The recording of demographic information on death certificates: a national survey of funeral directors.
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OBJECTIVE: The authors sought to ascertain the methods used by funeral directors to determine the demographic information recorded on death certificates. METHODS: Standardized questionnaires were administered to funeral directors in five urban locations in the U.S. In addition, personnel on four Indian reservations were interviewed. Study sites were selected for diverse racial/ethnic populations and variability in recording practices; funeral homes were selected by stratified random sampling. RESULTS: Fifty-two percent of responding funeral directors reported receiving no formal training in death certification. Seventy-nine percent of respondents reported finding certain demographic items difficult to complete--26% first specified race as the problematic item, and 25% first specified education. The decedent's race was "sometimes" or "often" determined through personal knowledge of the family by 58% of respondents; 43% reported "sometimes" or "often" determining race by observation. Only three respondents reported that occupation was a problematic item. CONCLUSIONS: The authors recommend that the importance of demographic data and the instructions for data collection be clarified for funeral directors, that standard data collection worksheets be developed, and that training videos be developed. (+info)
Public health and disability: emerging opportunities.
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The public health community has traditionally paid little attention to the health needs of people with disabilities. Recent activities, however, on the part of federal and international organizations mark a shift toward engaging the health concerns of this large and growing population. First, the World Health Organization published the International Classification of Functioning, Disability, and Health (ICF), a companion to the International Classification of Diseases. The ICF describes both a conceptual framework and a classification system, providing the foundation for public health science and policy. Second, a vision for the future of public health and disability is outlined in Healthy People 2010 that, for the first time, includes people with disabilities as a targeted population. The article briefly describes activities and emerging opportunities for a public health focus on people with disabilities with the ICF as a foundation and Healthy People 2010 as a vision. Public health has traditionally responded to emerging needs; people with disabilities are a group whose health needs should be targeted. (+info)
Relationship between children's dental needs and dental care utilization: United States, 1988-1994.
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OBJECTIVES: This study describes the relationship between dental needs and dental care utilization among children. METHODS: Data from the third National Health and Nutrition Examination Survey (1988-1994) were used to analyze dental care needs and dental care utilization. RESULTS: Younger children with perceived needs (needs perceived by the child or responsible adult) were more likely to be episodic users of dental care than children without perceived needs. Younger children with normative needs (defined by the presence of untreated caries diagnosed by a dentist) were less likely to be regular users. Older children with perceived or normative needs were more likely to be episodic users and less likely to have had a previous-year visit than children with no needs. CONCLUSIONS: Despite their presence, dental needs do not drive dental care use among children, and children's dental care utilization is inadequate. (+info)
A summary measure of health disparity.
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OBJECTIVES: Eliminating health disparities is a goal of Healthy People 2010. In order to track progress toward this goal, we need improved methods for measuring disparity. The authors present the Index of Disparity (ID) as a summary measure of disparity. METHODS: The ID, a modified coefficient of variation, was used to measure disparity across populations defined on the basis of race/ethnicity, income, education, and gender. Disparity was also assessed for a diverse range of health indicators and over time to monitor trends. RESULTS: Disparity in cardiovascular disease deaths decreased based on gender from 1989 to 1998 but was largely unchanged based on race/ethnicity. The magnitude of disparities in cervical cancer and cholesterol screening, smoking, exercise, and health insurance ranged from 1.9% to 78.6%. The largest disparities for health indicators were not associated with any particular population classification, whether defined on the basis of race/ethnicity, education, or income. CONCLUSIONS: To eliminate disparities, we need a means to assess disparities across many types of health indicators. Furthermore, for a given health indicator, disparities may differ for populations defined on the basis of race/ethnicity, education, income, and so on. The ID is a simple method for summarizing disparities across groups within a population that can be applied across health indicators regardless of magnitude, over time to monitor trends, and across different populations. (+info)
Preventive-care practices among persons with diabetes--United States, 1995 and 2001.
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Effective interventions are available to persons with diabetes that can prevent or delay the development of serious health complications such as lower limb amputation, blindness, kidney failure, and cardiovascular disease. However, the use of preventive-care practices is lower than recommended, and the national health objectives for 2010 aim to improve care for all persons with diabetes. To assess progress toward meeting these goals, CDC analyzed data on selected diabetes-related preventive-care practices, including influenza and pneumococcal vaccination coverage, from the Behavioral Risk Factor Surveillance System (BRFSS) from 1995 and 2001. This report presents the findings of these analyses, which indicate that levels of preventive-care practices among persons with diabetes in the United States increased from 1995 to 2001. Further efforts are needed to improve care among persons with diabetes, reduce the burden of diabetes-related complications, and achieve the national health objectives, including continued surveillance of diabetes-related preventive-care practices and collaboration with community-based organizations, health-care providers, public health officials, and persons with diabetes. (+info)
Statewide prevalences of concern about enough food, 1996-1999.
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OBJECTIVE: Food insecurity is defined as not having access at all times to enough food for an active and healthy life-style. A Healthy People 2010 objective is to increase food security and reduce the risk of hunger for all households. The objective of this study was to characterize the prevalence of concern about enough food and its association with other sociodemographic and health characteristics at the state level. METHODS: Adult respondents participating in the Behavioral Risk Factor Surveillance System survey provided information on concern about enough food from nine states from 1996 through 1999. RESULTS: Overall, the prevalence of concern about enough food ranged from 3.1% to 11.8% for individual states. Across states, low household income was the strongest predictor of concern about enough food. The odds of being concerned about enough food were generally higher among respondents who were female, younger, and without health care coverage. The odds were generally lower among those reporting excellent or very good general health and among non-Hispanic whites. CONCLUSION: Food security scales could be used at the state level to track progress for the Healthy People 2010 objective of reducing food insecurity and hunger across American households. (+info)
Information from primary care: its importance and value. A comparison of information from Slovenia and England and Wales, viewed from the 'Health 21' perspective.
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BACKGROUND: The WHO have set health standards in the form of 21 targets--Health 21--and the EU are developing a set of health indicators whereby national health status can be measured. Data from Slovenia and from England and Wales assessing information systems in primary care and their capacity to deliver the requirements of these initiatives have been examined. In both countries, primary care is provided through a state-led service. METHODS: Consultation data from the annual report of the Department of Health Slovenia (1999) are compared in respect of relevant targets with data from the Fourth National Morbidity Survey (1992) in England and Wales. Consultation rates were standardized to the European Union 15 country population (1998). RESULTS: Consultation rates in females were similar in the two countries whereas in males rates were higher in Slovenia. The proportionate distributions of consultations by chapter of the International Classification of Diseases (ICD) were similar in both countries, respiratory (17%) and musculoskeletal (9%) disorders ranked first and second. For eye diseases, injury and poisoning, factors influencing health status (e.g. medical examination). proportions were higher in Slovenia: for mental disorders higher in England and Wales. The relativity of male to female consultation rates was broadly similar with higher rates in females in most ICD chapters. These differences are considered in detail against the background of WHO targets. CONCLUSIONS: Data gathered systematically from the surveillance of consultations in primary care are important to the measurement of WHO 'Health 21' targets. (+info)
A comprehensive "Healthy Schools Programme" to promote school health: the Hong Kong experience in joining the efforts of health and education sectors.
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Both health and education are linked to economic performance. The success of education depends on good health, and vice versa. Modern education should help young people to determine values, and accept responsibility for their health and social behaviour. The success of health promotion in schools requires the joint efforts of both the health and education sectors. A comprehensive programme is needed to include teachers' training, curriculum development, community participation, changing policies and practices, and research. All these components are needed to build up a successful model of a health promoting school. The "Healthy Schools Programme" in Hong Kong gives a good example of close partnership between the health and education sectors, and moves towards a multidisciplinary approach and active learning towards health promotion. (+info)