Strategy for a public health initiative at regional level—the example of Bavaria

Aim The authors introduced a new public health initiative in Bavaria.Subjects and methods The initiative called Gesund.Leben.Bayern. (Healthy Living in Bavaria) applies a complementary promotion-prevention approach to the settings of daily living. The priorities for the Bavarian initiative are based on specific Bavarian epidemiological data and the Bavarian situation, and reflect WHO recommendations, including those contained in the World Health Report 2002.Results The initiative includes four priorities for public cofinancing and recognition: freedom from tobacco smoke, responsible use of alcohol, availability and choice of healthy nutrition and sufficient physical exercise opportunities, and health promotion at the workplace. A specific aspect of the Bavarian initiative is the requirement for explicit evaluation, aiming at generating new evidence of adequacy, success and cost-effectiveness of different prevention and promotion approaches. First steps have been taken: gearing up for participation and shaping the strategy; setting up a programme secretariat; building criteria for evidence, self reporting and evaluation into the application form; gearing up for scientific support; and setting an example of good practice.Conclusion Bavaria is embarking on an evidence-based, focused and participative approach to health promotion and disease prevention that aims at improving the participants health and quality of life.     

Basics of Bavarian health assessment reporting

Management information systems which support a demand-oriented, integrative and comprehensive decision-making in health care policy are of pre-eminent importance for the health care system. Present health care legislation in Bavaria underlines the importance of health reporting as a tool for periodical assessment of the situation and starting-point for decision-making in health care. Demands made on the Bavarian health report stem from both European and national levels and also from the regional structure within the state. It is intended that the health reporting should reach the local level. Single reports cannot cover all relevant aspects. Therefore, health reporting in Bavaria has a modular structure. There is a need for integrated, flexibly useful information. Following an evidence-based approach, health information may be subject to critical assessment. This approach enables decision makers to assess the grade of certainty of recommendations. Health reporting in Bavaria aims at following the people through time. The intelligent use of new media will have to play a key role.     

Improving and integrating data systems for public health surveillance.

The National Center for Health Statistics (NCHS) is the nation's principal health statistics agency, with a primary mission to collect, disseminate, and analyze health data. NCHS has a clear commitment to a wide range of improvements in surveillance and public health information systems. Building on its long history of conducting multipurpose surveys where the needs and interests of a variety of programmatic interests have to be accommodated, NCHS is working on a number of fronts to improve and better integrate data systems so that they will be more useful for public health surveillance. Examples include the redesign of the National Health Interview Survey, the integration of the Department of Health and Human Services' health surveys, the retooling of the vital statistics system, and the movement to subnational data collection.     

第八次全国学生体质与健康调研精准科学实施及重要意义

2019年第八次全国学生体质与健康调研在全国31个省(自治区、直辖市)的93个地市1 258所学校进行。全国学生体质与健康调研从样本构成和调研内容等方面确保了调查设计的科学性, 并形成了系统的组织协调和质量控制制度; 是学校体育、卫生与健康教育工作的重要内容, 能够及时、动态、全面、科学地掌握学生体质与健康状况, 服务于国家和社会经济发展的需要, 为国家儿童青少年健康相关政策的制定提供科学依据。     

Health Care Utilization by Canadian Women

HEALTH ISSUES: While women are reported to be more frequent users of health services in Canada, differences in women's and men's health care utilization have not been fully explored. To provide an overview on women's healthcare utilization, we selected two key issues that are important for public policy purposes: access to care and patterns of utilization. These issues are examined using primarily data from the 1998/99 National Population Health Survey, complemented by the 2000 Canadian Community Health Survey and the 2001 Health Service Access Survey. KEY FINDINGS: * Women are twice as likely as men to report a regular family physician, but that proportion is very low (15.8%).* Women report significantly shorter specialist wait times (20.9 days) than men (55.4 days) for mental health, while the reverse is true for asthma and other breathing conditions (10.8 for men, 78.8 for women).* Reported mean wait times are significantly lower for men than for women pertaining to overall diagnostic tests: for MRI, 70.3 days for women compared to 29.1 days for men. DATA GAPS AND RECOMMENDATIONS: * Measurement of possible system bias and its implication for equitable and quality healthcare for women requires larger provincial samples of the national surveys, along with a longitudinal design.* Either a national database on preventive services, or better alignment of provincial databases pertaining to health promotion and preventive services, is needed to facilitate data linkage with national surveys to undertake longitudinal studies that support gender based analyses.en are reported to be more frequent users of health services in Canada, differences in women's and men's health care utilization have not been fully explored. To provide an overview on women's healthcare utilization, we selected two key issues that are important for public policy purposes: access to care and patterns of utilization. These issues are examined using primarily data from the 1998/99 National Population Health Survey, complemented by the 2000 Canadian Community Health Survey and the 2001 Health Service Access Survey. KEY FINDINGS: * Women are twice as likely as men to report a regular family physician, but that proportion is very low (15.8%).* Women report significantly shorter specialist wait times (20.9 days) than men (55.4 days) for mental health, while the reverse is true for asthma and other breathing conditions (10.8 for men, 78.8 for women).* Reported mean wait times are significantly lower for men than for women pertaining to overall diagnostic tests: for MRI, 70.3 days for women compared to 29.1 days for men. DATA GAPS AND RECOMMENDATIONS: * Measurement of possible system bias and its implication for equitable and quality healthcare for women requires larger provincial samples of the national surveys, along with a longitudinal design.* Either a national database on preventive services, or better alignment of provincial databases pertaining to health promotion and preventive services, is needed to facilitate data linkage with national surveys to undertake longitudinal studies that support gender based analyses.     

Media Complementarity and Health Information Seeking in Puerto Rico

This investigation incorporates the Orientation1-Stimulus-Orientation2-Response model on the antecedents and outcomes of individual-level complementarity of media use in health information seeking. A secondary analysis of the Health Information National Trends Survey Puerto Rico data suggests that education and gender were positively associated with individual-level media complementarity of health information seeking, which, in turn, was positively associated with awareness of health concepts and organizations, and this awareness was positively associated with a specific health behavior: fruit and vegetable consumption. This study extends the research in media complementarity and health information use; it provides an integrative social psychological model empirically supported by the Health Information National Trends Survey Puerto Rico data.     

Psychometrics of the MHSIP Adult Consumer Survey

The reliability and validity of the Mental Health Statistics Improvement Program (MHSIP) Adult Consumer Survey were assessed in a statewide convenience sample of 459 persons with severe mental illness served through a public mental health system. Consistent with previous findings and the intent of its developers, three factors were identified that demonstrate good internal consistency, moderate test–retest reliability, and good convergent validity with consumer perceptions of other aspects of their care. The reliability and validity of the MHSIP Adult Consumer Survey documented in this study underscore its scientific and practical utility as an abbreviated tool for assessing access, quality and appropriateness, and outcome in mental health service systems.This research was performed in 17 mental health centers of the South Carolina Department of Mental Health (SC DMH). The views expressed are those of the author and do not necessarily represent those of SC DMH.     

Die Bayerische Landesarbeitsgemeinschaft Multiresistente Erreger (LARE)

The Bavarian National Working Group Antibiotic Resistent Pathogens addresses to the task of reducing these pathogens in the bayarian health system. This aim can only be reached, if the institutions of the health system all pull together and take care to implement consistent strategies in the fight against pathogens with antibiotic resistance.     

A comparison of two multidimensional measures of health status: The Nottingham Health Profile and the RAND 36-Item Health Survey 1.0

In this study the applicability of two multidimensional instruments, the NHP and the RAND 36-Item Health Survey 1.0, for measuring health status in population surveys was examined. A population sample of 1,063 persons aged over 17 years participated in the study. It was shown that, as compared with the NHP, the RAND 36-Item Health Survey 1.0 is a more reliable measure of health status. Second, within a group of subjects who scored zero on the NHP, considerable dispersion in RAND 36-Item Health Survey 1.0 scores was found. For the whole group, no significant differences were found in the amount of variance explained by the corresponding scales from both instruments in the prevalence of chronic diseases. However, among subjects with a zero score on the NHP, the RAND 36-Item Health Survey 1.0 scores were still predictive of the occurrence of chronic diseases. it was concluded that, compared with the NHP, the RAND 36-Item Health Survey 1.0 seems to be a more sensitive instrument for the use in population samples.     

Neighbourhood environment and its association with self rated health: evidence from Scotland and England

OBJECTIVES: To investigate associations between measures of neighbourhood social and material environment and self rated health. DESIGN: New contextual measures added to cross sectional study of a sample of people from the Health Survey for England and the Scottish Health Survey to provide multilevel data. PARTICIPANTS: 13,899 men and women aged 16 or over for whom data on self rated health were available from the Health Survey for England (years 1994-99) and the Scottish Health Survey (years 1995 and 1998). RESULTS: Fair to very bad self rated health was significantly associated with six neighbourhood attributes: poor physical quality residential environment, left wing political climate, low political engagement, high unemployment, lower access to private transport, and lower transport wealth. Associations were independent of sex, age, social class, and economic activity. Odds ratios were larger for non-employed residents than for employed residents. Self rated health was not significantly associated with five other neighbourhood measures: public recreation facilities, crime, health service provision, access to food shops, or access to banks and buildings societies. CONCLUSIONS: Some, but not all, features of the neighbourhood environment are associated with self rated health and may be indicators of important causal pathways that could provide a focus for public health intervention strategies. Associations were more pronounced for non-employed residents, perhaps because of greater exposure to the local environment compared with employed people. Operationalizing specific measures of the characteristics of local areas hypothesised to be important for living a healthy life provides a more focused approach than general measures of deprivation in the search for area effects.     

The health status of the elderly population: what do we need to know?

The objective of this research was to evaluate the data on the health of the elderly population available in the Brazilian information system and their correspondence with the North American statistics using the Internet. The North American publication "Older Americans 2000: Key Indicators of Well-Being" was used as a standard. The databases and instruments used in the North American and Brazilian surveys are presented. The North American data are based on the Supplement on Aging and Second Supplement on Aging; Health and Retirement Study; National Health Interview Survey and National Long Term Care Survey. The Brazilian data were collected from the Mortality Information System; Information System of the National Program of Immunizations; National Household Sample Survey conducted in 1998 and 2003 and from the Household Survey on Risk Behavior and Morbidity from Not Transmissible Diseases of 2002-2003. There is a great number of Brazilian information about the aged population of the Country available in the Internet and with few exceptions the information on aged Brazilians corresponds to the information available about aged North Americans.     

Public health care and private insurance demand: The waiting time as a link

This paper analyzes the effect of waiting times in the Spanish public health system on the demand for private health insurance. Expected utility maximization determines whether or not individuals buy a private health insurance. The decision depends not only on consumer's covariates such as income, socio-demographic characteristics and health status, but also on the quality of the treatment by the public provider. We interpret waiting time as a qualitative attribute of the health care provision. The empirical analysis uses the Spanish Health Survey of 1993. We cope with the absence of income data by using the Spanish Family Budget Survey of 1990–91 as a complementary data set, following the Arellano–Meghir method [4]. Results indicate that a reduction in the waiting time lowers the probability of buying private health insurance. This suggests the existence of a crowd-out in the health care provision market. This revised version was published online in July 2006 with corrections to the Cover Date.     

Differentiating Subgroups of Children with Special Health Care Needs by Health Status and Complexity of Health Care Needs

Objectives Our objective is to use the Children with Special Health Care Needs (CSHCN) Screener to identify subgroups of CSHCN differentiated by health status and complexity of need. Methods Data are from the National Survey of Children with Special Health Care Needs, 2001 and the National Survey of Children’s Health, 2003 (conducted by the Maternal and Child Health Bureau and the National Center for Health Statistics); and the 2001 and 2002 Medical Expenditure Panel Survey, conducted by the Agency for Healthcare Research and Quality. A broad array of variables measuring health status, complexity of need, and related issues are examined by subgroupings of CSHCN. Results Relative to other CSHCN, CSHCN with functional limitations or who qualify on more CSHCN Screener items have poorer health status and more complex health care needs. They more often experience a variety of health issues; their insurance is more often inadequate; the impact of their conditions on their families is higher; and their medical costs are higher. Conclusion In the absence of information on specific conditions, health status, or complexity of need, the CSHCN Screener alone can be used to create useful analytic subgroups that differ on these dimensions. The proposed subgroups, based on the type or number of CSHCN screening criteria, differentiate CSHCN by health status and complexity of health care needs, and also show differences in the impact of their conditions on their families, costs of their medical care, and prevalence of various health problems. Certification of ethical research: This material presents a secondary data analysis of a deidentified data set. Human subjects review was therefore not required for this study.     

Guidelines for designing a Web-delivered college health risk behavior survey: lessons learned from the University of Florida Health Behavior Survey

Collecting health-risk behavior data from college students is a Web survey research application with extraordinary potential that has implications for individual schools and for the next National College Health Risk Behavior Survey. Recent evidence suggests that it is now feasible to collect health-risk behavior data from college students using the Web. This article describes the eight steps used in the 1999 University of Florida Health Behavior Survey that demonstrated the feasibility of the Web to collect health-risk behavior data from undergraduates. Practical issues researchers should consider when conducting Web-delivered survey research also are presented. Information in this article can be used by college and university health survey researchers and student health service administrators to plan and conduct their own health-risk behavior Web-delivered survey, and to develop an electronic college health-risk behavior surveillance system for their schools.     

Association between educational level and health related quality of life in Spanish adults

OBJECTIVE: To analyse differences in health by educational level in Spanish adults by comparing the health dimensions of the SF-36 Heath Survey. DESIGN: Data were taken from the National Survey on Drug Use carried out in February 1996. The information was collected by home personal interview. In addition to measuring the use of legal and illegal drugs and their associated health risks, the health status of the Spanish population was analysed using the Spanish version of the SF-36 Health Survey. MAIN OUTCOME MEASURE: Absolute and standardised differences between mean score on each dimension of the SF-36 Health Survey in each educational group with respect to the group with the highest educational level. RESULTS: Perceived health status declines with decreasing educational level, except in women with second level education who have a higher mean rating than women with third level education on various health dimensions. The absolute differences in perceived health between the different categories of educational level and the reference category become larger with increasing age. The greatest differences by educational level in both men and women were found in mental health and general health among persons 25 to 44 years of age, and in physical function and general health among those 45 to 64 years. In persons aged 65 or older, the greatest differences are seen in physical function and vitality in men, and in bodily pain and emotional role in women. CONCLUSIONS: The influence of educational level on the different dimensions of perceived health may vary by sex.     

The German Health Survey. 1997/98

The first German Health Survey, a representative study of the health status of the population in unified Germany, was started in October 1997. In this project which is being carried out by the Robert Koch Institute on behalf of the Federal Ministry of Health about 7,200 study participants aged between 18 and 79 are going through a medical check-up and are interviewed as to health-relevant issues. The German National Health Survey consists of a core survey and supplementary modules. These modules are, for the most part, carried out in subsamples of the study population. They partially have been designed and co-financed by cooperating institutions of the RKI. This time, the opportunity given to the individual L?nder to increase the size of the sample was realized by Bavaria. This practised principle of a modular structure and co-financing may be regarded as a model and serve as an example for the cost effective implementation of such extensive health surveys. As a result, the German National Health Examination Survey will yield information enabling the RKI to deliver relevant health reports on a federal level and, therefore, to support decisions in health policy. The demand for representative population-based data will be met by supply of survey data as a file for public use.     

第八次全国学生体质与健康调研结果发布

根据国务院1987年同意建立的全国学生体质与健康调研制度, 2019年, 教育部等部署开展了第八次全国学生体质与健康调研工作。发现中国学生体质与健康状况总体有所改善, 并提出了促进学生体质与健康水平提高的主要因素, 针对本次调研发现的问题提出以下相关安排: 全面加强和改进学校体育工作、落实学校卫生与健康教育政策要求、持续综合防控儿童青少年近视、实施全国健康学校建设计划。     

Primary care of patients without insurance by community health centers

Community health centers (CHCs) are in a strong position to meaningfully contribute to health promotion, early detection, and improvement in health care outcomes for some of the most vulnerable person in the nation, since almost one in three users of federally funded CHCs was uninsured in 1994. The purpose of this article is to compare uninsured CHC users with uninsured people nationwide. Data for the analysis came primarily from two population-based surveys: the 1994 National Health Interview Survey (NHIS) and the 1995 Community Health Center (CHC) User Survey.     

Suitability of the National Health Care Surveys to Examine Behavioral Health Services Associated with Polycystic Ovary Syndrome

The National Institutes of Health, Office of Disease Prevention, has described polycystic ovary syndrome (PCOS) as a major public health problem for women in the USA. This study examines the suitability of the National Health Care Surveys, collected by the Centers for Disease Control and Prevention, to understand patient demographics and behavioral health services associated with PCOS-related medical visits. Data were from the 2005–2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. PCOS-related medical visits were identified using the International Classification of Diseases, 9th Revision, Clinical Modification code 256.4. Items on mental health and health education ordered or provided did not meet the National Center for Health Statistics criteria necessary to produce reliable national estimates (i.e., at least 30 unweighted records and a relative standard error <30%). Findings underscore the need to strengthen national surveillance to further understand behavioral health care for patients with PCOS.