Household food insufficiency is associated with poorer health

The purposes of this study were to estimate the prevalence of household food insufficiency in Canada, to identify sociodemographic characteristics of households most likely to report food insufficiency and to examine the relationship between food insufficiency and physical, mental and social health. These objectives were achieved through an analysis of data from the 1996/1997 National Population Health Survey. An estimated 4% of Canadians, 1.1 million people, were found to be living in food-insufficient households. Single-parent families, households reporting their major source of income as welfare, unemployment insurance or workers' compensation, those who did not own their own homes and households in Western Canada were more likely to report food insufficiency. The likelihood of reporting food insufficiency increased dramatically as income adequacy deteriorated. Individuals from food-insufficient households had significantly higher odds of reporting poor/fair health, of having poor functional health, restricted activity and multiple chronic conditions, of suffering from major depression and distress, and of having poor social support. Individuals in food-insufficient households were also more likely to report heart disease, diabetes, high blood pressure and food allergies. Men in food-insufficient households were less likely to be overweight; after adjusting for potentially confounding variables, no other associations were found between food insufficiency and body mass index. These findings suggest that food insufficiency is one dimension of a more pervasive vulnerability to a range of physical, mental and social health problems among households struggling with economic constraints.     

Household food insecurity is associated with adult health status

The prevalence of household food security, which reflects adequacy and stability of the food supply, has been measured periodically in the United States and occasionally in high-risk groups or specific regions. Despite a plausible biological mechanism to suggest negative health outcomes of food insecurity, this relation has not been adequately evaluated. This study was conducted in the Lower Mississippi Delta region to examine the association between household food insecurity and self-reported health status in adults. A two-stage stratified cluster sample representative of the population in 36 counties in the Delta region of Arkansas, Louisiana, and Mississippi was selected using list-assisted random digit dialing telephone methodology. After households were selected and screened, a randomly selected adult was interviewed within each sampled household. Data were collected to measure food security status and self-reported mental, physical, and general health status, using the U.S. Food Security Survey Module and the Short Form 12-item Health Survey (SF-12). Data were reported on a sample of 1488 households. Adults in food-insecure households were significantly more likely to rate their health as poor/fair and scored significantly lower on the physical and mental health scales of the SF-12. In regression models controlling for income, gender, and ethnicity, the interaction between food insecurity status and race was a significant predictor of fair/poor health and lower scores on physical and mental health. Household food insecurity is associated with poorer self-reported health status of adults in this rural, high-risk sample in the Lower Mississippi Delta.     

Household food insecurity with hunger is associated with women's food intakes, health and household circumstances

This study investigated food intake patterns and contextual factors related to household food insecurity with hunger among a sample of 153 women in families seeking charitable food assistance in Toronto. Women in households characterized by food insecurity with severe or moderate hunger over the past 30 d (as assessed by the Food Security Module) reported lower intakes of vegetables and fruit, and meat and alternatives than those in households with no hunger evident. Women were more likely to report household food insecurity with hunger over the past 12 mo and 30 d if they also reported longstanding health problems or activity limitations, or if they were socially isolated. The circumstances that women identified as precipitating acute food shortages in their households included chronically inadequate incomes; the need to meet additional, unusual expenditures; and the need to pay for other services or accumulated debts. Women who reported delaying payments of bills, giving up services, selling or pawning possessions, or sending children elsewhere for a meal when threatened with acute food shortages were more likely to report household food insecurity with hunger. These findings suggest that expenditures on other goods and services were sometimes foregone to free up money for food, but the reverse was also true. Household food insecurity appears inextricably linked to financial insecurity.     

Early puberty is associated with mental health problems in middle adolescence

This study set out to assess the relationship between pubertal timing and emotional and behavioural problems in middle adolescence. The study involved a school based survey of health, health behaviour and behaviour in school as well as questions about emotional and behavioural problems (the School Health Promotion Study). Secondary schools in four regions and 13 towns in Finland participated in the study in 1998. The respondents were 36,549 adolescents aged 14-16. The study included questions on depression, bulimia nervosa, psychosomatic symptoms, anxiety, drinking, substance use, smoking, bullying and truancy. Among girls, both internalising and externalising symptoms were more common the earlier puberty occurred. Among boys, externalising symptoms only were associated with early puberty. It is concluded that early pubertal timing is associated with increased mental health problems. Professionals working with adolescents should consider the mental health needs of early maturing adolescents.     

Indoor air quality and health problems associated with damp floor coverings

Objectives To study the relationship between a high incidence of bronchial asthma among employees working in an office building and an indoor air problem related to the degradation of polyvinyl chloride (PVC) floor coverings in the building. The indoor air measurements and results of renovations are also described.Methods Employees symptoms were surveyed by a questionnaire, and the incidence of asthma was calculated from the medical records for 1997–2000. The quality of indoor air was assessed by microbial sampling and by investigation of the building for possible moisture damage. Indoor air was sampled for volatile organic compounds (VOCs) through Tenax adsorbent tubes. In situ volatile emission measurements from the concrete floor were performed via the field and laboratory emission cell (FLEC) method.Results In an office with approximately 150 employees, eight new cases of asthma were found in 4 years. In addition, the workers complained of respiratory, conjunctival and nasal symptoms. Emissions indicating the degradation of plastic floor coverings (e.g. 2-ethyl-1-hexanol, 1-butanol) were found in the indoor air and floor material samples. The plastic floor coverings, adhesives and the levelling layers were carefully removed from 12 rooms. The VOCs had diffused into the underlying concrete slabs. The concrete was warmed to remove the diffused VOCs from these areas. After the repairs the concentrations of the VOCs indicating the degradation of PVC, decreased, as did the prevalence of the employees symptoms and several asthma patients need for medication.Conclusions The workers in the office building complained of several respiratory, conjunctival and dermal symptoms. The incidence of adult-onset asthma was approximately nine-times higher than that among Finns employed in similar work. The most probable single cause of the indoor air problem was the degradation of the plastic floor coverings.     

关于当前卫生事业发展问题的思考

国务院决定在部分城市进行深化城市医疗服务体制改革的试点工作。笔者认为,目前至少6个方面的问题迫切需要加以解决。1卫生事业是“事业”还是“产业”关于卫生事业是“事业”还是“产业”的争论已经由来已久,结果是“事业”派和“产业”派各执其辞,各行其是。笔者认为,我国卫生事业的本质就是“事业”。所谓“事业”即是为了达到某种目标而由一个群体通过工作而形成的系统,所谓“产业”即是要通过经营和管理来追求利益的最大化。两者最基本的差异在于:“事业”追求的是“社会效益第一”;“产业”追求的是“经济效益第一”。我们知道,卫生事…     

Emerging issues associated with HIV patients seeking advice from health food stores

OBJECTIVES: To ascertain the recommendations, training and education of health food store employees and determine how they communicate the costs, benefits and risks associated with natural health products for the HIV/AIDS community. METHODS: Four male research assistants, posing as asymptomatic HIV-positive individuals, inquired of employees of all retail health food stores in a major Canadian city as to what is recommended for their condition. The research assistants asked about product costs, side effects, potential drug interactions and efficacy. They also inquired as to employee education related to Complementary and Alternative Medicine (CAM) and noted whether employees asked about which conventional medications they were taking and whether they recommended that the subjects seek physician or CAM provider advice. RESULTS: A total of 32 stores were included. Eight store employees (25%) offered no advice; eight (25%) inquired whether the subjects were currently taking medications; six (19%) suggested visiting a physician; and eight (25%) suggested visiting a CAM provider. A total of 36 different products (mean 2.3 per employee) were recommended with considerable variability in product evidence and cost. The education of the employees varied from postgraduate education (n=3), to undergraduate degree (n=3), college level (n=5) in CAM, or no formal education in CAM (n=21). CONCLUSION: There was considerable heterogeneity in advice on natural food products provided by employees of natural food stores and, in general, these individuals had limited formal training in CAM. The products they recommended had limited evidence supporting their efficacy and in some instances were potentially harmful and had considerable costs. The findings of this study support the need to further examine how best to regulate this growing component of the health care system.     

Human ecology in understanding environmental health problems.

The role of human ecology in understanding of environmental health problems is discussed, and the importance of study on "regional" ecosystems is emphasized in consideration of recent arguments on theoretical frame work of human ecology. After brief conceptual discussion on "regional" ecosystems, the environmental health on hunter-gatherer populations, and then, the influence of agricultural development is discussed in relation to the "closedness" of regional ecosystems. Finally, by an example, e.g. islanders on small islands of southern Japan, the differentiation of economic activities by island is shown as the most important regulating factor for the accumulation of mercury in islanders.     

Factors associated with self-reported, pesticide-related visits to health care providers in the agricultural health study.

To investigate factors associated with pesticide-related visits to health care providers (i.e., doctor or hospital visits), responses to self-administered questionnaires received from 35,879 licensed restricted-use pesticide applicators participating in the Agricultural Health Study were analyzed. (In Iowa, applicators are actually certified, whereas in North Carolina they are licensed; for ease of reference, the term license will be used for both states in this paper.) The cohort reported a total of more than 10.9 million pesticide-application days. These applications were associated with one or more pesticide-related health care visits by 2,214 applicators (7.0% of the applicator cohort for whom health care visit data were available). The odds of a pesticide-related health care visit were increased for commercial applicators compared to private applicators [odds ratio (OR = 1.77; 95% confidence interval (CI), 1.52-2.06) and for applicators who used insecticides 70 times or more in their lifetime compared to those who used insecticides less frequently (OR = 1.43; CI, 1.26-1.63). After adjusting for the number of applications in a logistic regression model, significantly higher odds of health care visits were observed among North Carolina applicators compared to Iowa applicators (OR = 1.35; CI, 1.17-1.52), among applicators who mixed their own pesticides (OR = 1.65; CI, 1. 22-2.23), and among applicators who personally repaired their pesticide application equipment at least once per year (OR = 1.12; CI, 1.06-1.25). Significantly lower odds were found among female versus male applicators (OR = 0.68; CI, 0.46-0.99) and among applicators who graduated from high school versus those who did not (OR = 0.82; CI, 0.71-0.94 for high school graduates and OR = 0.79; CI, 0.68-0.91 for those with at least some college). Several methods of pesticide application to crops, seed, or stored grain were also associated with significantly elevated odds ratios of health care visits. These observations suggest that several steps can be taken to reduce the number of health care visits resulting from occupational exposure to pesticides. The implications of this pattern of pesticide-related health care visits may have etiologic implications for cancer and other chronic diseases.     

Human health impact from antimicrobial use in food animals

There is accumulating evidence that the use of antimicrobials in food-producing animals has adverse human health consequences. The use of antibiotics in food animals selects for resistant pathogens and resistance genes that may be transferred to humans through the consumption or handling of foods of animal origin. Recent studies have demonstrated that antimicrobial-resistance among foodborne bacteria may cause excess cases of illness, prolonged duration of illness, and increased rates of bacteremia, hospitalization, and death. The continued availability of safe and effective antimicrobials for humans and animals depends upon the responsible use of these products.     

Irrigated crop production is associated with less malaria than traditional agricultural practices in Tanzania

There is concern that crop irrigation that results in increased numbers of vector mosquitoes will lead to a rise in malaria in local communities. We evaluated the level of malaria experienced in 3 communities in northern Tanzania with different agricultural practices: rice irrigation, sugar-cane irrigation and traditional maize cultivation. Five cross-sectional surveys were used to measure the prevalence of infection with falciparum malaria in 1-4 years old children in each community over a period of 12 months. Active case detection was also carried out to record clinical episodes of malaria during the study period. Information on antimalarial measures was also recorded. Results from the cross-sectional surveys showed that the overall prevalence of malaria parasites was less near the rice irrigation (12.5%) and sugar-cane (16.9%) schemes than the savannah village (29.4%). There were also significantly fewer clinical episodes of malaria in the rice village (15 cases/1000 child-weeks at risk [cwar]) than either the sugar-cane (36 cases/1000 cwar) or savannah (40 cases/1000 cwar) villages. Overall, rice irrigation was associated with less malaria than alternative agricultural practices, despite the considerable numbers of vectors produced in the paddies. This finding supports other studies that indicate that irrigation in much of sub-Saharan Africa will not lead to increased malaria. Nonetheless, African governments planning irrigation projects need effective policies to encourage local communities to use personal protection measures, such as insecticide-treated bednets, and to ensure that these communities have access to effective antimalarial drugs and efficient health services.     

Human health implications associated with mucilage in the northern Adriatic Sea

Mucilage in the northern Adriatic Sea is well known for its negative impact not only on the ecology of the affected area and on fishing activities but on tourism as well. The microhabitat mucilage creates in the sea can provide favourable conditions for the growth and/or survival of some environmental microorganisms that include human opportunistic pathogens. It also seems to favour the selective development of some marine toxic algae. Finally, mucilage can concentrate chemical contaminants from surrounding waters, hence increasing their bioaccumulation in seafoods. This paper examines the possible direct and indirect effects on human health of mucilage and other forms of marine aggregates.