Objective Health Indicators Research Articles

Influence of work-related factors and individual characteristics on work ability among Dutch construction workers

The objective of this study was to evaluate the association of individual characteristics, health problems, lifestyle factors, and work-related factors with work ability among Dutch construction workers. In this cross-sectional survey, the study population consisted of 19 507 Dutch construction workers who had participated in a voluntary periodic medical examination in 2005 and for whom complete information on laboratory tests and spirometry was available. The main outcome of the study was work ability, measured by the work ability index. Independent variables consisted of physical and psychosocial work-related factors, individual characteristics, lifestyle factors, and some objective health indicators. Multiple linear and logistic regression models were used to determine the influence of different factors on work ability. Physical workload and, to a less extent, psychosocial factors at work together explained 22% of the variability in work ability. Age, leisure-time physical activity, lung obstruction, and cardiovascular risk profile explained about 10% of the workers' ability to work, but, when adjusted for work-related risk factors, their effects became very small. Awkward back posture, static work postures, repetitive movements, and lack of support at work had the highest influence on work ability. In the construction industry, work-related risk factors were the most important in association with work ability. This finding suggests that interventions aimed at preventing construction workers from dropping out of the workforce should primarily focus on reducing physical and psychosocial load at work.

Healthy, wealthy and insured? The role of self‐assessed health in the demand for private health insurance

Both adverse selection and moral hazard models predict a positive relationship between risk and insurance; yet the most common finding in empirical studies of insurance is that of a negative correlation. In this paper, we investigate the relationship between ex ante risk and private health insurance using Australian data. The institutional features of the Australian system make the effects of asymmetric information more readily identifiable than in most other countries. We find a strong positive association between self-assessed health and private health cover. By applying the Lokshin and Ravallion (J. Econ. Behav. Organ 2005; 56:141-172) technique we identify the factors responsible for this result and recover the conventional negative relationship predicted by adverse selection when using more objective indicators of health. Our results also provide support for the hypothesis that self-assessed health captures individual traits not necessarily related to risk of health expenditures, in particular, attitudes towards risk. Specifically, we find that those persons who engage in risk-taking behaviours are simultaneously less likely to be in good health and less likely to buy insurance.

Mr. Harrington, Self-Rated Health and the Canadian Chicken

The simplest way to find out how healthy people are is to ask them. The question: "Would you rate your health as excellent, very good, good, fair or poor?" is quick and easy (and cheap) to administer, and correlates well with more objective indicators of health (such as subsequent death). But there are significant cross-national differences in response patterns. Canadians are much less likely than Americans to provide extreme responses - excellent or poor. International comparisons yield more striking examples. Americans rate their health among the highest in the OECD, despite mortality measures that are among the worst. The Japanese, with the world's best mortality measures, rate their health near the bottom. Can self-reports be standardized for these cultural effects?

THE EFFECT OF MARKET ECONOMIES ON THE WELL-BEING OF INDIGENOUS PEOPLES AND ON THEIR USE OF RENEWABLE NATURAL RESOURCES

Assessing the effects of markets on the well-being of indigenous peoples and their conservation of natural resources matters to identify public policies to improve well-being and enhance conservation and to test hypotheses about sociocultural change. We review studies about how market economies affect the subsistence, health, nutritional status, social capital, and traditional ecological knowledge of indigenous peoples and their use of renewable natural resources. Market exposure produces mixed effects on well-being and conservation. Unclear effects arise from the small sample size of observations; reliance on cross-sectional data or short panels; lack of agreement on the measure of key variables, such as integration to the market or folk knowledge, or whether to rely on perceived or objective indicators of health; and endogeneity biases. Rigorous empirical studies linking market economies with the well-being of indigenous peoples or their use of renewable natural resources have yet to take off.

Pessimistic Explanatory Style and Cardiac Health: What is the Relation and the Mechanism that Links Them?

This study examined the relation between pessimistic explanatory style and cardiac health among a sample of cardiovascular disease patients participating in cardiac rehabilitation programs. Data were collected from 72 patients at the beginning and end of their cardiac rehabilitation programs. Participants completed questionnaires assessing explanatory style, depressive symptoms, and subjective appraisals of cardiac health. Objective indicators of cardiovascular health were collected from participants' medical files. Results showed that the stable dimension of pessimistic explanatory style had a direct and negative effect on self-reported cardiac health appraisals over the course of cardiac rehabilitation. Although there was support for partial mediation cross-sectionally, findings did not support prospective mediation by depressive symptoms for the relation between pessimistic explanatory style and cardiac health appraisals.

Psychosocial Predictors of Health Status Revisited

A one-year prospective design was used to explore health care costs, claims, and job burnout in relation to the following predictors: work and life stress, social support, exercise, Type A behavior, and personal hardiness. Nowack's (1991) model guided the study. A sample of 260 working adults from two organizations participated. Bivariate correlational results suggested that stressful work events were positively related to health care costs and the number of claims filed. With regard to job burnout, (a) stress appeared positively related to personal accomplishment and (b) Type A behavior was associated with greater emotional exhaustion. Higher job satisfaction, social support, and Type A behavior were associated with an increased sense of personal accomplishment. Findings concerning objective health indicators are discussed in relation to previous results pertaining to self-reports of health/illness.

The effects of intervention with local electrostatic air cleaners on airborne dust and the health of office employees

The aim of this intervention study was to identify any health improvements in the upper and lower airways of office workers after the installation of local electrostatic air cleaners. Eighty persons with airways symptoms were recruited and randomly assigned to an intervention or control group. Half of the air cleaners had a non-functioning electrostatic unit. Both participants and field researchers were blinded to the group status. Subjective symptoms were recorded using a questionnaire, and indexes calculated for general, irritation and skin symptoms. Objective respiratory health indicators were recorded, with acoustic rhinometry and peak expiratory flow (PEF) meters. In the intervention group there was a decrease in mean dust concentration from 65 to 35 microg/m(3), and a reduction from 57 to 47 microg/m(3) in the control group (P < 0.05 for difference in decline). The reduction was observed for all particles sizes. The irritation and general symptom indices decreased in both groups, but there was no improvement in the intervention group, compared with the control group. Median PEF increased 3 ml/s in the intervention group, and decreased 4 ml/s in the control group. The adjusted odds ratio for an increase above the 70th percentile was 5.7 (95% CI 1.0-32). Electrostatic air cleaners can reduce the dust concentration effectively in the office environment. Small, medium and large sized particles can be reduced by approximately 50%, relatively most effectively for the respirable particles. However, the air cleaners tested in this study produced an annoying fan noise. Cleaning efficiency and noise data should be given consideration before installation. This experimental field study suggests that office workers with airways symptoms may benefit from installation of local electrostatic air cleaners.

Subjektive Gesundheit als Prädiktor für Mortalität

In the last two decades self-rated health has received growing interest in international studies because of its consistent prediction for mortality. However, for Germany there are no studies confirming a long-term effect independent from objective health indicators in comparison of different follow-up. On the basis of the Life-Expectancy-Study (1984/86 - 1998) from the Federal Institute for Population Research it was possible to analyze the association between subjective health and mortality in relation to the length of observation. A stronger correlation between bad self-rated health and objective health status could be indicated because of a better prediction for mortality in a short-term follow-up. The evidence of a significant effect between self-rated health and mortality in the long-term follow-up not including the deaths from the short-term follow-up indicates that the mechanisms between subjective health and mortality are more complex than those between objective health status and death.

Subjektive Gesundheit als Prädiktor der Mortalität

Hintergrund: Durch zahlreiche internationale Studien wird bestätigt, dass die subjektive Gesundheitseinschätzung auch bei Kontrolle des objektiven Gesundheitsstatus eine hohe Prädiktivität für die Mortalität besitzt. Ziel: Untersucht wird, ob sich der Zusammenhang zwischen subjektiver Gesundheit und Mortalität auch in Deutschland beobachten lässt und ob in dieser Hinsicht Geschlechtsunterschiede bestehen. Außerdem wird gefragt, ob die Prädiktivität mit der Länge des Beobachtungszeitraums variiert. Methoden: Die statistischen Analysen basieren auf Daten des Lebenserwartungssurveys des Bundesinstitutes für Bevölkerungsforschung. Die Erstbefragung dieser Längsschnittuntersuchung wurde 1984–86 im Rahmen der Deutschen Herz-Kreislauf-Präventionsstudie durchgeführt und 1998 für die Jahrgänge vor 1952 wiederholt. Mittels Cox-Regressionsanalysen wird der Einfluss der subjektiven Gesundheit auf das Mortalitätsrisiko bestimmt, unter Berücksichtigung von soziodemografischen Merkmalen, Gesundheitsverhalten und objektiven Gesundheitsindikatoren (die Fallzahl für die Auswertungen beträgt N=6.670, von denen 892 im Beobachtungszeitraum gestorben sind). Ergebnisse: Die subjektive Gesundheit übt einen Einfluss auf die Mortalität aus, der bei Männern stärker ausgeprägt ist als bei Frauen. Nach Einbeziehung möglicher Confounder und Mediatoren bleibt der Effekt bei Männern signifikant, bei Frauen sinkt er knapp unter die Signifikanzgrenze. Den größten erklärenden Anteil des Zusammenhangs zwischen subjektiver Gesundheit und Mortalität kommt dem objektiven Gesundheitsstatus zu. Bezüglich der Länge der Follow-ups zeigt sich eine deutlich höhere Prädiktivität schlechter subjektiver Gesundheit für Mortalität innerhalb der ersten 5 Jahre. Der Zusammenhang bleibt aber auch bei längerfristiger Beobachtung bedeutsam. Diskussion und Schlussfolgerung: Die Ergebnisse zum Einfluss der subjektiven Gesundheit auf die Mortalität decken sich mit dem internationalen Forschungsstand. Weiteren Aufschluss versprechen Analysen, die eine genauere Erklärung kurzfristiger und langfristiger Effekte der subjektiven Gesundheit auf die Mortalität ermöglichen. Insbesondere eine genauere Erfassung objektiver Gesundheit könnte die Frage klären, ob subjektive Gesundheit ein Indikator für den objektiven Gesundheitszustand ist oder darüber hinaus einen unabhängigen Einfluss auf die Mortalität hat.

Breakfast Cereal Consumption and Subjective Reports of Health by Young Adults

The aim of the present research was to extend previous research which has shown that consumption of breakfast is associated with reports of better health. Previous research has confirmed this in samples in the age ranges from mid-twenties to early eighties. The present study considered young adults (189 volunteers, aged between 19-21 years, mean age 19.6 years) living at home. The results showed that skipping breakfast is associated with reports of poorer health and that regular breakfast cereal consumption is associated with better reported health. The effects of breakfast could not be explained by other health-related behaviours or other aspects of diet. Further research is now required to determine the mechanisms underlying this robust association to examine whether it is observed with objective indicators of health and specific diseases.

VALIDATION OF THE HEALTH PERCEPTIONS QUESTIONNAIRE FOR AN OLDER MEXICAN POPULATION

The objective was to translate, adapt, and validate the Health Perceptions Questionnaire for use on an older Mexican population. After translating and pretesting, three items were eliminated and answers were dichotomised. In the scale, 24 items were used to interview a representative sample of 4,966 respondents. Internal consistency was .91. Principal components analysis for categorical data gave four similar factors to those reported in the original version. Scoring was made by weighting items, using (A) homogeneous values (1 or 2) or (B) factor loadings (0–1.0). Scoring A is proposed for clinical settings or research since no differences were found and this procedure is easier to compute. Objective health indicators such as chronic diseases, depression, incontinence, death during follow up, and disability were associated with the self-perception of health measured with the revised version.

Self-perceived effects of sexual trauma among women who smoke crack.

This descriptive study examined how Black women who smoke crack cocaine spoke about their experiences of sexual trauma, drug use, and the implications of these experiences for their lives. The authors also explored whether the women's perceptions of the effects of sexual abuse were related to objective indicators of mental health and drug use. The most commonly reported effects of sexual trauma were feeling dirty or ashamed or blaming self, having negative feelings toward the perpetrator, experiencing a general dislike of men or sex, and reporting a conscious reluctance to cope with the incident. In addition, conscious or unconscious denial of the effects of sexual trauma was associated with use of drugs to cope with intrapersonal and interpersonal feelings, inwardly directed responses to the trauma (e.g., self-blaming, feeling ashamed) were positively related to depression, and outwardly directed responses to the trauma (e.g., anger at the perpetrator) were positively related to self-esteem. These findings are discussed in terms of their implications for the self-medication model of substance use, treatment implications for women who have been sexually abused, and the role of self-perception in the relationship between sexual trauma and long-term outcomes.

Successful Use of Hypnosis as an Adjunctive Therapy for Weaning from Mechanical Ventilation

HYPNOTIC techniques have been used in medical practice in different situations, mainly for pain control and anxiety relief 1-6 and to reduce stress symptoms such as tachycardia or shivering. 7 In burn victims, Crasilneck et al. showed that hypnosis could stimulate emotional recovery, mobility, and wound healing. 8 Hypnosis could also reduce by one third the incidence of postoperative nausea and vomiting in women undergoing breast surgery. 9 In the case we report, hypnotic psychotherapy resulted in hastened weaning from mechanical ventilation as well as to reestablishment the day-night sleep cycle.

The role of objective health indicators and neuroticism in perceived health and psychological well-being among patients with chronic heart failure

A total of 119 clinically stable patients with symptomatic congestive heart failure (34 females, 85 males) were recruited from an outpatient hospital practice to explore the role of objective health indicators and neuroticism in subjective health (physical limitations) and psychological well-being. Patients were grouped according to the New York Heart Association functional class criteria (NYHA: indicator of functional status) and proatrial natriuretic factor (proANF), a cardiac hormone that maintains normal fluid balance and vascular resistance. Scores on these two objective indicators of disease severity were generally unrelated to psychological measures, whereas neuroticism scores (EPQ-N) were significantly correlated with indicators of subjective health (perceived disease-related physical limitations) and psychological well-being (depression, general life-satisfaction). Significant interactions between proANF and neuroticism appear due to low physical limitation score among subjects with elevated level of proANF and low scores on neuroticism. High physical limitation was reported by subjects with high level of proANF as well as high scores on neuroticism. Moreover, a marginal significant interaction between NYHA and EPQ-N scores in relation to severity of depression was detected by analyses from two-way ANOVA. Gender differences were due to higher proANF scores in males than females, whereas females scored higher than males on EPQ-N, perceived physical limitation and depression. Results from path analyses supported an indirect effect of neuroticism via perceived physical limitation for males. Possible mechanisms involved in these relations are discussed.

Self-rated health among Hispanic vs non-Hispanic white adults: the San Luis Valley Health and Aging Study.

This study investigated whether objective health indicators explained lower self-rated health among Hispanics compared with non-Hispanic Whites. It also considered socioeconomic and cultural explanations. Health ratings of 429 Hispanics and 583 non-Hispanic Whites aged 20 through 74 were analyzed with logistic regression. Illness indicators were found to be strongly correlated with self-rated health in both ethnic groups, but after such markers were controlled for, Hispanics remained 3.6 times more likely to report fair or poor health (95% confidence interval = 2.4, 5.3). Adjustment for socioeconomic factors accounted for a portion of Hispanics' lower health rating, but the strongest explanatory factor was acculturation. Because of cultural and economic influences on definitions of health, ethnic differences in self-assessed health may not accurately reflected patterns resulting from objective health measurements.

Looking after health: the Basque health care reform

The Basque health care system is at present a national service, based on the principles of universal care and equity, similar to those found in countries such as the United Kingdom or Sweden. It was modelled on the British National Health Service (NHS), and on objective health indicators it can be seen to provide good value for money, and is at least as efficient as the NHS. However, as in the United Kingdom, the Basque Health Service is now going through a process of change, change that very much resembles that undergone by the NHS. This paper gives an overview of the Basque situation and describes the proposed new Basque Health Service, changes which were recently approved by the Basque parliament.

Understanding the context of perceived health ratings: The case of spousal bereavement in later life

Using a sample of 339 older adults at 2 to 3 months of bereavement the following research questions are addressed: What objective physical and psycho-emotional factors influence the perceived health ratings of older adults following the death of their spouses and how much of the variance in their ratings can be explained by the specific set of characteristics? This investigation helps to identify the major factors that older adults take into account in rating their perceived health. Perceived health status was most strongly related to the number of symptoms reported. The objective physical health indicators as well as grief and depression were significantly correlated with perceived health ratings. Nearly 41% of the variance in perceived health was explained by six factors of which 25.9% was due to the number of reported symptoms. Depression and medical conditions made a moderate contribution while the role of unresolved grief was minimal. Physician visits and days sick also made minor contributions. The general conclusion is that the bereavement context influences the factors that older adults take into account in their perceived health ratings and that it is important to recognize that perceived health ratings occur within and are influenced by personal and situational factors of the context.

Self-assessed health as predictor of objective health status among rural aged in Nigeria

Structured interviews of 112 old males and females in three rural locations in Nigeria examine the relationship between self-assessed health and four objective health indicators. Results show that although almost all of the respondents describe their health as 'better' or 'much better' than that of their peers, other health indicators reveal evidence of a generally poor health status. There was no significant association between self-assessed health and three out of the four objective health indicators. The best predictor of both objective and subjective health status was the degree of stress experienced by the respondents in the six months preceding the survey. Discussions examine possible reasons for the finding and pay particular attention to those factors which may encourage the overestimation of good health and underestimation of objective health failings among rural elderly in Nigeria.

Objective indicators of health in Western Zambia

In this paper a short introduction is given to the general topic of health and health related indicators, emphasizing the need and the difficulty to construct indicators which are appropriate for specific situations and specific questions. The non-existence of vital statistics in most Third World rural areas is then discussed, with comment on some solutions proposed to generate health indicators from defective data. It is argued that the problem becomes more urgent with the growing attention for primary health care programmes. A new indicator is then introduced, called the Survival Index, which is basically the relation between gravidity number and number of children alive. This indicator is illustrated with some preliminary data. The possible uses and restrictions are discussed and indications are given for further research needed for development of this indicator or related types.