Reciprocal relations between effort-reward imbalance at work and adverse health: a three-wave panel survey

Siegrist's [1996. Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1, 27-41.] Effort-Reward Imbalance (ERI) Model assumes that ERI at one point in time influences health at a later point in time. Empirical cross-sectional and longitudinal findings have supported the influence of ERI on adverse health. However, the ERI model does not explicitly take into account that the relation between ERI and adverse health may be also explained by reversed causal relations, or even reciprocal (bi-directional) relations in which ERI and health mutually influence each other. The present 3-wave panel study among 211 Japanese male blue-collar workers in one construction machinery company examined reciprocal relations between ERI and adverse health (i.e., psychological distress and physical complaints) with a 1-year time-lag per wave. Hypotheses were tested using structural equation modeling (Amos 7.0J). Results showed cross-lagged and causally dominant effects of ERI on both psychological distress and physical complaints after 1 year for both Time 1-Time 2 and Time 2-Time 3. In addition, cross-lagged effects of psychological distress on ERI were found after 1 year for both Time 1-Time 2 and Time 2-Time 3. These findings suggest that (perceived) ERI and employee health influence each other reciprocally rather than uni-directionally, and underline the importance of studying reversed causal effects in the relation between ERI and employee health.     

Racial and ethnic disparities in self‐assessed health status: Evidence from the national survey of families and households

We examined racial and ethnic disparities in global health assessment and functional limitations of daily activities among whites, blacks and Hispanics, and within the Hispanic origin among Mexicans, Puerto Ricans, Cubans, and ‘Others’. Logistic regressions were employed to estimate the log odds of reporting ‘poor health’ and ‘having functional limitations’ among 12 814 respondents from the 1987—1988 National Survey of Families and Households. Compared with whites, blacks had an increased risk of reporting poor health and functional limitations. Hispanics had even a higher risk of reporting poor health, but did not have an increased risk of reporting functional limitations. Among Hispanics, Mexicans were more likely than whites to report poor health, whereas Puerto Ricans were more likely than whites to experience functional limitations. Both race and ethnicity remain important factors in explaining the disparities in self‐assessed health status independent of socioeconomic status (SES). Meanwhile, the way self‐assessed health status varies with ethnicity is importantly stratified by SES as measured by income and education. These results suggest that future research should analyze the interplay between ethnicity and SES rather than assuming measuring either captures all the important variation.     

Are Japanese people satisfied with their health care system and services? Empirical evidence from survey data

Background

Japan’s universal health care system provides many advantages for its users, including affordable health coverage with free and equal access to medical institutions. However, the Japanese population’s satisfaction with the health care system is among the lowest internationally. This paper investigates the extent and determinants of satisfaction toward Japan’s health care system and services, and compares the results with those of eleven other high-income countries.

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.

---

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.

---

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.

     

Factors associated with self-rated health in Greece: a population-based postal survey

BACKGROUND: Self-rated health (SRH), as an indicator of population health, is a concept useful both for research and planning. This study reports SRH, and factors related to it, in Greece. METHODS: Population-based postal survey, using World Health Organisation (WHO) questionnaires with a sample of randomly selected geographically stratified individuals. Response rate reached 41%. RESULTS: As expected, age, income and education were related to SRH, but accounted for only 20% of the variance. CONCLUSIONS: SRH in Greece is related to sociodemographic factors, but perhaps not as strongly as in other populations. Other explanatory variables will require further research.     

Adolescents' physical activity habits – results from a national health survey

Background The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of Health and the Center for Disease Control. This article presents results of physical activity (PA) habits in Israel, in relation to recommendations by world health organizations. Methods Participants were 6274 adolescents, grades 7–12, enrolled in a cross‐sectional, representative, school‐based survey. Sufficient level of PA was defined as any moderate and vigorous level of PA that adds up daily to 60 min/day. Light PA was considered to be an insufficient level of PA. Results Only 10.5% of the participants reported performing sufficient PA. Large gender differences were found, with 17.7% of boys versus only 4.6% of girls meeting the guidelines. Conclusions Results highlight the need to develop programmes for school children in Israel to promote PA. Such programmes have been initiated in many countries that have a large percentage of adolescents with a sedentary lifestyle.     

Interest in health screening as a predictor of long-term overall mortality: multilevel analysis of a Japanese national cohort study

Background

In Japan, screening programmes have been widely implemented as a public health practice. We investigated the effect of the area-level interest in health screening on mortality using data from a large cohort in Japan.

Methods

A baseline survey was conducted between 1988 and 1990 among 110,792 residents of 45 areas, aged 40-79 years. Area-level interest in health screening was defined as the proportion of people with high and moderate interest in health screening in an area. Multilevel Poisson regression was employed in a two-level structure of individuals nested within the areas. During 15 years of follow-up (1,035,617 person-years), 13,184 deaths were observed.

Results

The reduction in mortality rate was (a) 2% in both men (p = 0.009) and women (p = 0.038) for each percent increase in area-level interest in screening, and (b) 10% in men (p = 0.001) and 9% in women (p = 0.001) for individual attendance to screening in the year before follow-up. There was no interaction between area-level interest in screening, individual-level attendance at screening and overall mortality.

Conclusion

Area-level and individual interest for health screening appear to be independent predictor of 15-year mortality in this national Japanese study. The present findings may support public health practices to promote knowledge and participation in screening programmes.     

Measuring change over time: a comparison of results from a global single item of health status and the multi-dimensional SF-36 health status survey questionnaire in patients presenting with menorrhagia

This paper compares the sensitivity to change of a multi-item, multi-dimensional health status measure with a single global health status question, in the assessment of treatment for menorrhagia. A cohort study of patients recruited by general practitioners, was carried out, with a follow up at eighteen months. Questionnaires were administered postally at baseline and follow up. General practices in Berkshire, Buckinghamshire, Northamptonshire and Oxford-shire supplied three hundred and nine women who reported heavy menstrual bleeding, and received either drug treatment alone or both drug and surgical treatment (endometrial resection or hysterectomy) during the eighteen months between the two admini-strations of the questionnaires. A single global question was given to patients asking them to rate their overall health status as excellent, very good, good, fair or poor. The eight dimensions of the SF-36 health survey questionnaire were also given to patients to complete. The dimensions of the SF-36 indicated only small levels of improvement for patients who received drug treatment. However, on many dimensions of the SF-36, a moderate to large improvement was detected for the surgical group. However, small changes were reported in overall health status, as indicated by the single global question, for both groups. Single item measures of health status may not provide a sufficiently accurate indication of health status to be appropriate for use in longitudinal studies.     

Socioeconomic status and health status: A study of males in the Canada health survey

The relationships between education/occupation/income and health status have been well documented in the international epidemiological and sociological literature for many years, however, specific studies on the subject are scarce in Canada. Even when relationships have been demonstrated, the reasons for these relationships are much debated. This study presents an analysis of the relationship between socioeconomic status (SES) and health status. The study is based on analysis of data from a sample of nearly 2000 male principal income earners from the 1978 Canada Health Survey. Firstly, is there a relationship between an individual's SES and health status in Canada? Secondly, what aspects of SES--education, occupational status, and/or income--are most important? Thirdly, what are the possible explanations of the observed relationship? That is, is it possible to disaggregate the relationship and thereby infer possible causal mechanisms? The findings indicated a direct positive relationship between SES and health status, i.e. the higher an individual's SES, the better that person's health. The major exception to this was the SES/fitness relationship. In this instance, the higher the SES, the lower the level of fitness. Though age was an important control variable as SES, fitness and illness are age related, the findings relating SES to the health measures remained even when age was controlled for. Of the three SES measures, income was consistently the best correlate of health status. Occupational status showed the most inconsistent relationships with health status. The findings supported both the social causation and social selection hypotheses. That is, social position can have an effect on health status (social causation), while health status can affect one's social position (social selection).     

Reversal pattern of health inequality: New evidence from a large-scale national survey in Japan

Despite extensive evidence for a positive association between socio-economic status (SES) and health, some studies have shown that this well-established pattern of health inequality is reversed in Japan due to individuals of high SES working in stressful workplace environments. High-SES workers in Japan generally belong to a lifetime employment system (LES) in large companies. Thus, in this study, individuals who had been working for a single company for several decades at the time of a 2005 survey (LES workers) were compared with other workers by logistic regression and ordinary least squares regression. These analyses showed that LES workers had 36% more household savings. However, despite their relatively high income, the LES workers were more likely to develop diabetes (odds ratio 1.134: 95% CI 1.022–1.259) and hyperlipidemia (odds ratio 1.184: 95% CI 1.079–1.300). Among women, LES workers were at higher risk of developing cancer (odds ratio 1.570: 95% CI 1.174–2.098). In addition, these effects were consistently found in subsequent surveys between 2006 and 2015, suggesting that the LES had long-term adverse effects on health. These results taken together show that career trajectory is an important determinant of health inequality in the elderly population.     

Farmers are the most trusted part of the Australian food chain: results from a national survey of consumers

Objective : Trust is a crucial component of food safety and governance. This research surveyed a random selection of the population to examine its level of trust in a variety of ‘actors’ and organisations in the food chain. Methods : A computer‐assisted telephone interviewing (CATI) survey addressing trust in the food system was administrated during October to December 2009 to a random sample of 1,109 participants across all states (response rate 41.2%). Results : Farmers enjoyed high levels of trust, whereas politicians were considered less trustworthy. Supermarkets were afforded more trust than media and news outlets. Logistic regression analysis determined that two socio‐demographic variables – age and education level – were significantly associated with trust in food actors, with young people finding the media the least trustworthy. Conclusions : Our respondents invested the most trust in farmers, possibly indicating an awareness and appreciation of primary food production among the Australian public. The finding that young people's trust in the media is low challenges media use in social marketing campaigns aimed to improve health and nutrition in younger age groups. Implications : Health education, including nutrition education, needs to consider the channels of communication most suited to age and social grouping.     

健康危险因素对健康状况影响效应分析

目的量化分析健康危险因素对健康状况的影响效应。方法采用多元多水平方法(MVML)探索4 926名参加体检人员不同时间(2008—2010年)在体质指数(BMI)、吸烟、饮酒、体育锻炼和蔬菜、水果摄入等可控因素上的变化对脂蛋白、甘油三酯(TG)、总胆固醇(TC)等多个相关测量指标变化的影响。结果随着BMI增加,TG、TC、低密度脂蛋白(LDL)明显增加,而高密度脂蛋白(HDL)明显降低;男性组BMI平均每增加1 kg/m²,TG增加10.14 mg/dL,TC增加1.72 mg/dL,LDL增加1.91 mg/dL,而HDL则降低1.01 mg/dL;女性组,BMI平均每增加1 kg/m²,TG增加8.50 mg/dL,TC增加0.93 mg/dL,LDL增加1.40 mg/dL,而HDL则降低1.27 mg/dL;参加体育锻炼能明显降低TC、TG和LDL;经常吸烟、饮酒的男性的TC、TG和LDL明显升高;男性组蔬菜、水果摄入不足者的TC、TG水平较高。结论健康危险因素对健康状况有影响,可通过选择性干预措施有效改善我国居民健康状态。     

Sampling and recruitment methodology for a national eye health survey of Indigenous Australians

Objective: To review the process of sample selection and highlight the methodological difficulties encountered during a nationwide survey of Indigenous Australians, to determine the prevalence and causes of vision impairment and evaluate access to and utilisation of eye care services. Methods: Using a multi‐stage, random cluster sampling methodology, 30 geographic areas stratified by remoteness, were selected to provide a representative population of approximately 3,000 Indigenous Australians aged 5–15 and 40 years and older, and a small non‐Indigenous sample in selected remote areas. Recruitment was adapted to local conditions. The rapid assessment methodology included a questionnaire, tests of visual acuity, trachoma grading, frequency doubling perimetry and non‐mydriatic fundus photography. Results: The number of people examined was 2883/3662 (78.7%) Indigenous and 136 (83.4%) non‐Indigenous. The percentage of the expected population who were enumerated during the survey varied; discrepancies were largest in urban areas (34.5%) compared to very remote areas (97.1%). Conclusions: The unexpected variation in predicted population numbers and participation rates could be explained in part by local circumstances, degree of urbanisation, interpretation of the definition of ‘Indigenous’ and time constraints. Implications: For successful recruitment, a community‐specific approach is essential, including collaboration with local organisations and liaison with health workers of each gender.     

End-of-life preferences of the general public: Results from a Japanese national survey

PurposeTo determine under different End-of-Life (EoL) scenarios the preferences of the general public for EoL care setting and Life-sustaining-Treatments (LST), and to develop a new framework to assess these preferences.MethodUsing a 2-stage, geographical cluster sampling method, we conducted a postal survey across Japan of 2000 adults, aged 20+. Four EoL scenarios were used: cancer, cardiac failure, dementia and persistent vegetative state (PVS).ResultsWe received 969 valid responses (response rate 48.5%). Preference for EoL care setting varied by illness with those wishing to spend EoL at home only 39% for cancer, 22% for cardiac failure, and 10–11% for dementia and PVS. Preference for LST differed by scenario and treatment type. In cancer, cardiac failure and dementia, about half to two thirds expressed a preference for antibiotics and fluid drip infusion but few for nasogastric (NG) tube feeding, percutaneous endoscopic gastrostomy (PEG), ventilation or cardiopulmonary resuscitation (CPR). Although our models accounted for only 3–9% of the variance, preferences to receive LST were associated with preference to spend EoL in hospital for cancer and cardiac failure but not dementia.ConclusionsFew people preferred to die at home, while a preference for hospital was largely determined by factors other than preference for LST.     

富阳市某镇农民健康状况及卫生服务需求调查

目的：了解富阳市某镇农民健康状况及卫生需求。方法：采用整群随机抽样方法,抽取富阳市里山镇3个行政村6个自然村2047名农民进行健康检查,对1181名农民上门调查;召开30名代表（镇干部、社区卫生服务中心代表、村干部和村民代表）参加的座谈会。结果：农民慢性患病率高;社区卫生服务内容仍需不断拓展,补偿机制不合理,专业人员素质不高;健康教育工作未能满足广大农民需求。结论：应增加投入全面实施农民健康工程;推进包括调整和制定相应政策、加快人才队伍建设、研究和制定相应评价体系在内的农村社区卫生服务工作;建立农村健康教育体系,提高健康教育效率。     

新疆沙湾县哈萨克族居民营养健康状况调查

目的 了解新疆哈萨克族居民膳食营养与健康状况,为制定营养改善策略提供科学依据。方法 采用3 d 24 h膳食回顾法和称重法,对新疆沙湾地区牛圈子牧场1 628名≥18岁常住哈萨克族居民进行膳食调查和医学体检。结果 哈萨克族居民膳食构成以粮谷类为主,食盐摄入过多,蔬菜水果摄入不足,豆类、蛋类和鱼虾类等食物基本不吃;能量的日均摄入量为11 762.5 kJ,蛋白质为103.8 g,占供能的14.2%;脂肪为50.3 g,占供能的16.2%;碳水化合物为485.0 g,占供能的69%;膳食纤维和微量营养素低于参考摄入量;动物性食物提供的蛋白质占33.5%,提供的脂肪占54.2%;高血压患病率为39.7%,超重为26.2%,肥胖为27.7%。结论 膳食结构不合理、能量过剩、微量元素不足、高血压、超重和肥胖已成为影响哈萨克族居民健康的重要因素,应加强对居民的营养干预和健康教育,预防相关疾病的发生。     

Social support, social selection and self-assessed health status: results from the veterans health study in the United States

This study provided a comprehensive assessment of the association between social support and health using longitudinal data from the Veterans Health Study. Unlike previous studies which examined the relationship between one single domain of social support with either mental or physical health, the present study assessed the effects of three different domains of social support on multiple measures of health. The findings of the study indicated that social support tended to mediate the deleterious effects of non-military traumatic events; whereas the adverse consequences of traumatic events experienced in the military were not affected by social support, suggesting that stressors associated with combat had a long lasting effect on the health status of veterans. The study results revealed that compared with those with better health, respondents with poor health were more likely to have lower levels of social support, suggesting that poor health might be a barrier to a person's ability to participate and/or maintain social relationships. The study also showed that different types of social support had varying beneficial effects on different measures of health. While perceived support had a strong effect on all the measures of health (except alcoholism) included in the study, living arrangement had a significant effect on post-traumatic stress disorder or physical health and participation in group activities had a strong effect only on physical functioning. The results of the study highlight the need for future research to determine whether particular types of social support affect various aspects of health differently. This simultaneous focus on multiple support functions and health outcomes is important because it provides insight into the mechanisms linking social support to health.     

Self-rated health in Pakistan: results of a national health survey

Background  

Self-rated health (SRH) is a robust predictor of mortality. In UK, migrants of South Asian descent, compared to native Caucasian populations, have substantially poorer SRH. Despite its validation among migrant South Asian populations and its popularity in developed countries as a useful public health tool, the SRH scale has not been used at a population level in countries in South Asia. We determined the prevalence of and risk factors for poor/fair SRH among individuals aged ≥15 years in Pakistan (n = 9442).