Trends of socioeconomic differences in daily vegetable consumption, 1979-2002

BACKGROUND: Studies from different time periods have shown that consumption of vegetables is more common in higher socioeconomic groups and among women. However, there are only few studies of changes of socioeconomic differences in vegetable consumption over time. Our aim was to determine whether socioeconomic differences, measured by educational level and household income, in daily vegetable consumption have increased, decreased or been stable over the last two decades among Finnish men and women. METHODS: Data on daily consumption of fresh vegetables were derived from repeated annual cross-sectional surveys performed among representative samples of Finnish working aged (15-64 years) population. Data from the years 1979-2002 were linked with data on education and household income from Statistics Finland. Those under 25 years and all students were excluded, giving a total of 69 383 respondents. The main analyses were conducted with logistic regression. RESULTS: Daily consumption of fresh vegetables became overall more prevalent during the study period. Daily consumption of fresh vegetables was more common among those with higher education and higher income during the whole study period. Both educational level and household income differences in daily vegetable consumption slightly narrowed since 1979 among men and women. CONCLUSIONS: Women with high socioeconomic position have been initial trend setters, but the prevalence of daily consumers of vegetables in these groups has not increased since the early 1990s. The prevalence of daily consumption of fresh vegetables has increased more in lower educational and income groups during the 1980s and 1990s along with narrowing socioeconomic differences.     

Trends in HIV prevalence and risk behaviour among injecting drug users in Rotterdam, I994-2002

OBJECTIVE: To gain insight into the prevalence of HIV infection, the determinants thereof and the risk behaviour in injecting drug users (IDUs) in Rotterdam, The Netherlands, in 2002 in comparison to the HIV survey data from 1994 and 1997. DESIGN: Questionnaire study. METHOD: In 1994-2002, three periodic HIV surveys were conducted in Rotterdam among IDUs using semi-structured questionnaires on risk behaviour and saliva samples for HIV-antibody determination. In the present study, the data for 2002 were analysed and compared with those from 1994 and 1997. RESULTS: The number of participants recruited was 494, 470 and 452, respectively. HIV prevalence did not change over time: 1994: 11.4%, 1997: 9.4% and 2002: 10.2%. In the 2002 survey, independent risk factors for HIV were homelessness and onset of injecting drug use at an early age. The percentage of IDUs that had recently shared needles declined from 18% in 1994 to 8% in 2002. Risky sexual behaviour remained prevalent: inconsistent condom use was reported by 85% with steady partners, 43% with casual partners and 31% with clients. The IDUs who knew that they were HIV positive used condoms consistently more often. CONCLUSION: The combination of a relatively high HIV prevalence among IDUs in Rotterdam and the high level of unsafe sexual behaviour results in a serious risk of further spread of HIV among both IDUs and the general population.     

Change in the prevalence of overweight and obesity among young Australians, 1969-1997

BACKGROUND: Effective public policy requires information on the prevalence of overweight and obesity. OBJECTIVE: We determined changes in the population prevalence of overweight and obesity among young Australians (aged 7-15 y) from 1969 to 1985 to 1997. DESIGN: Data from 5 independent population surveys were analyzed: the Australian Youth Fitness Survey, 1969; the Australian Health and Fitness Survey, 1985; the South Australian Schools Fitness and Physical Activity Survey, 1997; the New South Wales Schools Fitness and Physical Activity Survey, 1997; and the Health of Young Victorians Study, 1997. Measured body mass index was used as the index of adiposity, and recently published body mass index cutoff values were used to categorize each subject as nonoverweight, overweight, obese, or either overweight or obese. RESULTS: For 1985-1997, the population prevalence of overweight increased by 60-70%, obesity increased 2-4-fold, and the combined overweight and obesity categories doubled. The findings were consistent across data sets and between the sexes. For 1969-1985, there was no change in the prevalence of overweight or obesity among girls, but among boys the prevalence of overweight increased by 35%, the prevalence of obesity trebled, and the prevalence of overweight and obesity combined increased by 60%. CONCLUSIONS: The data show that in 1985-1997, the prevalence of overweight and obesity combined doubled and that of obesity trebled among young Australians, but the increase over the previous 16 y was far smaller. These results should increase our sense of urgency in identifying and implementing effective responses to this major threat to public health.     

Hearing loss and perceptions of noise in the workplace among rural Australians

OBJECTIVE: To compare measured hearing levels of individuals regularly exposed to noise in their workplace to self-reported and family-reported hearing loss. To compare the attitudes and preventative actions adopted by individuals who are more aware of the potential for hearing loss to less aware individuals. DESIGN: The project examined the perceptions of rural workers concerning noise, noise exposure and hearing. The subjects completed a 'Noise at Work' questionnaire and some demographic data at the time of audiometric testing. SETTING: The subjects were recruited when attending their rural health clinic for audiometric testing. PARTICIPANTS: Participants comprised 113 men and 23 women (20-65 years, mean = 39.6, SD = 11.4) working across a range of activities at different levels in their workplaces. The range in current employment was from 0.5 to 45 years (mean = 13.8, SD = 10.7). RESULTS: Hearing tests were compared with perceptions of noise annoyance, hearing damage risk and preventative action. Self- and family-reported hearing loss and conversational difficulties in noise correlated well with measured audiograms. Perceptions of workplace noise tended to be more positive if people felt they had hearing problems. There was no difference in preventative action between those who did and did not feel they had hearing problems. Both groups rated barriers to action and lack of self-efficacy in a similar negative way. CONCLUSIONS: There is a need for specific training to ensure that rural workers have skills to take more positive action in reducing noise exposure at work.     

State-specific prevalence of current cigarette smoking among adults--United States, 2002

Cigarette smoking in the United States causes serious illnesses among an estimated 8.6 million persons and approximately 440,000 deaths annually, resulting in 157 billion dollars in health-related economic costs. To reduce smoking prevalence, morbidity, mortality, and economic impact, state tobacco-control programs should include interventions to help persons stop smoking. To assess the prevalence of current cigarette smoking among adults, attempts to quit, and receipt of physician advice to quit during the preceding year, CDC analyzed data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report summarizes the results of that analysis, which indicated a threefold difference in smoking prevalence across the 50 states, the District of Columbia (DC), Guam, Puerto Rico, and the U.S. Virgin Islands (range: 9.5%-32.6%). To support smokers' attempts to quit, states/areas should implement comprehensive tobacco-control programs that include interventions to help persons stop smoking (e.g., quitlines).     

Incidence of tooth loss among elderly Iowans.

This study investigated the 18-month incidence of tooth loss in a random sample of 451 dentate noninstitutionalized Iowans aged 65 and older residing in two rural counties. They had a mean of 19.0 teeth at baseline and lost an average of 0.4 teeth during the subsequent 18 months. Twenty-one per cent of the population lost at least one tooth. Four people had all their teeth extracted. Of the teeth present at baseline, 1.9 per cent subsequently were extracted. The highest incidence of tooth loss occurred among mandibular molars (3.7 per cent), followed by maxillary premolars and canines (3.1 per cent each). The best predictors of tooth loss were previous coronal and root caries.     

Trends in the US prevalence of drug-using parturient women and drug-affected newborns, 1979 through 1990.

OBJECTIVES. There has been a lack of reliable national data on the number of pregnant women using drugs and the number of newborns affected by such use. The major reasons for this lack have been inadequate sampling and data collection procedures and the lack of a risk assessment perspective in analysis. This paper corrects for these inadequacies. METHODS. Data from 1979 through 1990 from the National Hospital Discharge Survey, an annual survey by the National Center for Health Statistics, were analyzed. RESULTS. Between 1979 and 1990 there was a 576% increase in the rate of discharges of drug-using parturient women in the United States and a 456% increase in the rate of discharges of drug-affected newborns. After adjustment for underreporting, a "best estimate" of the number of discharges from 1988 through 1990 was about 88,000 per year for drug-using parturient women and about 48,000 per year for drug-affected newborns. CONCLUSIONS. Although the data support the occurrence of a national epidemic of drug use among pregnant women during the 1980s, the size and severity of this epidemic have been overstated.     

Trends in prevalence of substance use among Icelandic adolescents, 1995–2006

Background  

Adolescent substance use continues to be of great global public health concern in many countries with advanced economies. Previous research has shown that substance use among 15–16 year-old-youth has increased in many European countries in recent years. The aim of this study was to examine trends in prevalence of daily smoking, alcohol intoxication, and illicit substance use among Icelandic adolescents.     

Obesity prevalence and time trend among youngsters in China, 1982-2002

Purpose of present study is to describe the prevalence and trend of overweight and obesity, as well as its co-existence with stunting, among youngsters in China, from 1982 to 2002. Data from children 7-17 years of age from three cross-sectional national surveys: "1982 China National Nutrition Survey" (5,334 boys and 4,793 girls), "1992 China National Nutrition Survey" (8,048 boys and 7,453 girls) and "2002 China National Nutrition and Health Survey" (23,242 boys and 21,638 girls) were used in this study. Overweight and obesity were defined according to age, sex and specific BMI cut-off points from the International Obesity Task Force, while stunting was defined as height-for-age below -2 standard deviation from the NCHS/WHO reference median value. RESULTS: Overweight prevalence of Chinese youngsters was 1.2%, 3.7% and 4.4%, while the obesity prevalence was 0.2%, 0.9% and 0.9% in 1982, 1992 and 2002, respectively. Both the overweight and obesity prevalence and their increment were higher among boys in urban areas. In 1982, 28.4% of overweight and 69.6% of obese youngsters were stunted, this decreased to 22.0% and 46.4% in 1992, and then to 5.7% and 7.7% in 2002, respectively. CONCLUSION: The prevalence of overweight and obesity in Chinese youngsters were low in 1982. There has been a rapid increase since then. If this trend continues, overweight will soon reach epidemic proportions. Stunting among overweight and obese youngsters decreased dramatically at the same time.     

Trends in health attitudes and self-perceptions among school-age South Australians between 1985 and 2004

OBJECTIVE: To describe trends in health attitudes and self-perceptions among school-age South Australians between 1985 and 2004. METHODS: The questionnaire from the 1985 Australian Schools Health and Fitness Survey was administered during 2004 in those South Australian schools that participated in the 1985 survey. Using chi square, responses were compared for 10-15 year-olds (1985, n=398; 2004, n=467) on attitudes to: visiting the doctor and dentist, smoking, sleep, diet, exercise, stress, having friends, and knowledge about fitness and health. Additionally, self-perceptions of health and fitness were compared. RESULTS: Among boys and girls between 1985 and 2004, there were significant declines in the perceived importance of regularly visiting the dentist and doctor, but improved attitudes to being a non-smoker. Among boys, the perceived importance of sleep and diet declined between surveys. A smaller percentage of boys and girls in the latter survey perceived their current health status as 'good'. In the lower SES sample, the percentage of girls rating healthy diet as 'very important' was lower in 2004. CONCLUSIONS: There have been general declines in perceived importance of many health-related behaviours among South Australian youth between 1985-2004. In contrast, the perceived importance of not smoking was higher in 2004 than 1985. Implications: The relative success of anti-smoking campaigns targeting youth suggests that health education must be accompanied by broader environmental support in order to effect positive behavioural change.     

Trends in socio-economic differences in tobacco smoking among German schoolchildren, 1994-2002

BACKGROUND: While the graded relationship between socio-economic status (SES) and risk behaviour in adulthood has been the subject of intense research, far less is known about socio-economic differences in health-related behaviour among adolescents. The purpose of the present study is to examine socio-economic differences in adolescent tobacco use in Germany as well as changes in the relationship between 1994 and 2002. METHODS: Data were obtained from the 'Health Behaviour in School-aged Children' study conducted in the largest federal state of Germany, Northrhine-Westfalia, in 1994, 1998 and 2002. The analysis is based on 11.401 11- to 15-year old students. Socio-economic differences in regular smoking were studied in relation to both parental SES (family affluence) and students own SES (school type). Trends from 1994 to 2002 were analysed for each category of family affluence and school type separately. RESULTS: Family affluence only had a weak effect on regular smoking while for type of school a strong social gradient for smoking was found for both the genders. Trend analyses within the different family affluence and school-type categories showed that smoking has generally increased in all socio-economic groups. The level of socio-economic differences remained virtually unchanged in girls and boys in the past 10 years in Germany. CONCLUSIONS: The same relationships of family affluence and school type with smoking have persisted for almost a decade in Germany. Students own SES affects adolescent smoking substantially. Prevention programmes should focus on the school setting in order to tackle current as well as future health inequalities.     

Relationship between intake of vegetables, fruit, and grains and the prevalence of tooth loss in Japanese women

Epidemiological evidence regarding dental status and its relationship to diet and nutritional status has been limited. The present cross-sectional study examined the relationship between intake of vegetables, fruit, grains, antioxidants, and fiber and the prevalence of tooth loss. Study subjects were 1,002 pregnant Japanese women. Tooth loss was defined as the previous extraction of 1 or more teeth. Adjustment was made for age, gestation, parity, cigarette smoking, passive smoking at home and at work, family income, education, changes in diet in the previous 1 mo, season when data were collected, and body mass index. Of the 1,002 subjects, 256 women had lost 1 or more teeth. Compared with intake of vegetables other than green and yellow vegetables in the lowest quartile, consumption of the other vegetables in the highest quartile was independently associated with a decreased prevalence of tooth loss, showing a clear inverse dose-response relationship. There was a marginally significant inverse dose-response relationship between the intake of insoluble fiber and tooth loss. No association was observed between intake of green and yellow vegetables, soluble fiber, or antioxidant nutrients and tooth loss. These findings suggested that consumption of vegetables other than green and yellow vegetables and insoluble fiber may be related to a decreased prevalence of tooth loss among young Japanese women.     

Trends in folic acid supplement intake among women of reproductive age--California, 2002-2006

Daily intake of 400 microg of folic acid before conception can reduce by approximately 80% the risk for having an infant with a neural tube defect (NTD) such as spina bifida or anencephaly. Although other risk factors for NTDs exist, such as diabetes, obesity, and family history of NTDs, prevention measures have focused predominantly on promoting folic acid consumption. Women can ensure they are consuming the recommended amount of folic acid by eating one serving of breakfast cereal fortified with 100% of the recommended daily value of folic acid or by taking a supplement with 400 microg folic acid daily. Annual surveys conducted for the March of Dimes (MOD) Birth Defects Foundation indicate that 40% of all U.S. women of reproductive age (i.e., aged 15-45 years) took supplements containing folic acid in 2007 (MOD, unpublished data, 2007), up from 28% in 1995. To analyze trends in folic acid-containing supplement intake among California women aged 18-44 years during 2002-2006, the California Department of Public Health conducted trend analyses of data from the California Women's Health Survey (CWHS). This report summarizes the results of those analyses, which indicated that although the overall prevalence of intake of folic acid-containing supplements remained stable from 2002 (40%) to 2006 (41%) in California, use of such supplements decreased among Hispanic women and women with less education. Downward trends among Hispanic women are of particular concern because 1) Hispanic women are at increased risk for having a fetus or an infant with an NTD compared with women of other races/ethnicities, 2) the number of births to Hispanics in California increased during 1993-2003, and 3) Hispanics accounted for nearly 52% of all births in California in 2005 (California Department of Public Health, unpublished data, 2005). Development of additional targeted and evidence-based public health interventions for increasing folic acid intake among these populations is needed.     

Heat-related mortality--Arizona, 1993-2002, and United States, 1979-2002

Hyperthermia is the elevation of body temperature resulting from the body's inability to dissipate heat. Continued exposure to ambient heat close to body temperature (98.6 degrees F [37.0 degrees C]) contributes to a substantial number of deaths from hyperthermia, especially among elderly persons. To assess the health risk from hyperthermia, Arizona health practitioners and CDC researched cases of heat-related death and illness in Arizona, used U.S. death certificate data to summarize trends in heat-related deaths, and compared age-specific, heat-related death rates in Arizona with those in the United States overall. Findings indicated that, during 1979-2002, a total of 4,780 heat-related deaths in the United States were attributable to weather conditions and that, during 1993-2002, the incidence of such deaths was three to seven times greater in Arizona than in the United States overall. Public health agencies in communities affected by periods of extreme heat should educate populations at risk (e.g., persons aged > or = 65 years) and consider designing and implementing location-specific heat response plans (HRPs).     

Trends in the incidence of treated end-stage kidney disease among Indigenous Australians and access to treatment

OBJECTIVE: To determine temporal trends of incidence of treated end-stage kidney disease in Indigenous Australians and the extent to which these patients had to move from their home community to access renal replacement therapy. METHODS: Data for 1993-2001, regarding place of residence before starting renal replacement therapy, were analysed to give accurate incidence for 1,194 Indigenous treated end-stage kidney disease patients. We calculated indirectly standardised incidence ratios of treated end-stage kidney disease by State and Territory. We surveyed treating renal units about which Indigenous patients relocated to access therapy from 1999 to 2001. RESULTS: The incidence of treated end-stage kidney disease among Indigenous Australians is high and rising; however, the rate of increase is lower than has been previously reported. The Northern Territory (NT) and Queensland have the most new Indigenous treated end-stage kidney disease cases. The highest standardised incidence ratio was in the NT (17.0), followed by Western Australia (WA) (11.9). From 1999 to 2001, half of the 476 Indigenous patients starting therapy had to relocate to access treatment. CONCLUSIONS: The incidence of end-stage kidney disease among Indigenous Australians continues to rise. However, significant gaps in knowledge remain about the burden of early chronic kidney disease and whether many Indigenous patients with end-stage kidney disease still choose not to receive renal replacement therapy. The need to relocate to access treatment has a strong negative impact on individuals, families and entire communities.     

Hepatitis C virus prevalence and associated risk factors among Indigenous Australians who inject drugs

Objective: To examine factors associated with hepatitis C virus (HCV) infection among a national sample of Indigenous and non‐Indigenous people who inject drugs (PWID) in Australia. Methods: Respondents were recruited from Australia's Needle Syringe Program Survey; an annual bio‐behavioural surveillance project that monitors HCV antibody prevalence among PWID. Data from 2006–2015 were de‐duplicated to retain only one record where individuals participated in >1 survey round. Univariate and multivariable logistic regression examined demographic characteristics and injection‐related behaviours associated with exposure to HCV. Results: Among 17,413 respondents, 2,215 (13%) were Indigenous Australians. Compared to their non‐Indigenous counterparts, Indigenous respondents were significantly more likely to be exposed to HCV infection (53% vs. 60% respectively, p<0.001). Among Indigenous respondents, HCV antibody positivity was independently associated with a history of imprisonment (Adjusted Odd Ratio [AOR] 2.13, 95%CI 1.73–2.64), opioid injection (AOR 1.53, 95%CI 11.43–2.16), recruitment in a metropolitan location (AOR 1.27, 95%CI 1.02–1.59), engagement in opioid substitution therapy (AOR 2.83, 95%CI 2.23–3.59) and length of time since first injection (p<0.001). Conclusion: Indigenous PWID are more likely to be exposed to HCV infection than their non‐Indigenous counterparts. Implications for public health: Increased access to culturally sensitive harm reduction programs is required to prevent primary HCV infection and reinfection among Indigenous PWID. Given recent advances in HCV treatment, promotion of treatment uptake among Indigenous PWID may reduce future HCV‐related morbidity and mortality.     

Eye health promotion to improve awareness and prevent vision loss among Indigenous Australians

Vision loss in Australian Indigenous communities can be largely prevented if appropriate eye care services are provided and accessed. Our extensive consultations across Australia identify opportunities to improve community and health provider awareness through eye health promotion. An improved awareness of eye care, service availability, and when and how to seek care, will contribute to closing the gap for vision.     

Trends in hospitalizations associated with gastroenteritis among adults in the United States, 1979-1995.

Gastroenteritis (GE) is among the most common illnesses of humans but the burden of disease, its epidemiology, and the distribution of pathogens in adults have not been fully examined. This information is needed to plan prevention strategies particularly for high-risk groups. This study is a retrospective analysis of data from the National Hospital Discharge Survey for the years 1979 through 1995 which describes the disease burden and epidemiology of hospitalizations associated with GE among adults in the United States. Diarrhoea was listed as a diagnosis on an average of 452,000 hospital discharges per year representing 1.5% of all hospitalizations among adults. The annual number of GE hospitalizations has decreased by 20% from approximately 500,000 in 1979 to 400,000 in 1995. The aetiology of 78% of cases coded as GE was undetermined. Until the aetiology of disease can be better established, specific strategies for prevention cannot be developed.