Promoting the Psychosocial Health of the Elderly—

Abstract

With the ageing of the global population, the wellbeing of older people in different parts of the world merits special attention. However, recent findings on certain aspects of the psychosocial health of the elderly are far from reassuring. The first problem is the inconsistency in psychosocial indicators, which give simultaneous high life satisfaction scores and high suicide rates. The second problem is the significant weakening of the social support network of the elderly. This article analyses the service and policy implications of these two problems. Suggestions are then made on the role of social workers in promoting the psychosocial health of the elderly at different levels of intervention, which include the individual level, the family and social network level, the community level and the international level.     

Do the Health Benefits of Cycling Outweigh the Risks?

Background

Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail.

Objective

We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outweigh the health risks.

Data sources and extraction

We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies.

Data synthesis

We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We have expressed mortality impacts in life-years gained or lost, using life table calculations. For individuals who shift from car to bicycle, we estimated that beneficial effects of increased physical activity are substantially larger (3–14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8–40 days lost) and the increase in traffic accidents (5–9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and greenhouse gas emissions and traffic accidents.

Conclusions

On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport.     

Making the Invisible Visible: Are Health Social Workers Addressing the Social Determinants of Health?

This study explored the ways in which health social workers (HSW) address the social determinants of health (SDH) within their social work practice. Social workers (n?=?54) employed at major hospitals across Toronto had many years of practice in health care (M?=?11 years; SD?=?10.32) and indicated that SDH were a top priority in their daily work; with 98% intentionally intervening with at least one and 91% attending to three or more. Health care services were most often addressed (92%), followed by housing (72%), disability (79%), income (72%), and employment security (70%). Few HSW were tackling racism, Aboriginal status, gender, or social exclusion in their daily practice.     

The Causal Effect of Education on Health: What is the Role of Health Behaviors?

We investigate the causal effect of education on health and the part of it that is attributable to health behaviors by distinguishing between short‐run and long‐run mediating effects: whereas, in the former, only behaviors in the immediate past are taken into account, in the latter, we consider the entire history of behaviors. We use two identification strategies: instrumental variables based on compulsory schooling reforms and a combined aggregation, differencing, and selection on an observables technique to address the endogeneity of both education and behaviors in the health production function. Using panel data for European countries, we find that education has a protective effect for European men and women aged 50+. We find that the mediating effects of health behaviors—measured by smoking, drinking, exercising, and the body mass index—account in the short run for around a quarter and in the long run for around a third of the entire effect of education on health. Copyright © 2015 John Wiley & Sons, Ltd.     

Whose is SUS? About the social representation of the users of the Family Health Program

The present study analyzes the representation of the users of SUS and PSF, presenting data obtained by semi-structured interviews, using the theoretical referential of the qualitative research. The results show a social representation marked by a focused vision and assistance, pointing to the concentration of public resources in poor segments of the society and centered in the biomedical model of attention. It stands out that PSF did not reach their objectives to provide changes in the praxis in health. In relation to the social control, it is observed that only 5.9% of the interviewees know the CMS. The presented data show a great ignorance by the studied population on the sanitary system and conquered social laws, and many people still see SUS as a "health plan for the poor". Due to the lived reality, the need of the implementation of strategies is emphasized for the reach of larger powerment/liberation of the population, seeking to build effective possibilities so that their actors will be active participant of the process of construction of a common project, actually based on the democratic ideals of SUS, being PSF strategically important in the accomplishment of these actions.     

Who Does the Numbers? The Role of Third-Party Technology Assessment to Inform Health Systems' Decision-Making about the Funding of Health Technologies

Background:  There is an increasing number of health-care systems using economic evaluations to inform decisions about the reimbursement of health technologies. There are usually two separate elements of this process: assembling relevant evidence and undertaking analyses (technology assessment), and decision-making. In most systems, technology assessment is undertaken by the manufacturer of the technology. In a few, "third-party" assessment is used.
Methods:  In the United Kingdom, the National Institute for Health and Clinical Excellence used a combination of third-party and manufacturer assessments between 1999 and 2005. After this point, a Single Technology Appraisal program (using manufacturer-based assessment) was instituted for some technologies. Here the role of third-party assessment is considered in this from of decision-making. The article reviews the requirements of economic evaluation to support decision-making, and considers the extent to which each type of assessment is likely to meet these requirements. It also attempts to address whether the two forms of assessment differ in their impact on decision-making using a comparison of the decisions made by National Institute for Health and Clinical Excellence (NICE) (under its multiple-technology appraisal system) and the Scottish Medicines Consortium (SMC), which relies on manufacturer assessment.
Results:  The comparison is limited by the small number of technologies considered by both bodies. Nevertheless, it suggests that there are potentially important differences between the two bodies, with NICE generally placing more restrictions of the use of technologies.
Conclusions:  The article concludes that there are potential advantages to third-party assessment, but its cost and timing may preclude its use for all new technologies. A hybrid arrangement is suggested where third-party assessment is used in particular circumstances.     

Examining the Health Information–Seeking Behaviors of Korean Americans

Many Korean Americans suffer from high levels of cancer incidence and have low cancer screening rates. A significant number of Korean Americans lack adequate information about cancer screening tests. However, little is known about their health behaviors. This article examines exposure to mass media and health information–seeking behaviors for Korean Americans, and their associations with demographic characteristics influencing variations in exposure to the different health information and trust in health information sources. The authors gathered data for this study using a cross-sectional, community-based survey conducted in the Washington, DC, metropolitan area during 2006 and 2007. It was administered to 254 Korean Americans who were 40 years of age or older. This study is part of the first health-related program of research to study exposure to mass media, health and cancer information sources, and seeking preferences and experiences of Korean Americans. Results indicated that Korean ethnic media sources and Internet are important sources used regularly. Age, years of education completed, and English proficiency levels for Korean Americans significantly predicted the likelihood of their Internet use. Low-income Korean Americans with less education were more likely to seek health information in Korean ethnic magazines and newspapers, whereas Korean Americans with higher education and English proficiency were more likely to seek information online. The most trusted source of health information among respondents was from a doctor or other health care professional. Future research should be conducted to determine whether physicians are actually used as a primary source for health information.     

Oregon Parents’ Perceptions of the Supportiveness of the School Environment for Their Children's Health Behaviors

ObjectiveTo describe Oregon parents’ perceptions of their children's school regarding health behaviors; examine how perceptions vary by parent, child, and community characteristics; and identify recommendations for improving school environments.MethodsOregon parents with an elementary school–aged child completed an electronic survey.ResultsOver 90% of parents (n = 814) described their child's school as supportive of healthy eating and physical activity. Parents who ate ≥5 fruits/vegetables per day more often perceived their children's school as unsupportive of healthy eating (P < 0.001) and physical activity (P < 0.05) relative to others. Parents of children eligible for free/reduced-price lunch more often perceived the school as unsupportive of physical activity (P < 0.05) relative to others. Parental recommendations included improving school meals and providing short physical activity breaks.Conclusions and ImplicationsParents’ suggested school improvements can inform school wellness committees’ and administrators’ quality-improvement efforts and, in turn, better support children's healthy behaviors.     

Evaluation of the implementation of the Primary Health Care Master Plan in Unaí, Brazil

Aim

To evaluate the level of implementation of the Primary Health Care Master Plan in Unaí, Minas Gerais state, Brazil.

Subject and methods

The study was held among Family Health Teams by means of a questionnaire to evaluate Primary Health Care structures, processes and outcomes. The Kruskal-Wallis test was used to analyze the differences in the degree of implementation among the different teams using a 5% level of significance.

Results

The structures were found to be incipient, with significant statistical differences in materials (p?<?0.05). Processes were evaluated as advanced, with statistical difference being observed for Primary Health Care principles, local work planning, monitoring, and women’s and children’s health (p?<?0.05). Outcomes were classified as advanced, and no statistical difference was found in the analyzed items.

Conclusion

The overall implementation of the Primary Health Care Master Plan in Unaí was considered incipient, that is, it is in an initial stage. It must overcome the precariousness in its structure and continue advancing in the processes and expected outcomes to achieve the optimal stage of its implementation. Although the master plan is based on some principles from the Declaration of Alma-Ata, there is still a primary focus on women’s and children’s health.