Unhealthy People Research Articles

In vivo dc and ac measurements at acupuncture points in healthy and unhealthy people

The aim of this work was to compare in vivo measurements of direct current (dc) and alternating current (ac) obtained from acupuncture points in Ukrainian and Mexican residents. Measurements were made using the method of Voll. The participants were 43 healthy Ukrainian and 71 healthy Mexican residents aged between 20 and 30 years, as well as 24 Mexican patients with a clinical diagnosis of rheumatoid arthritis and 14 patients with a clinical diagnosis of allergy. The results showed that dc measurements are not directly applicable to different populations. Thus, the dc resistance of the acupuncture points in the Mexican participants was 4-5 times larger than in the Ukrainians. In contrast, the capacitance of the two groups did not differ by more than 25%. Impedance measurements from acupuncture points can be used as an efficient and prompt non-invasive method for diagnostic purposes.

Hunger in Africa: the link between unhealthy people and unhealthy soils

Hunger in Africa: the link between unhealthy people and unhealthy soils

Selective migration, health and deprivation: a longitudinal analysis

Population migration is a major determinant of an area's age-sex structure and socio-economic characteristics. The suggestion that migration can contribute to an increase or decrease in place-specific rates of illness is not new. However, differences in health status between small geographical locations that may be affected by the inter-relationships between health, area-based deprivation and migration are under-researched. Using the Office for National Statistics (ONS) England and Wales Longitudinal Study (LS) 1971–1991, this research tracks individuals to identify any systematic sorting of people that has contributed to the area-level relationships between health (limiting long-term illness and mortality) and deprivation (Carstairs quintiles). The results demonstrate that among the young, migrants are generally healthier than non-migrants. Migrants who move from more to less deprived locations are healthier than migrants who move from less to more deprived locations. Within less deprived areas migrants are healthier than non-migrants but within deprived areas migrants are less healthy than non-migrants. Over the 20 year period, the largest absolute flow is by relatively healthy migrants moving away from more deprived areas towards less deprived areas. The effect is to raise ill-health and mortality rates in the origins and lower them in the destinations. This is reinforced by a significant group of people in poor health who move from less to more deprived locations. In contrast, a small group of unhealthy people moved away from more deprived into less deprived areas. These countercurrents of less healthy people have a slight ameliorating effect on the health–deprivation relationship. Whilst health–deprivation relationships are more marked for migrants there are also health (dis-) benefits for non-migrants if their location becomes relatively more or less deprived over time. Overall we found that between 1971 and 1991, inequalities in health increased between the least and most deprived areas, compared with the health–deprivation relationship which would have existed if peoples’ locations and deprivation patterns had stayed geographically constant. Migration, rather than changes in the deprivation of the area that non-migrants live in, accounts for the large majority of change.

Assurance maladie : Redéfinir le partage entre couverture obligatoire et complémentaire ?

<titre>Résumé</titre> L’article cherche à évaluer l’effet d’une modification du partage public/privé en matière d’assurance maladie, cette évolution étant toujours plausible compte tenu d’une certaine orientation du système de santé français vers le déremboursement public. Le travail est effectué à partir d’une base de données microéconomiques, permettant de lier conditions économiques (revenus déclarés), accès aux soins, consommation de soins et données de santé. On peut alors proposer des évaluations macroéconomiques — i.e. quelle réduction du déficit de l’assurance maladie ? — mais aussi microéconomiques : quels types de ménages et de malades risquent le plus de souffrir des déremboursements, quelle population cibler pour l’aide à l’achat d’une assurance complémentaire, quelle hausse peut-on prévoir pour les primes d’assurance ? On s’interroge enfin sur la rationalité d’une telle mesure, qui, pour être utile et efficace, devrait être accompagnée non seulement d’une politique de redistribution visant à compenser ses effets sur les personnes âgées et/ou les malades dénués d’assurances privées, mais aussi de mécanismes conduisant à un élargissement du pouvoir de régulation des assureurs maladie — notamment des assurances complémentaires — sur la demande et l’offre médicale : par exemple, une plus grande participation de celles-ci à la production de soins.

Unhealthy Disabled: Treating Chronic Illnesses as Disabilities

Chronic illness is a major cause of disability, especially in women. Therefore, any adequate feminist understanding of disability must encompass chronic illnesses. I argue that there are important differences between healthy disabled and unhealthy disabled people that are likely to affect such issues as treatment of impairment in disability and feminist politics, accommodation of disability in activism and employment, identification of persons as disabled, disability pride, and prevention and “cure” of disabilities.

Unhealthy Disabled: Treating Chronic Illnesses as Disabilities

Chronic illness is a major cause of disability, especially in women. Therefore, any adequate feminist understanding of disability must encompass chronic illnesses. I argue that there are important differences between healthy disabled and unhealthy disabled people that are likely to affect such issues as treatment of impairment in disability and feminist politics, accommodation of disability in activism and employment, identification of persons as disabled, disability pride, and prevention and “cure” of disabilities.

Managed care: made in America

Preface Introduction: Retrenchment and the Remaking of the Health-Care System What Is Managed Care? American Business Falls in Love with Managed Care Medicaid Managed Care Healthy and Unhealthy People at the HMO How HMOs Assure Quality Consumer Satisfaction Professional Autonomy and Managed Care Protecting Consumers and Providers through Legislation The Growing Business of HMOs Unresolved Issues Regarding Managed Care Bibliographical Essay Index

Going for the gold: the redistributive agenda behind market-based health care reform.

Political conflict over the respective roles of the state and the market in health care has a long history. Current interest in market approaches represents the resurgence of ideas and arguments that have been promoted with varying intensity throughout this century. (In practice, advocates have never wanted a truly competitive market, but rather one managed by and for particular private interests). Yet international experience over the last forty years has demonstrated that greater reliance on the market is associated with inferior system performance--inequity, inefficiency, high cost, and public dissatisfaction. The United States is the leading example. So why is this issue back again? Because market mechanisms yield distributional advantages for particular influential groups. (1) A more costly health care system yields higher prices and incomes for suppliers--physicians, drug companies, and private insurers. (2) Private payment distributes overall system costs according to use (or expected use) of services, costing wealthier and healthier people less than finance from (income-related) taxation. (3) Wealthy and unhealthy people can purchase (real or perceived) better access or quality for themselves, without having to support a similar standard for others. Thus there is, and always has been, a natural alliance of economic interest between service providers and upper-income citizens to support shifting health financing from public to private sources. Analytic arguments for the potential superiority of hypothetical competitive markets are simply one of the rhetorical forms through which this permanent conflict of economic interest is expressed in political debate.

Does Employment Affect Health?

Employment correlates positively with health, but is employment cause or consequence? The social causation hypothesis says that employment improves the health of men and women. The selection hypothesis says that healthy people get and keep jobs more than unhealthy people do. We test both hypotheses using longitudinal data from a national probability sample (N = 2,436 interviewed in both years). In the equations representing social causation, full-time employment predicts slower declines in perceived health and in physical functioning for both men and women. Full-time employment has the same effect for both sexes. Among women, it also has the same effect for White and non-White, and for married and nonmarried. In the equations representing social selection, physical functioning increases the odds of getting or keeping a full-time job for both sexes. Perceived health increases the odds for women but not for men. In regard to homemaking among women, homemaking predicts significantly greater declines in health, but health has no effect on the odds of becoming or staying a homemaker.

Patients' perceptions of need for primary health care services: useful for priority setting?

To assess the feasibility of using patients' perceptions of need for primary health care services to develop priorities. A postal survey of a random sample of 3478 patients registered with five general practices. Lothian, Scotland. Comparison of rankings of 36 different kinds of help or advice according to (a) popularity in the sample size as a whole and in healthy and unhealthy subgroups and (b) health status (severity of need) of potential service users. Popularity rankings differed between the healthy and unhealthy subgroups and the whole sample. Popularity rankings were almost the inverse of rankings based on health status. The analysis identified two areas of substantial need both in terms of popularity and severity: pain management and advice about welfare benefits. Methodological efforts to ensure equal participation in the processes of assessing health needs and of priority setting do not in themselves promote equity. To promote equity some opinions may need to be given greater weight.

Ancient genomes, wise bodies, unhealthy people: limits of a genetic paradigm in biology and medicine.

Ancient genomes, wise bodies, unhealthy people: limits of a genetic paradigm in biology and medicine.

CARPAL TUNNEL SYNDROME AND ITS RELATION TO GENERAL PHYSICAL CONDITION

Risk for carpal tunnel syndrome is closely related to general physical condition. Our findings confirm that healthy people are less likely to develop median nerve conduction abnormalities at the carpal tunnel than are unhealthy people. Being overweight, older, and physically inactive are major risk factors for slowing and clinical CTS. Workers' compensation patients with CTS, as a group, are identifiable by being overweight and physically inactive. Individual factors, such as body mass index, age, wrist dimensions, and physical activity, are far more important for determining who develops clinical CTS than are job-related factors, such as specific job, force or repetitions, duration of employment, or industry.

A longitudinal study of the causal relationship between social networks and health of the poor frail elderly.

Research over the past two decades has documented a positive relationship between social support and health. The causal interpretation of these associations has, however, been unclear. This study aims at filling the gap in our understanding of this causal link with respect to the frail poor elderly. The main questions addressed are, Does lack of social ties affect the elderly's health? or are unhealthy people less likely to establish and maintain social ties? We employed a time-series panel design to overcome problems of causal explanations and examine social networks and health in a sample of 3,559 poor frail elderly, participants of the California Multipurpose Senior Services Project. The results indicate that social networks have a positive effect on health (though only in the short run). However, neither the subjective nor the objective health measures have a significant effect on social networks. Implications for intervention are discussed.

Unemployment and mortality among Finnish men, 1981-5.

To ascertain whether, after controlling for several relevant background variables simultaneously, unemployment is related to mortality and to assess whether this relation is causal or whether unhealthy people are more likely to become unemployed. Prospective study of mortality in Finland during 1981-5 based on 1980 census data on 30-54 year old wage earner men and with particular attention to unemployment in the year before the census. Research project at the University of Helsinki. All wage earner men in Finland aged 30-54 at the 1980 census. Causes of death during 1981-5 and duration of unemployment in the year before the census. Background variables controlled for were age, socioeconomic state, marital state, and health. The data were analysed by log linear regression models. During the study period 1981-5, which covered almost 2.7 million person years, there were 9810 deaths. After controlling for all background variables relative total mortality among unemployed versus employed men was 1.93 (95% confidence interval 1.82 to 2.05). The excess mortality was highest in accidental and violent causes of death (relative mortality 2.51; 95% confidence interval 2.28 to 2.76). For circulatory diseases the relative death rate was 1.54 (95% confidence interval 1.40 to 1.70), but among neoplasms only lung cancer was associated with excess mortality. Selection for unemployment based on age, socioeconomic state, and marital state was evident but no such selection was detected based on health. Effects of unemployment on mortality were more pronounced with increasing duration of unemployment. The relative excess mortality of unemployed men in Finland cannot fully be explained by demographic, social, and health variables preceding unemployment. Unemployment therefore seems to have an independent causal effect on male mortality. Further studies are needed to elucidate the mechanisms between unemployment and mortality.

Multiple Roles and Physical Health of Women and Men

A survey of Detroit adults shows that employment, marriage, and parenthood are associated with good physical health for both women and men. Employed married parents tend to have the best health profile, while people with none of these roles tend to have the worst profile. Of the three roles, employment has the strongest effect, and parenthood the weakest. Multiple roles (the combination of job plus family responsibilities) have no special effects on health, either negative or positive. Thus, people with both job and family roles enjoy the health benefits of each role (main effects) and incur no special health disadvantage or benefit (interaction effect) for being so busy. This is true for both women and men. Three explanations are considered: First, health risks may actually be lower for socially active people than for nonactive ones. Second, involved people may have health attitudes which reduce their sensitivity to symptoms and their willingness to take curative health actions. Third, social selection may operate so that healthy people are able to acquire and keep roles more easily than unhealthy people. In sum, there is no evidence in the Detroit data that combining employment, marriage, and parenthood is harmful to women's health. Implications of the results for women's future health are suggested.

Dust storm in a buttercup

POLLUTION SEEMS SURE of a place among the top ten public relations campaigns of the century. Of course, it has enormous attractions as an issue. It has considerable emotional appeal for a start: images of unhealthy people breathing foul air in monstrously distorted countryside laid waste by generations of conspicuous consumption. It is also easy to become an instant self appointed expert, blandly rolling ecological disasters off the tongue with the cultured facility of the man reading out the football results on the television. The subject is so enormous that it is relatively easy to talk non‐stop for several hours in splendidly esoteric, unconstructive generalizations. And, dare one say it, the cynics among us have spotted its potential application as a genuine blockbuster of a political red herring. William Davis said recently in Punch that the British seem to need a crisis. If all else fails, or if we have a real crisis so nasty that we don't wish to discuss it, we can always rely on environment, pollution and ecology to turn up trumps.

Implant dentures: Prosthodontic—Unfavorable

In my discussion of the unfavorable prosthodontic aspects of implant dentures, I have avoided reference to the surgical techniques and consequences which are being discussed by others. I have only touched upon what I believe to be disadvantages or deficiencies of the procedures. The most serious disadvantage is that the procedure cannot be used for those who need it most. It is not advised for aged, infirm, or unhealthy people. Soft tissue-borne dentures can be and are made for these people, and if they are carefully and precisely constructed, these dentures do provide teeth which are comfortable and usable. Judging by the implant dentures I have seen and by many illustrations in books and periodicals, insufficient attention has been paid to jaw relations and occlusion. These are phases of construction techniques that could be corrected easily, however, if more attention was paid to them. The illustrations I have seen of upper implant dentures indicate that too little consideration has been given to phonetics. The shape of the maxillae and mandible is altered by resorption. This resorption may occur under soft tissue-borne dentures and implant dentures alike. It is more disastrous when it occurs under implant dentures. The expense of treatment of edentulous patients by implant dentures makes the procedure unavailable to many people who might be benefited by it. The time involved in treatment of edentulous patients by implant dentures makes the procedure unavailable to most edentulous patients because there are not enough dentists to provide the service, even if all other unfavorable considerations were eliminated. This discussion is not intended to discourage sincere workers from further experimentation in this field of prosthodontics. Instead, I hope that it may point the way to an improvement of implant denture service.

Marking of Patent Medicines

WHEN the question of withdrawing Medicine Stamp Duties was debated recently in the House of Commons, it was clear that there was a general feeling that proprietary medicines should not be freed from all restrictions, but should be subjected to effective control. Some of them are fraudulent, their advertisements encourage healthy people to think they are ill, and unhealthy people to postpone taking medical advice until it is too late, and some of them are poisons. The recent passing of effective legislation in the United States was largely due to the fact that seventy-three people were killed by an elixir containing diethylene glycol, just at the time when the matter was being debated in Congress. It would be unfortunate if another such accident were to occur in Great Britain before effective measures were introduced. Reforms of various kinds are being widely discussed. Prof. A. J. Clark, in a little tract published last year under the title “Patent Medicines” said: “The clearest line for the Government to take would be to say that it did not wish to tax any remedy that was beneficial to the health of the people, and wished to suppress all those that were useless and harmful.” This would imply regulations such as those now enacted in the United States, where new remedies can only be sold when they have been officially approved. Lord Horder, in his speech in the House of Lords, stressed the harm that is done by misleading advertisements and recommended that measures for the control of quack medicines should form part of the campaign for national fitness.