Housing and health: time again for public health action.
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Poor housing conditions are associated with a wide range of health conditions, including respiratory infections, asthma, lead poisoning, injuries, and mental health. Addressing housing issues offers public health practitioners an opportunity to address an important social determinant of health. Public health has long been involved in housing issues. In the 19th century, health officials targeted poor sanitation, crowding, and inadequate ventilation to reduce infectious diseases as well as fire hazards to decrease injuries. Today, public health departments can employ multiple strategies to improve housing, such as developing and enforcing housing guidelines and codes, implementing "Healthy Homes" programs to improve indoor environmental quality, assessing housing conditions, and advocating for healthy, affordable housing. Now is the time for public health to create healthier homes by confronting substandard housing. (+info)
Unraveling the ecology of risks for early childhood asthma among ethnically diverse families in the southwest.
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OBJECTIVES: We describe the prevalence of asthma risk factors within racial/ethnic and language groups of infants participating in an intervention study for reducing chronic asthma. METHODS: Low-income children aged 9 to 24 months with 3 or more episodes of wheezing illness were enrolled. Baseline information included family and medical histories, allergic status, environmental exposures, emotional environment, and caregiver psychosocial resources. RESULTS: Racial/ethnic and language groups-European Americans, African Americans, high-acculturated Hispanics, and low-acculturated Hispanics-showed different patterns of risk factors for childhood asthma, with low-acculturated Hispanics showing the most distinctive pattern. CONCLUSIONS: Patterns of covariation of biological and psychosocial risk factors for childhood asthma were associated with racial/ethnic and language status among urban, low-income children. (+info)
International trends in occupational health research and practice.
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The paper argues for a "new generation" approach to occupational health, laying foundations for future demands. Occupational health deals with issues which are at the heart of the economy and society, and are beginning to attract increasing attention of politicians. Old disciplinary barriers must be crossed, and communication improved so that healthy work is accepted as a mainstream concern. This presents challenges both to occupational health professionals and to those with responsibilities for policy. As a first step, we need to make more effective use of the body of available research, and develop an understanding of how the conclusions from research can inform responsible decision making. (+info)
Work as a cultural and personal value: attitudes towards work in Polish society.
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The meaning of work for Poles is analyzed here from 2 perspectives: macrosocial and individual. From the macrosocial perspective work attitudes are explained by 3 factors: traditional Polish Catholicism, cultural patterns (influence of noble class tradition), and experience of "real socialism." From an individual perspective some psychological and demographic predictors of an autonomous (intrinsic) work attitude are empirically tested. The autonomous attitude towards work is understood here as treating work as an important autonomous value versus only an instrumental means for earning money. The data was collected by means of standardized interviews run on a representative random sample of adult working Poles, N = 1340. (+info)
Social aetiology of violent deaths in Swedish children and youth.
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STUDY OBJECTIVE: To describe the contribution of social conditions for the main causes of injury deaths in Swedish children and youth aged 5-25 years. DESIGN: Cohort study. All children below 15 years of age that resided in Sweden 1985 were followed up during 1991-1995. Injury deaths were recorded from The National Cause of Death Register. Information on parental social determinants were collected from various national registers. Connections between the social determinants and an injury death outcome were analysed in multivariate Cox regression models. MAIN RESULTS: In total 1474 injury deaths were recorded during approximately 8 million person years. In a regression model, with control for sex, year of birth, and residency (urban/rural), the aetiological fraction for parental SES, maternal country of birth, family situation, parental risk factors, and all these factors combined were 13%, 6%, 1.4%, 1.3%, and 19%, respectively. Similar regression models were studied separately for each of the main causes of injury death. The parental social determinants explained 58% of all homicides, 47% of all motor traffic injuries, and 30% of all other traffic injuries while the suicide rate was not affected by these determinants. Parental socioeconomic status was the single most important parental determinant for all major causes of injury. CONCLUSIONS: There was a wide variation of the aetiological fractions of parental social determinants for different causes of injury death. This variation might be used to further investigate the social aetiology of injuries. (+info)
Genetic test evaluation: information needs of clinicians, policy makers, and the public.
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Growing knowledge about gene-disease associations will lead to new opportunities for genetic testing. Many experts predict that genetic testing will become increasingly important as a guide to prevention, clinical management, and drug treatment based on genetic susceptibilities. As part of a Human Genetic Epidemiology workshop convened by the Centers for Disease Control and Prevention, a group of experts evaluated the evidence needed when considering the appropriate use of new genetic tests. Because new tests are likely to vary in their predictive value, their potential to direct prevention or treatment efforts, and their personal and social consequences, the task of determining appropriate use will require careful consideration of a variety of factors, including the analytic validity, clinical validity, clinical utility, and ethical, legal, and social implications of the test. Standardized formats are needed to summarize what is known and not known about new genetic tests with respect to each of these features. Following criteria for the objective assessment of test properties, reports should be structured to enable policy makers, clinicians, and the public to identify the available evidence, so that uncertainties can be taken into account when considering test use and planning future research. (+info)
Contributions of societal and geographical environments to "chronic Lyme disease": the psychopathogenesis and aporology of a new "medically unexplained symptoms" syndrome.
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Lyme disease is a relatively well-described infectious disease with multisystem manifestations. Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established. Chronic Lyme disease is the most recent in a continuing series of "medically unexplained symptoms" syndromes. These syndromes, such as fibromyalgia, chronic fatigue syndrome, and multiple chemical sensitivity, meet the need for a societally and morally acceptable explanation for ill-defined symptoms in the absence of objective physical and laboratory findings. We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia. (+info)
Collaborative research and action to control the geographic placement of outdoor advertising of alcohol and tobacco products in Chicago.
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Community activists in Chicago believed their neighborhoods were being targeted by alcohol and tobacco outdoor advertisers, despite the Outdoor Advertising Association of America's voluntary code of principles, which claims to restrict the placement of ads for age-restricted products and prevent billboard saturation of urban neighborhoods. A research and action plan resulted from a 10-year collaborative partnership among Loyola University Chicago, the American Lung Association of Metropolitan Chicago (ALAMC), and community activists from a predominately African American church, St. Sabina Parish. In 1997 Loyola University and ALAMC researchers conducted a cross-sectional prevalence survey of alcohol and tobacco outdoor advertising. Computer mapping was used to locate all 4,247 licensed billboards in Chicago that were within 500- and 1,000-foot radiuses of schools, parks, and playlots. A 50% sample of billboards was visually surveyed and coded for advertising content. The percentage of alcohol and tobacco billboards within the 500- and 1,000-foot zones ranged from 0% to 54%. African American and Hispanic neighborhoods were disproportionately targeted for outdoor advertising of alcohol and tobacco. Data were used to convince the Chicago City Council to pass one of the nation's toughest anti-alcohol and tobacco billboard ordinances, based on zoning rather than advertising content. The ordinance was challenged in court by advertisers. Recent Supreme Court rulings made enactment of local billboard ordinances problematic. Nevertheless, the research, which resulted in specific legislative action, demonstrated the importance of linkages among academic, practice, and grassroots community groups in working together to diminish one of the social causes of health disparities. (+info)