Health status disparities. Medical search

Health Status Disparities: Variation in rates of disease occurrence and disabilities between population groups defined by socioeconomic characteristics such as age, ethnicity, economic resources, or gender and populations identified geographically or similar measures.Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.Healthcare Disparities: Differences in access to or availability of medical facilities and services.Vision Disparity: The difference between two images on the retina when looking at a visual stimulus. This occurs since the two retinas do not have the same view of the stimulus because of the location of our eyes. Thus the left eye does not get exactly the same view as the right eye.Health Status Indicators: The measurement of the health status for a given population using a variety of indices, including morbidity, mortality, and available health resources.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Mental Health: The state wherein the person is well adjusted.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system.Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.Health Care Reform: Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.Health: The state of the organism when it functions optimally without evidence of disease.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Health Services: Services for the diagnosis and treatment of disease and the maintenance of health.Insurance, Health: Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.United States Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.Health Planning: Planning for needed health and/or welfare services and facilities.African Americans: Persons living in the United States having origins in any of the black groups of Africa.Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships.Depth Perception: Perception of three-dimensionality.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)European Continental Ancestry Group: Individuals whose ancestral origins are in the continent of Europe.Health Expenditures: The amounts spent by individuals, groups, nations, or private or public organizations for total health care and/or its various components. These amounts may or may not be equivalent to the actual costs (HEALTH CARE COSTS) and may or may not be shared among the patient, insurers, and/or employers.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Continental Population Groups: Groups of individuals whose putative ancestry is from native continental populations based on similarities in physical appearance.Social Class: A stratum of people with similar position and prestige; includes social stratification. Social class is measured by criteria such as education, occupation, and income.World Health: The concept pertaining to the health status of inhabitants of the world.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Educational Status: Educational attainment or level of education of individuals.Social Justice: An interactive process whereby members of a community are concerned for the equality and rights of all.Urban Health: The status of health in urban populations.Nutritional Status: State of the body in relation to the consumption and utilization of nutrients.Poverty: A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level.Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group.Public Health Administration: Management of public health organizations or agencies.Occupational Health: The promotion and maintenance of physical and mental health in the work environment.Rural Health: The status of health in rural populations.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Women's Health: The concept covering the physical and mental conditions of women.Child Health Services: Organized services to provide health care for children.Vision, Binocular: The blending of separate images seen by each eye into one composite image.Mental Health Services: Organized services to provide mental health care.Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health.National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Health Priorities: Preferentially rated health-related activities or functions to be used in establishing health planning goals. This may refer specifically to PL93-641.Health Care Rationing: Planning for the equitable allocation, apportionment, or distribution of available health resources.Health Literacy: Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Public Health Practice: The activities and endeavors of the public health services in a community on any level.Hispanic Americans: Persons living in the United States of Mexican (MEXICAN AMERICANS), Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin. The concept does not include Brazilian Americans or Portuguese Americans.Delivery of Health Care, Integrated: A health care system which combines physicians, hospitals, and other medical services with a health plan to provide the complete spectrum of medical care for its customers. In a fully integrated system, the three key elements - physicians, hospital, and health plan membership - are in balance in terms of matching medical resources with the needs of purchasers and patients. (Coddington et al., Integrated Health Care: Reorganizing the Physician, Hospital and Health Plan Relationship, 1994, p7)Community Health Planning: Planning that has the goals of improving health, improving accessibility to health services, and promoting efficiency in the provision of services and resources on a comprehensive basis for a whole community. (From Facts on File Dictionary of Health Care Management, 1988, p299)Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.Prejudice: A preconceived judgment made without factual basis.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Residence Characteristics: Elements of residence that characterize a population. They are applicable in determining need for and utilization of health services.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, or eating.African Continental Ancestry Group: Individuals whose ancestral origins are in the continent of Africa.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Rural Health Services: Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.World Health Organization: A specialized agency of the United Nations designed as a coordinating authority on international health work; its aim is to promote the attainment of the highest possible level of health by all peoples.Health Care Sector: Economic sector concerned with the provision, distribution, and consumption of health care services and related products.Insurance Coverage: Generally refers to the amount of protection available and the kind of loss which would be paid for under an insurance contract with an insurer. (Slee & Slee, Health Care Terms, 2d ed)Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Rural Population: The inhabitants of rural areas or of small towns classified as rural.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Demography: Statistical interpretation and description of a population with reference to distribution, composition, or structure.Population Surveillance: Ongoing scrutiny of a population (general population, study population, target population, etc.), generally using methods distinguished by their practicability, uniformity, and frequently their rapidity, rather than by complete accuracy.Income: Revenues or receipts accruing from business enterprise, labor, or invested capital.Infant, Newborn: An infant during the first month after birth.Health Resources: Available manpower, facilities, revenue, equipment, and supplies to produce requisite health care and services.Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Self-Assessment: Appraisal of one's own personal qualities or traits.Mortality: All deaths reported in a given population.Health Facilities: Institutions which provide medical or health-related services.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Health Manpower: The availability of HEALTH PERSONNEL. It includes the demand and recruitment of both professional and allied health personnel, their present and future supply and distribution, and their assignment and utilization.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Vulnerable Populations: Groups of persons whose range of options is severely limited, who are frequently subjected to COERCION in their DECISION MAKING, or who may be compromised in their ability to give INFORMED CONSENT.Health Services for the Aged: Services for the diagnosis and treatment of diseases in the aged and the maintenance of health in the elderly.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc.Employment: The state of being engaged in an activity or service for wages or salary.Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Medically Uninsured: Individuals or groups with no or inadequate health insurance coverage. Those falling into this category usually comprise three primary groups: the medically indigent (MEDICAL INDIGENCY); those whose clinical condition makes them medically uninsurable; and the working uninsured.Regional Health Planning: Planning for health resources at a regional or multi-state level.Convergence, Ocular: The turning inward of the lines of sight toward each other.Stress, Psychological: Stress wherein emotional factors predominate.Dental Health Surveys: A systematic collection of factual data pertaining to dental or oral health and disease in a human population within a given geographic area.Self Report: Method for obtaining information through verbal responses, written or oral, from subjects.Emigrants and Immigrants: People who leave their place of residence in one country and settle in a different country.Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.Health Services, Indigenous: Health care provided to specific cultural or tribal peoples which incorporates local customs, beliefs, and taboos.Asian Americans: Persons living in the United States having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent.Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Public Health Nursing: A nursing specialty concerned with promoting and protecting the health of populations, using knowledge from nursing, social, and public health sciences to develop local, regional, state, and national health policy and research. It is population-focused and community-oriented, aimed at health promotion and disease prevention through educational, diagnostic, and preventive programs.Health Benefit Plans, Employee: Health insurance plans for employees, and generally including their dependents, usually on a cost-sharing basis with the employer paying a percentage of the premium.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Maternal Health Services: Organized services to provide health care to expectant and nursing mothers.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Sickness Impact Profile: A quality-of-life scale developed in the United States in 1972 as a measure of health status or dysfunction generated by a disease. It is a behaviorally based questionnaire for patients and addresses activities such as sleep and rest, mobility, recreation, home management, emotional behavior, social interaction, and the like. It measures the patient's perceived health status and is sensitive enough to detect changes or differences in health status occurring over time or between groups. (From Medical Care, vol.xix, no.8, August 1981, p.787-805)State Health Plans: State plans prepared by the State Health Planning and Development Agencies which are made up from plans submitted by the Health Systems Agencies and subject to review and revision by the Statewide Health Coordinating Council.Psychometrics: Assessment of psychological variables by the application of mathematical procedures.Urban Health Services: Health services, public or private, in urban areas. The services include the promotion of health and the delivery of health care.Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression.Great Britain Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Morbidity: The proportion of patients with a particular disease during a given year per given unit of population.Indians, North American: Individual members of North American ethnic groups with ancient historic ancestral origins in Asia.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.Depression: Depressive states usually of moderate intensity in contrast with major depression present in neurotic and psychotic disorders.Healthy People Programs: Healthy People Programs are a set of health objectives to be used by governments, communities, professional organizations, and others to help develop programs to improve health. It builds on initiatives pursued over the past two decades beginning with the 1979 Surgeon General's Report, Healthy People, Healthy People 2000: National Health Promotion and Disease Prevention Objectives, and Healthy People 2010. These established national health objectives and served as the basis for the development of state and community plans. These are administered by the Office of Disease Prevention and Health Promotion (ODPHP). Similar programs are conducted by other national governments.Life Style: Typical way of life or manner of living characteristic of an individual or group. (From APA, Thesaurus of Psychological Index Terms, 8th ed)Life Expectancy: Based on known statistical data, the number of years which any person of a given age may reasonably expected to live.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.Reproductive Health: The physical condition of human reproductive systems.Health Maintenance Organizations: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)Consumer Participation: Community or individual involvement in the decision-making process.Men's Health: The concept covering the physical and mental conditions of men.Sex Distribution: The number of males and females in a given population. The distribution may refer to how many men or women or what proportion of either in the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.Community-Institutional Relations: The interactions between members of a community and representatives of the institutions within that community.Politics: Activities concerned with governmental policies, functions, etc.Women's Health Services: Organized services to provide health care to women. It excludes maternal care services for which MATERNAL HEALTH SERVICES is available.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Oceanic Ancestry Group: Individuals whose ancestral origins are in the islands of the central and South Pacific, including Micronesia, Melanesia, Polynesia, and traditionally Australasia.Poverty Areas: City, urban, rural, or suburban areas which are characterized by severe economic deprivation and by accompanying physical and social decay.Dental Health Services: Services designed to promote, maintain, or restore dental health.Status Epilepticus: A prolonged seizure or seizures repeated frequently enough to prevent recovery between episodes occurring over a period of 20-30 minutes. The most common subtype is generalized tonic-clonic status epilepticus, a potentially fatal condition associated with neuronal injury and respiratory and metabolic dysfunction. Nonconvulsive forms include petit mal status and complex partial status, which may manifest as behavioral disturbances. Simple partial status epilepticus consists of persistent motor, sensory, or autonomic seizures that do not impair cognition (see also EPILEPSIA PARTIALIS CONTINUA). Subclinical status epilepticus generally refers to seizures occurring in an unresponsive or comatose individual in the absence of overt signs of seizure activity. (From N Engl J Med 1998 Apr 2;338(14):970-6; Neurologia 1997 Dec;12 Suppl 6:25-30)Electronic Health Records: Media that facilitate transportability of pertinent information concerning patient's illness across varied providers and geographic locations. Some versions include direct linkages to online consumer health information that is relevant to the health conditions and treatments related to a specific patient.Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Age Distribution: The frequency of different ages or age groups in a given population. The distribution may refer to either how many or what proportion of the group. The population is usually patients with a specific disease but the concept is not restricted to humans and is not restricted to medicine.California Disabled Persons: Persons with physical or mental disabilities that affect or limit their activities of daily living and that may require special accommodations.Health Care Coalitions: Voluntary groups of people representing diverse interests in the community such as hospitals, businesses, physicians, and insurers, with the principal objective to improve health care cost effectiveness.Catchment Area (Health): A geographic area defined and served by a health program or institution.Occupational Health Services: Health services for employees, usually provided by the employer at the place of work.Diagnostic Self Evaluation: A self-evaluation of health status.Cost of Illness: The personal cost of acute or chronic disease. The cost to the patient may be an economic, social, or psychological cost or personal loss to self, family, or immediate community. The cost of illness may be reflected in absenteeism, productivity, response to treatment, peace of mind, or QUALITY OF LIFE. It differs from HEALTH CARE COSTS, meaning the societal cost of providing services related to the delivery of health care, rather than personal impact on individuals.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982).Medicaid: Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.Mouth, Edentulous: Total lack of teeth through disease or extraction.Tooth Diseases Health Occupations: Professions or other business activities directed to the cure and prevention of disease. For occupations of medical personnel who are not physicians but who are working in the fields of medical technology, physical therapy, etc., ALLIED HEALTH OCCUPATIONS is available.Family Health: The health status of the family as a unit including the impact of the health of one member of the family on the family as a unit and on individual family members; also, the impact of family organization or disorganization on the health status of its members.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Florida Universal Coverage: Health insurance coverage for all persons in a state or country, rather than for some subset of the population. It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions.Diabetes Mellitus: A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.Health Planning Guidelines: Recommendations for directing health planning functions and policies. These may be mandated by PL93-641 and issued by the Department of Health and Human Services for use by state and local planning agencies.Emigration and Immigration: The process of leaving one's country to establish residence in a foreign country.National Institutes of Health (U.S.): An operating division of the US Department of Health and Human Services. It is concerned with the overall planning, promoting, and administering of programs pertaining to health and medical research. Until 1995, it was an agency of the United States PUBLIC HEALTH SERVICE.Confidence Intervals: A range of values for a variable of interest, e.g., a rate, constructed so that this range has a specified probability of including the true value of the variable.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Sociology, Medical: The study of the social determinants and social effects of health and disease, and of the social structure of medical institutions or professions.Public Health Informatics: The systematic application of information and computer sciences to public health practice, research, and learning.Reproductive Health Services: Health care services related to human REPRODUCTION and diseases of the reproductive system. Services are provided to both sexes and usually by physicians in the medical or the surgical specialties such as REPRODUCTIVE MEDICINE; ANDROLOGY; GYNECOLOGY; OBSTETRICS; and PERINATOLOGY.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Pulmonary Disease, Chronic Obstructive: A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.Adolescent Health Services: Organized services to provide health care to adolescents, ages ranging from 13 through 18 years.Disability Evaluation: Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits.Medicare: Federal program, created by Public Law 89-97, Title XVIII-Health Insurance for the Aged, a 1965 amendment to the Social Security Act, that provides health insurance benefits to persons over the age of 65 and others eligible for Social Security benefits. It consists of two separate but coordinated programs: hospital insurance (MEDICARE PART A) and supplementary medical insurance (MEDICARE PART B). (Hospital Administration Terminology, AHA, 2d ed and A Discursive Dictionary of Health Care, US House of Representatives, 1976)Community Networks: Organizations and individuals cooperating together toward a common goal at the local or grassroots level.Southeastern United States: The geographic area of the southeastern region of the United States in general or when the specific state or states are not included. The states usually included in this region are Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, West Virginia, and Virginia.North Carolina New York CityOrganizational Objectives: The purposes, missions, and goals of an individual organization or its units, established through administrative processes. It includes an organization's long-range plans and administrative philosophy.Geriatric Assessment: Evaluation of the level of physical, physiological, or mental functioning in the older population group.Cooperative Behavior: The interaction of two or more persons or organizations directed toward a common goal which is mutually beneficial. An act or instance of working or acting together for a common purpose or benefit, i.e., joint action. (From Random House Dictionary Unabridged, 2d ed)DMF Index: "Decayed, missing and filled teeth," a routinely used statistical concept in dentistry.Behavioral Risk Factor Surveillance System: Telephone surveys are conducted to monitor prevalence of the major behavioral risks among adults associated with premature MORBIDITY and MORTALITY. The data collected is in regard to actual behaviors, rather than on attitudes or knowledge. The Centers for Disease Control and Prevention (CDC) established the Behavioral Risk Factor Surveillance System (BRFSS) in 1984.

The health related quality of life of the employees in the Greek hospitals: assessing how healthy are the health workers. (1/2192)

BACKGROUND: The main aim of the study was to assess the health status and health related quality of life of the personnel of the Hellenic Network of Health Promotion Hospitals. The instrument used was SF-36. An additional aim was to contribute to the validation of the SF-36. METHODS: The study instrument was administered to 347 randomly selected employees from seven hospitals within major Athens area. Completed questionnaire were obtained by 292 employees. The statistical significance of the observed differences was tested with parametric (t-test and ANOVA) and non-parametric tests (Mann-Whitney and Kruskall-Wallis). Also, since the Greek national norms have not been published yet, the mean scores on all eight SF-36 dimensions of this study were compared with the U.S and several European national norms just to assess the extent to what there are significant differences between a Greek healthy population and the general populations of several other countries. RESULTS: Medical doctors and technical personnel (mostly engineers) reported better health status than nurses and administrative and auxiliary personnel; women reported poorer health status than men on all eight SF-36 dimensions; younger employees reported poorer health status than their older counterpartners. Moreover the mean scores on all SF-36 dimensions reported by the participants on this study were considerably lower than the U.S and many European national norms. Also the study results constitute an indication of the SF-36 construct validity. CONCLUSION: The findings of this study show that there are major and intense health inequalities among the employees in Greek hospitals. (+info)

Socioeconomic differences in the burden of disease in Sweden. (2/2192)

OBJECTIVE: We sought to analyse how much of the total burden of disease in Sweden, measured in disability-adjusted life years (DALYs), is a result of inequalities in health between socioeconomic groups. We also sought to determine how this unequal burden is distributed across different disease groups and socioeconomic groups. METHODS: Our analysis used data from the Swedish Burden of Disease Study. We studied all Swedish men and women in three age groups (15-44, 45-64, 65-84) and five major socioeconomic groups. The 18 disease and injury groups that contributed to 65% of the total burden of disease were analysed using attributable fractions and the slope index of inequality and the relative index of inequality. FINDINGS: About 30% of the burden of disease among women and 37% of the burden among men is a differential burden resulting from socioeconomic inequalities in health. A large part of this unequally distributed burden falls on unskilled manual workers. The largest contributors to inequalities in health for women are ischaemic heart disease, depression and neurosis, and stroke. For men, the largest contributors are ischaemic heart disease, alcohol addiction and self-inflicted injuries. CONCLUSION: This is the first study to use socioeconomic differences, measured by socioeconomic position, to assess the burden of disease using DALYs. We found that in Sweden one-third of the burden of the diseases we studied is unequally distributed. Studies of socioeconomic inequalities in the burden of disease that take both mortality and morbidity into account can help policy-makers understand the magnitude of inequalities in health for different disease groups. (+info)

Asthma patient education opportunities in predominantly minority urban communities. (3/2192)

Disenfranchised ethnic minority communities in the urban United States experience a high burden of asthma. Conventional office-based patient education often is insufficient to promote proper asthma management and coping practices responsive to minority patients' environments. This paper explores existing and alternative asthma information and education sources in three urban minority communities in western New York State to help design other practical educational interventions. Four focus groups (n = 59) and four town hall meetings (n = 109) were conducted in one Hispanic and two black communities. Focus groups included adult asthmatics or caretakers of asthmatics, and town meetings were open to all residents. A critical theory perspective informed the study. Asthma information and education sources, perceptions of asthma and ways of coping were elicited through semi-structured interviews. Data analysis followed a theory-driven immersion-crystallization approach. Several asthma education and information resources from the health care system, media, public institutions and communities were identified. Intervention recommendations highlighted asthma workshops that recognize participants as teachers and learners, offer social support, promote advocacy, are culturally appropriate and community-based and include health care professionals. Community-based, group health education couched on people's experiences and societal conditions offers unique opportunities for patient asthma care empowerment in minority urban communities. (+info)

Socioeconomic risk, parenting during the preschool years and child health age 6 years. (4/2192)

BACKGROUND: Parent child relationships and parenting processes are emerging as potential life course determinants of health. Parenting is socially patterned and could be one of the factors responsible for the negative effects of social inequalities on health, both in childhood and adulthood. This study tests the hypothesis that some of the effect of socioeconomic risk on health in mid childhood is transmitted via early parenting. METHODS: Prospective cohort study in 10 USA communities involving 1041 mother/child pairs, selected at birth at random with conditional sampling. EXPOSURES: income, maternal education, maternal age, lone parenthood, ethnic status and objective assessments of mother child interaction in the first 4 years of life covering warmth, negativity and positive control. OUTCOMES: mother's report of child's health in general at 6 years. Modelling: multiple regression analyses with statistical testing of mediational processes. RESULTS: All five indicators of socioeconomic status (SES) were correlated with all three measures of parenting, such that low SES was associated with poor parenting. Among the measures of parenting maternal warmth was independently predictive of future health, and among the socioeconomic variables maternal education, partner presence and 'other ethnic group' proved predictive. Measures of parenting significantly mediated the impact of measures of SES on child health. CONCLUSIONS: Parenting mediates some, but not all of the detectable effects of socioeconomic risk on health in childhood. As part of a package of measures that address other determinants, interventions to support parenting are likely to make a useful contribution to reducing childhood inequalities in health. (+info)

Inequality in the health status of workers in small-scale enterprises. (5/2192)

BACKGROUND: Small-scale enterprises (SSEs) usually share poorer resources for promoting occupational health. AIM: To investigate inequality of health status among SSEs in Japan. METHOD: A cross-sectional, multiple-centred study was carried out using the periodical health check-up data for the fiscal year 2000 to compare the age-adjusted proportions of workers with hypertension (HT), hyperlipidaemia, impaired glucose tolerance (IGT) and obesity and of current smokers by size of enterprise, i.e. or=1000 employees in Japan. RESULTS: From five leading occupational health organizations, data were collected for 9833 enterprises with a total of 436 729 subjects, 302 383 males and 134 346 females. The proportions of workers in SSEs with or=50 male employees. The prevalence of smokers in SSEs with or=50 male employees. These proportions showed a significantly increasing tendency with decreasing size of male workforce. CONCLUSION: Despite the cross-sectional design and only adjusting age as a potential confounder, higher proportions of HT, IGT, obesity and smoking in male workers were found in SSEs compared to larger organizations. (+info)

Possible socioeconomic and ethnic disparities in quality of life in a cohort of breast cancer survivors. (6/2192)

BACKGROUND: This paper describes the ethnic and socioeconomic correlates of functioning in a cohort of long-term nonrecurring breast cancer survivors. METHODS: Participants (n = 804) in this study were women from the Health, Eating, Activity, and Lifestyle (HEAL) Study, a population-based, multicenter, multiethnic, prospective study of women newly diagnosed with in situ or Stages I to IIIA breast cancer. Measurements occurred at three timepoints following diagnosis. Outcomes included standardized measures of functioning (MOS SF-36). RESULTS: Overall, these long-term survivors reported values on two physical function subscales of the SF-36 slightly lower than population norms. Black women reported statistically significantly lower physical functioning (PF) scores (P = 0.01), compared with White and Hispanic women, but higher mental health (MH) scores (P < 0.01) compared with White and Hispanic women. In the final adjusted model, race was significantly related to PF, with Black participants and participants in the "Other" ethnic category reporting poorer functioning compared to the White referent group (P < 0.01, 0.05). Not working outside the home, being retired or disabled and being unemployed (on leave, looking for work) were associated with poorer PF compared to currently working (both P < 0.01). CONCLUSION: These data indicate that race/ethnicity influences psychosocial functioning in breast cancer survivors and can be used to identify need for targeted interventions to improve functioning. (+info)

Health inequalities with the National Statistics-Socioeconomic classification: disease risk factors and health in the 1958 British birth cohort. (7/2192)

BACKGROUND: Health inequalities using the new National Statistics socioeconomic classification (NS-SEC) have so far been assessed using only general measures of health, with little known about inequality for specific health outcomes. Preliminary analyses show that self-employed workers, distinguished for the first time by NS-SEC, show increased mortality risk in the last 5 years of working life. We examined health inequalities for multiple disease risk factors and health outcomes, with particular reference to cardiorespiratory risk in the self-employed. METHODS: 8952 participants in the 1958 British birth cohort with information on adult occupation and disease risk factors at 45 years. Systolic and diastolic blood pressure, body mass index, glycosylated haemoglobin, total and high density lipoprotein (HDL) cholesterol, triglycerides, fibrinogen, C-reactive protein, tissue plasminogen activator (t-PA), von Willebrand factor, total immunoglobulin E (IgE), one-second forced expiratory volume, 4 kHz hearing threshold, visual impairment, depressive symptoms, anxiety, chronic widespread pain and self-rated health were measured. RESULTS: Routine workers had poorer health than professional workers for most outcomes examined, except HDL cholesterol, triglycerides, t-PA and IgE in men; total cholesterol and IgE in women. Patterns of inequality varied depending on the outcome but rarely showed linear trend across the classes. Relative to professionals, own account workers (self-employed) did not show consistently increased levels of cardiorespiratory risk markers. CONCLUSIONS: Health inequalities are seen with NS-SEC across diverse outcomes for men and women. In mid-life, self-employed workers do not have an adverse cardiorespiratory risk profile. (+info)

Race and risk of schizophrenia in a US birth cohort: another example of health disparity? (8/2192)

BACKGROUND: Immigrant groups in Western Europe have markedly increased rates of schizophrenia. The highest rates are found in ethnic groups that are predominantly black. Separating minority race/ethnicity from immigration in Western Europe is difficult; in the US, these issues can be examined separately. Here we compared rates of schizophrenia between whites and African Americans and evaluated whether the association was mediated by socioeconomic status (SES) of family of origin in a US birth cohort. METHODS: Study subjects were offspring of women enrolled during pregnancy at Alameda County Kaiser Permanente Medical Care Plan clinics (1959-66) in the Child Health and Development Study. For schizophrenia spectrum disorders, 12 094 of the 19 044 live births were followed over 1981-97. The analysis is restricted to cohort members whose mothers identified as African American or white at intake. Stratified proportional hazards regression was the method of analysis; the robustness of findings to missing data bias was assessed using multiple imputation. RESULTS: African Americans were about 3-fold more likely than whites to be diagnosed with schizophrenia [Rate Ratio (RR) = 3.27; 95% confidence interval (CI): 1.71-6.27]. After adjusting for indicators of family SES at birth, the RR was about 2-fold (RR = 1.92; 95% CI: 0.86-4.28). Using multiple imputation in the model including family SES indicators, the RR for race and schizophrenia was strengthened in comparison with the estimate obtained without imputation. CONCLUSION: The data indicate substantially elevated rates of schizophrenia among African Americans in comparison with whites in this birth cohort. The association may have been partly but not wholly mediated by an effect of race on family SES. (+info)