Qat chewing and pesticides: a study of adverse health effects in people of the mountainous areas of Yemen

Chewing qat leaves, Cathula Edulis, is now a very common behaviour among the people of the mountainous areas of Yemen. For about the past 20 years, in tandem with national development, qat chewing has been rapidly expanding, and the use of chemical pesticides in qat production has been increasing. In this study, the adverse effects on human health of qat chewing combined with pesticide use were investigated. Results of interviews and questionnaires showed that chewers of qat grown with few or no chemical pesticides and chewers of qat grown with chemical pesticides have considerably different subjective symptoms. Chewers of qat produced in fields where chemical pesticides are used regularly have more symptoms than chewers of qat produced in fields where chemical pesticides are rarely or never used. Chewers of qat produced with more chemical pesticides, in particular, experience acute adverse effects on the digestive system and chronic adverse effects such as body weakness and nasal problems. Farmers who chew homemade qat on which they spread chemical pesticides by themselves may have the highest health risks regarding the combination of qat and pesticides. It is concluded that chewing qat grown with chemical pesticides causes considerable adverse health effects in human beings.     

昆山市以健康俱乐部为载体的医院健康教育效果评价

目的通过对昆山市864名各类人员进行健康教育前后的健康知识、健康信念、生活饮食习惯调查,评价以健康俱乐部为载体的医院健康教育方法及其效果。方法自编调查问卷,在健康教育前后分别对昆山市5大类人群随机抽取864名人员进行无记名自填封闭式问卷,用《医学卫生统计软件》对教育前后结果进行统计分析。结果在调查所涉及的3个范围28项条目中,有25项的认识教育后比教育前有不同程度提高,占总条目的89.29%,有显著性差异的14项,占总条目的50.00%;提高尤为明显的为健康知识知晓率(提高均值17.89个百分点)、其次为健康信念所持有的正确率(提高均值10.19个百分点)、提高不太明显的为生活饮食习题(提高均值1.46个百分点)。结论以健康俱乐部为载体的医院健康教育方法切实可行,但今后仍需加强民众良好的生活、饮食习惯养成教育,进一步提高俱乐部覆盖人群的知识、态度、行为水平。     

军队老年人健康相关知识知信行状况的调查

目的了解军队老年人心血管疾病危险因素的知晓率、治疗率和控制率,为制定该人群的健康管理提供依据。方法于2007年10月1日～2008年3月30日调查了430名军队老年人主要慢性疾病的知晓率、治疗率和控制率以及健康知识知晓率、保健态度和保健行为、自我保健意识及保健方式等。结果5种慢性疾病中高血压和糖尿病的知晓率较高（〉85%）,代谢综合征知晓率最低（12.5%）;治疗率以高血压和糖尿病最高（〉80%）,代谢综合征最低（14.5%）;控制率各种疾病均低于50%,代谢综合征最低（13.3%）。该人群对烟酒膳食习惯、情绪状况、规律运动、身高、体重和血压值知晓率较高（均〉70%）,腰臀围、体重指数、超重和肥胖、血糖水平和代谢综合征预防等知晓率较低（均〈50%）。保健态度较为积极,愿戒烟、少吃盐、锻炼身体以及劝他人改变不良生活习惯的人数占调查总人数的比率均大于75%,但实际戒烟、限酒、少吃盐和锻炼者较少。结论保健意愿转化为实际行动还有一定的差距,需加强代谢综合征的预防、超重和肥胖等知识和生活方式的健康教育和管理。     

A review of the use of health examination data from the Health Survey for England in government policy development and implementation

Background

Information is needed at all stages of the policy making process. The Health Survey for England (HSE) is an annual cross-sectional health examination survey of the non-institutionalised general population in England. It was originally set up to inform national policy making and monitoring by the Department of Health. This paper examines how the nurse collected physical and biological measurement data from the HSE have been essential or useful for identification of a health issue amenable to policy intervention; initiation, development or implementation of a strategy; choice and monitoring of targets; or assessment and evaluation of policies.

Methods

Specific examples of use of HSE data were identified through interviews with senior members of staff at the Department of Health and the Health and Social Care Information Centre. Policy documents mentioned by interviewees were retrieved for review, and reference lists of associated policy documents checked. Systematic searches of Chief Medical Officer Reports, Government ‘Command Papers’, and clinical guidance documents were also undertaken.

Results

HSE examination data have been used at all stages of the policy making process. Data have been used to identify an issue amenable to policy-intervention (e.g. quantifying prevalence of undiagnosed chronic kidney disease), in strategy development (in models to inform chronic respiratory disease policy), for target setting and monitoring (the 1992 blood pressure target) and in evaluation of health policy (the effect of the smoking ban on second hand smoke exposure).

Conclusions

A health examination survey is a useful part of a national health information system.     

Use of the internet for health care information: results from a national telephone survey

Summary. Use of the internet for health care information results from a national telephone surveyObjectives: The Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent internet use for health care really is. Available estimates for Germany dont exist. Without accurate estimates of use, it is difficult to focus policy discussions or design appropriate policy activities.Methods: 2026 individuals aged 16 years or older were interviewed in Germany using computer-assisted telephone interview (CATI) in 2001. The sampling frame based on a modified RLD-Design.Results: Approximately 50% of respondents with Internet access reported using the internet to look for advice or information about health or health care. The internet is differently used by the population for the health care information. There is a higher use rate of men, of younger people, of people with high socio-economic status and of the healthy ones. After controlling in multivariate analysis for the user, merely an significant age effect exists.Conclusions: The use of the internet for health care information in Germany is quite different. Questions about consequences remain unanswered. Do the differences increase or do they decrease? And which role does play the health politics? This and other questions could be answered by further studies.

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Verbreitung und Sozialprofil der gesundheitsthemenbezogenen Internetnutzung: Ergebnisse einer bundesweiten Telefonumfrage

Zusammenfassung. Fragestellung: Bereits jeder zweite Bundesbürger nutzt das Internet. Weniger klar ist die Nutzung des Internets speziell zur Beschaffung von Gesundheitsinformationen. Angaben darüber gibt es für Deutschland gegenwärtig nicht. Um eine gezielte Sozial- und Gesundheitspolitik betreiben zu können, sind Bevölkerungsangaben jedoch unerlässlich.Methoden: 2026 Personen im Alter von 16 Jahren und älter wurden mittels einer computergestützten Telefonumfrage (CATI) im Frühjahr 2001 befragt. Grundlage der Stichprobe bildet eine Zufallsauswahl nach einem modifizierten RLD-Design.Ergebnisse: Von den Bürgern, die das Internet schon einmal genutzt haben, gaben ca. 50% der Befragten an, sich schon einmal im Internet über Gesundheitsthemen informiert zu haben. Das Internet wird zur Beschaffung von Gesundheitsinformationen von der Bevölkerung unterschiedlich genutzt, es sind die Männer, die Jüngeren, die besser Gebildeten, Personen aus Haushalten mit einem höheren Haushaltsnettoeinkommen und die Gesünderen, die sich auf diesem Wege eher informieren. Sind die Bürger jedoch einmal Online, so die Ergebnisse der multivariaten Analyse, bleibt lediglich ein signifikanter Alterseffekt bestehen.Schlussfolgerungen: Ob die dargestellten Unterschiede der gesundheitsthemenbezogenen Nutzung des Internets in Zu-kunft zu-oder abnehmen, hängt nicht zuletzt auch von den politischen Rahmenbedingungen ab. Diese und weitere Fragen, wird man erst durch weitere Studien klären können.

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Résumé. Internet et santé une enquête téléphonique nationaleObjectifs: Linternet est devenu une source importante permettant dobtenir des informations médicales. II existe toutefois peu de recherches sur lutilisation de ces informations en Allemagne. Des recherches apparaissent donc nécessaires afin de pouvoir adopter des politiques sociales sensées.Méthode: 2026 individus âgés de 16 ans ou plus ont été interviewés en 2001 en Allemagne au moyen dinterviews assistées par ordinateur (ITAO). Léchantillonnage a été constitué par une sélection aléatoire sur la base dune méthode RLD modifiée.Résultats: Environ 50% des répondants ayant un accès internet ont rapporté utiliser linternet comme source dinformations médicales. Cet usage de linternet varie toutefois au sein de la population. Il y a un taux plus élevé dutilisation parmi les hommes, les personnes plus jeunes, les personnes avec un statut socioéconomique élevé et parmi les individus en bonne santé. Les résultats des analyses multivariées montrent que parmi les gens ayant un accés à Internet, seul lâge demeure significativement relié à lutilisation de linternet à des fins dinformation médicale.Conclusions: Lutilisation de linternet comme source dinformations médicales en Allemagne varie au sein de la population. Les questions concernant les conséquences demeurent sans réponse. Est-ce que les différences augmentent ou diminuent? Quel est le rôle des politiques de santé? Cette question et dautres pourraient être répondues à laide dautres enquêtes.

     

Barriers to health care access and service utilization of refugees in Austria: Evidence from a cross-sectional survey

This paper provides evidence on (1) refugees’ subjective well-being, (2) their access and barriers to health care utilization and (3) their perception of health care provision in Austria, one of the countries most heavily affected by the European ‘refugee crisis.’ It is based on primary data from the Refugee Health and Integration Survey (ReHIS), a cross-sectional survey of roughly five hundred Syrian, Iraqi and Afghan refugees. Results indicate that refugees’ self-rated health falls below the resident population’s, in particular for female and Afghan refugees. Whereas respondents state overall high satisfaction with the Austrian health system, two in ten male and four in ten female refugees report unmet health needs. Most frequently cited barriers include scheduling conflicts, long waiting lists, lack of knowledge about doctors, and language. Although treatment costs were not frequently considered as barriers, consultation of specialist medical services frequently associated with co-payment by patients, in particular dental care, are significantly less often consulted by refugees than by Austrians. Refugees reported comparably high utilization of hospital services, with daycare treatment more common than inpatient stays. We recommend to improve refugees’ access to health care in Austria by a) improving the information flow about available treatment, in particular specialists, b) fostering dental health care for refugees, and c) addressing language barriers by providing (web-based) interpretation services.     

Differences between Eastern European immigrants of German origin and the rest of the German population in health status, health care use and health behaviour: a comparative study using data from the KORA-Survey 2000

Summary. Differences between Eastern European immigrants of German origin and the rest of the German population in health status, health care use and health behaviour: a comparative study using data from the KORA-Survey 2000Objectives: To identify differences in health status, health care use and health behaviour between Eastern European immigrants of German origin and the rest of the German population in order to develop new concepts for preventive programs.Methods: Using data from the KORA-Survey 2000 (Cooperative Health Research in the Region of Augsburg), immigrants of German origin were compared to the rest of the German population with multiple regression models controlling for sex, age, living with partner, years of education and occupation. Tests of trend were performed for the groups classified according to the year of immigration.Results: Compared to other Germans, immigrants of German origin consider their health status more often as poor. They were more likely to be obese (OR = 1.95) and have hyperlipidemia (total-cholesterol/HDL-C > 4: OR = 1.71). They were less likely to use cancer screening (OR = 0.41) or to perform sport activities (OR = 0.47). All these differences decrease with the length of residence in Germany.Conclusions: Concerning their health status, Eastern European immigrants of German origin were identified as a high risk group. They should be considered for specific preventive programs and health care interventions, especially during the first years of immigration.

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Unterschiede zwischen Aussiedlern und der übrigen deutschen Bevölkerung bezüglich Gesundheit, Gesundheitsversorgung und Gesundheitsverhalten: eine vergleichende Analyse anhand des KORA-Surveys 2000

Zusammenfassung. Fragestellung: Bis zum Jahre 2000 sind ca. 4 Mio. Aussiedler nach Deutschland eingereist. Trotzdem ist diese Bevölkerungsgruppe in der Public-Health-Forschung bisher wenig beachtet worden. Ziel dieser Studie ist es, Unterschiede bezüglich Gesundheit, Gesundheitsversorgung und Gesundheitsverhalten zwischen Aussiedlern und Nicht-Aussiedlern zu ermitteln, um auf dieser Basis Konzeptionen für Präventionsmassnahmen in der Gesundheitsversorgung entwickeln zu können.Methodik: Anhand des KORA-Surveys 2000 (Kooperative Gesundheitsforschung in der Region Augsburg) wurde eine vergleichende Analyse von Aussiedlern und den übrigen Studienteilnehmern durchgeführt. Die Zielgrössen sind den drei Bereichen Gesundheit, Gesundheitsversorgung und Gesundheitsverhalten zugeordnet. Es wurden unter Berücksichtigung von Geschlecht, Alter, Zusammenleben mit Partner, Ausbildungsdauer und Beschäftigung multiple Regressionsmodelle berechnet. Mittels Trendtest wurden Unterschiede nach der Aufenthaltsdauer untersucht.Ergebnisse: Im Vergleich zum Rest der Studienpopulation schätzen Aussiedler ihre eigene Gesundheit als schlechter ein (OR = 0,68). Sie sind eher übergewichtig (OR = 1,95) und haben häufiger ein ungünstiges Lipidverhältnis (OR = 1,71) (Gesamtcholesterin/ HDL-C>4). Ausserdem nehmen sie weniger an Krebsvorsorgeuntersuchungen teil (OR = 0,41) und sind weniger sportlich aktiv (OR = 0,47). Die beobachteten Unterschiede sind am deutlichsten bei den Aussiedlern, die vor höchstens fünf Jahren nach Deutschland übergesiedelt sind.Schlussfolgerung: Aussiedler sind eine Risikogruppe, die bei Präventions- und Versorgungsmassnahmen berücksichtigt werden sollten. Dies gilt insbesondere für Aussiedler, die sich erst seit kurzem in Deutschland aufhalten.

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Résumé. Différences entre les immigrants de lEurope de lEst dorigine allemande et le reste de la population allemande: état de santé, utilisation des services de santé, et comportement en matière de santé. Une analyse comparative basée sur les données du KORA-Survey 2000Objectifs: Jusquen 2000, environ 4 millions de personnes ont immigré en Allemagne. Ce groupe a fait lobjet de très peu de recherches en santé publique. Lobjectif de cet article est de mettre en évidence les différences sur le plan de létat de santé, de lutilisation des services de santé et du comportement en matière de santé entre les immigrants dEurope de lEst dorigine allemande et le reste de la population allemande, afin de pouvoir développer de nouvelles pratiques de prévention.Méthodes: Sur la base de lenquête KORA 2000 (Kooperative Gesundheitsforschung in der Region Augsburg), une analyse comparative a été menée entre les immigrants et les autres participants de létude,à laide de modèles de régressions multiples tenant compte du sexe, de lâge, du fait que la personne vit seule ou en couple, du nombre dannées de formation et de lactivité professionnelle. Les différences selon les dates dimmigration ont été examinées au moyen de tests de tendance.Résultats: Les immigrants de lEurope de lEst dorigine allemande estiment leur santé plus mauvaise. Ils tendent à être plus en surpoids (OR = 1,95) et à avoir un rapport lipidique défavorable (cholestérol total/cholestérol HDL > 4) (OR = 1,71). Ils utilisent moins les services de dépistage du cancer (OR = 0,41) et ils font moins de sport (OR = 0,47). Ces différences sont particulièrement nettes chez les personnes arrivées en Allemagne depuis moins de cing ans.Conclusions: Les immigrants de lEurope de lEst dorigine allemande représentent un groupe à haut risque. Il faut leur prêter une attention particulière lors de la mise en place de services de soins et de programmes de prévention, particulièrement lorsque ces personnes résident depuis peu de temps en Allemagne.

     

Measuring the health and health behaviours of adolescents through cross-national survey research: recent developments in the Health Behaviour in School-aged Children (HBSC) study

Cross-national surveys have the potential to make a significant contribution to the study of adolescent health. The Health Behaviour in School-aged Children (HBSC) study was among the first international studies established in three countries in 1983 and growing to more than 40 countries for the seventh wave of fieldwork in 2005/06. The original aim of the study has remained largely the same since its inception, to increase understanding of adolescent health behaviours, health and well being in their social context and to collect high quality comparable data to achieve this. The challenges to producing valid and reliable data from cross-national, school-based research were recognised from the outset and reflected in the methodological development of the study. The paper sets out how these challenges were addressed, examining key aspects of the methodology, including study design, questionnaire content, data collection and file preparation. These methods are still in place, but HBSC has had to recognise the social and political change of recent years. The challenges that were recognised 20 years ago are magnified today, with the study embracing a variety of cultures across Europe and North America. As demand for HBSC data has grown from the scientific and policy communities, greater attention has been paid to scrutiny of the data produced, matched by a sharper focus on continuous improvement in data quality. Key developments of recent years are summarised in the paper, focusing on study organisation, review of the international Research Protocol, strengthening support for sampling, greater attention to translation and improvements in data processing and documentation. It is concluded that the HBSC study has evolved over the last 20 years and continues to do so, recognising the importance of data quality, but also the constraints of cross-national survey research. Looking to the future, some outstanding issues for consideration are touched upon, including the opportunities and challenges for expanding our knowledge on the possibilities for gathering cross-national and cross-cultural data, with the HBSC study being used to build capacity in understanding the health needs of young people in other regions of the world.     

Political attitudes and efficacy of health expert communication on the support for COVID-19 vaccination program: Findings from a survey in Hong Kong

Despite evidence suggesting that vaccines offer protection against COVID-19, the uptake rates of COVID-19 vaccines have been low in some high-income regions. Support for vaccination program is important to fight the pandemic. This study aimed at exploring two research questions: first, to what extent political attitudes are associated with support for COVID-19 vaccination program; and second, whether health expert communication is effective in increasing the support. An online survey was undertaken by 1079 Hong Kong residents aged 18–77 years from May 26 to June 3, 2021. The survey found higher support in pro-government respondents, and lower support in political opposition. A strategy of positive communication by health experts could increase support in the opposition and politically attentive respondents. Other variables that were positively related to program support were quarantine experience, trust in government, preference for pandemic control over freedom, political attentiveness, and disagreement with China’s influence on Hong Kong’s COVID-19 policymaking. This study contributes to understanding the relationship between political attitudes and support for vaccination program and provides empirical evidence of the efficacy of health expert communication strategy in improving support for vaccination program for people with certain political attitudes.     

Impact of health education and screening over all-cause mortality in Japan: evidence from a cohort study during 1984-2002

BACKGROUND: Health education and screening are two components of preventive health services in Japan since 1983. This study investigated their relationships with all-cause mortality as they are studied insufficiently in Hokkaido, Japan. METHODS: This study enrolled 1,532 men and 1,653 women aged 40-97 years from 1,702 randomly selected households of 60 areas during 1984-1985 and followed them until 2002. At baseline survey, staffs of 45 health centers collected sociodemographic, medical, behavioral, and dietary information including health education and screening from study subjects with informed consent. RESULTS: For men, age-adjusted Cox proportional hazard model indicated lower mortality for those who received health education (RR = 0.76, P < 0.01) and screening (RR = 0.83, P < 0.05) than those who did not. Health education showed lower mortality even after adjusting for many variables. Similarly for women, health education (RR = 0.66, P < 0.01) and screening (RR = 0.64, P < 0.001) revealed lower age-adjusted mortality. Almost similar results were found for both services when models were adjusted for many variables and when the deaths including lost to follow-up cases of the first 4 years of baseline survey are excluded. CONCLUSIONS: This study shows protective effects of health education and screening over all-cause mortality for both sexes. However, further studies are needed to confirm the results.     

Study of Health In Pomerania (SHIP): a health examination survey in an east German region: objectives and design

SummaryObjectives The reason for the Study of Health in Pomerania (SHIP) is the lack of epidemiological studies with a broad range of health indicators. Furthermore, in Germany there is a need for studies that take into account the particular situation of life after the reunification. One objective of SHIP is to provide prevalence estimates on a broad range of diseases, risk and health factors for a defined region in the former GDR.Methods A sample of 7008 women and men aged 20 to 79 years in a north-east region of Germany, 4900 expected participants. The sample was drawn in two steps: First, 32 communities in the region were selected. Second, within the communities a simple random sample was drawn from residence registries, stratified by gender and age. The data collection and instruments include four parts: oral health examination, medical examination, health-related interview, and a health- and riskfactor-related questionnaire. The oral health examination includes the teeth, periodontium, oral mucosa, craniomandibular system, and prosthodontics. The medical examination includes blood pressure measurements, electrocardiography, echocardiography, carotid, thyroid and liver ultrasounds, neurological screening, blood and urine sampling. The computer-aided health-related interview includes cardiovascular symptoms, utilisation of medical services, health-related behaviours, and socioeconomic variables. The self-administered questionnaire comprises housing conditions, social network, work conditions, subjective well-being and individual consequences from the German reunification.The research work reported is funded by grants from the German Federal Ministry for Education and Research (BMBF, grant no. 01ZZ96030), of the Ministry for Education, Research and Cultural Affairs and the Ministry for Social Affairs of the State of Mecklenburg-West Pomerania as well as the Municipal Hospital of Stralsund GmbH.     

Health inequalities in different age groups: the case of type 2-diabetes: a study with health insurance and medication data

Summary Objectives:This study investigates social differentials in the prevalence of diabetes type 2 in women and men in a health insurance population. It is considered whether social gradients are present over different age strata. Methods:Analyses were performed with records obtained from a German statutory health insurance comprising 77294 women (31.8%) and men (68.2%) of at least 20 years. Occupational status was used as indicator of socio-economic position. Individuals with diabetes were identified using information about antidiabetic medication or by hospital diagnoses according to ICD9. The analyses were performed for the entire insurance population and for different age strata (<40yrs/40–55yrs/>55yrs). Results:The analyses revealed considerable social differences in diabetes risks. Considering the whole insurance population with the highest socio-economic category as reference group, the odds ratio (OR) for skilled non-manuals was OR=2.9, for skilled manuals it was OR=4.7, and OR=5.6 for unskilled and semi-skilled individuals. After stratifying the insurance population into three age groups the social gradients were reproduced for each stratum, but their magnitudes increased with age. Conclusions:In the health insurance population considered health inequalities with respect to diabetes are considerable, and they are persisting after stratification into age groups.     

The association between physical exercises and health-related quality of life in subjects with mental disorders: results from a cross-sectional survey

OBJECTIVES: The present study examines the relationship between health-related quality of life and physical activity among adults with affective, anxiety, and substance dependence disorders. METHODS: Analyses were conducted among participants in the German National Health Interview and Examination Survey (GHS), a nationally representative multistage probability survey, conducted from 1997 to 1999. Multiple linear regression analyses were used to determine the relationship between health-related quality of life and physical activity among subjects with mental disorders. RESULTS: Affective, anxiety, and substance dependence disorders were associated with substantial impairment in health-related quality of life. Higher levels of physical activity were associated with higher health-related quality of life among persons with mental disorders. Even after controlling for sociodemographic characteristics, physically inactive subjects reported poorer quality of life. CONCLUSIONS: Physical activity can be considered as beneficial for people suffering from mental disorders. The promotion of a physically active lifestyle is an important public health objective.     

Partner number and use of COVID-19 risk reduction strategies during initial phases of the pandemic in British Columbia,Canada: a survey of sexual health service clients

ObjectivesInitial public health guidance related to sex and COVID-19 infection focused on reducing partner number. We characterized individuals having a higher partner number during the initial phases of the pandemic.MethodsIn British Columbia, the initial wave of COVID-19 cases was from March 14 to May 19, 2020, followed by gradual lifting of public health restrictions. We conducted an e-mail survey of existing sexual health service clients during the period of July 23 to August 4, 2020. We used bivariate logistic regression to examine the association between the reported number of sexual partners since the start of the pandemic and key variables (level of significance p < 0.01).ResultsOf the 1196 clients in our final sample, 42% reported 2+ partners since the start of the pandemic, with higher odds among participants who were men who have sex with men, and single or in open relationships prior to the pandemic. This group was more likely to perceive stigma associated with having sex during the pandemic, and had the highest use of strategies to reduce risk of COVID-19 infection during sexual encounters (mainly focused on reducing/avoiding partners, such as masturbation, limiting sex to a “bubble”, and not having sex).ConclusionSexual health service clients in BC with 2+ partners during the initial phases of BC’s pandemic used strategies to reduce their risk of COVID-19 infection during sex. Our study provides support for a harm reduction approach to guidance on COVID-19 risk during sex, and highlights the need for further research on stigma related to having sex during the COVID-19 pandemic.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-021-00566-9.     

Urban blue space and health and wellbeing in Hong Kong: Results from a survey of older adults

The potential benefits of aquatic environments for public health have been understudied in Asia. We investigated the relationships between blue space exposures and health outcomes among a sample of predominantly older adults in Hong Kong. Those with a view of blue space from the home were more likely to report good general health, while intentional exposure was linked to greater odds of high wellbeing. Visiting blue space regularly was more likely for those within a 10–15 min walk, and who believed visit locations had good facilities and wildlife present. Longer blue space visits, and those involving higher intensity activities, were associated with higher recalled wellbeing. Our evidence suggests that, at least for older citizens, Hong Kong's blue spaces could be an important public health resource.     

U.S. military deployment during 2001-2006: comparison of subjective and objective data sources in a large prospective health study

PURPOSE: Studies researching service members' health after deployment have relied on self-reported deployment history, although validity of these data remains unknown. This study compared self-reported and electronic deployment data and explored differences in functional health. METHODS: Self-reported and military deployment data were compared for more than 51,000 participants enrolled in the Millennium Cohort Study (2004-2006). Kappa statistics were used to measure agreement. Analysis of variance was used to assess functional health, as measured by the Medical Outcomes Study Short Form 36-Item Health Survey for Veterans (SF-36V). RESULTS: Of 51,741 participants who completed the initial deployment question, objective records and self-report agreed in 47,355 (92%). Agreement was substantial for deployment status, frequency, and number of deployments (kappa = 0.81, 0.71, and 0.61, respectively). Deployment start dates agreed within 1 month for 82% of participants confirmed as deployed once. Participants' Mental and Physical Component Summary scores from the SF-36V did not differ by agreement level. CONCLUSIONS: These findings indicate substantial agreement between self-reported and objective deployment information and no clinically meaningful differences in functional health for the small proportion with inconsistent deployment information. These findings should be reassuring to investigators who examine military deployment as a determinant of future health.