Association of age and social class with suicide among men in Great Britain.

STUDY OBJECTIVE--The aim was to investigate suicide and "undetermined" deaths by age, economic activity status, and social class in Great Britain among males of working age. DESIGN--The study was a cross sectional analysis of Registrar General's data for England and Wales around 1981, repeated for around 1971, and for Scotland around 1971 and 1981. MEASUREMENTS AND MAIN RESULTS--For England and Wales around 1971, suicide and undetermined death rates showed a progressive increase with age and a markedly higher rate in the lower social classes. A significant interaction effect was identified in the central age groups of the lower occupational categories. This interaction was confirmed in the remaining three data sets, notwithstanding some differences in the profile of age specific mortality. Other findings included a higher standardised mortality ratio for the economically inactive, who also showed an earlier peak in age specific mortality, and a relative concentration of undetermined as compared to suicide deaths in the lower social classes, but not all these further results were fully replicated. CONCLUSIONS--There is a concentration of suicide and undetermined deaths in the middle age groups of the lower social classes. Plausible explanations include both the social drift and the social genesis hypotheses, the latter including the effects of long term unemployment.     

The persisting effect of unemployment on health and social well-being in men early in working life.

In our studies of the effects of unemployment in the early working life of men in a British national birth cohort we have shown elsewhere that this experience was part of a longer term accumulation of social and health disadvantage. This present study asks whether men's unemployment also inflicted potential longterm damage to future socio-economic chances and health. We therefore constructed indicators of socio-economic circumstances and health at 33 years from factors already shown to be associated with health in later life. For the socio-economic indicator we used a combination of income, occupational status and home ownership and described this as socio-economic capital. For the health indicator we combined scores of body mass index, leisure time exercise, frequency of eating fresh fruit and of smoking, and described this as health capital. After controlling for pre-labour market socio-economic and health factors, prolonged unemployment is shown here to reduce significantly both socio-economic and health capital by age 33 years. We conclude that the experience of prolonged unemployment early in the working life of this population of young men looks likely to have a persisting effect on their future health and socio-economic circumstances.     

Changes in diet and coronary heart disease mortality among social classes in Great Britain.

Coronary heart disease (CHD) mortality has declined in Britain since the early 1970s and followed a reduction in dietary fat intake in the population. We attempted to determine whether there have been changes in dietary fat intakes by social classes and to see whether they correspond to social class changes in CHD mortality, where the greatest reduction has been in the upper social class groups. Dietary fat intake was specially obtained by social class on a household basis from the National Food Survey (NFS) for 1974 and 1981. The decline in saturated fat intake and increase in polyunsaturated fat is shown to have occurred in each social class group, although it was not possible to examine the data separately for men and women. In contrast, the decline in the proportion of current smokers between 1974 and 1980 (from the General Household Survey) was greatest in the higher social classes. Rates of CHD mortality showed the greatest decline among men in social classes I & II over the period 1969/73 to 1979/83. However, despite some problems in the interpretation of the data collected by the NFS, this study shows that recent social class trends in dietary fat intakes are unlikely to account for the differential changes in CHD mortality. Changes in the prevalence of smoking among social classes are more consistent with the change in CHD mortality.     

Suicide, unemployment, and domestic gas detoxification in Britain.

Between 1962 and 1971 the United Kingdom suicide rate fell while the unemployment rate rose, contrary both to earlier British experience and recent trends in other developed countries. It is hypothesised that the "British anomaly" is due to the coincident detoxification of domestic gas after 1963. Unemployment and suicide by means other than domestic gas were found to correlate +0.88 between 1955 and 1980, and +0.70 between 1964 and 1974. These findings are discussed with respect to the role of availability of method in the epidemiology of suicide. It is also suggested that the relation between unemployment and suicide is complex and probably largely indirect.     

Health literacy and substance use in young Swiss men

Objectives

The purpose of the present study was to describe health literacy and its association with substance use among young men.

Methods

The present study was part of the Cohort Study on Substance Use Risk Factors that included 11,930 Swiss males participating in initial screening from August 2010 to July 2011. Self-completed questionnaires covered use of three substances and three components of health literacy.

Results

Roughly 22 % reported having searched the Internet for health information and 16 % for information on substances over the past 12 months. At-risk and not at-risk users of alcohol (adjusted odds ratio (AOR) = 2.50 and 1.46), tobacco (AOR = 2.51 and 1.79) and cannabis (AOR = 4.86 and 3.53) searched for information about substances significantly more often via the Internet than abstainers. Furthermore, at-risk users reported better knowledge of risks associated with substance use and a marginally better ability to understand health information than abstainers.

Conclusions

Substance users appear to be more informed and knowledgeable about the risks of substance use than non-users. Consequently, interventions that focus only on information provision may be of limited benefit for preventing substance use.     

Diabetes in young adult men: social and health-related correlates

Background

Diabetes is a global public health issue. It is associated with significant disability, morbidity and mortality risks and substantial healthcare costs. Of great concern is the fact that its prevalence is rising, particularly amongst the young, while epidemiological data regarding the incidence, prevalence and complications of early-onset type 2 diabetes is noted to be sparse.

Methods

We used data from the baseline wave of Ten to Men, a national cohort study of Australian males, to investigate the social and health-related correlates of Australian males aged 18–49 years reporting being diagnosed with diabetes.

Results

The estimated prevalence of a self-reported diabetes diagnosis amongst Australian males aged 18–49 years was 2.95 % (95 % CI: 2.54–3.43 %). Within this age group, approximately 75 % of those diagnosed with diabetes are expected to be living with a known diagnosis of type 2 diabetes; the remainder are expected to be living with type 1 diabetes. Of the 20 social and health-related factors considered, we found evidence to support the association of eighteen factors after adjusting for age and body mass index. The strongest correlates of reporting a diabetes diagnosis, associated with a ≥2-fold increase in the odds of reporting diabetes were being aged 35–49 years, being unemployed, being obese, seeing a doctor for a check-up more frequently, reporting comorbid high blood pressure or physical or mental health comorbidities and worse self-rated and physical health status.

Conclusion

Australian males aged 18–49 years who are living with a known diagnosis of diabetes are more likely to be socio-economically disadvantaged and suffer substantially worse health status than Australian males aged 18–49 years living without a diabetes diagnosis. Based on the associations detected in this study, older, single males living in regional areas who are socioeconomically disadvantaged, obese and/or who have other comorbidities may be an important subgroup to target for diabetes screening, disease management and prevention efforts.