Good Self-reported Health Status Research Articles

Factors Associated with the Delay in Seeing a Doctor: Evidence of Chinese Middle-Aged and Older Adults.

There have been few studies concerning delayed medical attention among middle-aged and older adults, and in-depth analyses of delay duration and symptoms have been lacking. In this cross-sectional study exploiting a face-to-face questionnaire survey, we investigated delays in seeing a doctor among ≥ 45-year-old people in Zhejiang, China over the past year, and analyzed relevant influencing factors through logistics regression. A total of 1034 people aged ≥45 years were enrolled, whose overall occurrence of delay in seeing a doctor was 28.24% (23.00% for older adults aged ≥60 years). Factors like the presence of 2 chronic diseases, intense social loneliness, and more health care needs contributed to the occurrence of delay in seeing a doctor (OR (95% CI) = 2.102 (1.252-3.529); OR (95% CI) = 1.030 (1.002-1.059); OR (95% CI) = 1.049 (1.002-1.099). Contrastively, factors like convenient access to medical care and good self-reported health status inhibited such occurrence OR (95% CI) = 0.321 (0.199-0.519); OR (95% CI) = 0.369 (0.183-0.745). The foremost reason was wanting to wait and see if the problem would get better on its own (117, 40.07%). Respiratory system disease (14.90%), dental problems (13.82%), and cardiac disease (13.61%) constituted the top 3 types of diseases whose treatments were delayed. Additionally, for the majority of older adults, the delay duration was 1-2 weeks (99, 33.90%), and the economic burden was the cause of the longest delay in seeing a doctor among middle-aged and older adults. To alleviate the problem of delay in seeing a doctor among middle-aged and older adults, their families and society should enhance care for them and reduce their sense of social loneliness. Emphasis should be placed by the government on helping middle-aged and older adults with financial difficulties so that their medical convenience can be improved.

Clinical debate on papillary thyroid microcarcinoma-could genetic testing change the decision of papillarythyroid microcarcinoma (mPTC) treatment: A case report

The objective of this case report is to explore whether genetic testing is appropriate to guide the treatment of papillary thyroid microcarcinoma (PTMC). In this case report, we describe a 27-year-old female who had no significant medical history and no tumor detected in the thyroid gland by ultrasound or computed tomography (CT), but had multiple enlarged lymph nodes at the right cervical lymph node levels II, III, IV, and V. The intraoperative frozen section pathology results showed that seven out of 23 right lymph nodes were metastatic from thyroid papillary carcinoma, but no primary lesion was found in the thyroid gland. After multiple post-operative sampling and micro section, only a 1 mm papillary carcinoma in the left thyroid gland was identified. The genetic testing result showed that the patient was positive for CCDC6-exon 1-RET-exon 12 fusion. The final diagnosis of the patient was left thyroid micro-papillary carcinoma (1 mm) with the right lateral cervical lymph node metastasis. She received iodine-131 treatment with nuclide and lifelong levothyroxine therapy in the 3rd month after surgery. Continuous follow-up showed no elevation of thyroglobulin, no recurrence signs on positron emission tomography-CT re-examination, and good self-reported health status. In conclusion, the identification of CCDC6-RET fusion by genetic testing in the PTMC case aided diagnosis and treatment.

SOCIO-DEMOGRAPHIC, COMMUNITY CHARACTERISTICS AND FEAR OF CRIME AS CORRELATES OF SELF-REPORTED HEALTH STATUS IN LAGOS, NIGERIA

The main objective of this study was to examine the influence of socio-demographic characteristics, community characteristics and fear of crime on self-reported health status among residents in selected communities in Lagos, Nigeria. The study was conducted in four selected communities in Lagos, namely Mushin, Idi-Oro, Idi-Araba and Surulere. Cross-sectional design survey was used to select 799 respondents using stratified sampling technique. Data were analysed at univariate, bivariate and ordinal logistic regression using SPSS version 22.0. Majority of the respondents rated their self-reported health status as excellent to good. The findings show that education increases the chances of achieving excellent to good selfreported health status; that female respondent reported excellent to good self-reported health status compared to the male respondents Also, Christians and Muslims reported excellent to good self-reported health status. Safely walking alone at night/day in the community positively affected self-reported health status. Fear of crime has direct relationship with self-reported health status. Sociodemographic, community characteristics and fear of crime influence self-reported health status. Policy on crime control should be specific at reducing fear of crime at individual and community levels to promote healthy individuals and communities.

Dietary supplement use in Greece: methodology and findings from the National Health and Nutrition Survey - HYDRIA (2013-2014).

The use of dietary supplements (DS) is increasing worldwide. There is limited evidence of their intake level and mode of consumption in association with the Greek population's dietary and lifestyle habits. Adults (n 4011, 1873 males and 2138 females) aged > 18 years old living in Greece were included in the 2013-2014 National Health and Nutrition Survey - HYDRIA. A dietary supplement user (DSU) was defined as anyone who reported one or more DS on either a Food Propensity Questionnaire, two 24-h dietary recalls, or a questionnaire completed during the blood sample collection examination. DS use was examined according to socio-economic, anthropometric and lifestyle characteristics and the participants' health and dietary status. DS use was reported by 31 % of the population (40 % women and 22 % men), and it was higher among individuals living in urban areas, men with good self-reported health status and women with a chronic medical condition and higher consumption of fruits. The types of DS more frequently reported were multivitamins with minerals (5·4 %), Ca (5·3 %), multivitamins (4·7 %) and Fe (4·6 %). MVM supplements were preferred by men, while Ca was more frequently reported by women and participants with low education levels. Plant- and oil-based supplement use was below 5 %. Whether DS intake benefits health must be explored. It should also be assessed if dietary supplement intake is as efficient as food intake.

COVID-19 Vaccine Hesitancy Among Older Adolescents and Young Adults: A National Cross-Sectional Study in China.

BackgroundWith promotion of COVID-19 vaccinations, there has been a corresponding vaccine hesitancy, of which older adolescents and young adults represent groups of particular concern. In this report, we investigated the prevalence and reasons for vaccine hesitancy, as well as potential risk factors, within older adolescents and young adults in China.MethodsTo assess these issues, an online survey was administered over the period from March 14 to April 15, 2021. Older adolescents (16–17 years old) and young adults (18–21 years old) were recruited nationwide from Wechat groups and results from a total of 2,414 respondents were analyzed. Socio-demographic variables, vaccine hesitancy, psychological distress, abnormal illness behavior, global well-being and social support were analyzed in this report.ResultsCompared to young adults (n = 1,405), older adolescents (n = 1,009) showed higher prevalence rates of COVID-19 vaccine hesitancy (16.5 vs. 7.9%, p < 0.001). History of physical diseases (p = 0.007) and abnormal illness behavior (p = 0.001) were risk factors for vaccine hesitancy among older adolescents, while only a good self-reported health status (p = 0.048) was a risk factor for young adults. Concerns over COVID-19 vaccine side effects (67.1%) and beliefs of invulnerability regarding infection risk (41.9%) were the most prevalent reasons for vaccine hesitancy. Providing evidence on the vaccine reduction of COVID-19 infection risk (67.5%), ensuring vaccine safety (56.7%) and the low risk of side effects (52.7%) were the most effective persuasions for promoting vaccinations.ConclusionIn China, older adolescents showed a higher prevalence for vaccine hesitancy than that of young adults. Abnormal illness behavior and history of physical diseases were risk factors for vaccine hesitancy among these older adolescents, while social support represents an important factor which could help to alleviate this hesitancy.

Association of Regular Leisure-Time Physical Activity with Self-Reported Body Mass Index and Obesity Risk among Middle-Aged and Older Adults in Taiwan.

Through this study, we aimed to determine the association of regular leisure-time physical activity (LTPA) with self-reported body mass index (BMI) and obesity risk among middle-aged and older adults in Taiwan. We conducted a cross-sectional study and reviewed the data derived from the Taiwan National Physical Activity Survey (TNPAS). Responses from 12,687 participants aged 45–108 years from the database were collected in this study. All the participants completed a standardized structured questionnaire that solicitated information regarding their demographic characteristics (age, gender, education, occupation, and self-reported health status), physical activity behaviors (regular/nonregular LTPA), and self-reported anthropometrics (height, weight, and BMI). Multiple linear and logistic regressions were used to examine the association between regular LTPA and BMI, and between regular LTPA and obesity status, respectively. Regular LTPA was associated with male gender, normal weight, excellent or good self-reported health status, and a lower rate of being underweight compared with nonregular LTPA. Regular LTPA was significant negatively associated with being underweight (OR = 0.71, p < 0.05), whereas it had no significant relationship with BMI and obesity (p > 0.05). Regular LTPA was associated with a reduced risk of being underweight among middle-aged and elderly adults in Taiwan. Further research on the relevant mechanism underlying this phenomenon is warranted.

Psychometric Properties of the Health Literacy Scale Used in the Taiwan Longitudinal Study on Middle-Aged and Older People.

Health literacy, an important factor in public and personal health, is regarded as the core of patient-centered care. Older people with high health literacy are more likely to maintain a healthier lifestyle, with good control and management of chronic diseases, than those lacking or with poor health literacy. Purpose: The present study investigated the validity and reliability of the Taiwan Longitudinal Study on Aging (TLSA) Health Literacy Scale. We also evaluated the health literacy of middle-aged and older Taiwanese adults, and its probable association with health outcomes and life satisfaction. Method: We analyzed the internal consistency reliability of the nine items of the 2015 TLSA Health Literacy Scale, and their relationship with the demographic variables. Brody Instrumental Activities of Daily Living (IADL) and the Life Satisfaction Index were used for criterion validity. Moreover, exploratory factor analysis was used to examine the construct validity and to test the known-group validity. Results: The TLSA health literacy scale has good internal consistency reliability. Criterion-related validity was supported by the fact that the health literacy score was significantly correlated with the IADL and Life Satisfaction Index. Factor analysis indicated a three-factor structure. Known-group validity was supported by the results, showing that middle-aged and older people with good self-reported health status had better health literacy. Conclusions: The TLSA health literacy scale is a reliable and valid instrument for measuring health literacy in middle-aged and older people.

Influencing Factors of Psychological Well-Being of the Non-designated Hospital Staff in China During the COVID-19 Pandemic.

Background: Recent studies report that hospital staff at the forefront of caring for COVID-19 patients experience increased psychological distress. To effectively manage the outbreak of COVID-19, China established COVID-19 designated and non-designated hospitals. To date, few studies have examined the impacts of COVID-19 on psychological health of staff working at non-designated hospitals. This study is to explore factors affecting psychological health of non-designated hospital staff in China during the COVID-19 pandemic.Methods: Data were collected through an online questionnaire between February and March 2020. The questionnaire consists of General Health Questionnaire (GHQ-20), Social Support Rating Scale (SSRS), Simplified Coping Style Questionnaire (SCSQ), sociodemographic characteristics, employment history, health status, and contact history of COVID-19. The questionnaire was distributed through hospital WeChat groups and work colleague referrals. A total of 470 non-designated hospital staff members completed the questionnaire. Multiple Linear Regression analysis was used to interpret the associations among social support, coping styles, sociodemographic factors, job roles, and psychological status. Data were analyzed using SPSS version 21.0.Results: The non-designated hospital staff differed significantly in anxiety and depression subscores of the GHQ-20 by their job roles, levels of social support, and history of mental disorders. Staff with medical job roles, good self-reported health status, no previous mental disorders, adequate social support, and positive coping styles scored lower in GHQ-20 total score, which indicated healthier psychological status.Conclusions: The results indicate that history of mental health disorders, non-medical job roles, and inadequate social support are associated with greater psychological distress. Personalized support should be provided to those who are vulnerable and in need of social and psychological support.

Sleep Status and the Associated Factors: A Large Cross-Sectional Study in Shaanxi Province, China.

This study aimed at investigating the sleep status and its associated factors in Shaanxi province, China. We conducted a cross-sectional study among 11,399 subjects in Shaanxi Province, China. Data were collected via spot field questionnaire surveys. The contents included demographic characteristics, sleep status, lifestyles, disease history and other associated factors. Logistic regression analysis was used to estimate the effect of associated factors on sleep quality. A total of 11,036 subjects were included in the final analysis. In total, 12.8% of the participants had bad or very bad sleep. In the last month, 8.4% of the participants had difficulty in initiating sleep, 7.6% of the participants had difficulty in maintaining sleep, 8.8% of the participants suffered from awakening earlier and 10.3% of the participants had the problem of feeling sleepy during the day ≥3 times per week. Poorer sleep quality was associated with being female, being unmarried or without cohabiting with a boyfriend/girlfriend, being divorced or widowed, heart diseases, musculoskeletal diseases, concerns about their own health, drinking alcohol, taking hypnotics, and a longer daily screen time. Better sleep quality was associated with medium education level, high family monthly income, good self-reported health status, and having breakfast regularly. In conclusion, more than one in ten people did not sleep well and suffered from different sleep problems in Shaanxi, China. Sleep quality was associated with sex, marital status, educational level, family monthly income, heart disease, musculoskeletal diseases, degree of concerning about their own health, self-reported health status, drinking alcohol, having breakfast, taking hypnotics and daily screen time.

Self-reported health status and the associated risk of mortality in heart failure: The DANISH trial

ObjectiveTo examine the gradual association between self-reported health status and mortality in patients with heart failure (HF) as current research has focused on poor health status and increased risk of mortality. MethodThis is a substudy of the DANISH (Defibrillator Implantation in Patients with Nonischemic Systolic HF) trial in which 1116 patients were randomized to receive or not receive an implantable cardioverter-defibrillator. Health status was assessed by a single question of the Short-Form 36. Patients were classified as having excellent/very good, good, fair (reference) or poor health status. We assessed the association between health status and mortality using multivariable Cox proportional hazard models. ResultsSelf-reported health status was completed by 943 (84%) patients at randomization with a median follow-up of 67 months and a health status distribution of; excellent/very good (n = 79, 8%), good (n = 369, 39%), fair (n = 409, 43%), and poor (n = 86, 9%). All-cause mortality (death events/ 100 person-years) occurred with gradual differences according to health status from excellent/ very good (2.14), good (3.74), fair (5.21) to poor health status (5.57). The gradual difference yielded a crude hazard ratio (HR) of 0.40, 95% CI 0.20–0.80 (adjusted HR 0.47 (95% CI 0.23–0.95) for excellent/ very good health status, HR 0.71, 95% CI 0.52–0.97 (adjusted HR 0.78 (95% CI 0.56–1.08) for good health status. Poor being worse than fair health status yielded a crude HR of 1.07, 95% CI 0.67–1.69. ConclusionExcellent/very good self-reported health status as assessed by a single question was associated with lower long-term mortality in patients with HF.

Factors Associated with High Patient Activation Level among Individuals with Metabolic Syndrome at a Primary Care Teaching Clinic.

Background: High activation level has been associated with higher education background, better self-rated health status, and having adequate health literacy. However, there is a gap in the literature regarding the level of activation and the factors associated with it among patients with metabolic syndrome (MetS) in the Malaysian primary care setting. Objectives: This study aims to determine activation levels and the factors associated with high activation among individuals with MetS in primary care. Methods: A cross-sectional study was conducted at a university primary care clinic. Patient activation was measured using the Patient Activation Measure®–13 Malay version. Activation levels were dichotomized into “low activation” (levels 1 and 2) and “high activation” (levels 3 and 4). To determine the factors associated with high activation, simple logistic regressions (SLogR) followed by multiple logistic regressions (MLogR) were performed. Results: Of 333 participants, 280 (84.1%) were included in the final analysis. The mean activation score was 59.4 (SD ±10.20) and 61.8% had high activation level. Two variables were found to be significant on MLogR. Those who were employed have the odds of 3.135 (95% CI 1.442-6.816) of having high activation compared with those who were unemployed. Those with good self-reported health status have the odds of 6.482 (95% CI 1.243-33.792) of having high activation compared to those with poor self-reported health status. Conclusions: The majority of participants had high activation levels. Those who were employed and those who had good self-reported health status were more likely to have high activation levels. Findings of this study could be used to develop patient activation interventions to improve self-management skills among individuals with MetS in primary care. These may include problem solving support, individualized care plans, peer or family support, and skill building. Those in high activation group can be trained to become mentors to support their peers who have low activation level.

Factors associated with healthcare utilization among community-dwelling elderly in Shanghai, China.

ObjectiveThe objective of this study was to evaluate the factors associated with the health status of older Chinese people living in the community, in order to inform strategies to expand access to healthcare.MethodsTwo-phase stratified cluster sampling was applied; 2000 older people participated in this study. Face-to-face interviews were conducted in Shanghai between June and August, 2011. Descriptive analysis was used to examine the respondents’ characteristics. Based on Andersen’s healthcare utilization model, a chi-squared test and multiple logistic regression were performed to examine the influences of predisposing, enabling, need, and contextual factors on healthcare utilization.ResultsWe found that 44.5% of the older people in the sample had good self-reported health status, while 12.8% were poor, 14.5% had visited hospitals or clinics as outpatients in the previous two weeks, and 16.5% had been hospitalized in the previous year. Logistic regression analysis revealed that outpatient health services were more likely to be used by women and those whose income was from friends or social relief, who had poor to good self-reported health status, who were experiencing declining health, who engaged in volunteer activities, and who had chronic diseases. Meanwhile, hospitalization was more likely among those in the older age groups, those with pension income, living in outer suburbs, with poor self-reported health status, experiencing difficulty with activities of daily living and outdoor activities, or having a chronic disease.ConclusionsThe results showed the impact of economic status, health status, demographic and social characteristics, and other factors on the health service utilization of elderly people living in the community in Shanghai. Need variables were the strongest predictors of health service use, although contextual factors also contributed.

Prostate cancer-specific anxiety and the resulting health-related quality of life in couples.

To explore health-related quality of life (HRQOL) and its individual or mutual influences in people with prostate cancer and their spouses. Few studies have explored the influence of prostate cancer-specific anxiety of these people and their spouses on their individual or mutual HRQOL. Repeated-measures design. Data on 48 dyadic of people and their spouses were collected from August 2015 - December 2016. Before the people' treatment for prostate cancer, the first data collection occurred for the people and their spouses. The second to fifth data collections were conducted 6, 10, 18, and 24weeks after the initial measurement. The variables concerned health status, marital satisfaction, positive affect, negative affect, prostate cancer-specific anxiety, and HRQOL. The Actor-Partner-Interdependence Model was adopted for data analysis. The people who had better physical HRQOL were those with good self-reported health status, higher positive affect and lower prostate cancer-specific anxiety. Better physical HRQOL was observed in the spouses who had good self-reported health status and had lower prostate cancer-specific anxiety. The people with localized cancer stages and lower negative affect had a better mental HRQOL. Better mental HRQOL was detected in spouses who had higher marital satisfaction, higher positive affect and lower negative affect. Nurses can improve the HRQOL of people and their spouses by implementing activities that promote health and energy and reduce stress and by administering a mindfulness intervention.

THE RELATIONSHIPS BETWEEN SELF-REPORTED HEALTH STATUS AND SUBJECTIVE HEALTH LITERACY AMONG YOUNG ADULTS IN LITHUANIA

Seeking to successfully act in the 21st century, a person should have a relatively big spectrum of abilities and competences; in other words, s/he should develop literacy in a number of spheres. Health literacy is essential for a person’s daily capability to manage own health and the quality of life, which is dependent on it. It is significant for the social and economic development of the society. The purpose of the research was to identify the relationships between subjective health literacy and self-reported health status among young adults in Lithuania. The methods of the research included the analysis, interpretation and generalisation of scientific literature on the topic of research, as well as anonymous questionnaire survey. Self-reported health status was ascertained by a single WHO recommended question: “How is your health in general?” Subjective health literacy of young adults was measured using an HLS-EU-Q-47 questionnaire. The survey was conducted in 2014. The research sample included 798 young adults. The results showed high correlation between health literacy in the three health relevant areas and general health literacy. Having generalised the research data, it was noted that the young adults with good/very good selfreported health status tend to achieve sufficient or excellent levels of health literacy on health care, disease prevention or health promotion and general health literacy.

Elderly’s Self-Rated Health Status and Functional Capacity at the District Level in Indonesia

This study aims to fill the knowledge gap on the issues related to health status and functional capability of older persons aged 60 years and above at the district level where the policy making process is taken place and assess the relationship between the two. It describes an ecological study derived from 388 selected districts covered by the Indonesian 2005 Population Intercensal Survey. Descriptive analysis and a series of multiple regressions were employed. Sex, type of district, and location of the districts were also included in the analysis. The study found a wide range of older people reporting to be in good health, from 7 to 68 % across districts. The percentage of people reporting good health was generally lower among females, and those living in regencies and outside Java/Bali Islands. Functional self-reported capacity or (instrumental) activities of daily living (IADL) also varied across districts. The percentage of elderly reporting “no help needed” in functioning physical activities ranged from 30 to 96 %. This study also took into account different types of ADL (getting dressed, using the toilet, taking a bath, and eating) and IADL (preparing a meal). Regression analysis showed that a good self-reported health status (SRHS) was associated with good overall functional capacity. Good SRHS was statistically related to difficulty in bathing and eating, as well as with difficulties in preparing a meal, but not with getting dressed or using the toilet. Controlling for other variables, sex remained significant in analyses needing help in functional activities of daily living, and in needing help in taking a bath. Those living in rural regencies and on islands outside the Java/Bali districts may also need more support and governmental resources to reduce differences in functional capability.

Heterogeneity in Healthy Aging

For a surprisingly large segment of the older population, chronological age is not a relevant marker for understanding, measuring, or experiencing healthy aging. Using the 2003 Medical Expenditure Panel Survey and the 2004 Health and Retirement Study to examine the proportion of Americans exhibiting five markers of health and the variation in health-related quality of life across each of eight age groups, we find that a significant proportion of older Americans is healthy within every age group beginning at age 51, including among those aged 85+. For example, 48% of those aged 51-54 and 28% of those aged 85+ have excellent or very good self-reported health status; similarly, 89% of those aged 51-54 and 56% of those aged 85+ report no health-based limitations in work or housework. Also, health-related quality of life ranges widely within every age group, yet there is only a comparatively small variation in median quality of life across age groups, suggesting that older Americans today may be experiencing substantially different age-health trajectories than their predecessors. Patterns are similar for medical expenditures. Several policy implications are explored.

Prevalência de adultos e idosos insuficientemente ativos moradores em áreas de unidades básicas de saúde com e sem Programa Saúde da Família em Pernambuco, Brasil

The epidemiological transition in Brazil has been explained partially by the low levels of physical activity. However, few studies have explored physical inactivity in low-income population groups. Within this context, primary healthcare units gain strategic importance. This article describes the prevalence of sedentary lifestyle and associated factors in a cross-sectional study, including 1,018 adults and 1,010 elderly adults in 10 cities in Pernambuco State. Prevalence of sedentary lifestyle was 37.8% (95%CI: 34.0-40.2) in adults and 68.3% (95%CI: 65.3-71.3) in the elderly. Identification of physical activity as the most important factor for good health was associated with sedentary lifestyle in elderly adults. A lower proportion of sedentary lifestyle among non-elderly adults was associated with good self-reported health status. We concluded that sedentary lifestyle prevalence is high in elderly and non-elderly people covered by primary healthcare units in Pernambuco State as compared to the South of Brazil.

Social determinants of self-evaluated good health status of rural men in Jamaica

A comprehensive literature review revealed a gap in health research regarding the determinants of good health for rural men in Jamaica. This study seeks to fill this void by examining cross-sectional survey data to model the social determinants of the self-reported good health status of rural men in Jamaica. A sample of 5041 males (> or = 15 years) was extracted from a national cross-sectional survey of 25 018 respondents. A stratified random probability sampling technique was used to draw the sample. Data were stored, retrieved and analyzed using SPSS for Windows 16.0 (SPSS; Chicago, IL, USA). Descriptive statistics were used to provide pertinent socio-demographic characteristics of the sample, and logistic regression was used to establish a predictive model for good self-reported health status in rural Jamaican males. Seventeen percent of rural men claimed that they had poor health, 4.9% had health insurance, 61.6% visited a healthcare practitioner, 96.0% purchased prescribed medications and 45.3% completed the course of prescribed medications. The social determinants of good health status of rural men in Jamaica are cost of medical care (OR = 0.916, 95% CI = 0.841-0.997); retirement income (OR = 0.0.382, 95% CI = 0.206-0.707); marital status: separated, divorced or widowed with reference to those never married (OR = 0.270, 95% CI = 0.178-0.410), and married with reference to never married men (OR = 0.465, 95% CI = 0.356-0.609); health insurance coverage (OR = 0.041, 95% CI = 0.027-0.063); number of children in household (OR = 1.200, 95% CI = 1.069-1.347); and number of durable goods owned (OR = 1.107, 95% CI = 1.050-1.166). Children continue to be not only futuristic assets to parents, but they also currently improve the health status of rural men.

Factors Explaining Disability-free Life Expectancy in Japan: the Proportion of Older Workers, Self-reported Health Status, and the Number of Public Health Nurses

BACKGROUND: Disability-free life expectancy (DFLE) data for 47 prefectures in Japan were reported in 1999; however, few studies have identified the factors associated with the length of the DFLE. The objective of this study was to elucidate the primary factors that explain differences in DFLEs in Japan.METHODS: In our ecological study, 47 prefectures in Japan were used as units of analysis. The DFLEs for men and women at 65 years of age (DFLE65), calculated by Hashimoto et al using Sullivan’s method, were set as dependent variables. From various national surveys, 181 factors associated with demographics, socioeconomic status, health status and health behaviors, medical environment, social relationships, climate, and other areas were gathered as independent variables. Pearson’s or Spearman’s correlation coefficients were calculated to screen independent variables potentially associated with the DFLE65s. Then, multivariate linear regression analyses were conducted for the selected 24 independent variables after adjusting for the proportion of older people (65 years or more) and population density.RESULTS: Multivariate linear regression analyses revealed that the large number of public health nurses per 100,000 population, a good self-reported health status, and a high proportion of older workers were significantly associated with long DFLE65s for both genders.CONCLUSIONS: These three factors could potentially explain the differences in DFLE of the older population in Japan.

The Fort McMurray demonstration project in social marketing: Health- and safety-related behaviour in a prosperous industrial community

This is the first in a series of surveys conducted in Fort McMurray, Alberta, Canada, as part of the Fort McMurray Demonstration Project in Social Marketing. The Project is a community-based, cooperative program designed to demonstrate and to evaluate the application of social marketing and community animation to health- and safety-promoting interventions. This baseline survey was for the purpose of planning specific interventions and to support evaluation of the impact of these interventions. In 1992, a survey of Fort McMurray residents was conducted by telephone. Respondents to the survey tended to be disproportionately women (60%) and aged 30 to 44 (men 55%, women 54%). Most of the findings reported describe a generally affluent community with good self-reported health status and satisfaction in the quality of life. Occupational and personal health-and safety-related behaviours showed some contradictions. Both hearing protection and eye protection are much more frequently practiced at work than at home by both men and women. Protection from ultraviolet radiation, in the form of sunscreens or clothes cover, is practiced with about the same frequency at home or at work, suggesting that this behaviour is conditioned by lifestyle attitudes. Warm-up exercises are much more commonly practiced by both men and women before exertion at home than at work. We conclude that safety-related practices at home and at work are often at variance. The strategy of encouraging generalization of safety-related behaviours, to be practiced consistently both at home and at work, seems to hold promise for achieving greater compliance and promoting both community and workplace safety.