Self-rated General Health Status Research Articles

Attitudes Toward Hysterectomy in Saudi Arabian Women Undergoing Evaluation for Uterovaginal Prolapse: A Cross-Sectional Study.

Hysterectomy isan effective management approach for uterovaginal prolapse. However, the decision to undergo hysterectomy is a complex matter, influenced not only by medical factors but also cultural beliefs, societal norms, and individual attitudes.In Saudi Arabia, a nation with its distinctive cultural and social norms, the understanding of women's attitudes toward hysterectomy is of utmost importance. Unfortunately, such related attitudes have not been explored. This first-ever study aimed to investigate the attitudes toward hysterectomy among Saudi Arabian women undergoing evaluation for uterovaginal prolapse, by exploring the factors influencing their decision-making process and treatment choices, with a particular focus on the potential impact of cultural beliefs and societal norms. A survey was conducted among 404 women referred for uterovaginal prolapse evaluation. The participants completed a self-administered questionnaire, which included demographic information, perceptions on hysterectomy's impact on well-being, and factors affecting decision-making. The mean ± standard deviation of participants was 51.07 ± 11.1 years. Most participants were currently married (n=327, 81%), were unemployed (n=309, 76.5%), and had an "excellent" self-rated general health status (n=138, 34%). Current prolapse management methods included Kegel exercises (n=103, 25.5%), pessary use (n=32, 8%), physical therapy (n=12, 3%), planned surgery (n=75, 18.5%), and no specific treatment (n=182, 45%). Overall, the study revealed diverse findings on the potential perceived impact of hysterectomy on different aspects of well-being. Notably, for pain symptoms, 152 participants (38%) reported potential improvement, while 123 participants (30%) predicted worsening, and 129participants (32%) anticipated no change. Moreover, the study unveiled insights into the factors influencing patients' decision-making between hysterectomy and uterine-sparing procedures. Remarkably, 97 respondents (24%) considered the doctor's opinion to be "very Important," while 91 respondents (22%) rated the impact on surgical complication risk as "very important." Furthermore, the desire to preserve all healthy organs was deemed "very important" by 106 respondents (26%). The resources of information women depended on when making a decisionto undergo hysterectomy varied and included a second opinion from another physician (n=68, 17%), social media (n=81, 20%), opinion from spouse/partner (21%), second opinion from female family members (n=99, 25%), and opinion from friends (n=70, 17%).Regarding preferences for decision-making, the responses varied substantially. Overall, 65 participants (16%) indicated a preference for their doctor to make the decision entirely, 81 participants (20%) preferred shared decision-making with their doctor, 89 participants (22%) wanted their doctor to make the decision after considering their input, 77 participants (19%) wished to make the final decision after discussing it with their doctor, and 93 participants (23%) expressed a preference for independently making the final decision. Lastly, correlations between women's responses and some demographic factors were identified. This pioneering study provides valuable insights into Saudi Arabian women's attitudes toward hysterectomy, emphasizing the need for patient-centered care and culturally sensitive approaches in managing uterovaginal prolapse.

Racism, self-rated general health status, and health-related quality of life among Black and Asian Americans

Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities. Extant research shows significant health inequities between white and Black people. However, little is known about health gaps between or among other racial groups. This study investigated how Blacks and Asian Americans perceive and experience racism in healthcare settings and in general daily life situations, and how these factors relate to their self-rated general health status and health-related quality of life. Findings from an online survey suggest strong similarities and subtle differences between the two racial groups and within the Asian subgroups.

Caregivers’ Self-Rated General Health, Physical and Mental Health Status, Disease Morbidity and Association with Uncontrolled Asthma in Children

This study examined the association between caregivers' self-rated general health, poor physical/mental health days, disease morbidity and asthma control in children from the United States with current asthma. The data analyzed for this study were obtained from 7522 children aged 0-17 years who participated in the 2012-2014, 2015-2017, 2018, and 2019 cycles of the Behavioral Risk Factor Surveillance System Asthma Call-back Survey (ACBS). We employed univariate analysis to describe the study population and weighted binary logistic regression to examine the association of predictors with asthma control. Approximately 50% of the children had uncontrolled asthma. The results show that caregivers who reported fair general health had a 61% higher likelihood of reporting uncontrolled asthma in their children compared to those who reported good/very good/excellent health (adjusted odds ratio [aOR] = 1.61; 95% confidence interval [CI], 1.14-2.26). Poor caregiver general health did not reach statistical significance in predicting uncontrolled asthma (aOR = 1.05, 95% CI, 0.62-1.75). Furthermore, having 1 to 14 poor physical/mental health days ([aOR] = 1.70; 95% CI, 1.28-2.227) and ≥15 poor physical/mental health days (aOR = 1.82, 95% CI, 1.31-2.53) was predictive of uncontrolled asthma in children. Additionally, endorsing one reported disease (aOR = 1.49, 95% CI, 1.15-1.93) and ≥2 diseases (aOR = 1.38, 95% CI, 1.08-1.78) was associated with uncontrolled child asthma. These findings underscore the association between caregivers' self-reported general health, poor mental/physical health days, disease morbidity and uncontrolled asthma among children from the U.S. with asthma. Pediatricians and child health practitioners should recall the importance of this relationship. To facilitate the identification of caregivers at risk and provide more comprehensive and effective care for children with asthma, healthcare practitioners should utilize every child asthma care encounter to inquire about the overall health of caregivers.

1063-P: Social Risks and Health-Related Quality of Life in Women Who Have Experienced Gestational Diabetes

Objective: To examine the relationship between social risk factors (housing instability and food insecurity) on health-related quality of life (HRQoL) in women with a previous diagnosis of gestational diabetes mellitus (GDM) . Methods: Cross-sectional data on women aged 18 and older from the Behavioral Risk Factor Surveillance System (2014, 2015, 2017) were analyzed. GDM was defined by self-reported diagnosis of diabetes only during pregnancy. Social risks were defined by experiences of housing instability or food insecurity within the previous year. Linear regression was run to evaluate the association between social risks and HRQoL controlling for sociodemographic confounders. Interaction terms between each social risk factor and race/ethnicity were tested for each outcome but were not significant, thus the analysis was not stratified. Results: Among the total study sample (weighted N=3,080,442) of adult women with a prior GDM diagnosis, 14.8% and 12.6% reported recent housing instability and food insecurity, respectively. Among women with prior GDM, housing instability was associated with reduced self-rated general health status (-0.36; 95%CI -0.53, -0.19) and increased days of poor mental health (4.81; 95%CI 1.23, 8.39) . Food insecurity was associated with reduced self-rated general health status (-0.43, 95%CI -0.59, -0.27) and increased days of poor mental health (5.29; 95%CI 1.95, 8.64) . Conclusion: Our findings indicate an inverse association between food insecurity and housing instability and self-rated general health status and mental health functioning among women with a prior GDM diagnosis. There was no differential relationship by race/ethnicity. These findings highlight the importance of interventions which address social risks to improve quality of life in women with a prior GDM diagnosis. Disclosure S.L.Walker: None. R.J.Walker: None. L.Hawks: None. E.Mosley-johnson: None. S.Nagavally: None. L.E.Egede: None. Funding American Diabetes Association (1-19-JDF-075) ; National Institute of Diabetes and Digestive Kidney Disease (K24DK093699, R01DK118038, R01DK120861, PI: Egede) , the National Institute for Minority Health and Health Disparities (R01MD013826, PI: Egede/Walker)

Social and emotional loneliness among older adults in a coastal suburb in Sri Lanka

Loneliness is defined as an unpleasant experience due to lack of social interactions. Older adults are more susceptible to loneliness resulting poor quality life. There is evidence that loneliness can have both physical and mental health consequences. Our cross-sectional study aimed to describe the prevalence and associated factors of social and emotional loneliness (SEL) among older adults in Hikkaduwa Municipality (HM), a suburb in Sri Lanka. A multistage cluster sample of 120 older adults were interviewed administering a questionnaire comprising of De-Jong-Gierveld Loneliness Scale. Prevalence of SEL was calculated. Chi-square test was used to describe associated factors of SEL. We found a high prevalence of SEL of 47.8% in HM. Unmarried/ widowed status, non usage of phones and self-rated poor general health status were significantly associated with SEL. Several sociodemographic and social and health related factors significantly related to loneliness were observed, calling for further exploration of this to improve the life of the older adults. Interventions such as developing telephone hotlines, befriending schemes, facilitating to participate in activities of interest, frequent medical check-up are recommended.

Factors Associated With High Rates of Depressive Symptomatology in Older People in Vietnam

This study aimed to identify the prevalence and correlates of depressive symptomatology among Vietnamese older people. We used baseline survey data collected in 2018 from the Longitudinal Study of Ageing and Health in Vietnam (LSAHV) conducted across seven regions and comprising 6,050 people aged 60 years and over of whom 4962 completed the brief 11-item Center for Epidemiological Studies-Depression (CES-D) scale. Clinically significant depressive symptomatology was a CES-D score of 8.8 or higher. The association between demographic, physical, and mental factors with depressive symptomatology was examined using univariate and multivariable logistic regression. The prevalence of depressive symptomatology was 31.3% (95% CI 29.8% - 32.9%). Depressive symptomatology was highest among people living in the Central Coast region (46.8%, 95% CI 44.5% - 49.2%). Factors associated with depressive symptomatology from the multivariable model included female sex (OR 1.3, 95% CI: 1.1-1.6), rural residence (OR 1.4, 95%CI: 1.1-1.7), not having a partner (OR 1.6, 95% CI: 1.3-1.9), low income (OR 1.8, 95% CI: 1.5-2.1), and health-limitations on activities (OR 1.3, 95% CI: 1.1-1.6). Poorer self-rated mental health (OR 2.1, 95% CI:1.8-2.5) or general health status (OR 1.5, 95% CI: 1.3-1.9) was associated with a higher prevalence of depressive symptomatology, as was poorer function with respect to different activities of daily living, and dissatisfaction with current life (OR 6.1, 95% CI: 4.4-8.4). Depressive symptomatology was frequent among older Vietnamese. Efforts to improve mental health in older persons in Vietnam, including prevention, early intervention and better medical care, appear warranted.

Subgingival microbiome is associated with alveolar bone loss measured 5 years later in postmenopausal women.

The aim of this study was to quantify the association between subgingival microbiota and periodontal disease progression in older women, for which limited published data exist. A total of 1016 postmenopausal women, aged 53 to 81 years, completed baseline (1997 to 2001) and 5-year (2002 to 2006) dental exams that included probing depth, clinical attachment level, gingival bleeding, and radiographic alveolar crestal height (ACH). Baseline microbiota were measured in subgingival plaque using 16S rRNA sequencing. Associations between 52 microbiota we previously found statistically significantly associated with clinical periodontal disease at baseline, were examined with disease progression. The traditional Socransky microbiota complexes also were evaluated. Side-by-side radiograph comparisons were used to define progression as ≥2 teeth with ≥1mm ACH loss or ≥1 new tooth loss to periodontitis. The association between baseline centered log(2) ratio transformed microbial relative abundances and 5-year periodontal disease progression was measured with generalized linear models. Of 36 microbiota we previously showed were elevated in moderate/severe disease at baseline, 24 had statistically significantly higher baseline mean relative abundance in progressing compared with non-progressing women (P<.05, all); which included all Socransky red bacteria (P. gingivalis, T. forsythia, T. denticola). Of 16 microbiota elevated in none/mild disease at baseline, five had statistically significantly lower baseline abundance in non-progressing compared with progressing women (P< 0.05, all), including one Socransky yellow bacteria (S. oralis). When adjusted for baseline age, socioeconomic status, and self-rated general health status, odds ratios for 5-year progression ranged from 1.18 to 1.51 (per 1-standard deviation increment in relative abundance) for microbiota statistically significantly (P< 0.05) positively associated with progression, and from 0.77 to 0.82 for those statistically significantly (P< 0.05) inversely associated with progression. These associations were similar when stratified on baseline levels of pocket depth, gingival bleeding, ACH, and smoking status. These prospective results affirm clearly that subgingival microbiota are measurably elevated several years prior to progression of alveolar bone loss, and include antecedent elevations in previously undocumented taxa additional to known Socransky pathogenic complexes.

Association of academic performance, general health with health-related quality of life in primary and high school students in China

PurposeTo explore the association of academic performance and general health status with health-related quality of life (HRQoL) in school-aged children and adolescents in China.MethodsIn this cross-sectional study conducted in 2018, students (grade 4–12) were randomly chosen from primary and high schools in Nanjing, China. HRQoL, the outcome measure, was recorded using the Child Health Utility 9D, while self-rated academic performance and general health were the independent variables. Mixed-effects regression models were applied to compute mean difference (MD) and 95% confidence interval (CI) of HRQoL utility score between students with different levels of academic performance and general health.ResultsTotally, 4388 participants completed the study, with a response rate of 97.6%. The mean HRQoL utility score was 0.78 (SD: 0.17). After adjustment for socio-demographic attributes, physical activity, sedentary behavior, dietary patterns, body weight status and class-level clustering effects, students with fair (MD = 0.048, 95% CI 0.019, 0.078) and good (MD = 0.082, 95% CI 0.053, 0.112) self-rated academic performance reported higher HRQoL utility scores than those with poor academic performance, respectively. Meanwhile, students with fair (MD = 0.119, 95% CI 0.083, 0.154) and good (MD = 0.183, 95% CI 0.148, 0.218) self-assessed general health also recorded higher HRQoL utility scores than those with poor health, separately. Consistent findings were observed for participants by gender, school type and residential location.ConclusionsBoth self-rated academic performance and general health status were positively associated with HRQoL among Chinese students, and such relationships were independent of lifestyle-related behaviors and body weight status.

Aging Adults' Preferences for Wellness Program Activities and Delivery Characteristics: A Cross-Sectional Survey.

Lifestyle wellness programs help prevent and manage chronic diseases, yet few are designed for aging adults. Identify characteristics associated with aging adults' preferences for wellness program activities and delivery characteristics. Cross-sectional, self-administered survey of a convenience sample of 386 adults aged ≥55 years. Logistic regression models identified characteristics influencing preferences. Current healthy behaviors, gender, and age influenced many preferences, while BMI, multiple chronic conditions, self-rated general health status, and quality of life did not. Incorporating aging adults' preferences for wellness programs will help design appealing and engaging programs.

Changes in Self-Rated Physical Health After Moving Into Permanent Supportive Housing.

Homelessness is associated with poor health outcomes and heightened risk of premature mortality. Permanent supportive housing (PSH) is a key solution for ending homelessness, but there is insufficient evidence of a relationship between PSH and improvements in physical health. Self-rated health-a consistent predictor of mortality-is a meaningful approach to understanding health improvements in PSH. Longitudinal, observational design with interviews at baseline, 3-months, 6-months, and 12-months (with 91% retention at 12-months). Permanent supportive housing in Los Angeles, CA. Four hundred twenty-one adults moving into PSH (baseline interview prior to/within 5 days of housing). Three self-rated health assessments: general health status, and limitations to physical and social activity because of health problems. Generalized Estimating Equations (controlling for demographics and important health covariates; n = 420) found self-rated general health status improved between baseline and 3-months (coef: 0.13; 95% confidence interval [CI]: 0.02-0.24) and persisted at 12-months (coef: 0.16; 95% CI: 0.05-0.27). Improvements in limitations to physical or social activity because of health problems started at 6-months posthousing (physical: coef: 0.25; 95% CI: 0.12-0.39; social: coef: 0.18; 95% CI: 0.05-0.32) and persisted through 12-months (physical: coef: 0.14; 95% CI: 0.01-0.27; social: coef: 0.16; 95% CI: 0.02-0.29). Despite limitations associated with observational study design, these findings provide further evidence that PSH may improve health among those with homelessness histories.

Cognitive function and oral health among ageing adults.

There is inconclusive evidence that cognitive function is associated with oral health in older adults. This study investigated the association between cognitive function and oral health among older adults in England. This longitudinal cohort study included 4416 dentate participants aged 50years or older in the English Longitudinal Study of Ageing during 2002-2014. Cognitive function was assessed at baseline in 2002/2003 using a battery of cognitive function tests. The self-reported number of teeth remaining and self-rated general oral health status was reported in 2014/2015. Ordinal logistic regression was applied to model the association between cognitive function at baseline and tooth loss or self-rated oral health. Cognitive function at baseline was negatively associated with the risk of tooth loss (per each 1 standard deviation lower in cognitive function score, OR: 1.13, 95% CI: 1.05-1.21). When cognitive function score was categorized into quintiles, there was a clear gradient association between cognitive function and tooth loss (P-trend=0.003); people in the lowest quintile of cognitive function had higher risk of tooth loss than those in the highest quintile (OR: 1.39, 95% CI: 1.12-1.74). A similar magnitude and direction of association were evident between cognitive function and self-rated oral health. This longitudinal study in an English ageing population has demonstrated that poor cognitive function at early stage was associated with poorer oral health and higher risk of tooth loss in later life. The gradient relationship suggests that an improvement in cognitive function could potentially improve oral health and reduce the risk of tooth loss in the ageing population.

Exploring Digital Health Use and Opinions of University Students: Field Survey Study.

BackgroundDuring university, students face some potentially serious health risks, and their lifestyle can have a direct effect on health and health behaviors later in life. Concurrently, university students are digital natives having easy access to the internet and new technologies. Digital health interventions offer promising new opportunities for health promotion, disease prevention, and care in this specific population. The description of the current use of and opinions on digital health among university students can inform future digital health strategies and interventions within university settings.ObjectiveThe aim of this exploratory study was to report on university students’ use and opinions regarding information and communication technologies for health and well-being, taking into account sociodemographic and self-rated general and mental health correlates.MethodsThis field survey was conducted from March to April 2017. An informed consent form and a paper questionnaire were given to students aged 18 to 24 years in 4 university campuses in Bordeaux, France. The survey was formulated in 3 sections: (1) sociodemographic characteristics and self-rated general and mental health, (2) information about the use of digital health, and (3) opinions about digital health. Data were analyzed using descriptive statistics and tests of independence.ResultsA total of 59.8% (303/507 females) students completed the questionnaire. Concerning digital health use, 34.9% (174/498) had at least 1 health app mostly for physical activity (49.4%, 86/174) and general health monitoring (41.4%, 72/174,), but only 3.9% (20/507) of students had a wearable device. Almost all (94.8%, 450/476) had searched for Web-based health-related information at least once in the last 12 months. The most sought health-related topics were nutrition (68.1%, 324/476); pain and illnesses (64.5%, 307/476); and stress, anxiety, or depression (51.1%, 243/476). Although Wikipedia (79.7%, 357/448) and general health websites (349/448, 77.9%) were the most consulted sources, students considered institutional or official websites as the most credible sources (309/335, 92.2%). There were significant differences in digital health use by gender, field, and year of study. No statistically significant association was found between digital health use and self-rated general and mental health status. Concerning opinions on digital health, although 94.1% (475/505) of students estimated that today’s digital health cannot replace traditional health services and medical consultations, 44.6% (207/464) of students declared that this could be possible in the future, provided that digital health interventions are promoted by institutional or official entities.ConclusionsUniversity students are largely using the internet for health information seeking, but using less mobile health apps and very few wearable devices. Our data suggest that digital health has the potential for improving health and well-being at the university, especially if digital health interventions take into account students’ profiles, interests, and needs.

Examining fear-evoking factors in urban parks in Hong Kong

Understanding fear-evoking factors in urban parks is important for planning and management, but such research is lacking in many cities. This study examined three groups of fear-evoking factors, including inherent park characteristics (IPC), park design and management issues (PDMI), and visitor-related concerns (VC). Besides mainly environmental factors reported in the literature, new ones such as social and personal have been proposed to explore how they may evoke fear in park users. The relationships between the dependent (fear-evoking factors) and independent variables (park users’ socio-demographic and visit-related characteristics) were investigated. Primary data were gleaned by a questionnaire survey, encompassing 90 fear-related factors, 872 park users in eight study sites in Hong Kong. The results identified insufficient park gates as the most fearful factor among 18 IPC. The presence of critical substances such as unusual and undesirable wastes (e.g. syringes, condoms) evoked the most unsafe feelings among 21 PDMI. Of the 26 VC, the presence of critical park users, including drug addicts, drunken persons, suspected undesirable elements or thieves, and persons with suspected mental health problems induced key fear-evoking concerns. The presence of other non-critical park users generally lowered fearful feelings. Gender and self-rated general health status were the most influential socio-demographic factors. Overall, the fear-of-crime factors were subsumed under three groups, respectively affected mainly by PDMI, followed by VC and IPC. The findings provided cross-cultural insights and identified specific but rather eclectic factors to inform improvement of park safety by modifying planning and management inputs.

The association between dental, general, and mental health status among underserved and vulnerable populations served at health centers in the US.

Vulnerable populations in underserved communities are disproportionately at high risk for multiple medical, dental, and behavioral health conditions. This study aims to: a) examine the occurrence of acute dental needs and b) investigate the association of acute dental needs and self-rated general and mental health status among the adult dentate health center population. This cross-sectional study analyzed data on adult patients (n = 5,035) from the 2014 Health Center Patient Survey, a nationally representative survey of health center patients. Multivariate logistic regression was used to assess the association of acute dental needs and a) self-rated general health status and b) mental health status. Approximately, two thirds of adult dentate heath center patients reported having an acute dental need. After adjusting for confounding factors, not having or having had health insurance that pays for dental care, general health status of fair or poor, and ever having a mental illness were associated with higher odds of having an acute dental need. The results highlight the role of health centers in addressing oral health disparities among vulnerable populations and the importance of a team-based multidisciplinary approach to ensuring the integration and coordination of oral health services within a comprehensive primary care delivery system.

National survey of the Portuguese elderly nutritional status: study protocol.

BackgroundWorldwide we are facing a serious demographic challenge due to the dramatic growth of the population over 60 years. It is expected that the proportion of this population will nearly double from 12 to 22 %, between 2015 and 2050. This demographic shift comes with major health and socio-economic concerns. Nutrition is a fundamental determinant of both health and disease and its role in extending a healthy lifespan is the object of considerable research. Notably, malnutrition is one of the main threats to health and quality of life among the elderly. Therefore, knowledge about nutritional status among the elderly is essential for the promotion and maintenance of healthy ageing and to support the development of health protection policies and equity in elderly health care.MethodsThis is a nationwide nutrition survey of the Portuguese population over 65 years old, with data collection through face-to-face interviews. A representative and random sample of community dwelling elderly and nursing homes residents will be obtained by multistage sampling stratified per main Portuguese regions, sex and age groups. Minimum sample size was estimated to be 2077 elderly (979 in the community and 1098 in nursing homes). Data will be collected on food habits and eating patterns, nutritional status, food insecurity, lifestyle, self-rated general health status and self-reported diseases, functionality, loneliness, cognitive function, emotional status and demographic and socio-economic characterization.DiscussionThis is the first national survey to evaluate the prevalence of nutritional risk and malnutrition of the Portuguese population above 65 years old, including those living in nursing homes. It will allow the identification of population subgroups of elderly with increased odds of malnutrition and nutritional risk. In addition, this survey will contribute to the identification of psychosocial and clinical predictors of malnutrition among elderly, which is an important risk factor for other devastating medical conditions.

Health-promoting factors in the freshman year of medical school: a longitudinal study.

The freshman year of medical school is a stressful period in the lives of future doctors. Resilience to this stress differs greatly, leading to different health outcomes. Less resilient students, whose health may deteriorate early in their education, are at greater risk for developing stress-related diseases. Early identification of individuals at risk and the provision of tailored health-promoting interventions might prevent this. This study was designed to investigate: (i) how the health of medical students develops over the freshman year, and (ii) whether certain protective factors can predict general and mental health status after 1year of medical education. A prospective, longitudinal, observational study was conducted at one medical school. Self-rated general and mental health status before and after the freshman year were used as outcomes. In addition to socio-demographic variables and leisure activities, personality and study-related behaviour and experience were surveyed as potential predictors. Both descriptive techniques and logistic regression analyses were employed to identify predictors for general and mental health separately. At baseline, 93% of medical students rated their general health and 88% rated their mental health as good. These frequencies declined over the first year to 76% and 84%, respectively. For general health, regular physical activity was the strongest predictor (odds ratio [OR] 4.58). Satisfaction with life (OR 1.18) and balance and mental stability (OR 1.20) emerged as positive predictors, and age (OR 0.85) and striving for perfection (OR 0.76) as negative predictors. Mental health status was predicted by emotional distancing (OR 1.25), experience of social support (OR 0.73), neuroticism (OR 0.89) and age (OR 0.85). Self-rated general and mental health declined throughout the first year of medical education. Physical activity proved to be a strong predictor for the maintenance of good general health. This finding may represent a starting point for health-promoting interventions, such as the provision of time slots for physical activity.

What are the specific disability and limitation types underlying responses to the BRFSS disability questions?

BackgroundResearchers rely on resources such as BRFSS data to understand the health status of people with disability. However, the survey data rely on a limited definition of disability resulting in imprecise inferences about the nature of disability. Understanding how health varies among people with different types of disability is vital to tailoring interventions for improving health and eliminating disparities. ObjectiveThe purpose of this study was to utilize state added follow-up questions in the 2011 South Carolina BRFSS to describe the specific health conditions and limitations attributed to their disability and to compare health status across different types of disability. MethodsParticipants reporting a disability were asked to name health condition(s) causing disability and describe their disability-related limitations. Descriptive statistics were calculated using weighted proportions. Logistic regression was used to model the associations of specific health conditions and limitations with the outcomes of self-rated general health and mental health status, controlling for demographic factors. ResultsThe 5 most commonly reported health condition categories were (weighted percentage): musculoskeletal (68.56%); pulmonary (10.41%); neurologic (8.48%); heart disease (8%) and mental health (7.31%). The 5 most commonly reported limitation categories were: mobility/balance limitations (46.29%); pain (23.22%); breathing problems (12.36%); general weakness/fatigue (9.57%) and limited lifting (8.24%). There was substantial variation in the degree of association between categories of conditions and limitations and the outcomes of self-rated physical and mental health. ConclusionsResearchers and practitioners should consider variability in the nature of disability when designing interventions to improve the health of people with a disability.

Caffeine and Urinary Incontinence in US Women

Caffeine may have a diuretic effect in some adults. It is unclear whether changes in caffeine and fluid intake in women have impact on urinary incontinence (UI). Five epidemiologic and clinical cohort studies and 3 randomized trials have reported mixed results; some supported a possible relationship, and others showed no association. It is unclear whether high caffeine intake is associated with UI. This cross-sectional study tested the hypothesis that moderate and high caffeine intake in US women would be associated with UI when controlling for other factors associated with UI. Participants had been enrolled in the 2005 to 2006 and 2007 to 2008 National Health and Nutrition Examination Survey (NHANES), a cross-sectional, nationally representative survey of community-dwelling women. Data were analyzed using the Incontinence Severity Index, which categorized UI as “any” and “moderate/severe.” Dietary caffeine intake was evaluated for types of UI (stress, urge, mixed, and other). Food diaries were used to determine average intake of caffeine (in milligrams per day), water (grams per day) from tap or other consumed liquids, and total moisture (grams per day) present in foods and beverages. Caffeine intake from these sources was divided into quartiles. Multivariable stepwise logistic regression models were constructed adjusting for body mass index, sociodemographics, chronic disease, self-rated general health status, depression, alcohol use, reproductive health (vaginal deliveries, hormone therapy use, and prior hysterectomy), vigorous physical activity, and dietary water and moisture intake. A total of 4309 nonpregnant women 20 years or older with complete dietary and UI data were included in the final analysis. Among these women, UI prevalence was 41.0% for any UI and 16.5% for moderate/severe UI; stress UI was the most common type of UI (36.6%). Mean caffeine intake was 127 mg/d. In the adjusted models, there was a significant association for caffeine intake in the highest quartile (≥204 mg/d) with any UI (prevalence odds ratio, 1.47; 95% confidence interval, 1.07–2.01), but not with moderate/severe UI (prevalence odds ratio, 1.42; 95% confidence interval, 0.98–2.07). No association was found for types of UI (stress, urgency, mixed) and caffeine intake. These data show that higher caffeine intake (≥204 mg/d) was associated with any UI but not with moderate/severe UI in a cohort of US women.

Selbstberichteter allgemeiner Gesundheitszustand nach Beruf und Alter in der Erwerbsbevölkerung

In occupations, self-rated general health status was examined under special consideration of age. Data from the GEDA 2009 and 2010 surveys (N = 26,303) were analyzed. Professionals had a low prevalence of poor health, whereas unskilled service workers and-among males-unskilled manual workers had a high prevalence. In older workers the prevalence of poor general health was greater than among younger workers. However, the difference in health between young and old was significantly smaller than the general pattern among male managers and women in skilled commercial and administrative occupations. Among male skilled workers and female unskilled manual workers, the difference in health between young and old was greater. The-with increasing age-growing health gap between occupational groups should receive more attention. In order to understand the relationship between work, age and health, targeted longitudinal sectional studies are needed. It might be misleading to adjust associations between work and health by age, because age might moderate this relationship.

Cross-border ties and self-rated health status for young Latino adults in Southern California

At the same time that health researchers have mostly ignored the cross-border nature of immigrant social networks, scholars of immigrant “transnationalism” have left health largely unexamined. This paper addresses this gap by analyzing the relationship between cross-border ties and self-rated health status for young Latino adults living in the greater Los Angeles area (n = 1268). Findings based on an ordered logistic regression analysis suggest that cross-border relationships may have both protective and adverse effects on overall health status. Specifically, those reporting a period of extended parental cross-border separation during childhood have lower odds of reporting better categories of self-rated health, all else equal. Conversely, a significant positive association was found between having a close relative living abroad and self-rated health status for foreign-born respondents when interacted with immigrant generation (foreign versus U.S.-born). Given the findings of significant negative and positive relationships between cross-border ties and self-rated general health status, I discuss the implications for future research on the social determinants of immigrant health.