Individual-level analysis of social capital and health: a comparison of Arab and Jewish Israelis

Discrepancies exist in existing research regarding the association between social capital and self-rated health, most of which has been undertaken in the developed world. The aim of this study is first to assess the levels of the various variables describing individual social capital in Jews and Arab residing in Israel, and second to assess the association between individual social capital and self-rated health in these two population groups. The data were obtained from an Israeli health interview survey (knowledge, attitudes and practices (KAP)) conducted during 2004-2005, which is based on 3,365 interviews with adult Jews and 985 adult Arabs. Social capital measures included social trust, neighborhood safety, perceived helpfulness, trust in local and national authorities and social support. Data were also obtained on self-rated health and socioeconomic and demographic variables. Multivariate logistic regression revealed that Jews reported higher levels of social trust, perceived helpfulness, trust in authorities, and social support compared to Arabs, after adjusting for demographic and socioeconomic variables. Social contacts, however, were reported more frequently in the Arab population. Neighborhood safety was similar in the two population groups. Among Jews, those reporting higher levels of individual social capital reported better self-rated health after adjusting for demographic and socioeconomic variables. Among Arabs, only those reporting higher levels of social support reported better self-rated health. In Israel, individual levels of social capital seem to be lower in the Arab minority than in the Jewish majority. Individual social capital was associated with better self-rated health mainly in the Jewish population and less so in the Arab population. Social capital factors may be associated with health to a higher extent in affluent populations with relatively high social capital and less so in low social capital and more traditional communities. More research is needed to verify these differences.     

Colorectal cancer screening behavior in women attending screening mammography: Longitudinal trends and predictors

PURPOSE: Nationally representative surveys demonstrate that the adherence to screening mammography guidelines are associated with increased prevalence of colorectal cancer (CRC) screening; however, the incidence of CRC screening in the screening mammography population is unknown. Our purpose was to describe non-fecal occult blood test (FOBT) CRC screening utilization by women prior to and subsequent to screening mammography at a large academic medical center. MATERIALS AND METHODS: Using the institutional administrative data base, 17,790 women aged 50 and older who underwent screening mammography between 1998 and 2002 were retrospectively identified. We determined that women were current with non-FOBT CRC screening at the time of mammography if they had undergone flexible sigmoidoscopy or double-contrast barium enema in the 5 years or colonoscopy since 1995, the earliest for which data are available. We excluded FOBT as a form of CRC screening because the administrative data base did not adequately capture episodes of FOBT. Women who were not current were considered eligible for non-FOBT CRC screening. We then assessed the number of women who underwent flexible sigmoidoscopy, barium enema, or colonoscopy within 12 months following mammography. Age, insurance status, Breast Imaging Reporting and Data System classification, recommendations after screening mammography and year of mammography were examined as potential predictors of non-FOBT CRC screening completion. RESULTS: At the time of mammography, 13.3% women were current with non-FOBT CRC screening. Of women eligible for non-FOBT CRC screening at the time of mammography, 1.1% completed non-FOBT CRC screening within 12 months after mammography. The rate of non-FOBT CRC screening completion increased over time. After multivariate analysis, being insured by a commercial managed care organization or by Medicaid remained significant predictors of non-FOBT CRC screening. CONCLUSION: The prevalence of non-FOBT CRC screening is low in the population of women undergoing screening mammography, with an incidence of 1.0%. Future studies should examine whether delivering CRC screening interventions at a screening mammography visit increase adherence to non-FOBT CRC screening.     

Factors associated with prostate cancer screening: a population-based study

The aim of this study was to analyze the prevalence of prostate cancer screening among men aged 50 years or older based on socioeconomic, demographic, and health-related behavioral variables and the presence of morbidity. A population-based cross-sectional study was performed. The following factors were associated with failure to undergo screening: age under 70 years; less than eight years of schooling; per capita household income less than one-half the minimum wage; not having diabetes; lack of visual impairment; and lack of visit to the dentist in the previous year. The Brazilian public healthcare system accounted for 41% of the reported prostate cancer screening tests. According to the present study, despite controversy over the effectiveness of digital rectal examination and prostate-specific antigen for detecting prostate cancer, a significant portion of the male population has been undergoing these tests, the access to which displays significant socioeconomic inequalities.     

Self-reported health as a cultural health determinant in Arab and Jewish Israelis MABAT--National Health and Nutrition Survey 1999-2001

Subjective health (SH) status serves as a measure of health in many studies of health-related issues as it is a good predictor of mortality, morbidity, and use of health services. The measure is used in many population groups. However, the degree to which it measures the same condition in different ethnic groups is not clear. Within Israel's first National Health and Nutrition Survey (MABAT) conducted during 1999-2001, face-to-face interviews were held with 3222 Israeli interviewees, 2379 Jews and 843 Arabs, aged between 25-64 years. Respondents reported their SH, co-morbidity, and other socioeconomic characteristics. Arabs reported higher levels of SH than Jews. In logistic regression analysis, co-morbidity was a much stronger correlate of poorer SH in the Arab than in the Jewish population. The association between socioeconomic variables depended on ethnic group and sex. The findings indicate that SH in Jews and Arabs does not necessarily have the same meaning in relation to objective measures of health, and caution should be exercised in the use of this measure in different population groups with different cultures. Arabs tend to evaluate health better than Jews even though life expectancy is lower and morbidity and mortality are higher in the former population group. Yet diagnosis of a disease increases the frequency of reporting lower SH, more in Arabs than in Jews.     

Increasing uptake of colorectal cancer screening in Korea: a population-based study

Background  

Colorectal cancer (CRC) screening rates are low in most Asian countries and remain largely unknown. This study examined trends in CRC screening rates after the introduction of the Korean National Cancer Screening Programme (NCSP) and determined the factors associated with uptake of CRC screening by test modality over time.     

Early breast cancer detection practices, health beliefs, and cancer worries in Jewish and Arab women

BACKGROUND: Breast examinations (BE) for the early detection of breast cancer are the principal way of increasing survival rates in breast cancer. To date, BE practices among Jewish as compared with Arab women, and the factors associated with them have not been examined in Israel. OBJECTIVES: (1) To study differences in BE practices among Arab and Jewish women. (2) To characterize demographic, cognitive, and emotional factors related to Arab and Jewish women's BE practices. METHOD: In 2004, 489 Jewish women and 440 Arab women, ages 20-60, and randomly sampled from the female population of Israel, answered a telephone questionnaire related to BE practices, health beliefs, and breast cancer worries.     

Health beliefs as predictors of intentions toward prostate cancer screening among Nigerian immigrant men

Journal of Public Health - Prostate cancer (PCa) globally impacts men of African descent disproportionately more than any other ethnicity. Studies focusing on PCa among the U.S.-based Nigerian...     

Colorectal cancer and its prevention: prevalence of beliefs,attitudes, intentions and behaviour

Abstract: There is so far only limited evidence from randomised controlled trials that screening for colorectal cancer using the faecal occult blood test produces significant mortality reductions in screened groups, but there is considerable activity and interest in the use of such screening in Australia. Beliefs, attitudes, intentions and behaviour in relation to colorectal cancer and screening were examined among participants 40 years and older (n = 1776) who took part in a representative population survey. While there were high levels of awareness of faecal occult blood test screening, most respondents had not had a test, nor did they intend to take a test in the future. Important determinants of participation in screening were a family history of colorectal cancer, a belief that bowel cancer can be cured if detected at an early stage, a perception of personal susceptibility to bowel cancer and an acceptance of the technique. Factors such as these are likely to influence the success of any future screening program in Australia.     

Cervical cancer screening coverage and associated factors in a city in southern Brazil: a population-based study

This study focused on coverage of screening for cervical cancer and associated factors in women 20 to 59 years of age in Florianópolis, Santa Catarina State, Brazil, in 2009. This was a cross-sectional study using cluster random sampling. Two outcomes were examined: a history of at least one Papanicolaou test and delaying the test (never performed or performed more than three years previously). Among 952 women, 93% (95%CI: 91.5-94.7) had ever had a Pap smear, whereas 14% (95%CI: 11.8-16.2) had delayed the test. According to Poisson regression, both outcomes were associated with marital status, schooling, presence of chronic disease, and consulting a physician for other reasons. Age, income, and hospitalization in the previous year were only associated with ever having a Pap smear. Although test coverage was high, much of the screening was opportunistic. In addition, various social, economic, and demographic disparities influenced the odds of being screened.     

Attitudes, beliefs, and knowledge as predictors of nonattendance in a Swedish population-based mammography screening program

BACKGROUND: The effectiveness of mammography screening could be improved if factors that influence nonattendance were better understood. METHODS: We examined attitudes, beliefs, and knowledge in relation to nonattendance in a population-based mammography screening program, using a case-control design. Data were collected from November 1997 to March 1998 through telephone interviews with 434 nonattenders and 515 attenders identified in a population-based mammography register in central Sweden. The questions asked drew primarily upon the components constituting the Health Belief Model. RESULTS: Multivariate analysis showed that nonattendance was most common among women within the highest quartile of perceived emotional barriers, compared to women within the lowest quartile (OR = 4.81; 95% CI 2.96-7.82). Women who worried most about breast cancer were more likely to attend than those who worried least (OR = 0.09; 95% CI 0.02-0.31). Women with the highest scores of perceived benefits were more likely to attend than women with the lowest ones (OR = 0.35; 95% CI 0.08-0.75). Other factors associated with nonattendance were less knowledge about mammography and breast cancer, lack of advice from a health professional to participate, and very poor trust in health care. CONCLUSIONS: Our findings suggest that increased participation in outreach mammography screening programs can be achieved through enhancement of breast cancer awareness and possibly by reducing some of the modifiable barriers. mammography; mass screening; breast cancer; attitudes; Sweden.     

Colorectal cancer screening: efficiency and effectiveness

The cost-effectiveness of a series of mutually exclusive colorectal cancer screening programmes with varying screening interval and target group are analysed. Costs and effects for 60 possible screening programmes are simulated on the basis of data collected from a randomized trial initiated in 1985 in Funen County, Denmark. The screening test applied is the unhydrated Hemoccult-II. The analysis identifies six efficient programmes with cost-effectiveness estimates ranging from 17 000 to 42 500 Danish kroner (DKK) per life-year. © 1998 John Wiley & Sons, Ltd.     

Risk factors and predictors of induced abortion: a population-based study

This study aimed to identify key risk factors and predictors of induced abortion. A cross-sectional population-based study was conducted with a representative sample of 3,002 women 15 to 49 years of age in southern Brazil, randomly assigned to answer questions on induced abortion using either the ballot-box method or the indirect questioning method. Socioeconomic, demographic, and reproductive data were obtained through a pre-coded questionnaire. Data analysis used epidemiological statistical inferences and Bayes' theorem to calculate a posteriori probability. Induced abortion was strongly associated with fetal loss for all age groups. In adolescents, the main predictors were low socioeconomic level, low schooling, elevated school drop-out, and knowledge of a large number of contraceptive methods. For all other women, socioeconomic characteristics and skin color were not associated with abortion. For women aged 20 to 49 years, marital status and reproductive characteristics, including knowledge of contraceptive methods, were the most frequent risk factors and predictors of induced abortion.     

Increased risk for familial ovarian cancer among Jewish women: A population-based case-control study

Jewish women have been reported to have a higher risk for familial breast cancer than non-Jewish women and to be more likely to carry mutations in breast cancer genes such as BRCA1. Because BRCA1 mutations also increase women's risk for ovarian cancer, we asked whether Jewish women are at higher risk for familial ovarian cancer than non-Jewish women. To determine the effects of 1) Jewish religion and 2) ovarian cancer in a first-degree relative on women's risk for epithelial ovarian cancer, we used data from a population-based, case-control study conducted in 8 geographic regions in the United States from 1980 through 1982. The study group included 471 cases and 4,025 controls. Jewish women were more likely to have familial ovarian cancer than non-Jewish women [odds ratio (OR) = 8.4,95% confidence interval (CI) = 2.6–28]. The risk of having ovarian cancer appeared to be greater in Jewish women having a first-degree relative with ovarian cancer (OR = 8.81,95% CI = 2.02–38.23) than in non-Jewish women having a first-degree relative with ovarian cancer (OR = 3.01,95% CI = 1.61–5.64), but differences between Jewish and non-Jewish women were not statistically significant. Jewish women with no first-degree relative with ovarian cancer had no increased risk for ovarian cancer (OR = 1.27,95% CI = 0.74–2.91) compared to non-Jewish women. These results suggest that Jewish women may have a higher rate of familial ovarian cancer than non-Jewish women, but because the results are based on a small number of Jewish women with familial ovarian cancer, the results need to be confirmed in larger studies. Genet. Epidemiol. 15:51–59,1998. © 1998 Wiley-Liss, Inc. This article was prepared by a group consisting of both United States government employees and non-United States government employees, and as such is subject to 17 U.S.C. Sec. 105.     

Reasons women do not attend screening for cervical cancer: a population-based study in Sweden

BACKGROUND: With an improved compliance with screening a larger reduction of cervical cancer incidence would be within reach. We aimed at investigating why certain women do not attend Pap smear screening and at validating the reliability of self-reported screening. METHODS: In 1998 in the county of Uppsala, Sweden, information was collected through telephone interviews with 430 nonattendees and 514 attendees to Pap smear screening, who were all sampled from a population-based database. The women's recall of attendance was validated against the database. The main outcome measures used were odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Non-attendance was positively associated with nonuse of oral contraceptives (OR = 3.56, 95% CI 2.18-5.83), seeing different gynecologists (OR = 1.90, 95% CI 1.34-2.70), and seeing a physician very often (OR = 3.12, 95% CI 1.45-6.70) or not at all (OR = 1.78, 95% CI 1.09-2.90). Frequent condom use (OR = 1.88, 95% CI 1.02-3.47), living in rural/semirural areas (OR = 1.55, 95% CI 1.07-2.21), and not knowing the recommended screening interval (OR = 2.16, 95% CI 1.20-3.89) were all associated with nonattendance, whereas socioeconomic status was not, when tested in a multivariate model. Among the nonattendees, 57% underestimated the time lapse since last smear. CONCLUSIONS: Seeing a gynecologist on a regular basis and information guiding women to have a Pap smear on their own initiative are important factors for recurrent screening. Therefore, information should be given to all women about the purpose and benefits of Pap smear testing. Self-reports on screening should be treated with caution.     

Lower utilization of cervical cancer screening by nurses in Taiwan: a nationwide population-based study

ObjectiveUsing a nationwide population-based database in Taiwan, this study compares use of Pap smear testing by nurses and the general population.MethodWe compared 1093 practicing female nurses and 5465 randomly selected female patients from the 2006 National Health Insurance (NHI) database to evaluate the likelihood of receiving at least one Pap smear during a three-year period.ResultsWe found that 48.9% of the nurses and 56.2% of comparison subjects received a Pap test from 2004 to 2006 in Taiwan. Regression analysis showed that practicing female nurses were less likely to receive a Pap smear compared with the general population (OR = 0.42, 95% CI = 0.35–0.50, p < 0.001), after adjusting for monthly incomes, number of ob/gyn ambulatory care visits, urbanization level and the geographic location of the communities where subjects resided.ConclusionNurses were less likely to undergo cervical screening than the general population, despite ease of access and a national health insurance system providing universal coverage to residents of Taiwan. Efforts to raise the Pap screening rate among nurses may require addressing unique cultural and occupational concerns.     

Colorectal cancer screening attitudes and practices in the general population: a risk-adjusted survey.

OBJECTIVES: To characterize self-reported colorectal cancer (CRC) screening behavior, and to identify characteristics of CRC screening practices, stratified by risk. METHODS: Using random-digit-dial methodology, we conducted telephone surveys in US adults 50 years of age and older. Respondents provided data on utilization of CRC screening tests; demographic characteristics; and awareness, concerns, attitudes and beliefs about the tests, CRC, and health care. On the basis of available guidelines, three definitions of adequate screening were considered. RESULTS: Among persons reporting having ever had a CRC screening exam, the exam was more likely to have been a fecal occult blood test than a radiologic or endoscopic exam (p < .0001). Subjects at increased CRC risk were more likely to have met the screening criteria (p < .001) compared with average-risk subjects. Receipt of information or advice about cancer screening tests, male gender, and concern about managed care were positively associated with adequate screening. Smoking, low health self-monitoring, and an average risk for CRC reduced the probability of CRC screening. CONCLUSIONS: Lack of awareness about screening remains common, regardless of CRC risk. Providing information and advice about cancer screening may be the single most important tool available to improve screening rates.     

Occupation and bladder cancer: a population-based,case-control study in Iowa

While considerable efforts have been made to investigate the role of occupation and industry in the risk of bladder cancer, many reported associations have not been consistent, and strong evidence of increased risk is apparent for few occupational groups. To further examine the issue, a large, population-based, case-control study was conducted in the state of Iowa among both men and women. A total of 1452 incident bladder cancer cases and 2434 controls were included in the study. Occupational history was collected from respondents for each job held for 5 years or longer since age 16. Among men, excess risk was observed for industries including plumbing, heating, and air conditioning (odds ratio [OR], = 2.2; 95% confidence interval [CI], 1.0 to 5.0); rubber and plastic products (OR = 3.1; 95% CI, 1.2 to 8.5), motor vehicle parts and supplies (OR = 4.5; 95% CI, 1.2 to 16.5), and occupations including supervisors for transportation and material moving (OR = 6.5; 95% CI, 1.4 to 29.9), material-moving-equipment operators (OR = 1.9; 95% CI, 1.0 to 3.6), automobile mechanics (OR = 1.6; 95% CI, 1.0 to 2.6), painters (OR = 2.7; 95% CI, 1.0 to 7.7), and metal- and plastic-working machine operators (OR = 2.0; 95% CI, 1.1 to 3.4). Among women, significant excess risk was observed for secondary school teachers and record clerks. Housekeepers and butlers and workers in laundering and dry cleaning were also at increased risk. In conclusion, these results suggest that occupational exposures may play a significant role in the risk of bladder cancer.     

Colorectal cancer screening knowledge and uptake in lebanon: a national survey

ObjectiveThe main aim of this national survey was to identify the levels of colorectal cancer screening knowledge and uptake in Lebanon.MethodsA total of 1200 participants were enrolled in this cross-sectional household survey targeting the Lebanese population aged 50 years and above. The sample was recruited using a two-stage stratified cluster sampling approach.ResultsOf the total sample, 38.3% knew about any screening test for colorectal cancer but only 7.5% had ever used any. Thirty-nine percent of the participants rated their risk of getting colorectal cancer as very low or low, and only 53.5% were confident in their ability to undertake a screening test. Almost all participants agreed that medical advice and test reimbursement would encourage them to do a screening test. At the multivariate analysis level, hearing of an awareness campaign in the last two years showed the strongest association with the knowledge of a colorectal cancer screening test with an estimated OR_adj = 5.12 (95%CI: 3.67 – 7.15). Other factors that were significantly associated with this knowledge variable included: a family history of colorectal cancer, a personal history of colorectal illness, having a health coverage, and knowledge of colorectal cancer signs and symptoms.DiscussionThis national study highlights an alarming lack of uptake and low levels of knowledge of colorectal cancer screening tests even though it is among the most prevalent cancers in Lebanon and its prevalence has been continuously increasing in the past years. The evidence suggests that people who had an experience with colorectal cancer diagnostic tests, either personally or through a family member, and those who have heard of an awareness campaign about colorectal cancer in the last two years are more likely to know its screening tests.ConclusionColorectal cancer screening knowledge and uptake in Lebanon are limited and justify the need for public health interventions. This study gives evidence that awareness campaigns, coupled with the involvement of medical providers and the reimbursement of screening test fees, would alleviate the burden of colorectal cancer in Lebanon.