicators of deprivation, various measures of self rated health status and lifestyle factors. Aggregated at 26 county level percentage unemployed (r=0.408, p=0.038), and level of education (r=0.475, p=0.014) related significantly to SMR and inversely to both fruit and vegetable consumption (r= -0.672, p=0.001) and excess alcohol

Indicators of deprivation, voting patterns, and health status at area level in the Republic of Ireland

PubMed Central

Kelleher, C; Timoney, A; Friel, S; McKeown, D

2002-01-01

Study objective: To determine what relation, if any, exists between mortality patterns, indicators of deprivation, general lifestyle and social attitudes, as exemplified by general election voting pattern, in the Republic of Ireland. A relation has been demonstrated previously between voting and mortality patterns in the United Kingdom. Design: Cross sectional ecological study using three data sources. Standardised mortality ratios (SMR) were based on mortality rates at county level and 1996 census data from the Central Statistics Office, 1997 general election first preference voting data in all 41 constituencies were aggregated to county level. Selected reported measures of health status, lifestyle and social circumstances are from the first ever National survey on lifestyles, attitudes and nutrition (SLAN). This study comprised adults over 18 years sampled by post using the electoral register from 273 representative district electoral divisions. Univariate inter-relations were examined at individual level for the dataset as a whole, adjusting for age and at aggregated level for 26 county borough areas, which included the two largest cities and for 22 county areas, which afforded correlation with voting pattern, using the method of Pearson's correlation coefficient. Participants: 1 806 932 votes were cast nationally at the 1997 general election, representing a voter turnout of 65.92 %. There was an overall response rate of 62% to SLAN comprising 6539 adults (47% male). The demographic pattern of survey respondents was consistent with that of the general population over 18 years. Main results: At individual level there was a large number of highly significant inter-relations between indicators of deprivation, various measures of self rated health status and lifestyle factors. Aggregated at 26 county level percentage unemployed (r=0.408, p=0.038), and level of education (r=0.475, p=0.014) related significantly to SMR and inversely to both fruit and vegetable

Generation and evaluation of an indicator of the health system's performance in maternal and reproductive health in Colombia: An ecological study.

PubMed

Pinzón-Flórez, Carlos Eduardo; Fernandez-Niño, Julian Alfredo; Cardenas-Cardenas, Luz Mery; Díaz-Quijano, Diana Marcela; Ruiz-Rodriguez, Myriam; Reveiz, Ludovic; Arredondo-López, Armando

2017-01-01

To generate and evaluate an indicator of the health system's performance in the area of maternal and reproductive health in Colombia. An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the states were classified according to the indicator's score. A path analysis was used to evaluate the relationship between the indicator and social determinants, with the maternal mortality ratio as the response variable. The factor analysis indicates that only one principal factor exists, namely "coverage and utilization of maternal healthcare services" (eigenvalue 4.35). The indicator performed best in the states of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander (Q4). The poorest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. The indicator's behavior was found to have an association with the unsatisfied basic needs index and women's education (β = -0.021; 95%CI -0031 to -0.01 and β 0.554; 95%CI 0.39 to 0.72, respectively). According to the path analysis, an inverse relationship exists between the proposed indicator and the behavior of the maternal mortality ratio (β = -49.34; 95%CI -77.7 to -20.9); performance was a mediating variable. The performance of the health system with respect to its management of access and coverage for maternal and reproductive health appears to function as a mediating variable between social determinants and maternal mortality in Colombia.

The role of income inequality and social policies on income-related health inequalities in Europe.

PubMed

Jutz, Regina

2015-10-31

The aim of the paper is to examine the role of income inequality and redistribution for income-related health inequalities in Europe. This paper contributes in two ways to the literature on macro determinants of socio-economic inequalities in health. First, it widens the distinctive focus of the research field on welfare state regimes to quantifiable measures such as social policy indicators. Second, looking at income differences completes studies on socio-economic health inequalities, which often analyse health inequalities based on educational differences. Using data from the European Values Study (2008/2009), 42 European countries are available for analysis. Country characteristics are derived from SWIID, Eurostat, and ILO and include indicators for income inequality, social policies, and economic performance. The data is analysed by using a two-step hierarchical estimation approach: At the first step-the individual level-the effect of household income on self-assessed health is extracted and introduced as an indicator measuring income-related health inequalities at the second step, the country-level. Individual-level analyses reveal that income-related health inequalities exist all across Europe. Results from country-level analyses show that higher income inequality is significantly positively related to higher health inequalities while social policies do not show significant relations. Nevertheless, the results show the expected negative association between social policies and health inequalities. Economic performance also has a reducing influence on health inequalities. In all models, income inequality was the dominating explanatory effect for health inequalities. The analyses indicate that income inequality has more impact on health inequalities than social policies. On the contrary, social policies seemed to matter to all individuals regardless of socio-economic position since it is significantly positively linked to overall population health. Even though

Health-Promoting School Indicators: Schematic Models from Students

ERIC Educational Resources Information Center

Gabhainn, Saoirse Nic; Sixsmith, Jane; Delaney, Ellen-Nora; Moore, Miriam; Inchley, Jo; O'Higgins, Siobhan

2007-01-01

Purpose: The purpose of this paper is to outline a three-stage process for engaging with students to develop school level indicators of health in sequential class groups students first generated, then categorised indicators and finally developed schematic representations of their analyses. There is a political and practical need to develop…

Health-Related Quality of Life of Former Lead Workers in Brazil.

PubMed

Teixeira, Martha Carvalho Pereira; Carvalho, Fernando Martins; Lins, Liliane

2015-11-03

Little is known about the health-related quality of life of former lead workers. Using the Short-Form 36 Questionnaire (SF-36), a cross-section design study evaluated the health-related quality of life of 186 former workers of a lead smelter that operated in Santo Amaro da Purificação, Brazil, from 1960 to 1993, when it closed down. The smelter had very poor occupational and environmental hygiene standards. The health-related quality of life of former lead workers was low, compared to population-based and other nosological groups from Brazil. Former lead workers who indicated metal poisoning, difficulty getting another job and who could not get another job after dismissal by the smelter presented poorer health-related quality of life. Former lead workers with poor health-related quality of life form part of the huge occupational liability left by the Santo Amaro lead smelter.

Morningness-eveningness and health-related quality of life among adolescents.

PubMed

Delgado Prieto, Pedro; Diaz-Morales, Juan Francisco; Escribano, Barreno Cristina; Collado Mateo, M José; Randler, Christoph

2012-07-01

Accumulating evidence suggests that evening-type adolescents are exposed to a number of determinants that might have a negative impact on their health condition. Given that few studies have investigated the association between chronotype and quality of life measures in large samples of adolescents, the aim of this study was to assess the relationship between morningness-eveningness and health-related quality of life among 1600 adolescents (aged 12-16 years). Adolescents completed the Veçu et Santé Perçue de L'adolescent (VSP-A) and the Morningness-Eveningness Scale for Children (MESC). Girls and older adolescents reported worse health indicators and were more evening oriented. Evening-type adolescents obtained lower scores on vitality, physical and psychological well-being, body image, relations with parents, relations with teachers, school work and global health scale.

Health indicators: eliminating bias from convenience sampling estimators.

PubMed

Hedt, Bethany L; Pagano, Marcello

2011-02-28

Public health practitioners are often called upon to make inference about a health indicator for a population at large when the sole available information are data gathered from a convenience sample, such as data gathered on visitors to a clinic. These data may be of the highest quality and quite extensive, but the biases inherent in a convenience sample preclude the legitimate use of powerful inferential tools that are usually associated with a random sample. In general, we know nothing about those who do not visit the clinic beyond the fact that they do not visit the clinic. An alternative is to take a random sample of the population. However, we show that this solution would be wasteful if it excluded the use of available information. Hence, we present a simple annealing methodology that combines a relatively small, and presumably far less expensive, random sample with the convenience sample. This allows us to not only take advantage of powerful inferential tools, but also provides more accurate information than that available from just using data from the random sample alone. Copyright © 2011 John Wiley & Sons, Ltd.

Community indicators

PubMed Central

Flynn, Andrea; Wells, Samantha

2014-01-01

Community indicators are used to assess the impact of alcohol on communities. This article reviews the main data sources for community indicators, discusses their strengths and limitations, and discusses indicators used in reference to four main topics relating to alcohol use and problems at the community level: alcohol use, patterns, and problems; alcohol availability; alcohol-related health outcomes/trauma; and alcohol-related crime and enforcement. It also reviews the challenges associated with collecting community indicator data, along with important innovations in the field that have contributed to better knowledge of how to collect and analyze community-level data on the impact of alcohol. PMID:24881322

Using lagging and leading indicators for the evaluation of occupational safety and health performance in industry.

PubMed

Pawłowska, Zofia

2015-01-01

Improvement of occupational safety and health (OSH) management is closely related to the development of OSH performance measurement, which should include OSH outcomes (e.g., occupational accidents), OSH inputs (including working conditions) and OSH-related activities. The indicators used to measure the OSH outcomes are often called lagging indicators, and the indicators of inputs and OSH activities are leading indicators. A study was conducted in 60 companies in order to determine what kinds of indicators were used for OSH performance measurement by companies with different levels of OSH performance. The results reveal that the indicators most commonly used in all of the companies are those related to ensuring compliance with the statutory requirements. At the same time, the leading indicators are much more often adopted in companies with a higher performance level. These companies also much more often monitor on a regular basis the indicators adopted for the evaluation of their OSH performance.

Using lagging and leading indicators for the evaluation of occupational safety and health performance in industry

PubMed Central

Pawłowska, Zofia

2015-01-01

Improvement of occupational safety and health (OSH) management is closely related to the development of OSH performance measurement, which should include OSH outcomes (e.g., occupational accidents), OSH inputs (including working conditions) and OSH-related activities. The indicators used to measure the OSH outcomes are often called lagging indicators, and the indicators of inputs and OSH activities are leading indicators. A study was conducted in 60 companies in order to determine what kinds of indicators were used for OSH performance measurement by companies with different levels of OSH performance. The results reveal that the indicators most commonly used in all of the companies are those related to ensuring compliance with the statutory requirements. At the same time, the leading indicators are much more often adopted in companies with a higher performance level. These companies also much more often monitor on a regular basis the indicators adopted for the evaluation of their OSH performance. PMID:26647949

Sustainability of green jobs in Portugal: a methodological approach using occupational health indicators.

PubMed

Moreira, Sandra; Vasconcelos, Lia; Silva Santos, Carlos

2017-09-28

This study aimed to develop a methodological tool to analyze and monitor the green jobs in the context of Occupational Health and Safety. A literature review in combination with an investigation of Occupational Health Indicators was performed. The resulting tool of Occupational Health Indicators was based on the existing information of "Single Report" and was validated by national's experts. The tool brings together 40 Occupational Health Indicators in four key fields established by World Health Organization in their conceptual framework "Health indicators of sustainable jobs." The tool proposed allows for assessing if the green jobs enabled to follow the principles and requirements of Occupational Health Indicators and if these jobs are as good for the environment as for the workers' health, so if they can be considered quality jobs. This shows that Occupational Health Indicators are indispensable for the assessment of the sustainability of green jobs and should be taken into account in the definition and evaluation of policies and strategies of the sustainable development.

Cultural, socioeconomic, and health indicators among Inuit preschoolers: Nunavut Inuit Child Health Survey, 2007-2008.

PubMed

Egeland, Grace M; Faraj, Nancy; Osborne, Geraldine

2010-01-01

Indicators of socioeconomic status, health behaviours and health histories are important for evaluating population health and indicators associated with 'indigeneity' features, prominently as determinants of health for Indigenous peoples. Health surveillance of young children, who represent society's most vulnerable, can provide meaningful data regarding achieving an optimal healthy start in life. A cross-sectional health survey of Inuit children, aged 3-5 years, was conducted between 2007 and 2008. The latitude of the communities ranged from 56 degrees 32'N to 72 degrees 40'N. A bilingual research team conducted face-to-face interviews which included the use of questionnaires covering factors associated with indigeneity, the physical and socio-economic environment, health behaviours and health histories. Weighted prevalence estimates were calculated. The participation rate was 72.3%; 388 randomly selected children participated. Indicators of traditional food utilization and sharing were highly prevalent and Inuktitut was spoken by 65.2% of preschoolers in the Inuktitut speaking regions. A large percent of the preschoolers lived in a crowded dwelling (53.9%) and in public housing (69.7%), and in a home in need of major repairs (37%). There was an average of 2 smokers per household but the majority of homes restricted smoking to outside the home (83.1%). The majority of mothers smoked during pregnancy (82.5%). For children who were not adopted, there was a high prevalence of breastfeeding initiation (80.6%). A high prevalence of children were ever hospitalized, excluding deliveries (41.6%), and within the past year 40.7% of the children had to be taken to the health centre or hospital for a respiratory problem. Indicators of indigeneity suggest the Inuktitut language is thriving and that children are learning Inuit ways through extended family contact and country food utilization and sharing. The high prevalence of smoking restrictions in the home is evidence of the

Television viewing and other screen-based entertainment in relation to multiple socioeconomic status indicators and area deprivation: the Scottish Health Survey 2003.

PubMed

Stamatakis, E; Hillsdon, M; Mishra, G; Hamer, M; Marmot, M

2009-09-01

Sedentary behaviour (sitting) is detrimental to health, independently of participation in physical activity. Socioeconomic position (SEP) is known to relate strongly to physical activity participation but we know very little about how SEP relates to sedentary behaviour. This study aimed to assess the relationships between SEP, neighbourhood deprivation and an index of sedentary time. Cross-sectional study of a representative sample of 7940 Scottish adults who participated in the 2003 Scottish Health Survey, which collected information on SEP (household income, social class and education), neighbourhood deprivation (Scottish Index of Multiple Deprivation), television and other screen-based entertainment time, and physical activity. The three indicators of SEP and deprivation index were independently of each other associated with daily times of television and other screen-based entertainment, even after adjustment for occupational and leisure-time physical activity, health status, smoking, alcohol drinking, car ownership and body mass index: income p = 0.002; social class p<0.001; education p<0.001, deprivation p<0.001. Also, there was a strong cumulative effect of SEP (a composite scale where 0 = lowest, 9 = highest SEP position) with those in the lowest SEP spending an additional 109 minutes each day on screen-based entertainment compared to those in the highest socioeconomic position (p<0.001 for linear trend). Adverse socioeconomic position is associated with a cumulative increase in the time spent on screen-based entertainment. Reducing inequalities would be expected to reduce exposure to sedentary behaviours, such as excessive screen-based entertainment times, and therefore reduce the risk of chronic disease.

Relative deprivation, poverty, and subjective health: JAGES cross-sectional study.

PubMed

Saito, Masashige; Kondo, Katsunori; Kondo, Naoki; Abe, Aya; Ojima, Toshiyuki; Suzuki, Kayo

2014-01-01

To evaluate the association between relative deprivation (lacking daily necessities) and subjective health in older Japanese adults, we performed a cross-sectional analysis using data from the Japan Gerontological Evaluation Study (JAGES). The data were obtained from functionally independent residents aged ≥65 years from 24 municipalities in Japan (n = 24,742). Thirteen items in three dimensions were used to evaluate relative deprivation of material conditions. Approximately 28% of older Japanese people indicated that they lacked some daily necessities (non-monetary poverty). A two-level Poisson regression analysis revealed that relative deprivation was associated with poor self-rated health (PR = 1.3-1.5) and depressive symptoms (PR = 1.5-1.8) in both men and women, and these relationships were stronger than those observed in people living in relative poverty (monetary poverty). The interaction effect between relative deprivation and relative poverty was not associated with poor health. As a dimension of the social determinants of health, poverty should be evaluated from a multidimensional approach, capturing not only monetary conditions but also material-based, non-monetary conditions.

The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review.

PubMed

Costigan, Sarah A; Barnett, Lisa; Plotnikoff, Ronald C; Lubans, David R

2013-04-01

Evidence suggests sitting time is independently associated with a range of health issues in adults, yet the relationship between sedentary behavior and health indicators in young people is less clear. Age-related increases in sedentary behavior are well-documented; the behavioral patterns of adolescent girls are of particular concern. More than one third of adolescent girls' sedentary behavior time is accumulated through use of recreational screen-based behaviors. The objective of this review was to investigate the association between recreational screen-based sedentary behavior and the physical, behavioral, and psychosocial health indicators for adolescent girls. A secondary objective was to identify studies that have adjusted sedentary behavior indicators for physical activity. A structured electronic search of all publication years (through December 2011) was conducted to identify studies in: CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text. Included publications were observational and interventional studies involving adolescent girls (12-18 years) that examined associations between screen-based, sedentary behavior and health indicators (physical, psychosocial, and/or behavioral). The search identified 33 studies that evaluated health indicators of screen-based sedentary behaviors among adolescent girls. Strong evidence for a positive association between screen-based sedentary behavior and weight status was found. A positive association was observed between screen-time and sleep problems, musculoskeletal pain and depression. Negative associations were identified between screen time and physical activity/fitness, screen time and psychological well-being, and screen time and social support. The relationship between screen-based sedentary behavior and diet quality was inconclusive. Less than half of the studies adjusted sedentary behavior indicators for physical activity. Screen-based sedentary

Sustainability of green jobs in Portugal: a methodological approach using occupational health indicators

PubMed Central

Moreira, Sandra; Vasconcelos, Lia; Silva Santos, Carlos

2017-01-01

Objective: This study aimed to develop a methodological tool to analyze and monitor the green jobs in the context of Occupational Health and Safety. Methods: A literature review in combination with an investigation of Occupational Health Indicators was performed. The resulting tool of Occupational Health Indicators was based on the existing information of "Single Report" and was validated by national's experts. Results: The tool brings together 40 Occupational Health Indicators in four key fields established by World Health Organization in their conceptual framework "Health indicators of sustainable jobs." The tool proposed allows for assessing if the green jobs enabled to follow the principles and requirements of Occupational Health Indicators and if these jobs are as good for the environment as for the workers' health, so if they can be considered quality jobs. Conclusions: This shows that Occupational Health Indicators are indispensable for the assessment of the sustainability of green jobs and should be taken into account in the definition and evaluation of policies and strategies of the sustainable development. PMID:28794392

Socioeconomic indicators of heat-related health risk supplemented with remotely sensed data

PubMed Central

Johnson, Daniel P; Wilson, Jeffrey S; Luber, George C

2009-01-01

Background Extreme heat events are the number one cause of weather-related fatalities in the United States. The current system of alert for extreme heat events does not take into account intra-urban spatial variation in risk. The purpose of this study is to evaluate a potential method to improve spatial delineation of risk from extreme heat events in urban environments by integrating sociodemographic risk factors with estimates of land surface temperature derived from thermal remote sensing data. Results Comparison of logistic regression models indicates that supplementing known sociodemographic risk factors with remote sensing estimates of land surface temperature improves the delineation of intra-urban variations in risk from extreme heat events. Conclusion Thermal remote sensing data can be utilized to improve understanding of intra-urban variations in risk from extreme heat. The refinement of current risk assessment systems could increase the likelihood of survival during extreme heat events and assist emergency personnel in the delivery of vital resources during such disasters. PMID:19835578

Linking public relations processes and organizational effectiveness at a state health department.

PubMed

Wise, Kurt

2003-01-01

This qualitative case study explored a state health department's relationships with strategic constituencies from a public relations perspective. The relationships were explored within the theoretical framework of the Excellence Theory, the dominant paradigm in public research. Findings indicate application of the Excellence Theory has the potential to increase organizational effectiveness at public health entities. With respect to the case investigated, findings indicate that the state health department could increase its organizational effectiveness through the adoption of recommendations based on the Excellence Theory.

Developing the 18th indicator for interpreting indicators of rangeland health on Northern Great Plains rangelands

USDA-ARS?s Scientific Manuscript database

National Resources Inventory (NRI) resource assessment report shows little to no departure on Rangeland Health for most Northern Great Plains Rangelands. This information is supported by Interpreting Indicators of Rangeland Health (IIRH) data collected at local to regional scales. There is however a...

Adding Natural Areas to Social Indicators of Intra-Urban Health Inequalities among Children: A Case Study from Berlin, Germany.

PubMed

Kabisch, Nadja; Haase, Dagmar; Annerstedt van den Bosch, Matilda

2016-08-04

Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children's health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools.

Adding Natural Areas to Social Indicators of Intra-Urban Health Inequalities among Children: A Case Study from Berlin, Germany

PubMed Central

Kabisch, Nadja; Haase, Dagmar; Annerstedt van den Bosch, Matilda

2016-01-01

Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children’s health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools. PMID:27527197

Individual Income, Area Deprivation, and Health: Do Income-Related Health Inequalities Vary by Small Area Deprivation?

PubMed

Siegel, Martin; Mielck, Andreas; Maier, Werner

2015-11-01

This paper aims to explore potential associations between health inequalities related to socioeconomic deprivation at the individual and the small area level. We use German cross-sectional survey data for the years 2002 and 2006, and measure small area deprivation via the German Index of Multiple Deprivation. We test the differences between concentration indices of income-related and small area deprivation related inequalities in obesity, hypertension, and diabetes. Our results suggest that small area deprivation and individual income both yield inequalities in health favoring the better-off, where individual income-related inequalities are significantly more pronounced than those related to small area deprivation. We then apply a semiparametric extension of Wagstaff's corrected concentration index to explore how individual-level health inequalities vary with the degree of regional deprivation. We find that the concentration of obesity, hypertension, and diabetes among lower income groups also exists at the small area level. The degree of deprivation-specific income-related inequalities in the three health outcomes exhibits only little variations across different levels of multiple deprivation for both sexes. Copyright © 2014 John Wiley & Sons, Ltd.

Health-related shame: an affective determinant of health?

PubMed Central

Dolezal, Luna; Lyons, Barry

2017-01-01

Despite shame being recognised as a powerful force in the clinical encounter, it is underacknowledged, under-researched and undertheorised in the contexts of health and medicine. In this paper we make two claims. The first is that emotional or affective states, in particular shame, can have a significant impact on health, illness and health-related behaviours. We outline four possible processes through which this might occur: (1) acute shame avoidance behaviour; (2) chronic shame health-related behaviours; (3) stigma and social status threat and (4) biological mechanisms. Second, we postulate that shame's influence is so insidious, pervasive and pernicious, and so critical to clinical and political discourse around health, that it is imperative that its vital role in health, health-related behaviours and illness be recognised and assimilated into medical, social and political consciousness and practice. In essence, we argue that its impact is sufficiently powerful for it to be considered an affective determinant of health, and provide three justifications for this. We conclude with a proposal for a research agenda that aims to extend the state of knowledge of health-related shame. PMID:28596218

Health-related quality of life and related factors of military police officers

PubMed Central

2014-01-01

Purpose The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. Methods The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. Results The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. Conclusions These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life. PMID:24766910

Health-related quality of life and related factors of military police officers.

PubMed

da Silva, Franciele Cascaes; Hernandez, Salma Stéphany Soleman; Arancibia, Beatriz Angélica Valdivia; Castro, Thiago Luis da Silva; Filho, Paulo José Barbosa Gutierres; da Silva, Rudney

2014-04-27

The present study aimed to determine the effect of demographic characteristics, occupation, anthropometric indices, and leisure-time physical activity levels on coronary risk and health-related quality of life among military police officers from the State of Santa Catarina, Brazil. The sample included 165 military police officers who fulfilled the study’s inclusion criteria. The International Physical Activity Questionnaire and the Short Form Health Survey were used, in addition to a spreadsheet of socio-demographic, occupational and anthropometric data. Statistical analyses were performed using descriptive analysis followed by Spearman Correlation and multiple linear regression analysis using the backward method. The waist-to-height ratio was identified as a risk factor low health-related quality of life. In addition, the conicity index, fat percentage, years of service in the military police, minutes of work per day and leisure-time physical activity levels were identified as risk factors for coronary disease among police officers. These findings suggest that the Military Police Department should adopt an institutional policy that allows police officers to practice regular physical activity in order to maintain and improve their physical fitness, health, job performance, and quality of life.

Community, Family, and Subjective Socioeconomic Status: Relative Status and Adolescent Health

PubMed Central

Quon, Elizabeth C.; McGrath, Jennifer J.

2017-01-01

Objective Relative socioeconomic status (SES) may be an important social determinant of health. The current study aimed to examine how relative SES, as measured by subjective SES, income inequality, and individual SES relative to others in the community, is associated with a wide range of adolescent health outcomes, after controlling for objective family SES. Method Adolescents (13–16 years; N = 2,199) from the Quebec Child and Adolescent Health and Social Survey were included. Socioeconomic measures included adolescents’ subjective SES; parental education and household income; community education/employment, income, and poverty rate; and community income inequality. Health outcomes included self-rated health, mental health problems, dietary and exercise health behaviors, substance-related health behaviors, reported physical health, and biomarkers of health. Best-fitting multilevel regression models (participants nested within schools) were used to test associations. Results Findings indicated that lower subjective SES was associated with poorer health outcomes. After accounting for family SES, lower community education/employment had an additional negative effect on health, while lower community income had a protective effect for certain health outcomes. There was less evidence for an independent effect of income inequality. Conclusions Findings highlight the importance of measures of relative SES that span across a number of levels and contexts, and provide further understanding into the socioeconomic gradient in adolescence. PMID:25222085

Community, family, and subjective socioeconomic status: Relative status and adolescent health.

PubMed

Quon, Elizabeth C; McGrath, Jennifer J

2015-06-01

Relative socioeconomic status (SES) may be an important social determinant of health. The current study aimed to examine how relative SES, as measured by subjective SES, income inequality, and individual SES relative to others in the community, is associated with a wide range of adolescent health outcomes, after controlling for objective family SES. Adolescents (13-16 years; N = 2,199) from the Quebec Child and Adolescent Health and Social Survey were included. Socioeconomic measures included adolescents' subjective SES; parental education and household income; community education/employment, income, and poverty rate; and community income inequality. Health outcomes included self-rated health, mental health problems, dietary and exercise health behaviors, substance-related health behaviors, reported physical health, and biomarkers of health. Best-fitting multilevel regression models (participants nested within schools) were used to test associations. Findings indicated that lower subjective SES was associated with poorer health outcomes. After accounting for family SES, lower community education/employment had an additional negative effect on health, while lower community income had a protective effect for certain health outcomes. There was less evidence for an independent effect of income inequality. Findings highlight the importance of measures of relative SES that span across a number of levels and contexts, and provide further understanding into the socioeconomic gradient in adolescence. (c) 2015 APA, all rights reserved).

Prevalence of building-related symptoms as an indicator of health and productivity.

PubMed

Niemelä, Raimo; Seppänen, Olli; Korhonen, Pirjo; Reijula, Kari

2006-10-01

The prevalence of building-related symptoms (BRS) is commonly used to characterize the indoor air quality in office buildings. To analyze the costs of building renovation and the improvement of the indoor environment, it is useful to quantitatively relate the prevalence or intensity of BRS to productivity. The intent of this study is to summarize the links between the BRS and productivity, and demonstrate this linkage in two case buildings. A literature was surveyed for studies that measured simultaneously the prevalence or intensity of BRS and subjectively reported or objectively measured productivity. Case studies in two office environments were performed. An association between the prevalence of BRS and productivity of workers in a call center and in an insurance office were investigated. In the first case study, the productivity was expressed using the direct productivity metrics, namely the number of telephone contacts during active working hours while in the second case, the productivity was assessed by using the data concerning sick leave rates. Employees who report more BRS also have more often absences which relate to indoor environment quality (IEQ). Their productivity is lower than those who have better IEQ in their offices. Despite uncertainties related to the data concerning recorded sick leave and self-reported productivity, the number of studies showing an association between BRS and productivity or sick leave suggests that such a relationship exists. The present case studies also demonstrated an association between the BRS and the direct productivity. Based on the data from the call center, a reduction of 10%-units in the prevalence of general symptoms (such as fatigue, headache, nausea, etc.) corresponded with a gain of 1.5% in performance. Based on the findings in the insurance company, a reduction of 10%-units in the prevalence of irritation symptoms corresponded with a decrease of 0.7% in the short-term absenteeism. A review of 23 studies

Monitoring gender equity in health using gender-sensitive indicators: a cross-national study.

PubMed

Diaz-Granados, Natalia; Pitzul, Kristen Blythe; Dorado, Linda M; Wang, Feng; McDermott, Sarah; Rondon, Marta B; Posada-Villa, Jose; Saavedra, Javier; Torres, Yolanda; Des Meules, Marie; Stewart, Donna E

2011-01-01

As gender is known to be a major determinant of health, monitoring gender equity in health systems remains a vital public health priority. Focusing on a low-income (Peru), middle-income (Colombia), and high-income (Canada) country in the Americas, this study aimed to (1) identify and select gender-sensitive health indicators and (2) assess the feasibility of measuring and comparing gender-sensitive health indicators among countries. Gender-sensitive health indicators were selected by a multidisciplinary group of experts from each country. The most recent gender-sensitive health measures corresponding to selected indicators were identified through electronic databases (CINAHL, PsycINFO, MEDLINE, Embase, LILACS, LIPECS, Latindex, and BIREME) and expert consultation. Data from population-based studies were analyzed when indicator information was unavailable from reports. Twelve of the 17 selected gender-sensitive health indicators were feasible to measure in at least two countries, and 9 of these were comparable among all countries. Indicators that were available were not stratified or adjusted by age, education, marital status, or wealth. The largest between-country difference was maternal mortality, and the largest gender inequity was mortality from homicides. This study shows that gender inequities in health exist in all countries, regardless of income level. Economic development seemed to confer advantages in the availability of such indicators; however, this finding was not consistent and needs to be further explored. Future initiatives should include identifying health system factors and risk factors associated with disparities as well as assessing the cost-effectiveness of including the routine monitoring of gender inequities in health.

Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015.

PubMed

2016-10-08

In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015). We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices. In 2015, the median health-related SDG index was 59·3 (95% uncertainty interval 56·8-61·8) and varied widely by country, ranging from 85·5 (84·2-86·5) in Iceland to 20·4 (15·4-24·9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r 2 =0·88) and the MDG index (r 2 =0·92), whereas the non-MDG index had a weaker relation with SDI (r 2 =0·79). Between 2000 and 2015, the health-related SDG index improved by a median of 7·9 (IQR 5·0-10·4), and gains on the MDG index (a median change of 10·0 [6·7-13·1]) exceeded that of the non-MDG index (a median change of 5·5 [2·1-8·9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for

Modeling the factors associating with health-related habits among Japanese students.

PubMed

Mato, Mie; Tsukasaki, Keiko

2017-11-23

The aim of the present study was to clarify the structural relationship between health-related habits and psychosocial factors during adolescence/early adulthood. An anonymous, self-administered questionnaire was provided to 1141 third- and fourth-year students at eight academic departments from six universities in regional Japanese cities. Surveys included items addressing participants' demographic characteristics, psychosocial factors (individual-level social capital, self-efficacy, mental health (from health-related quality of life SF-36v2), and sense of coherence (SOC)), and health-related habits. A multiple indicator analysis based on structural equation modeling was conducted to examine the structural relationship between health-related habits and these factors. Valid responses were obtained from 952 participants. The final model demonstrated a high level of goodness of fit. While the path from SOC to health-related habits was significant, those from self-efficacy to health-related habits and from mental health to health-related habits were not significant. The path coefficient from SOC to health-related habits was greater than the path coefficient from background characteristics. In the multiple population comparison that considered gender, a nearly identical model was supported for men and women. Psychosocial factors related to health-related habits were social capital, self-efficacy, mental health, and SOC. Furthermore, it was suggested that SOC functions as an intervening factor for maintaining a healthy lifestyle. It was observed that individual psychosocial factors influence health-related habits more than their background characteristics. Findings highlight that supporting the building of social relationships and social environments is essential to promote a healthy lifestyle among university students. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Correlation between Drug Market Withdrawals and Socioeconomic, Health, and Welfare Indicators Worldwide

PubMed Central

Lee, Kye Hwa; Kim, Grace Juyun

2015-01-01

The relationship between the number of withdrawn/restricted drugs and socioeconomic, health, and welfare indicators were investigated in a comprehensive review of drug regulation information in the United Nations (UN) countries. A total of of 362 drugs were withdrawn and 248 were restricted during 1950-2010, corresponding to rates of 12.02±13.07 and 5.77±8.69 (mean±SD), respectively, among 94 UN countries. A socioeconomic, health, and welfare analysis was performed for 33 OECD countries for which data were available regarding withdrawn/restricted drugs. The gross domestic product (GDP) per capita, GDP per hour worked, health expenditure per GDP, and elderly population rate were positively correlated with the numbers of withdrawn and restricted drugs (P<0.05), while the out-of-pocket health expenditure payment rate was negatively correlated. The number of restricted drugs was also correlated with the rate of drug-related deaths (P<0.05). The World Bank data cross-validated the findings of 33 OECD countries. The lists of withdrawn/restricted drugs showed markedly poor international agreement between them (Fleiss's kappa=-0.114). Twenty-seven drugs that had been withdrawn internationally by manufacturers are still available in some countries. The wide variation in the numbers of drug withdrawals and restrictions among countries indicates the need to improve drug surveillance systems and regulatory communication networks. PMID:26538999

Correlation between Drug Market Withdrawals and Socioeconomic, Health, and Welfare Indicators Worldwide.

PubMed

Lee, Kye Hwa; Kim, Grace Juyun; Kim, Ju Han

2015-11-01

The relationship between the number of withdrawn/restricted drugs and socioeconomic, health, and welfare indicators were investigated in a comprehensive review of drug regulation information in the United Nations (UN) countries. A total of of 362 drugs were withdrawn and 248 were restricted during 1950-2010, corresponding to rates of 12.02 ± 13.07 and 5.77 ± 8.69 (mean ± SD), respectively, among 94 UN countries. A socioeconomic, health, and welfare analysis was performed for 33 OECD countries for which data were available regarding withdrawn/restricted drugs. The gross domestic product (GDP) per capita, GDP per hour worked, health expenditure per GDP, and elderly population rate were positively correlated with the numbers of withdrawn and restricted drugs (P < 0.05), while the out-of-pocket health expenditure payment rate was negatively correlated. The number of restricted drugs was also correlated with the rate of drug-related deaths (P < 0.05). The World Bank data cross-validated the findings of 33 OECD countries. The lists of withdrawn/restricted drugs showed markedly poor international agreement between them (Fleiss's kappa = -0.114). Twenty-seven drugs that had been withdrawn internationally by manufacturers are still available in some countries. The wide variation in the numbers of drug withdrawals and restrictions among countries indicates the need to improve drug surveillance systems and regulatory communication networks.

Developing clinical indicators for the secondary health system in India.

PubMed

Thakur, Harshad; Chavhan, S; Jotkar, Raju; Mukherjee, Kanchan

2008-08-01

One of the prime goals of any health system is to deliver good and competent quality of healthcare. Through World Bank-assisted Maharashtra Health Systems Development Project, Government of Maharashtra in India developed and implemented clinical indicators to improve quality. During this, clinical areas eligible for monitoring quality of care and roles of health staff working at various levels were identified. Brainstorming discussion sessions were conducted to refine list of potential clinical indicators and to identify implementation problems. It was implemented in four stages. (a) Self-explanatory tool of record, standard operating procedures and training manual were prepared during tools preparation stage. (b) Pilot implementation was done to monitor the usefulness of indicators, document the experiences and standardize the system accordingly. (c) The final selection of indicators was done taking into consideration points like data reliability, indicator usefulness etc. For final implementation, 15 indicators for district and 6 indicators for rural hospitals were selected. (d) Transfer of skills was done through training of various hospital functionaries. Selection and prioritization of clinical indicators is the most crucial part. Active participation of local employees is essential for sustainability of the scheme. It is also important to ensure that data recorded/reported is both reliable and valid, to conduct monthly review of the scheme at various levels and to link it with the quality improvement programme.

Evaluating Area-Based Socioeconomic Status Indicators for Monitoring Disparities within Health Care Systems: Results from a Primary Care Network

PubMed Central

Berkowitz, Seth A; Traore, Carine Y; Singer, Daniel E; Atlas, Steven J

2015-01-01

Objective To determine which area-based socioeconomic status (SES) indicator is best suited to monitor health care disparities from a delivery system perspective. Data Sources/Study Setting 142,659 adults seen in a primary care network from January 1, 2009 to December 31, 2011. Study Design Cross-sectional, comparing associations between area-based SES indicators and patient outcomes. Data Collection Address data were geocoded to construct area-based SES indicators at block group (BG), census tract (CT), and ZIP code (ZIP) levels. Data on health outcomes were abstracted from electronic records. Relative indices of inequality (RIIs) were calculated to quantify disparities detected by area-based SES indicators and compared to RIIs from self-reported educational attainment. Principal Findings ZIP indicators had less missing data than BG or CT indicators (p < .0001). Area-based SES indicators were strongly associated with self-report educational attainment (p < .0001). ZIP, BG, and CT indicators all detected expected SES gradients in health outcomes similarly. Single-item, cut point defined indicators performed as well as multidimensional indices and quantile indicators. Conclusions Area-based SES indicators detected health outcome differences well and may be useful for monitoring disparities within health care systems. Our preferred indicator was ZIP-level median household income or percent poverty, using cut points. PMID:25219917

Education-related inequity in healthcare with heterogeneous reporting of health

PubMed Central

d’Uva, Teresa Bago; Lindeboom, Maarten; O’Donnell, Owen; van Doorslaer, Eddy

2011-01-01

Summary Reliance on self-rated health to proxy medical need can bias estimation of education-related inequity in healthcare utilization. We correct this bias both by instrumenting self-rated health with objective health indicators and by purging self-rated health of reporting heterogeneity that is identified from health vignettes. Using data on elderly Europeans, we find that instrumenting self-rated health shifts the distribution of visits to a doctor in the direction of inequality favouring the better educated. There is a further, and typically larger, shift in the same direction when correction is made for the tendency of the better educated to rate their health more negatively. PMID:21938140

Socio-demographic differentials of adult health indicators in Matlab, Bangladesh: self-rated health, health state, quality of life and disability level

PubMed Central

Razzaque, Abdur; Nahar, Lutfun; Akter Khanam, Masuma; Kim Streatfield, Peter

2010-01-01

Background Mortality has been declining in Bangladesh since the mid- twentieth century, while fertility has been declining since the late 1970s, and the country is now passing through the third stage of demographic transition. This type of demographic transition has produced a huge youthful population with a growing number of older people. For assessing health among older people, this study examines self-rated health, health state, quality of life and disability level in persons aged 50 and over. Data and methods This is a collaborative study between the World Health Organization Study on global AGEing and adult health and the International Network for the Demographic Evaluation of Populations and Their Health in developing countries which collected data from eight countries. Two sources of data from the Matlab study area were used: health indicator data collected as a part of the study, together with the ongoing Health and Demographic Surveillance System (HDSS) data. For the survey, a total of 4,000 randomly selected people aged 50 and over (HDSS database) were interviewed. The four health indicators derived from these data are self-rated health (five categories), health state (eight domains), quality of life (eight items) and disability level (12 items). Self-rated health was coded as dummy while scores were calculated for the rest of the three health indicators using WHO-tested instruments. Results After controlling for all the variables in the regression model, all four indicators of health (self-rated health, health state, quality of life and disability level) documented that health was better for males than females, and health deteriorates with increasing age. Those people who were in current partnerships had generally better health than those who were single, and better health was associated with higher levels of education and asset score. Conclusions To improve the health of the population it is important to know health conditions in advance rather than

Mental Health and Related Factors of Hospital Nurses.

PubMed

Nukui, Hiroshi; Murakami, Michio; Midorikawa, Sanae; Suenaga, Minako; Rokkaku, Yuichi; Yabe, Hirooki; Ohtsuru, Akira

2017-03-01

The mental health of hospital nurses is a key health issue in public health promotion during the recovery phase following the Fukushima disaster. In this study, conducted 4 years after the disaster, we analyzed the overall mental health, knowledge, risk perception of radiation, and work and daily life burdens of nurses working at medical institutions in the Fukushima Prefecture (collection rate = 89.6%; response number = 730). Overall mental health status was estimated using the 12-item version of the General Health Questionnaire, and 333 respondents (45.6%) scored above the 12-item General Health Questionnaire threshold point (≥4), indicating probable emotional distress compared with the general population under normal circumstances. Multivariate logistic analysis suggested that the ability to cope with daily life and work-related stressors were more important than risk perception and acquisition of knowledge regarding radiation and its control methods for supporting the mental health of nurses following the Fukushima disaster.

Perceived Racial Bias and Health-Related Stigma Among Youth with Sickle Cell Disease.

PubMed

Wakefield, Emily O; Popp, Jill M; Dale, Lourdes P; Santanelli, James P; Pantaleao, Ashley; Zempsky, William T

Little is known about the role of perceived racial bias and health-related stigma on the health of youth with sickle cell disease (SCD). The purpose of this study was to investigate the occurrence of perceived racial bias and health-related stigma among youth with SCD and its relationship with psychological and physical well-being. Twenty-eight youth with SCD, ages 13 to 21, were recruited from outpatient and inpatient settings at an urban children's medical center. Participants completed measures of perceived racial bias, perceived health-related stigma, depression, quality of life, and pain burden. Most participants endorsed occurrences of racial bias and health-related stigma. The findings indicate that greater perceived racial bias was associated with greater pain burden, and greater perceived health-related stigma was related to lower quality of life. Perceived racial bias and health-related stigma may be important to consider for future research investigating the psychological and physiological features of SCD for youth.

Body weight and health-related quality of life in Catalonia, Spain.

PubMed

Oliva-Moreno, Juan; Gil-Lacruz, Ana

2013-02-01

Obesity poses important burdens not only on the individuals whose quality of life is reduced but on national welfare systems that have to face growing premature mortality rates, increase healthcare expenditures to treat obesity-related diseases, and earmark vast amounts of healthcare resources for prevention. The main goal of this paper is to analyze the relationship between excess body weight and different dimensions of health-related quality of life for people 16 years and older and to identify the health dimensions most affected by excess weight. We have drawn data from the Catalonia Health Survey (2006). Our results reveal a relationship between excess weight and health-related quality of life. Even after controlling for socio-economic status and objective health variables, excess weight is shown to have a significant negative effect on health-related quality of life. Subjects responses revealed that the negative effect of excess weight was felt the strongest in the health-related quality of life dimensions of mobility and pain/discomfort. Our results indicate there are important differences among gender and age groups. Women and older people are more likely to suffer from the negative consequences of excess weight.

Elementary Physical Education Teachers' Content Knowledge of Physical Activity and Health-Related Fitness

ERIC Educational Resources Information Center

Santiago, Jose A.; Disch, James G.; Morales, Julio

2012-01-01

The purpose of this study was to examine elementary physical education teachers' content knowledge of physical activity and health-related fitness. Sixty-four female and 24 male teachers completed the Appropriate Physical Activity and Health-Related Fitness test. Descriptive statistics results indicated that the mean percentage score for the test…

Are Health-Related Tweets Evidence Based? Review and Analysis of Health-Related Tweets on Twitter.

PubMed

Alnemer, Khalid A; Alhuzaim, Waleed M; Alnemer, Ahmed A; Alharbi, Bader B; Bawazir, Abdulrahman S; Barayyan, Omar R; Balaraj, Faisal K

2015-10-29

Health care professionals are utilizing Twitter to communicate, develop disease surveillance systems, and mine health-related information. The immediate users of this health information is the general public, including patients. This necessitates the validation of health-related tweets by health care professionals to ensure they are evidence based and to avoid the use of noncredible information as a basis for critical decisions. The aim of this study was to evaluate health-related tweets on Twitter for validity (evidence based) and to create awareness in the community regarding the importance of evidence-based health-related tweets. All tweets containing health-related information in the Arabic language posted April 1-5, 2015, were mined from Twitter. The tweets were classified based on popularity, activity, interaction, and frequency to obtain 25 Twitter accounts (8 physician accounts, 10 nonofficial health institute accounts, 4 dietitian accounts, and 3 government institute accounts) and 625 tweets. These tweets were evaluated by 3 American Board-certified medical consultants and a score was generated (true/false) and interobserver agreement was calculated. A total of 625 health-related Arabic-language tweets were identified from 8 physician accounts, 10 nonofficial health institute accounts, 4 dietician accounts, and 3 government institute accounts. The reviewers labeled 320 (51.2%) tweets as false and 305 (48.8%) tweets as true. Comparative analysis of tweets by account type showed 60 of 75 (80%) tweets by government institutes, 124 of 201 (61.7%) tweets by physicians, and 42 of 101 (41.6%) tweets by dieticians were true. The interobserver agreement was moderate (range 0.78-0.22). More than half of the health-related tweets (169/248, 68.1%) from nonofficial health institutes and dietician accounts (59/101, 58.4%) were false. Tweets by the physicians were more likely to be rated "true" compared to other groups (P<.001). Approximately half of the medical tweets

Trends in Biometric Health Indices Within an Employer-Sponsored Wellness Program With Outcome-Based Incentives.

PubMed

Fu, Patricia Lin; Bradley, Kent L; Viswanathan, Sheila; Chan, June M; Stampfer, Meir

2016-07-01

To evaluate changes in employees' biometrics over time relative to outcome-based incentive thresholds. Retrospective cohort analysis of biometric screening participants (n = 26 388). Large employer primarily in Western United States. Office, retail, and distribution workforce. A voluntary outcome-based biometric screening program, incentivized with health insurance premium discounts. Body mass index (BMI), cholesterol, blood glucose, blood pressure, and nicotine. Followed were participants from their first year of participation, evaluating changes in measures. On average, participants who did not meet the incentive threshold at baseline decreased their BMI (1%), glucose (8%), blood pressure (systolic 9%, diastolic 8%), and total cholesterol (8%) by year 2 with improvements generally sustained or continued during each additional year of participation. On average, individuals at high health risk who participated in a financially incentivized biometric assessment program improved their health indices over time. Further research is needed to understand key determinants that drive health improvement indicated here. © The Author(s) 2016.

Making the Case for Using Financial Indicators in Local Public Health Agencies

PubMed Central

Suarez, Virginia; Denison, Dwight

2011-01-01

The strength of the public health infrastructure determines the ability of local public health agencies to respond to emergencies and provide essential services. Organizational and systems capacity measures and assessments are important components of the public health infrastructure. Hospitals and governments have a long tradition of using financial indicators to assess fiscal and operational activities. We reviewed the literature on how hospitals use financial indicators to monitor financial risk, promote organizational sustainability, and improve organizational capacity. Given that financial indicators have not generally been employed by public health practitioners, we discuss how these measures can be applied to local public health agencies to improve their organizational capacity. PMID:21233438

Spatial path models with multiple indicators and multiple causes: mental health in US counties.

PubMed

Congdon, Peter

2011-06-01

This paper considers a structural model for the impact on area mental health outcomes (poor mental health, suicide) of spatially structured latent constructs: deprivation, social capital, social fragmentation and rurality. These constructs are measured by multiple observed effect indicators, with the constructs allowed to be correlated both between and within areas. However, in the scheme developed here, particular latent constructs may also be influenced by known variables, or, via path sequences, by other constructs, possibly nonlinearly. For example, area social capital may be measured by effect indicators (e.g. associational density, charitable activity), but influenced as causes by other constructs (e.g. area deprivation), and by observed features of the socio-ethnic structure of areas. A model incorporating these features is applied to suicide mortality and the prevalence of poor mental health in 3141 US counties, which are related to the latent spatial constructs and to observed variables (e.g. county ethnic mix). Copyright © 2011 Elsevier Ltd. All rights reserved.

Indicators for Universal Health Coverage: can Kenya comply with the proposed post-2015 monitoring recommendations?

PubMed

Obare, Valerie; Brolan, Claire E; Hill, Peter S

2014-12-20

Universal Health Coverage (UHC), referring to access to healthcare without financial burden, has received renewed attention in global health spheres. UHC is a potential goal in the post-2015 development agenda. Monitoring of progress towards achieving UHC is thus critical at both country and global level, and a monitoring framework for UHC was proposed by a joint WHO/World Bank discussion paper in December 2013. The aim of this study was to determine the feasibility of the framework proposed by WHO/World Bank for global UHC monitoring framework in Kenya. The study utilised three documents--the joint WHO/World Bank UHC monitoring framework and its update, and the Bellagio meeting report sponsored by WHO and the Rockefeller Foundation--to conduct the research. These documents informed the list of potential indicators that were used to determine the feasibility of the framework. A purposive literature search was undertaken to identify key government policy documents and relevant scholarly articles. A desk review of the literature was undertaken to answer the research objectives of this study. Kenya has yet to establish an official policy on UHC that provides a clear mandate on the goals, targets and monitoring and evaluation of performance. However, a significant majority of Kenyans continue to have limited access to health services as well as limited financial risk protection. The country has the capacity to reasonably report on five out of the seven proposed UHC indicators. However, there was very limited capacity to report on the two service coverage indicators for the chronic condition and injuries (CCIs) interventions. Out of the potential tracer indicators (n = 27) for aggregate CCI-related measures, four tracer indicators were available. Moreover the country experiences some wider challenges that may impact on the implementation and feasibility of the WHO/World Bank framework. The proposed global framework for monitoring UHC will only be feasible in Kenya if

Indicators of food and water security in an Arctic Health context--results from an international workshop discussion.

PubMed

Nilsson, Lena Maria; Berner, James; Dudarev, Alexey A; Mulvad, Gert; Odland, Jon Øyvind; Parkinson, Alan; Rautio, Arja; Tikhonov, Constantine; Evengård, Birgitta

2013-01-01

In August 2012, a literature search with the aim of describing indicators on food and water security in an Arctic health context was initialized in collaboration between the Arctic Human Health Expert Group, SDWG/AHHEG and the AMAP (Arctic Monitoring and Assessment Programme within the Arctic Council) Human Health Assessment Group, AMAP/HHAG. In December 2012, workshop discussions were performed with representatives from both of these organizations, including 7 Arctic countries. The aim of this article is to describe the workshop discussions and the rational for the 12 indicators selected and the 9 rejected and to discuss the potential feasibility of these. Advantages and disadvantages of candidate indicators were listed. Informative value and costs for collecting were estimated separately on a 3-level scale: low, medium and high. Based on these reviews, the final selection of promoted and rejected indicators was performed and summarized in tables. Among 10 suggested indicators of food security, 6 were promoted: healthy weight, traditional food proportion in diet, monetary food costs, non-monetary food accessibility, food-borne diseases and food-related contaminants. Four were rejected: per-person dietary energy supply, food security modules, self-estimated food safety and healthy eating. Among 10 suggested indicators of water security, 6 were promoted: per-capita renewable water, accessibility of running water, waterborne diseases, drinking-water-related contaminants, authorized water quality assurance and water safety plans. Four were rejected: water consumption, types of water sources, periodic water shortages and household water costs.

Case studies on genetically modified organisms (GMOs): Potential risk scenarios and associated health indicators.

PubMed

de Santis, Barbara; Stockhofe, Norbert; Wal, Jean-Michel; Weesendorp, Eefke; Lallès, Jean-Paul; van Dijk, Jeroen; Kok, Esther; De Giacomo, Marzia; Einspanier, Ralf; Onori, Roberta; Brera, Carlo; Bikker, Paul; van der Meulen, Jan; Kleter, G

2018-07-01

Within the frame of the EU-funded MARLON project, background data were reviewed to explore the possibility of measuring health indicators during post-market monitoring for potential effects of feeds, particularly genetically modified (GM) feeds, on livestock animal health, if applicable. Four case studies (CSs) of potential health effects on livestock were framed and the current knowledge of a possible effect of GM feed was reviewed. Concerning allergenicity (CS-1), there are no case-reports of allergic reactions or immunotoxic effects resulting from GM feed consumption as compared with non-GM feed. The likelihood of horizontal gene transfer (HGT; CS-2) of GMO-related DNA to different species is not different from that for other DNA and is unlikely to raise health concerns. Concerning mycotoxins (CS-3), insect-resistant GM maize may reduce fumonisins contamination as a health benefit, yet other Fusarium toxins and aflatoxins show inconclusive results. For nutritionally altered crops (CS-4), the genetic modifications applied lead to compositional changes which require special considerations of their nutritional impacts. No health indicators were thus identified except for possible beneficial impacts of reduced mycotoxins and nutritional enhancement. More generally, veterinary health data should ideally be linked with animal exposure information so as to be able to establish cause-effect relationships. Copyright © 2017 Elsevier Ltd. All rights reserved.

Understanding Health and Health-Related Behavior of Users of Internet Health Information.

PubMed

Wimble, Matt

2016-10-01

Little is known about how actual use of Internet health-related information is associated with health or health-related behavior. Using a nationally representative sample of 34,525 from 2012, this study examined the demographics of users of Internet health-related information (users), reports estimates of association with several health and behavioral outcomes adjusting for demographic factors, and analyzed the sample by education level, race, gender, and age. Analysis of a large nationally representative sample shows evidence that users of health-related information (users) on the Internet are younger, more educated, more likely to be insured, more likely to be female, and less likely to be African American. After adjusting for demographic differences, users are more likely to have been diagnosed with hypertension, cancer, stroke, and high cholesterol, but no evidence of current hypertension, weight-related issues, or being in fair or poor health. Users are less likely to smoke and among smokers are more likely to attempt quitting. Users are more likely to exercise, get a flu shot, pap smear, mammogram, HIV test, colon cancer screening, blood pressure check, and cholesterol check, but likely to be heavy drinkers. With few exceptions, results appear robust across gender, age groups, level of education, and ethnicity. Use is generally positively associated with prior diagnosis for several conditions and behaviors related to improved health, but I find no relationship with existing health status. The association between use of health-related Internet information and health-related behavior seems robust across levels of education, age, gender, and race.

Mental health indicator interaction in predicting substance abuse treatment outcomes in nevada.

PubMed

Greenfield, Lawrence; Wolf-Branigin, Michael

2009-01-01

Indicators of co-occurring mental health and substance abuse problems routinely collected at treatment admission in 19 State substance abuse treatment systems include a dual diagnosis and a State mental health (cognitive impairment) agency referral. These indicators have yet to be compared as predictors of treatment outcomes. 1. Compare both indices as outcomes predictors individually and interactively. 2. Assess relationship of both indices to other client risk factors, e.g., physical/sexual abuse. Client admission and discharge records from the Nevada substance abuse treatment program, spanning 1995-2001 were reviewed (n = 17,591). Logistic regression analyses predicted treatment completion with significant improvement (33%) and treatment readmission following discharge (21%). Using Cox regression, the number of days from discharge to treatment readmission was predicted. Examined as predictors were two mental health indicators and their interaction with other admission and treatment variables controlled. Neither mental health indicator alone significantly predicted any of the three outcomes; however, the interaction between the two indicators significantly predicted each outcome (p < .05). Having both indices was highly associated with physical/sexual abuse, domestic violence, homelessness, out of labor force and prior treatment. Indicator interactions may help improve substance abuse treatment outcomes prediction.

Seeking consensus on universal health coverage indicators in the sustainable development goals.

PubMed

Reddock, Jennifer

2017-01-01

There is optimism that the inclusion of universal health coverage in the Sustainable Development Goals advances its prominence in global and national health policy. However, formulating indicators for Target 3.8 through the Inter-Agency Expert Group on Sustainable Development Indicators has been challenging. Achieving consensus on the conceptual and methodological aspects of universal health coverage is likely to take some time in multi-stakeholder fora compared with national efforts to select indicators.

Health sector employment: a tracer indicator for universal health coverage in national Social Protection Floors.

PubMed

Scheil-Adlung, Xenia; Behrendt, Thorsten; Wong, Lorraine

2015-08-31

Health sector employment is a prerequisite for availability, accessibility, acceptability and quality (AAAQ) of health services. Thus, in this article health worker shortages are used as a tracer indicator estimating the proportion of the population lacking access to such services: The SAD (ILO Staff Access Deficit Indicator) estimates gaps towards UHC in the context of Social Protection Floors (SPFs). Further, it highlights the impact of investments in health sector employment equity and sustainable development. The SAD is used to estimate the share of the population lacking access to health services due to gaps in the number of skilled health workers. It is based on the difference of the density of the skilled health workforce per population in a given country and a threshold indicating UHC staffing requirements. It identifies deficits, differences and developments in access at global, regional and national levels and between rural and urban areas. In 2014, the global UHC deficit in numbers of health workers is estimated at 10.3 million, with most important gaps in Asia (7.1 million) and Africa (2.8 million). Globally, 97 countries are understaffed with significantly higher gaps in rural than in urban areas. Most affected are low-income countries, where 84 per cent of the population remains excluded from access due to the lack of skilled health workers. A positive correlation of health worker employment and population health outcomes could be identified. Legislation is found to be a prerequisite for closing access as gaps. Health worker shortages hamper the achievement of UHC and aggravate weaknesses of health systems. They have major impacts on socio-economic development, particularly in the world's poorest countries where they act as drivers of health inequities. Closing the gaps by establishing inclusive multi-sectoral policy approaches based on the right to health would significantly increase equity, reduce poverty due to ill health and ultimately contribute

Health Indicators: A Tool for Program Review

ERIC Educational Resources Information Center

Abou-Sayf, Frank K.

2006-01-01

A visual tool used to evaluate instructional program performance has been designed by the University of Hawaii Community College system. The tool combines features from traffic lights, blood-chemistry test reports, and industry production control charts, and is labeled the Program Health-Indicator Chart. The tool was designed to minimize the labor…

Family relations and health over the life course. A Lebanese perspective.

PubMed

Ajrouch, Kristine J; Abdulrahim, Sawsan; Antonucci, Toni C

2015-01-01

The link between family relations and well-being in old age has received ample attention in the international literature, but remains least examined in the Arab region where cultural ideals assume positive intergenerational relations within families as the norm. In this paper, we employ survey data collected in Greater Beirut in 2009 to explore associations between family relations and health. over the life course. We tested (1) the extent to which age and social relation characteristics predict health; and (2) whether the association between age and health is stronger for those who report: smaller social networks and poorer relationship quality. We employed self-rated health and self-reported chronic illness as the health outcome measures and:social network size, positive quality and negative quality with family members as the social relations measures. Our findings suggest that social relations are differentially important depending on the health status indicator examined. The single dimension that influenced both self-rated health and the probability of reporting a chronic illness was positive relationship quality with spouse. Further, social relations, particularly having a negative relationship quality with spouse and adult child, exert stronger effects on both self-rated health and chronic illness for older compared to younger adults. The findings of the present study are important for clinical practitioners who often consider the role and importance of available social resources as they address the health needs of older adults.

Relative Deprivation, Poverty, and Subjective Health: JAGES Cross-Sectional Study

PubMed Central

Saito, Masashige; Kondo, Katsunori; Kondo, Naoki; Abe, Aya; Ojima, Toshiyuki; Suzuki, Kayo

2014-01-01

To evaluate the association between relative deprivation (lacking daily necessities) and subjective health in older Japanese adults, we performed a cross-sectional analysis using data from the Japan Gerontological Evaluation Study (JAGES). The data were obtained from functionally independent residents aged ≥65 years from 24 municipalities in Japan (n = 24,742). Thirteen items in three dimensions were used to evaluate relative deprivation of material conditions. Approximately 28% of older Japanese people indicated that they lacked some daily necessities (non-monetary poverty). A two-level Poisson regression analysis revealed that relative deprivation was associated with poor self-rated health (PR = 1.3–1.5) and depressive symptoms (PR = 1.5–1.8) in both men and women, and these relationships were stronger than those observed in people living in relative poverty (monetary poverty). The interaction effect between relative deprivation and relative poverty was not associated with poor health. As a dimension of the social determinants of health, poverty should be evaluated from a multidimensional approach, capturing not only monetary conditions but also material-based, non-monetary conditions. PMID:25350284

[Income-related health inequalities in France in 2004: Decomposition and explanations].

PubMed

Tubeuf, S

2009-10-01

This analysis supplements existing work on social health inequalities at two levels: the measurement of health and the measurement of inequalities. Firstly, individual health status was measured using a subjective health indicator corrected within a promising cardinalisation method which had not yet been carried out on French data. Secondly, this study used an innovative methodology to measure income-related health inequalities, to understand the relationships between income, income inequality, various social determinants, and health. The analysis was based on a sample of working-age adults from the 2004 Health and Health Insurance Survey. The methodology used in the study measures the total income-related health inequality using the concentration index. This index is based on a linear model explaining health according to several individual characteristics, such as age, sex, and various socioeconomic characteristics. The method thus takes into account both the causal relationships between the various explicative factors introduced in the model and their relationship with health. Furthermore, it concretely measures the contribution of the social determinants to income-related health inequalities. The results show an income-related health inequality favouring individuals with a higher income. Moreover, income level, supplementary private health insurance, education level, and social class account for the main contributions to inequality. Therefore, the decomposition method highlights population groups that policies should target. The study suggests that reducing income inequality is not sufficient to lower income-related health inequalities in France in 2004 and needs to be supplemented with the reduction of the relationship between income and health and the reduction of income inequality over socioeconomic status.

An ideal-typical model for comparing interprofessional relations and skill mix in health care.

PubMed

Schönfelder, Walter; Nilsen, Elin Anita

2016-11-08

Comparisons of health system performance, including the regulations of interprofessional relations and the skill mix between health professions are challenging. National strategies for regulating interprofessional relations vary widely across European health care systems. Unambiguously defined and generally accepted performance indicators have to remain generic, with limited power for recognizing the organizational structures regulating interprofessional relations in different health systems. A coherent framework for in-depth comparisons of different models for organizing interprofessional relations and the skill mix between professional groups is currently not available. This study aims to develop an ideal-typical framework for categorizing skill mix and interprofessional relations in health care, and to assess the potential impact for different ideal types on care coordination and integrated service delivery. A document analysis of the Health Systems in Transition (HiT) reports published by the European Observatory on Health Systems and Policies was conducted. The HiT reports to 31 European health systems were analyzed using a qualitative content analysis and a process of meaning condensation. The educational tracks available to nurses have an impact on the professional autonomy for nurses, the hierarchy between professional groups, the emphasis given to negotiating skill mix, interdisciplinary teamwork and the extent of cooperation across the health and social service interface. Based on the results of the document analysis, three ideal types for regulating interprofessional relations and skill mix in health care are delimited. For each ideal type, outcomes on service coordination and holistic service delivery are described. Comparisons of interprofessional relations are necessary for proactive health human resource policies. The proposed ideal-typical framework provides the means for in-depth comparisons of interprofessional relations in the health care

Self-Reported Health among Older Bangladeshis: How Good a Health Indicator Is It?

ERIC Educational Resources Information Center

Rahman, M. Omar; Barsky, Arthur J.

2003-01-01

Purpose: This study examines the value of self-reported health (SRH) as an indicator of underlying health status in a developing country setting. Design and Methods: Logistic regression methods with adjustments for multistage sampling are used to examine the factors associated with SRH in 2,921 men and women aged 50 and older in rural Bangladesh.…

Public health ethics related training for public health workforce: an emerging need in the United States.

PubMed

Kanekar, A; Bitto, A

2012-01-01

Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported. Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making. Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential. In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health. There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.

Using indicators to determine the contribution of human rights to public health efforts

PubMed Central

Ferguson, Laura

2009-01-01

Abstract There is general agreement on the need to integrate human rights into health policies and programmes, although there is still reluctance to go beyond rhetorical acknowledgement of their assumed significance. To determine the actual value of human rights for the effectiveness of public health efforts requires clarity about what their incorporation looks like in practice and how to assess their contribution. Despite the pervasive use of indicators in the public health field, indicators that specifically capture human rights concerns are not well developed and those that exist are inconsistently used. Even though “health and human rights indicators” are increasingly being constructed, it is often the case that health indicators are used to draw conclusions about some interaction between human rights and health; or that law and policy or other indicators, traditionally the domain of the human rights community, are used to make conclusions about health outcomes. To capture the added value that human rights bring to health, the differences in the contributions offered by these indicators need to be understood. To determine the value of different measures for advancing programme effectiveness, improving health outcomes and promoting human rights, requires questioning the intended purpose behind the construction of an indicator, who uses it, the kind of indicator it is, the extent to which it provides information about vulnerable populations, as well as how the data are collected and used. PMID:19784452

Relative magnitude of presenteeism and absenteeism and work-related factors affecting them among health care professionals.

PubMed

Rantanen, Iina; Tuominen, Risto

2011-02-01

To examine the extent and relative value of presenteeism and absenteeism and work-related factors affecting them among health care professionals. Physicians and nurses estimated their hours of absenteeism and presenteeism during the last 4 weeks due to health reasons, and how much their work capacity had been reduced during their presenteeism hours. Socio-economic background, factors related to work and work conditions and possible chronic and acute diseases were solicited. Presenteeism was more common but indicated lower monetary value than absenteeism. Job satisfaction explained the probability and magnitude of presenteeism, but not absenteeism. Experience of acute disease(s) during the study period of 4 weeks significantly predicted the probability of both presenteeism and absenteeism. Experience of presenteeism seemed to be common among health care workers, and it had significant economic value, although not as significant as absenteeism had.

Universal Health Coverage and the Right to Health: From Legal Principle to Post-2015 Indicators.

PubMed

Sridhar, Devi; McKee, Martin; Ooms, Gorik; Beiersmann, Claudia; Friedman, Eric; Gouda, Hebe; Hill, Peter; Jahn, Albrecht

2015-01-01

Universal Health Coverage (UHC) is widely considered one of the key components for the post-2015 health goal. The idea of UHC is rooted in the right to health, set out in the International Covenant on Economic, Social, and Cultural Rights. Based on the Covenant and the General Comment of the Committee on Economic, Social, and Cultural Rights, which is responsible for interpreting and monitoring the Covenant, we identify 6 key legal principles that should underpin UHC based on the right to health: minimum core obligation, progressive realization, cost-effectiveness, shared responsibility, participatory decision making, and prioritizing vulnerable or marginalized groups. Yet, although these principles are widely accepted, they are criticized for not being specific enough to operationalize as post-2015 indicators for reaching the target of UHC. In this article, we propose measurable and achievable indicators for UHC based on the right to health that can be used to inform the ongoing negotiations on Sustainable Development Goals. However, we identify 3 major challenges that face any exercise in setting indicators post-2015: data availability as an essential criterion, the universality of targets, and the adaptation of global goals to local populations. © SAGE Publications 2015.

Forest health monitoring indicators and their interpretability: a Lithuanian case study

Treesearch

Romualdas Kuknys; Algirdas Augustaitis

1998-01-01

Growth and productivity of forests are important indicators for understanding the general condition and health of forests. It is very important that indicators detected during monitoring procedures afford an opportunity for direct or indirect evaluation of forest productivity and its natural and anthropogenic changes. Analysis of the U.S. Forest Health Monitoring (FHM...

Comparison of knowledge of and attitudes toward dementia between health-related and non-health-related university students.

PubMed

Yong, Mi-Hyun; Yoo, Chan-Uk; Yang, Yeong-Ae

2015-12-01

[Purpose] This study compared the knowledge of and attitudes toward dementia between health-related and non-health-related students. [Subjects] The subjects consisted of a total of 416 people, 213 health-related students and 203 non-health-related students, at K University, which is located in Gyeongsangbuk-do, Republic of Korea, between May 1 and 14, 2014. [Methods] The subjects answered a self-administered questionnaire about their knowledge of and attitudes toward dementia. [Results] There was a significant difference in knowledge of and attitudes toward dementia between the two groups examined. [Conclusion] Health-related students displayed higher knowledge of dementia and a more positive attitude toward dementia compared with non-health-related students. In the future, education to cultivate professional knowledge about dementia and enhance positive attitudes toward dementia should be provided continuously to health-related students. This is because students in health-related fields will likely provide services to patients with dementia in the clinical field. Additionally, as they will likely provide support to the elderly in the future, non-health-related students also need to be educated about and develop positive attitudes toward dementia.

Experience from a multi-country initiative to improve the monitoring of selected reproductive health indicators in Africa.

PubMed

Barreix, Maria; Tunçalp, Özge; Mutombo, Namuunda; Adegboyega, Ayotunde A; Say, Lale

2017-05-01

Universal access to sexual and reproductive health remains part of the unfinished business of global development in Africa. To achieve it, health interventions should be monitored using programmatic indicators. WHO's Strengthening Measurement of Reproductive Health Indicators in Africa initiative, implemented in Ghana, Nigeria, Kenya, Uganda, and Zimbabwe, aimed to improve national information systems for routine monitoring of reproductive health indicators. Participating countries developed action plans employing a two-pronged strategy: (1) revising, standardizing, and harmonizing existing reproductive health indicators captured through routine information-systems; and (2) building data-collection capacity through training and supervision at select pilot sites. Country teams evaluated existing and new indicators, and outlined barriers to strengthening routine measurement. Activities included updating abortion-care guidelines (spontaneous and induced abortions), providing training on laws surrounding induced abortions, and improving feedback mechanisms. The country teams updated monitoring and evaluation frameworks, and attempted to build recording/reporting capacity in selected pilot areas. Barriers to implementing the initiative that were encountered included restrictive induced-abortion laws, staff turn-over, and administrative delays, including low capacity among healthcare staff and competing priorities for staff time. The areas identified for further improvement were up-scaling programs to a national level, creating scorecards to record data, increasing collaborations with the private sector, conducting related costing exercises, and performing ex-post evaluations. © 2017 World Health Organization; licensed by Wiley on behalf of International Federation of Gynecology and Obstetrics.

Islamic Religious Leaders in Israel as Social Agents for Change on Health-Related Issues.

PubMed

Cohen-Dar, Michal; Obeid, Samira

2017-12-01

Islamic religious leaders (IRLs) have the potential to influence health education, health promotion, and positive health outcomes among their own communities. This study aims to examine the role and effectiveness of Arab Muslim religious leaders, in Israel, as social agents for change on health-related issues, focusing on reduction in infant mortality, prematurity, and congenital malformations attributed to consanguineous marriage. A self-administrated questionnaire was distributed to 127 IRLs, in 2012, to gain insights into practice, attitudes, and perceptions of IRLs toward their role as social agents for change on health-related issues. The results indicate that two-thirds (58%) of the surveyed IRLs have provided frequent advice on issues related to preventing infant mortality, congenital malformation, and prematurity over the past two years. Most IRLs indicated that they have keen interest in their communities' health matters (97%) and regard dealing with them as part of their job (85%). The study identified three enabling factors that had significant influence on the IRLs' attitude. These influences are: awareness and knowledge of the health issues, the perception that these issues and their impact on the community are part of their responsibility, and the empowerment they felt through the participation in the Ministry of Health (Northern Region Health Office) educational seminar series, in the year 2000. The main conclusion from this study indicates that IRLs are effective social agents for change and that the educational interventions can be a useful and effective strategy to encourage IRLs to cooperate with health providers and promote public health among their own communities.

Evolution of post-deployment indicators of oral health on the Family Health Strategy

PubMed Central

Palacio, Danielle da Costa; Vazquez, Fabiana de Lima; Ramos, Danielle Viana Ribeiro; Peres, Stela Verzinhasse; Pereira, Antonio Carlos; Guerra, Luciane Miranda; Cortellazzi, Karine Laura; Bulgareli, Jaqueline Vilela

2014-01-01

Objective To evaluate the evolution of indicators after the implementation of 21 Oral Healthcare Teams in the Family Health Strategy. Methods We used data from outpatient services of Oral Healthcare Teams to evaluate efficiency, access, percentage of absences and emergencies of oral healthcare professionals who worked in the partnership between the Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein and the Secretaria Municipal de Saúde de São Paulo, during the period 2009-2011. Results Percentages of emergencies, income, and access showed a significant difference during the period analyzed, but no difference for percentage of absences was found. When monthly analysis was made, it is noteworthy that at the beginning of service implementation a fluctuation occurred, which may indicate that the work was consolidated over the months, becoming capable of receiving new professionals and increasing the population served. Comparison of the indicators in that period with the goals agreed upon between the Sociedade Beneficente Israelita Brasileira Hospital Albert Einstein and the Secretaria Municipal de Saúde de São Paulo made it possible to notice that the Oral Health Teams had a good performance. Conclusion The results showed that the goals were achieved reflecting the increasing number of professionals, the maturing of work processes in the Oral Health Teams, and optimization of the manpower available to perform the activities. Understanding these results will be important to guide the actions of Oral Health Teams for the following years and to assess the achievement of goals. PMID:25295445

[Self-reported general health in older adults in Latin America and the Caribbean: usefulness of the indicator].

PubMed

Wong, Rebeca; Peláez, Martha; Palloni, Alberto

2005-01-01

To evaluate self-reported general health (SRGH) as a health indicator and to analyze its covariates in people 60 years old or older living in private homes in seven cities of Latin America and the Caribbean. This cross-sectional descriptive study was based on data from the Health, Well-Being, and Aging survey (Salud, Bienestar y Envejecimiento, or "SABE survey"), which was carried out in 1999 and 2000 in Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The survey looked at the demographic and socioeconomic characteristics of the participants, several health indicators (self-reported chronic diseases, depression, and cognitive features), the social and family support network, the use of health services, reported and observed functionality, the respondent's income, and the durable consumer goods in the household. In probit regression models, self-reported fair or poor health was used as the dependent variable. The marginal effect of each categorical explanatory variable was used to indicate the difference between the probability of reporting poor health by persons who did or did not have a given characteristic. In all the cities studied the self-reporting of "excellent" health was very low (6% or less). The results of the multivariate analysis of the relationships between SRGH and covariates showed: (1) the relative importance of several health indicators as covariates of SRGH, (2) the association between sociodemographic characteristics and SRGH, and (3) the differences or similarities found among the seven cities with respect to the relationships studied. The level of self-rated good health was highest in Buenos Aires and Montevideo (60%), followed by Bridgetown and São Paulo (around 50%) and Havana, Santiago, and Mexico City (between 30% and 40%). The respondents' evaluation of their memory was the factor that was most strongly related to SRGH, followed by satisfaction

Experiences of Transgender-Related Discrimination and Implications for Health: Results From the Virginia Transgender Health Initiative Study

PubMed Central

Reisner, Sari L.; Honnold, Julie A.; Xavier, Jessica

2013-01-01

Objectives. We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. Methods. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Results. Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Conclusions. Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers. PMID:23153142

Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study.

PubMed

Bradford, Judith; Reisner, Sari L; Honnold, Julie A; Xavier, Jessica

2013-10-01

We examined relationships between social determinants of health and experiences of transgender-related discrimination reported by transgender people in Virginia. In 2005 through 2006, 387 self-identified transgender people completed a statewide health needs assessment; 350 who completed eligibility questions were included in this examination of factors associated with experiences of discrimination in health care, employment, or housing. We fit multivariate logistic regression models using generalized estimating equations to adjust for survey modality (online vs paper). Of participants, 41% (n = 143) reported experiences of transgender-related discrimination. Factors associated with transgender-related discrimination were geographic context, gender (female-to male spectrum vs male-to-female spectrum), low socioeconomic status, being a racial/ethnic minority, not having health insurance, gender transition indicators (younger age at first transgender awareness), health care needed but unable to be obtained (hormone therapy and mental health services), history of violence (sexual and physical), substance use health behaviors (tobacco and alcohol), and interpersonal factors (family support and community connectedness). Findings suggest that transgender Virginians experience widespread discrimination in health care, employment, and housing. Multilevel interventions are needed for transgender populations, including legal protections and training for health care providers.

Use of surrogate indicators for the evaluation of potential health risks due to poor urban water quality: A Bayesian Network approach.

PubMed

Wijesiri, Buddhi; Deilami, Kaveh; McGree, James; Goonetilleke, Ashantha

2018-02-01

Urban water pollution poses risks of waterborne infectious diseases. Therefore, in order to improve urban liveability, effective pollution mitigation strategies are required underpinned by predictions generated using water quality models. However, the lack of reliability in current modelling practices detrimentally impacts planning and management decision making. This research study adopted a novel approach in the form of Bayesian Networks to model urban water quality to better investigate the factors that influence risks to human health. The application of Bayesian Networks was found to enhance the integration of quantitative and qualitative spatially distributed data for analysing the influence of environmental and anthropogenic factors using three surrogate indicators of human health risk, namely, turbidity, total nitrogen and fats/oils. Expert knowledge was found to be of critical importance in assessing the interdependent relationships between health risk indicators and influential factors. The spatial variability maps of health risk indicators developed enabled the initial identification of high risk areas in which flooding was found to be the most significant influential factor in relation to human health risk. Surprisingly, population density was found to be less significant in influencing health risk indicators. These high risk areas in turn can be subjected to more in-depth investigations instead of the entire region, saving time and resources. It was evident that decision making in relation to the design of pollution mitigation strategies needs to account for the impact of landscape characteristics on water quality, which can be related to risk to human health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using health-facility data to assess subnational coverage of maternal and child health indicators, Kenya.

PubMed

Maina, Isabella; Wanjala, Pepela; Soti, David; Kipruto, Hillary; Droti, Benson; Boerma, Ties

2017-10-01

To develop a systematic approach to obtain the best possible national and subnational statistics for maternal and child health coverage indicators from routine health-facility data. Our approach aimed to obtain improved numerators and denominators for calculating coverage at the subnational level from health-facility data. This involved assessing data quality and determining adjustment factors for incomplete reporting by facilities, then estimating local target populations based on interventions with near-universal coverage (first antenatal visit and first dose of pentavalent vaccine). We applied the method to Kenya at the county level, where routine electronic reporting by facilities is in place via the district health information software system. Reporting completeness for facility data were well above 80% in all 47 counties and the consistency of data over time was good. Coverage of the first dose of pentavalent vaccine, adjusted for facility reporting completeness, was used to obtain estimates of the county target populations for maternal and child health indicators. The country and national statistics for the four-year period 2012/13 to 2015/16 showed good consistency with results of the 2014 Kenya demographic and health survey. Our results indicated a stagnation of immunization coverage in almost all counties, a rapid increase of facility-based deliveries and caesarean sections and limited progress in antenatal care coverage. While surveys will continue to be necessary to provide population-based data, web-based information systems for health facility reporting provide an opportunity for more frequent, local monitoring of progress, in maternal and child health.

Does More Schooling Improve Health Outcomes and Health Related Behaviors? Evidence from U.K. Twins

PubMed Central

Amin, Vikesh; Behrman, Jere R.; Spector, Tim D.

2013-01-01

Several recent studies using instrumental variables based on changes in compulsory schoolleaving age laws have estimated the causal effect of schooling on health outcomes and health-related behaviors in the U.K. Despite using the same identification strategy and similar datasets, no consensus has been reached. We contribute to the literature by providing results for the U.K. using a different research design and a different dataset. Specifically, we estimate the effect of schooling on health outcomes (obesity and physical health) and health-related behaviors (smoking, alcohol consumption and exercise) for women through within-MZ twins estimates using the TwinsUK database. For physical health, alcohol consumption and exercise, the within-MZ twins estimates are uninformative about whether there is a causal effect. However, we find (1) that the significant association between schooling and smoking status is due to unobserved endowments that are correlated with schooling and smoking (2) there is some indication that more schooling reduces the body mass index for women, even once these unobserved endowments have been controlled for. PMID:24415826

Health-related quality of life across the anxiety disorders

PubMed Central

Comer, Jonathan S.; Blanco, Carlos; Hasin, Deborah S.; Liu, Shang-Min; Grant, Bridget F.; Turner, J. Blake; Olfson, Mark

2009-01-01

Objective Although clinical studies have documented that specific anxiety disorders are associated with impaired psychosocial functioning, little is known regarding their comparative effects on health-related quality of life within a general population. The current analysis compares health-related quality of life in a U.S. community-dwelling sample of adults with DSM-IV social anxiety disorder (SAD), generalized anxiety disorders (GAD), panic disorder (PD), and specific phobia (SP). Method Face-to-face survey of a U.S. nationally representative sample of over 43,000 adults aged 18 years and older residing in households and group quarters. Prevalence of DSM-IV anxiety disorders and relative associations with health-related quality of life indicators were examined. Results Roughly 9.8% of respondents met diagnostic criteria for at least one 12-month DSM-IV anxiety disorder which, relative to the non-anxiety-disordered general population, were each associated with lower personal income, increased rates of 12-month physical conditions, and greater numbers of Axis I and Axis II DSM-IV psychiatric conditions. After adjusting for socio-demographic and clinical correlates including other anxiety disorders, GAD was associated with significant decrements in the SF-12 Mental Component Summary score. In similar models, GAD and to a lesser extent PD were significantly associated with impairment in social functioning, role emotional, and mental health SF subscales. Conclusion GAD, followed by PD, appears to exact significant and independent tolls on health-related quality of life. Results underscore the importance of prompt and accurate clinical identification and improving access to effective interventions for these disorders. PMID:20816036

Mapping Spatial Variability in Health and Wealth Indicators in Accra, Ghana Using High Spatial Resolution Imagery

NASA Astrophysics Data System (ADS)

Engstrom, R.; Ashcroft, E.

2014-12-01

There has been a tremendous amount of research conducted that examines disparities in health and wealth of persons between urban and rural areas however, relatively little research has been undertaken to examine variations within urban areas. A major limitation to elucidating differences with urban areas is the lack of social and demographic data at a sufficiently high spatial resolution to determine these differences. Generally the only available data that contain this information are census data which are collected at most every ten years and are often difficult to obtain at a high enough spatial resolution to allow for examining in depth variability in health and wealth indicators at high spatial resolutions, especially in developing countries. High spatial resolution satellite imagery may be able to provide timely and synoptic information that is related to health and wealth variability within a city. In this study we use two dates of Quickbird imagery (2003 and 2010) classified into the vegetation-impervious surface-soil (VIS) model introduced by Ridd (1995). For 2003 we only have partial coverage of the city, while for 2010 we have a mosaic, which covers the entire city of Accra, Ghana. Variations in the VIS values represent the physical variations within the city and these are compared to variations in economic, and/or sociodemographic data derived from the 2000 Ghanaian census at two spatial resolutions, the enumeration area (approximately US Census Tract) and the neighborhood for the city. Results indicate a significant correlation between both vegetation and impervious surface to type of cooking fuel used in the household, population density, housing density, availability of sewers, cooking space usage, and other variables. The correlations are generally stronger at the neighborhood level and the relationships are stable through time and space. Overall, the results indicate that information derived from high resolution satellite data is related to

Income-related inequality in health and health care utilization in Chile, 2000-2009.

PubMed

Vásquez, Felipe; Paraje, Guillermo; Estay, Manuel

2013-02-01

To measure and explain income-related inequalities in health and health care utilization in the period 2000 - 2009 in Chile, while assessing variations within the country and determinants of inequalities. Data from the National Socioeconomic Characterization Survey for 2000, 2003, and 2009 were used to measure inequality in health and health care utilization. Income-related inequality in health care utilization was assessed with standardized concentration indices for the probability and total number of visits to specialized care, generalized care, emergency care, dental care, mental health care, and hospital care. Self-assessed health status and physical limitations were used as proxies for health care need. Standardization was performed with demographic and need variables. The decomposition method was applied to estimate the contribution of each factor used to calculate the concentration index, including ethnicity, employment status, health insurance, and region of residence. In Chile, people in lower-income quintiles report worse health status and more physical limitations than people in higher quintiles. In terms of health service utilization, pro-rich inequities were found for specialized and dental visits with a slight pro-rich utilization for general practitioners and all physician visits. All pro-rich inequities have decreased over time. Emergency room visits and hospitalizations are concentrated among lower-income quintiles and have increased over time. Higher education and private health insurance contribute to a pro-rich inequity in dentist, general practitioner, specialized, and all physician visits. Income contributes to a pro-rich inequity in specialized and dentist visits, whereas urban residence and economic activity contribute to a pro-poor inequity in emergency room visits. The pattern of health care utilization in Chile is consistent with policies implemented in the country and in the intended direction. The significant income inequality in the

Proposal of indicators to evaluate complementary feeding based on World Health Organization indicators.

PubMed

Saldan, Paula Chuproski; Venancio, Sonia Isoyama; Saldiva, Silvia Regina Dias Medici; de Mello, Débora Falleiros

2016-09-01

This study compares complementary feeding World Health Organization (WHO) indicators with those built in accordance with Brazilian recommendations (Ten Steps to Healthy Feeding). A cross-sectional study was carried out during the National Immunization Campaign against Poliomyelitis in Guarapuava-Paraná, Brazil, in 2012. Feeding data from 1,355 children aged 6-23 months were obtained through the 24 h diet recall. Based on five indicators, the proportion of adequacy was evaluated: introduction of solid, semi-solid, or soft foods; minimum dietary diversity; meal frequency; acceptable diet; and consumption of iron-rich foods. Complementary feeding showed adequacy higher than 85% in most WHO indicators, while review by the Ten Steps assessment method showed a less favorable circumstance and a high intake of unhealthy foods. WHO indicators may not reflect the complementary feeding conditions of children in countries with low malnutrition rates and an increased prevalence of overweight/obesity. The use of indicators according to the Ten Steps can be useful to identify problems and redirect actions aimed at promoting complementary feeding. © 2016 John Wiley & Sons Australia, Ltd.

Monitoring positive mental health and its determinants in Canada: the development of the Positive Mental Health Surveillance Indicator Framework

PubMed Central

Orpana, H.; Vachon, J.; Dykxhoorn, J.; McRae, L.; Jayaraman, G.

2016-01-01

Abstract Introduction: The Mental Health Strategy for Canada identified a need to enhance the collection of data on mental health in Canada. While surveillance systems on mental illness have been established, a data gap for monitoring positive mental health and its determinants was identified. The goal of this project was to develop a Positive Mental Health Surveillance Indicator Framework, to provide a picture of the state of positive mental health and its determinants in Canada. Data from this surveillance framework will be used to inform programs and policies to improve the mental health of Canadians. Methods: A literature review and environmental scan were conducted to provide the theoretical base for the framework, and to identify potential positive mental health outcomes and risk and protective factors. The Public Health Agency of Canada’s definition of positive mental health was adopted as the conceptual basis for the outcomes of this framework. After identifying a comprehensive list of risk and protective factors, mental health experts, other governmental partners and non-governmental stakeholders were consulted to prioritize these indicators. Subsequently, these groups were consulted to identify the most promising measurement approaches for each indicator. Results: A conceptual framework for surveillance of positive mental health and its determinants has been developed to contain 5 outcome indicators and 25 determinant indicators organized within 4 domains at the individual, family, community and societal level. This indicator framework addresses a data gap identified in Canada’s strategy for mental health and will be used to inform programs and policies to improve the mental health status of Canadians throughout the life course. PMID:26789022

The affective response to health-related information and its relationship to health anxiety: an ambulatory approach.

PubMed

Jasper, Fabian; Hiller, Wolfgang; Berking, Matthias; Rommel, Thilo; Witthöft, Michael

2015-01-01

Affective reactions to health-related information play a central role in health anxiety. Therefore, using ambulatory assessment, we analysed the time course of negative affect in a control group (CG, n = 60) which only rated their negative affect and an experimental group (EG, n = 97) which also rated the presence of somatic symptoms (e.g., back pain). By means of mixed regression models, we observed a decline of negative affect following the symptom self-ratings in the EG and a stable affect in the CG. The decline of negative affect was not moderated by the degree of health anxiety. Our findings might indicate that evaluating one's health status leads to a general reduction of negative affect in healthy individuals. The results of the study are in line with a bidirectional symptom perception model and underline the crucial role of affect regulation in the processing of health-related information.

Racial/ethnic disparities in history of incarceration, experiences of victimization, and associated health indicators among transgender women in the U.S.

PubMed

Reisner, Sari L; Bailey, Zinzi; Sevelius, Jae

2014-01-01

Limited national data document the prevalence of incarceration among transgender women, experiences of victimization while incarcerated, and associations of transgender status with health. Data were from the National Transgender Discrimination Survey (NTDS), a large convenience sample of transgender adults in the U.S., collected between September 2008 and March 2009. Respondents who indicated a transfeminine gender identity were included in the current study (n = 3,878). Multivariable logistic regression was used to model ever being incarcerated and experiencing victimization while incarcerated as a function of race/ethnicity and health-related indicators. Overall, 19.3% reported having ever been incarcerated. Black and Native American/Alaskan Native transgender women were more likely to report a history of incarceration than White (non-Hispanic) respondents, and those with a history of incarceration were more likely to report negative health-related indicators, including self-reporting as HIV-positive. Among previously incarcerated respondents, 47.0% reported victimization while incarcerated. Black, Latina, and mixed race transgender women were more likely to report experiences of victimization while incarcerated. Transgender women reported disproportionately high rates of incarceration and victimization while incarcerated, as well as associated negative health-related indicators. Interventions and policy changes are needed to support transgender women while incarcerated and upon release.

Records of medical malpractice litigation: a potential indicator of health-care quality in China

PubMed Central

Wang, Zhan; Jiang, Mengsi; Dear, Keith; Hsieh, Chee-Ruey

2017-01-01

Abstract Objective To assess the characteristics and incidence of medical litigation in China and the potential usefulness of the records of such litigation as an indicator of health-care quality. Methods We investigated 13 620 cases of medical malpractice litigation that ended between 2010 and 2015 and were reported to China’s Supreme Court. We categorized each case according to location of the court, the year the litigation ended, the medical specialization involved, the severity of the reported injury, the type of allegation raised by the plaintiff – including any alleged shortcomings in the health care received – and the outcome of the litigation. Findings The annual incidence of medical malpractice litigation increased from 75 in 2010 to 6947 in 2014. Most cases related to general surgery (1350 litigations), internal medicine (3500 litigations), obstetrics and gynaecology (1251 litigations) and orthopaedics (1283 litigations). Most of the reported injuries were either minor (1358 injuries) or fatal (4111 deaths). The most frequent allegation was of lack of consent or notification (1356 litigations), followed by misdiagnosis (1172 litigations), delay in treatment (1145 litigations) and alteration or forgery of medical records (975 litigations). Of the 11 014 plaintiffs with known litigation outcomes, 7482 (67.9%) received monetary compensation. Conclusion Over our study period, the incidence of litigation over potential medical malpractice increased in China. As many of the cases related to alleged inadequacies in the quality of health care, records of medical malpractice litigation in China may be worth exploring as an indicator of health-care quality. PMID:28603309

Comparison of relative and non-relative adoptive parent health status.

PubMed

Foli, Karen J; Lim, Eunjung; Sands, Laura P

2015-03-01

Across the United States, kinship parents, extended family members and close friends, render care to the 2.7 million children who have been removed from their birth parents' care. However, differences between relative and non-relative parents reported health statuses have not been explored. The National Survey of Adoptive Parents data were used to investigate the health status of relative (n = 469) and non-relative (n = 1,599) adoptive parents. Perceived happiness in the parent-child relationship and the parents' ability to cope appear to affect parental health status. Only non-related mothers of children younger than 6 years reported better emotional health than those mothers who were related to their children. With this exception, and despite caring for children who have a greater likelihood of abuse, neglect, and exposure to drugs and alcohol prior to birth, the reported health statuses of relative parents did not differ from non-relative parents. © The Author(s) 2013.

Application of rangeland health indicators on forested plots on the Fishlake National Forest, Utah

Treesearch

Maggie G. Toone; Sara Goeking

2017-01-01

Typical indicators of rangeland health are used to describe health and functionality of a variety of rangeland ecosystems. Similar indicators may be applied to forested locations to examine ecological health at a local forest level. Four rangeland health indicators were adapted and applied to data compiled by the U.S. Department of Agriculture, Forest Service, Rocky...

Income-related inequalities and inequities in health and health care utilization in Mexico, 2000-2006.

PubMed

Barraza-Lloréns, Mariana; Panopoulou, Giota; Díaz, Beatriz Yadira

2013-02-01

To measure income-related inequalities and inequities in the distribution of health and health care utilization in Mexico. The National Health Survey (NHS) 2000 and the National Health and Nutrition Survey (NHNS) 2006 were used to estimate concentration indices for health outcomes and health care utilization variables before and after standardization. The study analyzed 110 460 individuals 18 years or older for NHS 2000 and 124 149 individuals for NHNS 2006. Health status variables were self-assessed health, physical limitations, and chronic illness. Health care utilization included curative visits and dental, hospital, and preventive care. Individuals were ranked by three standard-of-living measures: household income, wealth, and expenditure. Other independent variables were area of residence, geographic region, education, employment, ethnicity, and health insurance. Decomposition analysis allowed for assessing the contributions of independent variables to the distribution of health care among individuals. The worse-off population reports less good self-assessed health and more physical limitations, whereas better-off individuals report more chronic illnesses. Utilization of curative visits and hospitalization is more concentrated among the better-off population. No significant changes in these results can be established between 2000 and 2006. According to available evidence, standard of living, health insurance, and education largely contribute to the inequitable distribution of health care. Despite improvements in health care utilization patterns, income-related health and health care inequities prevail. Equity remains a challenge for Mexico.

Indicators of food and water security in an Arctic Health context – results from an international workshop discussion

PubMed Central

Nilsson, Lena Maria; Berner, James; Dudarev, Alexey A.; Mulvad, Gert; Odland, Jon Øyvind; Parkinson, Alan; Rautio, Arja; Tikhonov, Constantine; Evengård, Birgitta

2013-01-01

In August 2012, a literature search with the aim of describing indicators on food and water security in an Arctic health context was initialized in collaboration between the Arctic Human Health Expert Group, SDWG/AHHEG and the AMAP (Arctic Monitoring and Assessment Programme within the Arctic Council) Human Health Assessment Group, AMAP/HHAG. In December 2012, workshop discussions were performed with representatives from both of these organizations, including 7 Arctic countries. The aim of this article is to describe the workshop discussions and the rational for the 12 indicators selected and the 9 rejected and to discuss the potential feasibility of these. Advantages and disadvantages of candidate indicators were listed. Informative value and costs for collecting were estimated separately on a 3-level scale: low, medium and high. Based on these reviews, the final selection of promoted and rejected indicators was performed and summarized in tables. Among 10 suggested indicators of food security, 6 were promoted: healthy weight, traditional food proportion in diet, monetary food costs, non-monetary food accessibility, food-borne diseases and food-related contaminants. Four were rejected: per-person dietary energy supply, food security modules, self-estimated food safety and healthy eating. Among 10 suggested indicators of water security, 6 were promoted: per-capita renewable water, accessibility of running water, waterborne diseases, drinking-water-related contaminants, authorized water quality assurance and water safety plans. Four were rejected: water consumption, types of water sources, periodic water shortages and household water costs. PMID:23940840

[Indicators to monitor the evolution of the economic crisis and its effects on health and health inequalities. SESPAS report 2014].

PubMed

Pérez, Glòria; Rodríguez-Sanz, Maica; Domínguez-Berjón, Felicitas; Cabeza, Elena; Borrell, Carme

2014-06-01

The economic crisis has adverse effects on determinants of health and health inequalities. The aim of this article was to present a set of indicators of health and its determinants to monitor the effects of the crisis in Spain. On the basis of the conceptual framework proposed by the Commission for the Reduction of Social Health Inequalities in Spain, we searched for indicators of social, economic, and political (structural and intermediate) determinants of health, as well as for health indicators, bearing in mind the axes of social inequality (gender, age, socioeconomic status, and country of origin). The indicators were mainly obtained from official data sources published on the internet. The selected indicators are periodically updated and are comparable over time and among territories (among autonomous communities and in some cases among European Union countries), and are available for age groups, gender, socio-economic status, and country of origin. However, many of these indicators are not sufficiently reactive to rapid change, which occurs in the economic crisis, and consequently require monitoring over time. Another limitation is the lack of availability of indicators for the various axes of social inequality. In conclusion, the proposed indicators allow for progress in monitoring the effects of the economic crisis on health and health inequalities in Spain. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Generation and evaluation of an indicator of the health system’s performance in maternal and reproductive health in Colombia: An ecological study

PubMed Central

Pinzón-Flórez, Carlos Eduardo; Fernandez-Niño, Julian Alfredo; Cardenas-Cardenas, Luz Mery; Díaz-Quijano, Diana Marcela; Ruiz-Rodriguez, Myriam; Reveiz, Ludovic; Arredondo-López, Armando

2017-01-01

Objective To generate and evaluate an indicator of the health system’s performance in the area of maternal and reproductive health in Colombia. Materials and methods An indicator was constructed based on variables related to the coverage and utilization of healthcare services for pregnant and reproductive-age women. A factor analysis was performed using a polychoric correlation matrix and the states were classified according to the indicator’s score. A path analysis was used to evaluate the relationship between the indicator and social determinants, with the maternal mortality ratio as the response variable. Results The factor analysis indicates that only one principal factor exists, namely "coverage and utilization of maternal healthcare services" (eigenvalue 4.35). The indicator performed best in the states of Atlantic, Bogota, Boyaca, Cundinamarca, Huila, Risaralda and Santander (Q4). The poorest performance (Q1) occurred in Caqueta, Choco, La Guajira, Vichada, Guainia, Amazonas and Vaupes. The indicator’s behavior was found to have an association with the unsatisfied basic needs index and women’s education (β = -0.021; 95%CI -0031 to -0.01 and β 0.554; 95%CI 0.39 to 0.72, respectively). According to the path analysis, an inverse relationship exists between the proposed indicator and the behavior of the maternal mortality ratio (β = -49.34; 95%CI -77.7 to -20.9); performance was a mediating variable. Discussion The performance of the health system with respect to its management of access and coverage for maternal and reproductive health appears to function as a mediating variable between social determinants and maternal mortality in Colombia. PMID:28854236

[Study of self-reported health of people living near point sources of environmental pollution: a review. First part: health indicators].

PubMed

Daniau, C; Dor, F; Eilstein, D; Lefranc, A; Empereur-Bissonnet, P; Dab, W

2013-08-01

Epidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. A first step focused on describing the indicators. The literature on indicators of self-reported health was reviewed, leading to a discussion on data collection, selection of health effects, data processing, and construction of indicators. The literature review concerned 51 articles. The use of self-reported health indicators allowed the studies to take into account the health concerns and complaints of populations exposed to environmental pollution. Various indicators of self-reported health were used in the studies. They measured physical, psychological and general dimensions of health. Standardized questionnaires were used less often than ad hoc questionnaires (78% of studies) developed to fit the needs of a given study. Three standardized questionnaires were used more frequently: the MOS Short-Form Health Survey (SF-36) to measure general health perceptions, the General Health Questionnaire (GHQ), and the Symptoms Checklist (SCL-90) to measure psychological distress. The choice of self-reported health indicators is a compromise between specificity of the studied health issues within a given environment and standardization of the questionnaires used to measure them. Such standardization is necessary to ensure the validity and the reliability of the information collected across time and situations. The psychometric properties of the measuring questionnaires are rarely estimated or verified when they are used. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Social Inequalities on Selected Determinants of Active Aging and Health Status Indicators in a Large Brazilian City (2003-2010).

PubMed

Braga, Luciana de Souza; Lima-Costa, Maria Fernanda; César, Cibele Comini; Macinko, James

2016-02-01

To assess trends in social inequalities among 2,624 elderly living in Belo Horizonte, Brazil, in three domains of the World Health Organization's Active Aging model (physical environment, social determinants, use of health services) and health status indicators. Data came from two representative household surveys conducted in 2003 and 2010. Social inequality was measured by the slope and the relative index of inequality. Educational level was used to define socioeconomic status. Significant improvements were observed in the prevalence rates of 7 out of 12 indicators. However, the social inequalities persisted through 10 out of 12 selected active aging and health status indicators, except for fear of falling on the sidewalks/crossing the streets and fear of being robbed. Social inequalities persistence might be assigned to the continuity of unequal distribution of resources among groups with different educational levels. © The Author(s) 2015.

Health system frameworks and performance indicators in eight countries: A comparative international analysis

PubMed Central

Braithwaite, Jeffrey; Hibbert, Peter; Blakely, Brette; Plumb, Jennifer; Hannaford, Natalie; Long, Janet Cameron; Marks, Danielle

2017-01-01

Objectives: Performance indicators are a popular mechanism for measuring the quality of healthcare to facilitate both quality improvement and systems management. Few studies make comparative assessments of different countries’ performance indicator frameworks. This study identifies and compares frameworks and performance indicators used in selected Organisation for Economic Co-operation and Development health systems to measure and report on the performance of healthcare organisations and local health systems. Countries involved are Australia, Canada, Denmark, England, the Netherlands, New Zealand, Scotland and the United States. Methods: Identification of comparable international indicators and analyses of their characteristics and of their broader national frameworks and contexts were undertaken. Two dimensions of indicators – that they are nationally consistent (used across the country rather than just regionally) and locally relevant (measured and reported publicly at a local level, for example, a health service) – were deemed important. Results: The most commonly used domains in performance frameworks were safety, effectiveness and access. The search found 401 indicators that fulfilled the ‘nationally consistent and locally relevant’ criteria. Of these, 45 indicators are reported in more than one country. Cardiovascular, surgery and mental health were the most frequently reported disease groups. Conclusion: These comparative data inform researchers and policymakers internationally when designing health performance frameworks and indicator sets. PMID:28228948

Obesity utilization and health-related quality of life in Medicare enrollees.

PubMed

Malinoff, Rochelle L; Elliott, Marc N; Giordano, Laura A; Grace, Susan C; Burroughs, James N

2013-01-01

The obese, with disproportionate chronic disease incidence, consume a large share of health care resources and drive up per capita Medicare spending. This study examined the prevalence of obesity and its association with health status, health-related quality of life (HRQOL), function, and outpatient utilization among Medicare Advantage seniors. Results indicate that obese beneficiaries, much more than overweight beneficiaries, have poorer health, functions, and HRQOL than normal weight beneficiaries and have substantially higher outpatient utilization. While weight loss is beneficial to both the overweight and obese, the markedly worse health status and high utilization of obese beneficiaries may merit particular attention.

[The European countries confronting cancer: a set of indicators assessing public health status].

PubMed

Borella, Laurent

2008-11-01

We now know that efficient public policies for cancer control need to be global and take into account each and all the factors involved: economics and level of development, style of life and risk factors, access to screening, effectiveness of the care-providing system. A very simple scorecard is proposed, based on publicized public health indicators, which allows a comparison between European countries. We extracted 49 indicators from public databases and literature concerning 22 European countries. We made correlation calculations in order to identify relevant indicators from which a global score was extracted. Using a hierarchical clustering method we were then able to identify subsets of homogeneous countries. A 7 indicator scorecard was drawn up: national gross product, scientific production, smoking rate, breast screening participating rate, all cancer mortality rate (male population), 5 years relative survival for colorectal cancer and life expectancy at birth. A global score shows: 1) the better positioned countries: Switzerland, Sweden, Finland and France; 2) the countries where cancer control is less effective: Estonia, Hungary, Poland and Slovakia. Three subsets of countries with a fairly similar profile were identified: a high level of means and results group; a high level of means but a medium level of results group; and a low level of means and results group. This work emphasizes dramatically heterogeneous situations between countries. A follow-up, using a reduced but regularly updated set of public health indicators, would help induce an active European policy for cancer control.

Development of an Urban Health Impact Assessment methodology: indicating the health equity impacts of urban policies.

PubMed

Pennington, Andy; Dreaves, Hilary; Scott-Samuel, Alex; Haigh, Fiona; Harrison, Annie; Verma, Arpana; Pope, Daniel

2017-05-01

An overarching recommendation of the global Commission on Social Determinants of Health was to measure and understand health inequalities and assess the impact of action. In a rapidly urbanising world, now is the time for Urban HIA. This article describes the development of robust and easy-to-use HIA tools to identify and address health inequalities from new urban policies. Rapid reviews and consultation with experts identified existing HIA screening tools and methodologies which were then analyzed against predefined selection criteria. A draft Urban HIA Screening Tool (UrHIST) and Urban HIA methodology (UrHIA) were synthesised. The draft tools were tested and refined using a modified Delphi approach that included input from urban and public health experts, practitioners and policy makers. The outputs were two easy-to-use stand-alone urban HIA tools. The reviews and consultations identified an underpinning conceptual framework. The screening tool is used to determine whether a full HIA is required, or for a brief assessment. Urban health indicators are a readily available and efficient means of identifying variations in the health of populations potentially affected by policies. Indicators are, however, currently underutilised in HIA practice. This may limit the identification of health inequalities by HIA and production of recommendations. The new tools utilise health indicator data more fully. UrHIA also incorporates a hierarchy of evidence for use during impact analysis. The new urban HIA tools have the potential to enhance the rigour of HIAs and improve the identification and amelioration of health inequalities generated by urban policies. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Consumer health information on the Internet about carpal tunnel syndrome: indicators of accuracy.

PubMed

Frické, Martin; Fallis, Don; Jones, Marci; Luszko, Gianna M

2005-02-01

To identify indicators of accuracy for consumer health information on the Internet. Several popular search engines were used to find websites on carpal tunnel syndrome. The accuracy and completeness of these sites were determined by orthopedic surgeons. It also was noted whether proposed indicators of accuracy were present. The correlation between proposed indicators of accuracy and the actual accuracy of the sites was calculated. A total of 116 websites and 29 candidate indicators were examined. A high Google toolbar rating of the main page of a site, many inlinks to the main page of a site, and an unbiased presentation of information on carpal tunnel syndrome were considered genuine indicators of accuracy. Many proposed indicators taken from published guidelines did not indicate accuracy (e.g., the author or sponsor having medical credentials). There are genuine indicators of the accuracy of health information on the Internet. Determining these indicators, and informing providers and consumers of health information about them, would be useful for public health care. Published guidelines have proposed many indicators that are obvious to unaided observation by the consumer. However, indicators that make use of the invisible link structure of the Internet are more reliable guides to accurate information on carpal tunnel syndrome.

Framework of behavioral indicators evaluating TB health promotion outcomes: a modified Delphi study of TB policymakers and health workers.

PubMed

Li, Ying; Ehiri, John; Hu, Daiyu; Oren, Eyal; Cao, Jia

2015-12-15

Although TB health promotion directed at policy makers and healthcare workers (HCWs) is considered important to tuberculosis (TB) control, no indicators currently assess the impact of such promotional activities. This article is the second in a series of papers that seek to establish a framework of behavioral indicators for outcome evaluation of TB health promotion, using the Delphi method. In the first article, we sought to establish a framework of behavioral indicators for outcome evaluation of TB health promotion among TB suspects and patients. The objective of this second article is to present an indicator framework that can be used to assess behavioral outcomes of TB health promotion directed at policy makers and HCWs. A two-round, modified Delphi method was used to establish the indicators. Sixteen experts who were knowledgeable and experienced in the field of TB control were consulted in Delphi surveys. A questionnaire was developed following 4 steps, and involved ranking indicators on a five-point Likert scale. The consensus level was 70 %. Median, mode, and Coefficient of variation (CV) were used to describe expert responses. An authority coefficient (Cr) was used to assess the degree of each expert's authority. Consensus was achieved following the two survey rounds and several iterations among the experts. For TB health-promotion activities directed at policymakers, the experts reached consensus on 2 domains ("Resource inputs" and "Policymaking and monitoring behaviors"), 4 subdomains ("Human resources" among others), and 13 indicators ("Human resources per 100,000 person" among others). For TB health-promotion activities directed at HCWs, the experts reached consensus on 5 domains ("Self-protective behaviors" among others), 6 sub-domains ("Preventing infection" among others), and 15 indicators ("Average hours of daily workplace disinfection by ultraviolet radiation" among others). This study identified a conceptual framework of core behavioral indicators

Are hospital process quality indicators influenced by socio-demographic health determinants.

PubMed

Buja, Alessandra; Canavese, Daniel; Furlan, Patrizia; Lago, Laura; Saia, Mario; Baldo, Vincenzo

2015-10-01

This population-level health service study aimed to address whether hospitals assure the same quality of care to people in equal need, i.e. to see if any associations exist between social determinants and adherence to four hospital process indicators clearly identified as being linked to better health outcomes for patients. This was a retrospective cohort study based on administrative data collected in the Veneto Region (northeast Italy). We included residents of the Veneto Region hospitalized for ST-segment elevation myocardial infarction (STEMI) or acute myocardial infarction (AMI), hip fracture, or cholecystitis, and women giving birth, who were discharged from any hospital operating under the Veneto Regional Health Service between January 2012 and December 2012. The following quality indicator rates were calculated: patients with STEMI-AMI treated with percutaneous coronary intervention, elderly patients with hip fractures who underwent surgery within 48 h of admission, laparoscopic cholecystectomies and women who underwent cesarean section. A multilevel, multivariable logistic regression analyses were conducted to test the association between age, gender, formal education or citizenship and the quality of hospital care processes. All the inpatient hospital care process quality indicators measured were associated with an undesirable number of disparities concerning the social determinants. Monitoring the evidence-based hospital health care process indicators reveals undesirable disparities. Administrative data sets are of considerable practical value in broad-based quality assessments and as a screening tool, also in the health disparities domain. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Farmworker Health-Related Bibliography.

ERIC Educational Resources Information Center

National Association of Farmworker Organizations, Washington, DC.

Documents pertaining to migrant and seasonal farmworker health comprise this bibliography of over 300 entries, nearly 100 of them annotated. The purpose of the bibliography is to provide health groups within the National Association of Farmworker Organizations with literature which may guide further research related to the provision of health care…

“Guilty until proven innocent”: the contested use of maternal mortality indicators in global health

PubMed Central

Storeng, Katerini T.; Béhague, Dominique P.

2017-01-01

Abstract The MMR – maternal mortality ratio – has risen from obscurity to become a major global health indicator, even appearing as an indicator of progress towards the global Sustainable Development Goals. This has happened despite intractable challenges relating to the measurement of maternal mortality. Even after three decades of measurement innovation, maternal mortality data are widely presumed to be of poor quality, or, as one leading measurement expert has put it, ‘guilty until proven innocent’. This paper explores how and why leading epidemiologists, demographers and statisticians have devoted the better part of the last three decades to producing ever more sophisticated and expensive surveys and mathematical models of globally comparable MMR estimates. The development of better metrics is publicly justified by the need to know which interventions save lives and at what cost. We show, however, that measurement experts’ work has also been driven by the need to secure political priority for safe motherhood and by donors’ need to justify and monitor the results of investment flows. We explore the many effects and consequences of this measurement work, including the eclipsing of attention to strengthening much-needed national health information systems. We analyse this measurement work in relation to broader political and economic changes affecting the global health field, not least the incursion of neoliberal, business-oriented donors such as the World Bank and the Bill and Melinda Gates Foundation whose institutional structures have introduced new forms of administrative oversight and accountability that depend on indicators. PMID:28392630

[Efficiency indicators to contribute to sustainability of health services in Spain].

PubMed

García, E I; Mira Solves, J J; Guilabert Mora, M

2014-01-01

Identifying a minimum set of efficiency indicators calculated from current information sources. Interventions adopted from the analysis of these indicators could contribute to health services sustainability. We applied the discussion group technique. A total of 23 quality coordinators from around the country and the representatives of the regional quality societies in SECA (Spanish Society for Quality in Healthcare) participated. Ten efficiency indicators useful for integrated management areas were identified and accepted, 5 in the area of primary care and 5 for hospital management. The efficiency indicators agreed upon could contribute to the sustainability of the health system without this affecting the quality of care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Indicators and measurement tools for health system integration: a knowledge synthesis protocol.

PubMed

Oelke, Nelly D; Suter, Esther; da Silva Lima, Maria Alice Dias; Van Vliet-Brown, Cheryl

2015-07-29

Health system integration is a key component of health system reform with the goal of improving outcomes for patients, providers, and the health system. Although health systems continue to strive for better integration, current delivery of health services continues to be fragmented. A key gap in the literature is the lack of information on what successful integration looks like and how to measure achievement towards an integrated system. This multi-site study protocol builds on a prior knowledge synthesis completed by two of the primary investigators which identified 10 key principles that collectively support health system integration. The aim is to answer two research questions: What are appropriate indicators for each of the 10 key integration principles developed in our previous knowledge synthesis and what measurement tools are used to measure these indicators? To enhance generalizability of the findings, a partnership between Canada and Brazil was created as health system integration is a priority in both countries and they share similar contexts. This knowledge synthesis will follow an iterative scoping review process with emerging information from knowledge-user engagement leading to the refinement of research questions and study selection. This paper describes the methods for each phase of the study. Research questions were developed with stakeholder input. Indicator identification and prioritization will utilize a modified Delphi method and patient/user focus groups. Based on priority indicators, a search of the literature will be completed and studies screened for inclusion. Quality appraisal of relevant studies will be completed prior to data extraction. Results will be used to develop recommendations and key messages to be presented through integrated and end-of-grant knowledge translation strategies with researchers and knowledge-users from the three jurisdictions. This project will directly benefit policy and decision-makers by providing an easy

Productivity loss at work; health-related and work-related factors.

PubMed

van den Heuvel, Swenne G; Geuskens, Goedele A; Hooftman, Wendela E; Koppes, Lando L J; van den Bossche, Seth N J

2010-09-01

Productivity loss is an increasing problem in an aging working population that is decreasing in numbers. The aim of this study is to identify work-related and health-related characteristics associated with productivity loss, due to either sickness absence or reduced performance at work. In this cross-sectional study, data of the Netherlands Working Conditions Survey of 2007 were used, which includes a national representative sample of 22,759 employees aged 15 to 64 years. Demographic characteristics, health-related and work-related factors were assessed with a questionnaire. Logistic regression analyses were carried out to study the relationship of work-related and health-related factors with low performance at work and sickness absence in the past 12 months. Poor general health, the number of longstanding health conditions, and most types of longstanding health conditions were associated with productivity loss. Health-related factors were in general stronger associated with sickness absence than with low performance at work. Performance: poor health OR 1.54 CI 1.38-1.71, >1 health conditions OR 1.21 CI 1.09-1.35; sickness absence: poor health OR 2.62 CI 2.33-2.93, >1 health conditions OR 2.47 CI 2.21-2.75. Of the different types of longstanding health conditions, only psychological complaints and to a small extent musculoskeletal symptoms, were associated with low performance (respectively OR 1.54 CI 1.27-1.87; OR 1.09 CI 1.00-1.18). Low performance at work was less likely among employees with high physically demanding work (shift work OR 0.70 CI 0.63-0.76, using force OR 0.78 CI 0.72-0.84, and repetitive movements OR 0.74 CI 0.70-0.79). Psychosocial factors were stronger associated with low performance at work than with sickness absence (performance: job autonomy OR 1.28 CI 1.21-1.37, job demands OR 1.23 CI 1.16-1.31, emotionally demanding work OR 1.73 CI 1.62-1.85; sickness absence: job autonomy ns, job demands OR 1.09 CI 1.03-1.17, emotionally demanding work OR

[Health-related scientific and technological capabilities and university-industry research collaboration].

PubMed

Britto, Jorge; Vargas, Marco Antônio; Gadelha, Carlos Augusto Grabois; Costa, Laís Silveira

2012-12-01

To examine recent developments in health-related scientific capabilities, the impact of lines of incentives on reducing regional scientific imbalances, and university-industry research collaboration in Brazil. Data were obtained from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (Brazilian National Council for Scientific and Technological Development) databases for the years 2000 to 2010. There were assessed indicators of resource mobilization, research network structuring, and knowledge transfer between science and industry initiatives. Based on the regional distribution map of health-related scientific and technological capabilities there were identified patterns of scientific capabilities and science-industry collaboration. There was relative spatial deconcentration of health research groups and more than 6% of them worked in six areas of knowledge areas: medicine, collective health, dentistry, veterinary medicine, ecology and physical education. Lines of incentives that were adopted from 2000 to 2009 contributed to reducing regional scientific imbalances and improving preexisting capabilities or, alternatively, encouraging spatial decentralization of these capabilities. Health-related scientific and technological capabilities remain highly spatially concentrated in Brazil and incentive policies have contributed to reduce to some extent these imbalances.

Investigating Relationships Between Health-Related Problems and Online Health Information Seeking.

PubMed

Oh, Young Sam; Song, Na Kyoung

2017-01-01

Online health information seeking (OHIS) functions as a coping strategy to relieve health-related stress and problems. When people rate their health as poor or felt concern about their health, they frequently visit the Internet to seek health-related information in order to understand their symptoms and treatments. Regarding this role of OHIS, it is important to understand the relationships between health-related problems and OHIS. This study applies the Common-Sense Model as a theoretical lens to examine the relationship between health-related problems (ie, diagnosis of cancer, poor self-rated health, and psychological distress) and OHIS of adults in the US. Using the Health Information National Trends Survey 4 Cycle 1 (2012), a total of 2351 adult Internet users was included in this research. Hierarchical logistic regression analyses were conducted to examine the research model, and the model adding psychological distress resulted in a statistically significant improvement in model fit. In this study, lower levels of self-rated health and higher levels of psychological distress were significantly associated with higher odds of OHIS. Study findings support the idea that individuals' low levels of self-rated health and high levels of perceived psychological distress make people search for health-related information via the Internet in order to cope with health-related concern and distress.

Effects of recreational soccer on physical fitness and health indices in sedentary healthy and unhealthy subjects

PubMed Central

Chamari, K; Slimani, M; Shephard, RJ; Yousfi, N; Tabka, Z; Bouhlel, E

2016-01-01

Recreational soccer (RS) is becoming a popular alternative to the classical continuous exercise mode used for the improvement of cardiovascular and metabolic fitness in untrained people. The objective of this paper was to conduct a detailed systematic review of the literature, identifying the physiological responses to RS and the training effects of RS on aerobic fitness and health in untrained healthy individuals and clinical patients. PubMed, Google Scholar and ScienceDirect databases were searched using terms related to recreational soccer. Inclusion criteria were randomized controlled trials (RCT) that assessed acute physiological responses to RS or the training effects of RS on physical fitness and health in sedentary, untrained subjects of any age or health status. All studies were assessed for methodological quality using the PEDro scale. Thirty-five articles met the inclusion criteria; seven examined the acute response to RS, and 28 assessed training effects. Clear evidence was found that RS had positive effects on many health-related indices and variables, including VO2max (gains of 7-16%), blood pressure (reductions of 6-13 mmHg), body composition (decreased fat mass and improved indices of bone health), and metabolic and cardiac function. These positive effects were observed in both healthy individuals and clinical patients, irrespective of age or sex. Although this review provides clear evidence of the positive effects of RS on health, most studies had limitations of methodology (an average PEDro score < 6). Furthermore, many of the training studies were from a small number of research groups. Future studies should be extended to other countries and institutions to ensure generality of the results. Regular RS training leads to significant cardiovascular and muscular adaptations and gains of health both in sedentary individuals and clinical patients at all ages, suggesting that RS is a potentially highly motivational method to enhance population health

The effects of built environment attributes on physical activity-related health and health care costs outcomes in Australia.

PubMed

Zapata-Diomedi, Belen; Herrera, Ana Maria Mantilla; Veerman, J Lennert

2016-11-01

Attributes of the built environment can positively influence physical activity of urban populations, which results in health and economic benefits. In this study, we derived scenarios from the literature for the association built environment-physical activity and used a mathematical model to translate improvements in physical activity to health-adjusted life years and health care costs. We modelled 28 scenarios representing a diverse range of built environment attributes including density, diversity of land use, availability of destinations, distance to transit, design and neighbourhood walkability. Our results indicated potential health gains in 24 of the 28 modelled built environment attributes. Health care cost savings due to prevented physical activity-related diseases ranged between A$1300 to A$105,355 per 100,000 adults per year. On the other hand, additional health care costs of prolonged life years attributable to improvements in physical activity were nearly 50% higher than the estimated health care costs savings. Our results give an indication of the potential health benefits of investing in physical activity-friendly built environments. Copyright © 2016 Elsevier Ltd. All rights reserved.

Situational analysis of the health insurance market and related educational needs in the era of health care reform in Thailand.

PubMed

Sriratanaban, J; Supapong, S; Kamolratanakul, P; Tatiyakawee, K; Srithamrongsawat, S

2000-12-01

The purposes of this study were to explore the situation of health insurance in Thailand, to compare public and private perspectives and to identify related educational needs. Between March and April of 1998, the study employed in-depth interviews of 12 public and private major stakeholders of the health insurance systems, including policy makers, providers and insurers. Additional inputs were gathered in a brainstorming session with 41 participants from organizations with important roles in regulating, monitoring, paying, or providing health care services, as well as research and education. The findings indicated the health insurance market was expanding. But there was no national policy on health insurance. Insurance-related law was outdated. Public and private schemes overlapped, and were generally characterized by inadequate risk diversification, overutilization of services, lack of effective cost containment, inconsistent service quality, and poor understanding of health insurance principles. There were needs for more education and training in various aspects of health services management and health-insurance related functions. Consequently, continuing education and training related to health insurance services for policy makers, system administrators, managers, providers and insurers are strongly recommended during the health-care reform process.

Theoretical investigation of the upper and lower bounds of a generalized dimensionless bearing health indicator

NASA Astrophysics Data System (ADS)

Wang, Dong; Tsui, Kwok-Leung

2018-01-01

Bearing-supported shafts are widely used in various machines. Due to harsh working environments, bearing performance degrades over time. To prevent unexpected bearing failures and accidents, bearing performance degradation assessment becomes an emerging topic in recent years. Bearing performance degradation assessment aims to evaluate the current health condition of a bearing through a bearing health indicator. In the past years, many signal processing and data mining based methods were proposed to construct bearing health indicators. However, the upper and lower bounds of these bearing health indicators were not theoretically calculated and they strongly depended on historical bearing data including normal and failure data. Besides, most health indicators are dimensional, which connotes that these health indicators are prone to be affected by varying operating conditions, such as varying speeds and loads. In this paper, based on the principle of squared envelope analysis, we focus on theoretical investigation of bearing performance degradation assessment in the case of additive Gaussian noises, including distribution establishment of squared envelope, construction of a generalized dimensionless bearing health indicator, and mathematical calculation of the upper and lower bounds of the generalized dimensionless bearing health indicator. Then, analyses of simulated and real bearing run to failure data are used as two case studies to illustrate how the generalized dimensionless health indicator works and demonstrate its effectiveness in bearing performance degradation assessment. Results show that squared envelope follows a noncentral chi-square distribution and the upper and lower bounds of the generalized dimensionless health indicator can be mathematically established. Moreover, the generalized dimensionless health indicator is sensitive to an incipient bearing defect in the process of bearing performance degradation.

A framework to assess the impacts of climate change on stream health indicators in Michigan watersheds

NASA Astrophysics Data System (ADS)

Woznicki, S. A.; Nejadhashemi, A. P.; Tang, Y.; Wang, L.

2016-12-01

Climate change is projected to alter watershed hydrology and potentially amplify nonpoint source pollution transport. These changes have implications for fish and macroinvertebrates, which are often used as measures of aquatic ecosystem health. By quantifying the risk of adverse impacts to aquatic ecosystem health at the reach-scale, watershed climate change adaptation strategies can be developed and prioritized. The objective of this research was to quantify the impacts of climate change on stream health in seven Michigan watersheds. A process-based watershed model, the Soil and Water Assessment Tool (SWAT), was linked to adaptive neuro-fuzzy inferenced (ANFIS) stream health models. SWAT models were used to simulate reach-scale flow regime (magnitude, frequency, timing, duration, and rate of change) and water quality variables. The ANFIS models were developed based on relationships between the in-stream variables and sampling points of four stream health indicators: the fish index of biotic integrity (IBI), macroinvertebrate family index of biotic integrity (FIBI), Hilsenhoff biotic index (HBI), and number of Ephemeroptera, Plecoptera, and Trichoptera (EPT) taxa. The combined SWAT-ANFIS models extended stream health predictions to all watershed reaches. A climate model ensemble from the Coupled Model Intercomparison Project Phase 5 (CMIP5) was used to develop projections of changes to flow regime (using SWAT) and stream health indicators (using ANFIS) from a baseline of 1980-2000 to 2020-2040. Flow regime variables representing variability, duration of extreme events, and timing of low and high flow events were sensitive to changes in climate. The stream health indicators were relatively insensitive to changing climate at the watershed scale. However, there were many instances of individual reaches that were projected to experience declines in stream health. Using the probability of stream health decline coupled with the magnitude of the decline, maps of

Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India.

PubMed

Senthil, Arasi; Anandh, Balasubramanian; Jayachandran, Palsamy; Thangavel, Gurusamy; Josephin, Diana; Yamini, Ravindran; Kalpana, Balakrishnan

2015-01-01

Health care workers (HCWs) are exposed to occupational related health hazards. Measuring worker perception and the prevalence of these hazards can help facilitate better risk management for HCWs, as these workers are envisaged to be the first point of contact, especially in resource poor settings. To describe the perception of occupational health hazards and self-reported exposure prevalence among HCWs in Southern India. We used cross sectional design with stratified random sampling of HCWs from different levels of health facilities and categories in a randomly selected district in Southern India. Data on perception and exposure prevalence were collected using a structured interview schedule developed by occupational health experts and administered by trained investigators. A total of 482 HCWs participated. Thirty nine percent did not recognize work-related health hazards, but reported exposure to at least one hazard upon further probing. Among the 81·5% who reported exposure to biological hazard, 93·9% had direct skin contact with infectious materials. Among HCWs reporting needle stick injury, 70·5% had at least one in the previous three months. Ergonomic hazards included lifting heavy objects (42%) and standing for long hours (37%). Psychological hazards included negative feelings (20·3%) and verbal or physical abuse during work (20·5%). More than a third of HCWs failed to recognize work-related health hazards. Despite training in handling infectious materials, HCWs reported direct skin contact with infectious materials and needle stick injuries. RESULTS indicate the need for training oriented toward behavioral change and provision of occupational health services.

Assessing the relevance of indicators in tracking social determinants and progress toward equitable population health in Brazil

PubMed Central

Rasella, Davide; Machado, Daiane Borges; Castellanos, Marcelo Eduardo Pfeirrer; Paim, Jairnilson; Szwarcwald, Celia Landmann; Lima, Diana; Magno, Laio; Pedrana, Leo; Medina, Maria Guadalupe; Penna, Gerson Oliveira; Barreto, Mauricio Lima

2016-01-01

Background The importance of the social determinants of health (SDH) and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC) in Brazil and other developing countries. Objective To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of healthcare – proposed by the SDH unit of the World Health Organization – with respect to their relevance in tracking progress in moving toward equitable population health and UHC in Brazil. Design This study had a mixed methodology, combining a quantitative analysis of secondary data from governmental sources with a qualitative study comprising two focus group discussions and six key informant interviews. The set of indicators tested covered a broad range of dimensions classified by three different domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified according to income quintiles, urbanization, race, and geographical region. Results Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the indicators were well known and already used by policymakers and health sector managers, whereas others were considered less useful in the Brazilian context. Conclusions Monitoring and evaluation practices have been developed in Brazil, and the set of indicators assessed in this study could further improve these practices, especially from a health equity perspective. Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be done in relation to addressing the SDH. PMID:26853898

Relation between induced labour indications and neonatal morbidity.

PubMed

Hernández-Martínez, Antonio; Pascual-Pedreño, Ana Isabel; Baño-Garnés, Ana Belén; Del Rocío Melero-Jiménez, Maria; Molina-Alarcón, Milagros

2014-12-01

To assess the main neonatal morbidity results in relation to induced labour indications. Historical groups from a total of 3,817 deliveries over a three year period (2009, 2010 and 2011) in "Mancha-Centro" Hospital (Alcázar de San Juan) formed the study group. All programmed and non-avoidable caesarean sections and pregnancies under 35 weeks were excluded. The main variable result was a neonatal morbidity variable made up of the Apgar score after 5 min, pH of umbilical artery <7.10 and the neonatal need for resuscitation type III-V. Multivariate analysis was used to control confounding variables. The incidence of induced labour was 22.6 % (862). The highest indication was premature rupture of membranes for more than 12 h 22.8 % (190), poorly controlled diabetes 22.6 % (189) and oligoamnios 16.2 % (135). The rate of pH lower than 7.10 was 2.8 % (22), the rate of the Apgar score lower than 7 after 5 min was 0.2 % (2) and the neonatal need for resuscitation type III-IV was 5.7 % (48) for induced labour. The relation between induced labour and neonatal morbidity indicators were not statistically significant. 10.1 % (4) of induced labour for suspected intrauterine growth restriction and 8.6 % (10) of postterm pregnancies required neonatal resuscitation type III-IV. No relation was found between induced labour and the neonatal morbidity indicators. The highest neonatal risk indicator is when a intrauterine growth restriction, hypertensión/preeclampsia or a postterm pregnancy is suspected.

The Relationship of Built Environment to Health-Related Behaviors and Health Outcomes in Elderly Community Residents in a Middle Income Country.

PubMed

Blay, Sergio L; Schulz, Amy J; Mentz, Graciela

2015-07-16

Few studies have examined the impact of the built environment (BE) on health behaviours and health outcomes in middle income countries. This study examines associations between self-assessed characteristics of the home and neighbourhood environment and health-related behaviours and health outcomes in an elderly population in Brazil. In a community sample of 6963 community dwellers 60 years old and older living in the state of Rio Grande do Sul, Brazil, associations between self-reported BE conditions and health behaviours and health outcomes were assessed using a structured questionnaire. Multivariate analysis was conducted to investigate these associations while accounting for other relevant characteristics. We found significant positive associations between adverse BE conditions and pulmonary, urinary conditions, gastrointestinal, problems, headache and depression. There were mixed associations between adverse BE conditions and musculoskeletal and sensory conditions, inverse associations with metabolic disorders. and no associations with dermatologic problems and cancer. After accounting for health related behaviours, results suggest a modest association between adverse BE conditions and hypertension, with no significant associations with other indicators of cardiovascular conditions (heart problems, stroke, varicose veins). The findings in this study suggest links between adverse conditions in the BE and health related behaviours in the hypothesized direction. Associations with the health conditions examined here are mixed. We find the strongest evidence for effects of adverse BE conditions for pulmonary and infectious conditions. Significant associations between the adverse BE indicators and health outcomes persist after accounting for health related behaviours, suggesting that BE conditions are linked to health pathways above and beyond the health related behaviours assessed in this study. Significance for public healthThe health outcomes for which we found

The Relationship of Built Environment to Health-Related Behaviors and Health Outcomes in Elderly Community Residents in a Middle Income Country

PubMed Central

Blay, Sergio L.; Schulz, Amy J.; Mentz, Graciela

2015-01-01

Background Few studies have examined the impact of the built environment (BE) on health behaviours and health outcomes in middle income countries. This study examines associations between self-assessed characteristics of the home and neighbourhood environment and health-related behaviours and health outcomes in an elderly population in Brazil Design and methods In a community sample of 6963 community dwellers 60 years old and older living in the state of Rio Grande do Sul, Brazil, associations between self-reported BE conditions and health behaviours and health outcomes were assessed using a structured questionnaire. Multivariate analysis was conducted to investigate these associations while accounting for other relevant characteristics. Results We found significant positive associations between adverse BE conditions and pulmonary, urinary conditions, gastrointestinal, problems, headache and depression. There were mixed associations between adverse BE conditions and musculoskeletal and sensory conditions, inverse associations with metabolic disorders. and no associations with dermatologic problems and cancer. After accounting for health related behaviours, results suggest a modest association between adverse BE conditions and hypertension, with no significant associations with other indicators of cardiovascular conditions (heart problems, stroke, varicose veins). Conclusions The findings in this study suggest links between adverse conditions in the BE and health related behaviours in the hypothesized direction. Associations with the health conditions examined here are mixed. We find the strongest evidence for effects of adverse BE conditions for pulmonary and infectious conditions. Significant associations between the adverse BE indicators and health outcomes persist after accounting for health related behaviours, suggesting that BE conditions are linked to health pathways above and beyond the health related behaviours assessed in this study. Significance for

A novel methodology for strengthening human rights based monitoring in public health: Family planning indicators as an illustrative example

PubMed Central

Ali, Moazzam; Khosla, Rajat

2017-01-01

Objective The last few years have seen a rise in the number of global and national initiatives that seek to incorporate human rights into public health practice. Nonetheless, a lack of clarity persists regarding the most appropriate indicators to monitor rights concerns in these efforts. The objective of this work was to develop a systematic methodology for use in determining the extent to which indicators commonly used in public health capture human rights concerns, using contraceptive services and programmes as a case study. Methods The approach used to identify, evaluate, select and review indicators for their human rights sensitivity built on processes undertaken in previous work led by the World Health Organization (WHO). With advice from an expert advisory group, an analytic framework was developed to identify and evaluate quantitative, qualitative, and policy indicators in relation to contraception for their sensitivity to human rights. To test the framework’s validity, indicators were reviewed to determine their feasibility to provide human rights analysis with attention to specific rights principles and standards. Findings This exercise resulted in the identification of indicators that could be used to monitor human rights concerns as well as key gaps where additional indicators are required. While indicators generally used to monitor contraception programmes have some degree of sensitivity to human rights, breadth and depth are lacking. Conclusion The proposed methodology can be useful to practitioners, researchers, and policy makers working in any area of health who are interested in monitoring and evaluating attention to human rights in commonly used health indicators. PMID:29220365

A novel methodology for strengthening human rights based monitoring in public health: Family planning indicators as an illustrative example.

PubMed

Gruskin, Sofia; Ferguson, Laura; Kumar, Shubha; Nicholson, Alexandra; Ali, Moazzam; Khosla, Rajat

2017-01-01

The last few years have seen a rise in the number of global and national initiatives that seek to incorporate human rights into public health practice. Nonetheless, a lack of clarity persists regarding the most appropriate indicators to monitor rights concerns in these efforts. The objective of this work was to develop a systematic methodology for use in determining the extent to which indicators commonly used in public health capture human rights concerns, using contraceptive services and programmes as a case study. The approach used to identify, evaluate, select and review indicators for their human rights sensitivity built on processes undertaken in previous work led by the World Health Organization (WHO). With advice from an expert advisory group, an analytic framework was developed to identify and evaluate quantitative, qualitative, and policy indicators in relation to contraception for their sensitivity to human rights. To test the framework's validity, indicators were reviewed to determine their feasibility to provide human rights analysis with attention to specific rights principles and standards. This exercise resulted in the identification of indicators that could be used to monitor human rights concerns as well as key gaps where additional indicators are required. While indicators generally used to monitor contraception programmes have some degree of sensitivity to human rights, breadth and depth are lacking. The proposed methodology can be useful to practitioners, researchers, and policy makers working in any area of health who are interested in monitoring and evaluating attention to human rights in commonly used health indicators.

The causal relationship between education, health and health related behaviour: evidence from a natural experiment in England.

PubMed

Braakmann, Nils

2011-07-01

I exploit exogenous variation in the likelihood to obtain any sort of educational qualification between January- and February-born individuals for 13 academic cohorts in England. For these cohorts compulsory schooling laws interacted with the timing of the CSE and O-level exams to change the probability of obtaining a qualification by around 2-3 percentage points. I then use data on individuals born in these two months from the British Labour Force Survey and the Health Survey for England to investigate the effects of education on health using being February-born as an instrument for education. The results indicate neither an effect of education on various health related measures nor an effect on health related behaviour, e.g., smoking, drinking or eating various types of food. Copyright © 2011 Elsevier B.V. All rights reserved.

Relationships of colorectal cancer with dietary factors and public health indicators: an ecological study.

PubMed

Abbastabar, Hedayat; Roustazadeh, Abazar; Alizadeh, Ali; Hamidifard, Parvin; Valipour, Mehrdad; Valipour, Ali Asghar

2015-01-01

Colorectal cancer (CRC) is the third most common cancer in Iranian women and fifth in men. The aims of this study were to investigate the relation of dietary factors and public health indicators to its development. The required information (2001-2006) about risk factors was obtained from the Non- Communicable Disease Surveillance Centre (NCDSC) of Iran. Risk factor data (RFD) from 89,404 individuals (15-64 years old) were gathered by questionnaire and laboratory examinations through a cross sectional study in all provinces by systematic clustering sampling method. CRC incidence segregated by age and gender was obtained from Cancer Registry Ministry of Health (CRMH) of Iran. First, correlation coefficients were used for data analysis and then multiple regression analysis was performed to control for confounding factors. Colorectal cancer incidence showed a positive relationship with diabetes mellitus, hypertension, lacking or low physical activity, high education, high intake of dairy products, and non-consumption of vegetables and fruits. We concluded that many dietary factors and public health indicators have positive relationships with CRC and might therefore be targets of preliminary prevention. However, since this is an ecological study limited by potential ecological fallacy the results must be interpreted with caution.

Health-related quality of life and satisfaction with case management in cancer survivors.

PubMed

Hsu, Ya-Hui; Chai, Hsiu-Ying; Lin, Yu-Fen; Wang, Chao-Hui; Chen, Shu-Ching

2017-12-01

To (i) investigate the characteristics of health-related quality of life and satisfaction with case management and (ii) to identify factors associated with health-related quality of life in cancer survivors. The level of health-related quality of life can reflect treatment efficacy and satisfaction with cancer care. A cross-sectional study design was adopted. Subjects from the outpatient setting of a cancer centre in northern Taiwan were recruited by consecutive sampling. A set of questionnaires were employed, including a background information form, case management service satisfaction survey (CMSS) and The European Quality of Life Scale (EQ-5D). Descriptive statistics were used to examine levels of health-related quality of life and satisfaction with case management. Pearson's correlation was used to identify relationships between treatment characteristics, satisfaction with case management and health-related quality of life. Multiple stepwise regression was used to identify factors associated with health-related quality of life. A total of 252 cancer patients were recruited. The three lowest scores for items of health-related quality of life were mobility, self-care and usual activities. Cancer survivors with higher mobility, less pain and discomfort, and lower anxiety and depression were more likely to have better health-related quality of life. Mobility, pain and discomfort, and anxiety and depression are important predictive factors of high health-related quality of life in cancer survivors. In clinical care, patients' physical mobility, pain and discomfort, and anxiety and depression are important indicators of health-related quality of life. Case managers should include self-care and symptom management into survivorship care plans to improve health-related quality of life during survival after treatment concludes. © 2017 John Wiley & Sons Ltd.

The association between physical environment and health: indicating the direction of effects using German panel data.

PubMed

Baar, Johanna; Romppel, Matthias; Igel, Ulrike; Brähler, Elmar; Grande, Gesine

2016-01-01

A growing body of research has identified an association between health and physical residential environmental characteristics. However, the direction of effects remains unclear, and further research is needed to determine whether the residential environment influences health. To specify the direction of the association between environmental disadvantage and self-reported health. Longitudinal data were obtained from the German Socioeconomic Panel and were examined at two points in time. Participants were grouped by relocation status assessed across a five-year period. Structural equation modeling was used to examine the effect of baseline environmental disadvantage on baseline health and on health five years later. In both groups, environmental disadvantage was cross-sectionally correlated with poor health. Only among people who did not relocate was baseline environmental disadvantage significantly related to health five years later in bivariate analyses. Results from the structural equation model found that environmental disadvantage was no longer significantly related to poor health five years later within the group of non-movers (β = -.02, p = .052). In addition, there was no effect in this direction within the group of movers (β = .02, p = .277). Our results suggest the existence of a weak contextual effect as group differences in longitudinal associations indicated the direction of ecological effects.

Depression and anxiety symptoms in bronchiectasis: associations with health-related quality of life.

PubMed

Olveira, Casilda; Olveira, Gabriel; Gaspar, Inmaculada; Dorado, Antonio; Cruz, Ivette; Soriguer, Federico; Quittner, Alexandra L; Espildora, Francisco

2013-04-01

Bronchiectasis causes pulmonary infections and loss of lung function, resulting in chronic respiratory symptoms and worsening health-related quality of life. The aims of this study were to measure symptoms of depression and anxiety in a sample of patients with bronchiectasis and evaluate their relationship to health outcomes and health-related quality of life. This cross-sectional study included adolescents and adults with bronchiectasis. Patients completed the hospital anxiety and depression scale and the St. George respiratory questionnaire. Health outcome data, including clinical, radiological and spirometric values, were recorded from medical charts. Ninety-three participants with bronchiectasis of any aetiology were recruited: 20 % had elevated depression-related scores and 38 % had elevated anxiety-related scores. Increased symptoms of depression and anxiety were significantly associated with age; anxiety was associated with more frequent exacerbations. Regression analyses indicated that after controlling for demographic (gender and age) and clinical variables (exacerbations frequency, daily sputum, aetiology and spirometry), both depression and anxiety symptoms predicted significantly worse health-related quality of life. In comparison with other predictors, psychological symptoms explained the largest amount of variance in health-related quality of life. Symptoms of depression and anxiety were significant predictors of health-related quality of life in patients with bronchiectasis, independently of respiratory involvement, gender, age or other variables.

Differences in Health Care Costs and Utilization among Adults with Selected Lifestyle-Related Risk Factors.

ERIC Educational Resources Information Center

Tucker, Larry A.; Clegg, Alan G.

2002-01-01

Examined the relationship between lifestyle-related health risks and health care costs and utilization among young adults. Data collected at a primarily white collar worksite in over 2 years indicated that health risks, particularly obesity, stress, and general lifestyle, were significant predictors of health care costs and utilization among these…

[Social support versus chosen health status indicators in primary care patients].

PubMed

Kurpas, Donata; Piotrowski, Patryk; Marciniak, Doininik; Kasprzak, Maja; MroczekS, Bożena; Nitsch-Osuchi, Aneta; Kasssolik, Krzysztof; Karakiewicz, Beata; Bielska, Dorota; Kiejna, Andrzej

2014-01-01

The purposes of our study were to determine the level of total social support, informational support, instrumental support, appraisal support and emotional support received by patients of primary care as well as factors related to this level with reference to health status and sociodemographic variables. The sample for current analysis included 516 patients of primary care clinics in Poland cooperating with medical universities. Questionnaires: STAI (State-Trait Anxiety Inventory), SCL-90 (Symptom Checklist-90), EPQ-R (Eysenck Personality Questionnaire-Revised), GHQ (General Health Questionnaire)and SSS (Social Support Scale)were used in the study. Results from last two questionnaires are presented in the paper. The highest mean levels were obtained for instrumental support, while the lowest levels were observed for emotional support. The highest means were indicated in the GHQ-28-social dysfunction, the lowest-GHQ-severe depression. Statistically significant relation was found between the level of social support and gender. Less subjectively evaluated total social support as well as instrumental and appraisal support were obtained by women. The highest Spearman score was found in the case of total GHQ-28 score, somatic symptoms, anxiety and insomnia, severe depression and total support. Taking into account the ANOVA findings, it was observed that an increasing GHQ score was associated with intensively increasing emotional support, informative support, appraisal support and the most- instrumental support. The results display the underestimated role of emotional, informational and appraisal support and the overestimated role of instrumental support in primary care. The consequence may be a more frequent using health care accompanied by low level of patients' satisfaction, severity of social dysfunction disorders, particularly in patients with chronic diseases, who constitute an increasingly large group of primary health care.

Key performance indicators for Australian mental health court liaison services.

PubMed

Davidson, Fiona; Heffernan, Ed; Greenberg, David; Butler, Tony; Burgess, Philip

2017-12-01

The aim of this paper is to describe the development and technical specifications of a framework and national key performance indicators (KPIs) for Australian mental health Court Liaison Services (CLSs) by the National Mental Health Court Liaison Performance Working Group (Working Group). Representatives from each Australian State and Territory were invited to form a Working Group. Through a series of national workshops and meetings, a framework and set of performance indicators were developed using a review of literature and expert opinion. A total of six KPIs for CLSs have been identified and a set of technical specifications have been formed. This paper describes the process and outcomes of a national collaboration to develop a framework and KPIs. The measures have been developed to support future benchmarking activities and to assist services to identify best practice in this area of mental health service delivery.

Investigation of Tear Biomarkers as an Indicator of Human Health

NASA Technical Reports Server (NTRS)

Morton, Stephen; Tucker, Bethany; Crucian, Brian; Steinberg, Susan; Hagan, Suzanne

2017-01-01

Scientific literature suggests that tear biomarkers can be used as a guide towards clinical diagnosis of human health (Hagan et al., 2016). This study will investigate whether tear biomarkers represents a research and clinical opportunity to assess human health prior to, during, and after exposure to the spaceflight environment. The focus of this study is to compare biomarkers previously identified as potentially relevant to both ocular and brain health against unique physiological outcomes of exposure to the space flight environment. Study subjects suffering from terrestrial conditions thought to be similar to Spaceflight Associated Neuro-ocular Syndrome (SANS: formerly VIIP), e.g. patients with idiopathic intracranial hypertension (IIH) and optic neuritis may be relevant to conditions associated with spaceflight. This study will review methodologies, tear biomarkers related to state of ocular and brain health, the strengths and weakness of using tear fluid biomarkers versus other body fluid samples, and will survey current tear fluid biomarker knowledge in research and clinical practice. A strength of using tear biomarkers is that sampling is non-invasive and used as a guide in understanding pathologies, including ocular and systemic inflammatory conditions (Cocho et al., 2016)., Salvisberg et al., 2014). Moreover, tear biomarkers may reflect diseases affecting the central nervous system (CNS) (Salvisberg et al., 2014). For example, in multiple sclerosis (MS), the concordance rate between tear biomarkers versus cerebrospinal fluid (CSF) is approximately 83%, indicating that, in the majority of cases, tears are at least as effective as CSF in potentially identifying novel MS biomarkers (Devos et al., 2001).

Health Locus of Control, Acculturation, and Health-Related Internet Use Among Latinas

PubMed Central

Roncancio, Angelica M.; Berenson, Abbey B.; Rahman, Mahbubur

2012-01-01

Among individuals residing in the United States, the Internet is the third most used source for obtaining health information. Little is known, however, about its use by Latinas. To understand health-related Internet use among Latinas, the authors examined it within the theoretical frameworks of health locus of control and acculturation. The authors predicted that acculturation would serve as a mediator between health locus of control and health-related Internet use, age and health-related Internet use, income and health-related Internet use, and education and health-related Internet use. Data were collected via a 25-minute self-report questionnaire. The sample consisted of 932 young (M age = 21.27 years), low-income Latinas. Using structural equation modeling, the authors observed that acculturation partially mediated the relation between health locus of control and health-related Internet use and fully mediated the relations among age, income, and Internet use. An internal health locus of control (p < .001), younger age (p < .001), and higher income (p < .001) were associated with higher levels of acculturation. Higher levels of acculturation (p < .001) and an internal health locus of control (p < .004) predicted health-related Internet use. The Internet is a powerful tool that can be used to effectively disseminate information to Latinas with limited access to health care professionals. These findings can inform the design of Internet-based health information dissemination studies targeting Latinas. PMID:22211397

Analyzing indicators of stream health for Minnesota streams

USGS Publications Warehouse

Singh, U.; Kocian, M.; Wilson, B.; Bolton, A.; Nieber, J.; Vondracek, B.; Perry, J.; Magner, J.

2005-01-01

Recent research has emphasized the importance of using physical, chemical, and biological indicators of stream health for diagnosing impaired watersheds and their receiving water bodies. A multidisciplinary team at the University of Minnesota is carrying out research to develop a stream classification system for Total Maximum Daily Load (TMDL) assessment. Funding for this research is provided by the United States Environmental Protection Agency and the Minnesota Pollution Control Agency. One objective of the research study involves investigating the relationships between indicators of stream health and localized stream characteristics. Measured data from Minnesota streams collected by various government and non-government agencies and research institutions have been obtained for the research study. Innovative Geographic Information Systems tools developed by the Environmental Science Research Institute and the University of Texas are being utilized to combine and organize the data. Simple linear relationships between index of biological integrity (IBI) and channel slope, two-year stream flow, and drainage area are presented for the Redwood River and the Snake River Basins. Results suggest that more rigorous techniques are needed to successfully capture trends in IBI scores. Additional analyses will be done using multiple regression, principal component analysis, and clustering techniques. Uncovering key independent variables and understanding how they fit together to influence stream health are critical in the development of a stream classification for TMDL assessment.

What Are Health-Related Users Tweeting? A Qualitative Content Analysis of Health-Related Users and Their Messages on Twitter

PubMed Central

DeCamp, Matthew; Dredze, Mark; Chisolm, Margaret S; Berger, Zackary D

2014-01-01

Background Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals’ behavior on Twitter. Objective Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health. Methods We performed an in-depth content analysis of 700 tweets. Qualitative content analysis was conducted on tweets by health users on Twitter. The primary objective was to describe the general type of content (ie, health-related versus non-health related) on Twitter authored by health professionals and further to describe health-related tweets on the basis of the type of statement made. Specific attention was given to whether a tweet was personal (as opposed to professional) or made a claim that users would expect to be supported by some level of medical evidence (ie, a “testable” claim). A secondary objective was to compare content types among different users, including patients, physicians, nurses, health care organizations, and others. Results Health-related users are posting a wide range of content on Twitter. Among health-related tweets, 53.2% (184/346) contained a testable claim. Of health-related tweets by providers, 17.6% (61/346) were personal in nature; 61% (59/96) made testable statements. While organizations and businesses use Twitter to promote their services and products, patient advocates are using this tool to share their personal experiences with health. Conclusions Twitter users in health-related fields tweet about both testable claims and personal experiences. Future work should assess the relationship between testable tweets and the actual level of evidence supporting them, including how Twitter users—especially patients—interpret the content of tweets posted by health providers. PMID

What are health-related users tweeting? A qualitative content analysis of health-related users and their messages on twitter.

PubMed

Lee, Joy L; DeCamp, Matthew; Dredze, Mark; Chisolm, Margaret S; Berger, Zackary D

2014-10-15

Twitter is home to many health professionals who send messages about a variety of health-related topics. Amid concerns about physicians posting inappropriate content online, more in-depth knowledge about these messages is needed to understand health professionals' behavior on Twitter. Our goal was to characterize the content of Twitter messages, specifically focusing on health professionals and their tweets relating to health. We performed an in-depth content analysis of 700 tweets. Qualitative content analysis was conducted on tweets by health users on Twitter. The primary objective was to describe the general type of content (ie, health-related versus non-health related) on Twitter authored by health professionals and further to describe health-related tweets on the basis of the type of statement made. Specific attention was given to whether a tweet was personal (as opposed to professional) or made a claim that users would expect to be supported by some level of medical evidence (ie, a "testable" claim). A secondary objective was to compare content types among different users, including patients, physicians, nurses, health care organizations, and others. Health-related users are posting a wide range of content on Twitter. Among health-related tweets, 53.2% (184/346) contained a testable claim. Of health-related tweets by providers, 17.6% (61/346) were personal in nature; 61% (59/96) made testable statements. While organizations and businesses use Twitter to promote their services and products, patient advocates are using this tool to share their personal experiences with health. Twitter users in health-related fields tweet about both testable claims and personal experiences. Future work should assess the relationship between testable tweets and the actual level of evidence supporting them, including how Twitter users-especially patients-interpret the content of tweets posted by health providers.

Short-term C mineralization (aka the flush of CO2) as an indicator of soil biological health

USDA-ARS?s Scientific Manuscript database

Soil biological activity is a key component of soil health assessments, as it (a) indicates soil nutrient cycling capacity from various organic matter sources to inorganic availability, (b) relates to soil structural conditions, (c) informs about the potential to harbor biodiversity in soil, and (d)...

Relations between retired agricultural land, water quality, and aquatic-community health, Minnesota River Basin

USGS Publications Warehouse

Christensen, Victoria G.; Lee, Kathy E.; McLees, James M.; Niemela, Scott L.

2012-01-01

The relative importance of agricultural land retirement on water quality and aquatic-community health was investigated in the Minnesota River Basin. Eighty-two sites, with drainage areas ranging from 4.3 to 2200 km2, were examined for nutrient concentrations, measures of aquatic-community health (e.g., fish index of biotic integrity [IBI] scores), and environmental factors (e.g., drainage area and amount of agricultural land retirement). The relation of proximity of agricultural land retirement to the stream was determined by calculating the land retirement percent in various riparian zones. Spearman's rho results indicated that IBI score was not correlated to the percentage of agricultural land retirement at the basin scale (p = 0.070); however, IBI score was correlated to retired land percentage in the 50- to 400-m riparian zones surrounding the streams (p < 0.05), indicating that riparian agricultural land retirement may have more influence on aquatic-community health than does agricultural land retirement in upland areas. Multivariate analysis of covariance and analysis of covariance models indicated that other environmental factors (such as drainage area and lacustrine and palustrine features) commonly were correlated to aquatic-community health measures, as were in-stream factors (standard deviation of water depth and substrate type). These results indicate that although agricultural land retirement is significantly related to fish communities as measured by the IBI scores, a combination of basin, riparian, and in-stream factors act together to influence IBI scores.

Developing Indicators for the Child and Youth Mental Health System in Ontario.

PubMed

Yang, Julie; Kurdyak, Paul; Guttmann, Astrid

2016-01-01

When the Government of Ontario launched a comprehensive mental health and addictions strategy, the Institute for Clinical Evaluative Sciences (ICES) was tasked with developing a scorecard for ongoing monitoring of the child and youth mental health system. Using existing administrative and survey-based healthcare and education data, researchers at ICES developed a scorecard consisting of 25 indicators that described at-risk populations, child and youth mental healthcare and relevant outcomes. This scorecard is the first in Canada to report on performance indicators for the child and youth mental health system and provides a model for monitoring child and youth mental health using routinely collected administrative data.

FIFTH NHEERL SYMPOSIUM FLYER -- INDICATORS IN HEALTH AND ECOLOGICAL RISK ASSESSMENT

EPA Science Inventory

Announcement for NHEERL Fifth Symposium - Indicators in Health and Ecological Risk Assessment. The purpose of the symposium is to address assessment of risk to public health or environmental resources which requires competent characterization of stressors and corresponding effec...

FIFTH NHEERL SYMPOSIUM POSTER -- INDICATORS IN HEALTH AND ECOLOGICAL RISK ASSESSMENT

EPA Science Inventory

Poster for announcing NHEERL Fifth Symposium - Indicators in Health and Ecological Risk Assessment. The purpose of the symposium is to address assessment of risk to public health or environmental resources which requires competent characterization of stressors and corresponding ...

The relative persuasiveness of narrative versus non-narrative health messages in public health emergency communication: Evidence from a field experiment.

PubMed

Bekalu, Mesfin A; Bigman, Cabral A; McCloud, Rachel F; Lin, Leesa K; Viswanath, K

2018-06-01

Previous studies indicated that narrative health messages are more effective than non-narrative messages in influencing health outcomes. However, this body of evidence does not account for differences in health domain, and little is known about the effectiveness of this message execution strategy during public health emergencies. In this study, we examined the relative effectiveness of the two formats in influencing knowledge and perceived response efficacy related to prevention of pandemic influenza, and determined whether effects of message format vary across population sub-groups. Data for the study come from an experiment fielded in 2013 that involved a nationally representative sample of 627 American adults. Participants were randomly assigned to view either a narrative (n=322) or a non-narrative (n=305) video clip containing closely matched information about knowledge and preventive actions related to pandemic influenza, and completed pre- and post-viewing questions assessing knowledge and perceived response efficacy related to the prevention of pandemic influenza. Results indicated that participants in the non-narrative condition reported greater knowledge and rated pandemic influenza prevention measures as more effective compared with those in the narrative condition. Message format effects did not vary across population sub-groups; post-viewing scores of knowledge and perceptions related to pandemic influenza were consistently higher in the non-narrative condition compared with the narrative condition across five socio-demographic groups: age, gender, education, race/ethnicity and income. We concluded that didactic, non-narrative messages may be more effective than narrative messages to influence knowledge and perceptions during public health emergencies. Copyright © 2017 Elsevier Inc. All rights reserved.

Coral Reef Health Indices versus the Biological, Ecological and Functional Diversity of Fish and Coral Assemblages in the Caribbean Sea

PubMed Central

Díaz-Pérez, Leopoldo; Ortiz, Marco; Cupul-Magaña, Amílcar Leví; Carriquiry, Jose D.; Ríos-Jara, Eduardo; Rodríguez-Troncoso, Alma Paola; García-Rivas, María del Carmen

2016-01-01

This study evaluated the relationship between the indices known as the Reef Health Index (RHI) and two-dimensional Coral Health Index (2D-CHI) and different representative metrics of biological, ecological and functional diversity of fish and corals in 101 reef sites located across seven zones in the western Caribbean Sea. Species richness and average taxonomic distinctness were used to asses biological estimation; while ecological diversity was evaluated with the indices of Shannon diversity and Pielou´s evenness, as well as by taxonomic diversity and distinctness. Functional diversity considered the number of functional groups, the Shannon diversity and the functional Pielou´s evenness. According to the RHI, 57.15% of the zones were classified as presenting a "poor" health grade, while 42.85% were in "critical" grade. Based on the 2D-CHI, 28.5% of the zones were in "degraded" condition and 71.5% were "very degraded". Differences in fish and coral diversity among sites and zones were demonstrated using permutational ANOVAs. Differences between the two health indices (RHI and 2D-CHI) and some indices of biological, ecological and functional diversity of fish and corals were observed; however, only the RHI showed a correlation between the health grades and the species and functional group richness of fish at the scale of sites, and with the species and functional group richness and Shannon diversity of the fish assemblages at the scale of zones. None of the health indices were related to the metrics analyzed for the coral diversity. In general, our study suggests that the estimation of health indices should be complemented with classic community indices, or should at least include diversity indices of fish and corals, in order to improve the accuracy of the estimated health status of coral reefs in the western Caribbean Sea. PMID:27579575

Coral Reef Health Indices versus the Biological, Ecological and Functional Diversity of Fish and Coral Assemblages in the Caribbean Sea.

PubMed

Díaz-Pérez, Leopoldo; Rodríguez-Zaragoza, Fabián Alejandro; Ortiz, Marco; Cupul-Magaña, Amílcar Leví; Carriquiry, Jose D; Ríos-Jara, Eduardo; Rodríguez-Troncoso, Alma Paola; García-Rivas, María Del Carmen

2016-01-01

This study evaluated the relationship between the indices known as the Reef Health Index (RHI) and two-dimensional Coral Health Index (2D-CHI) and different representative metrics of biological, ecological and functional diversity of fish and corals in 101 reef sites located across seven zones in the western Caribbean Sea. Species richness and average taxonomic distinctness were used to asses biological estimation; while ecological diversity was evaluated with the indices of Shannon diversity and Pielou´s evenness, as well as by taxonomic diversity and distinctness. Functional diversity considered the number of functional groups, the Shannon diversity and the functional Pielou´s evenness. According to the RHI, 57.15% of the zones were classified as presenting a "poor" health grade, while 42.85% were in "critical" grade. Based on the 2D-CHI, 28.5% of the zones were in "degraded" condition and 71.5% were "very degraded". Differences in fish and coral diversity among sites and zones were demonstrated using permutational ANOVAs. Differences between the two health indices (RHI and 2D-CHI) and some indices of biological, ecological and functional diversity of fish and corals were observed; however, only the RHI showed a correlation between the health grades and the species and functional group richness of fish at the scale of sites, and with the species and functional group richness and Shannon diversity of the fish assemblages at the scale of zones. None of the health indices were related to the metrics analyzed for the coral diversity. In general, our study suggests that the estimation of health indices should be complemented with classic community indices, or should at least include diversity indices of fish and corals, in order to improve the accuracy of the estimated health status of coral reefs in the western Caribbean Sea.