Piecework, musculoskeletal pain and the impact of workplace psychosocial factors

Aim To investigate the impact of piecework on musculoskeletalpain and general health, and the influence of perceived workplacepsychosocial factors on any such associations, in a generalUK population. Methods A questionnaire was mailed to an age-stratified randomsample of 10 000 adults aged 18–75 in North Staffordshire,UK. Respondents reporting a current main job were asked if thisjob was paid by a piecework system. Health measures were (i)number of pain areas according to a body manikin and (ii) generalhealth (SF-12v2). Other measures included questions on occupationalhistory and psychosocial aspects of the work environment. Results The adjusted response was 54%. A total of 1193 respondentsreported a current main job, of whom 201 (17%) reported piecework.Pieceworkers were more likely to be older (P < 0.05), male(P < 0.001) and in lower socioeconomic groups (P < 0.001)than non-pieceworkers. Piecework was associated with perceptionsof a poor psychosocial working environment, more pain areas(P < 0.05), more elbow (P < 0.01), forearm (P < 0.001)and hand pain (P < 0.05), and a lower physical health score(SF-12v2; P < 0.01), but no difference in mental health score(P = 0.60), compared with non-pieceworkers. After controllingfor psychosocial factors, and socioeconomic group, the associationsbetween piecework and pain areas, or physical health, were nolonger statistically significant. Conclusions These results show that piecework was associatedwith poorer self-reported general physical health and more areasof pain, which may be attributed to low socioeconomic group,and workplace perceptions of little job control, high physicaldemand and little supervisor support.     

Screening campaign of hepatitis C among underprivileged people consulting in health centres of Lyon area, France

Background: A screening campaign for hepatitis C virus (HCV)infection was carried out in eight health centres of Lyon fromJune 2003 until March 2004. The population targeted for screeningwas underprivileged individuals without any social insurance,protected by Couverture Mutuelle Universelle or Aide MédicaleEtat (AME), to estimate the prevalence of anti-HCV antibodiesin this population and to identify associated risk factors.Methods: After training in HCV infection and screening, 43 generalpractitioners participated in the campaign. Information aboutpatient socio-demographics and risk factors was collected priorto proposing screening serology. Blood samples were often takenin health centres. Follow-up of positive cases was organisedvia the Reference Centre of HCV Infection in Lyon with possiblespecialised consultations in health centres. Results: The averageage of the 988 individuals in the campaign was 37 years; 51%were women; 54% had a foreign nationality; 21% lived in shelteredaccommodation; 19% were lodged in third-party accommodation;9% were homeless; and 57% possessed less than 562 (Revenu Minimumd'Insertion level). Screening was not proposed to nine patientsbecause of medico-psychological problems. The acceptance ratefor screening was 98.8% (967/979), and testing was carried outon 97.6% of these subjects (944/967). The prevalence of anti-HCVantibodies in the sample was 4.7% (44/944) (95% CI = 3.4–6.2).Nearly 80% of positive cases were unknown prior to the campaign.Multivariate logistic regression modelling identified lifetimeinjection drug use [odds ratios (OR) = 15.99; P < 0.0001],lifetime medical care in a foreign country (OR = 4.46; P = 0.001),and wearing tattoos (OR = 2.75; P = 0.048) as significant riskfactors for carrying anti-HCV antibodies. Characteristics independentlyassociated with HCV seropositivity were age between 40 and 49years, AME benefits, and no social insurance. Conclusion: Wideacceptance of screening, high prevalence of anti-HCV antibodies(much higher than in the French population in general), a highproportion of positive cases unknown beforehand, and satisfactoryfollow-up of seropositive patients are all factors which supportthe need for a screening campaign targeting HCV infection inunderprivileged persons living in France.     

Health Disparities by Sexual Orientation: Results and Implications from the Behavioral Risk Factor Surveillance System

Until recently, population-based data for monitoring sexual minority health have been limited, making it difficult to document and address disparities by sexual orientation. The primary objective of this study was to examine differences by sexual orientation in an array of health outcomes and health risk factors using one of the nation’s largest health surveys. Data for this study came from 8290 adults who identified as lesbian, gay, or bisexual (LGB) and 300,256 adults who identified as heterosexual in the 2014–2015 Behavioral Risk Factor Surveillance System (BRFSS). Logistic regression models were used to compare physical and mental health outcomes, health condition diagnoses, and health risk factors by sexual orientation, controlling for demographic and socioeconomic status. Controlling for sociodemographic characteristics, gay and bisexual men reported higher odds of frequent mental distress [odds ratio (OR) 1.71, P?=?0.001; OR 2.33, P?<?0.001] and depression (OR 2.91, P?<?0.001; OR 2.41, P?<?0.001), compared with heterosexual men. Lesbian and bisexual women had higher odds of frequent mental distress (OR 1.53, P?<?0.001; OR 2.08, P?<?0.001) and depression (OR 1.93, P?<?0.01; OR 3.15, P?<?0.001), compared to heterosexual women. Sexual minorities also faced higher odds of poor physical health, activity limitations, chronic conditions, obesity, smoking, and binge drinking, although these risks differed by sexual orientation and gender. This study adds to the mounting evidence of health disparities by sexual orientation. Community health practitioners and policymakers should continue to collect data on sexual orientation in order to identify and address root causes of sexual orientation-based disparities, particularly at the community-level.     

Association of Coronary Artery and Aortic Calcium With Lumbar Bone Density: The MESA Abdominal Aortic Calcium Study

Atherosclerosis and osteoporosis share many risk factors, buttheir independent association is unclear. The authors investigatedthe independent associations between volumetric trabecular bonemineral density (vBMD) of the lumbar spine and coronary arterycalcium (CAC) and abdominal aortic calcium (AAC). During 2002–2005,they used quantitative computed tomography to assess vBMD andthe presence and extent of CAC and AAC among 946 women (meanage = 65.5 years) and 963 men (mean age = 64.1 years) in a substudyof the Multi-Ethnic Study of Atherosclerosis. Prevalences ofCAC were 47% and 68% in women and men, respectively, and AACprevalences were 70% and 73%. Sequential, sex-specific regressionmodels included adjustment for age, ethnicity, body mass index,hypertension, dyslipidemia, diabetes mellitus, smoking, alcoholconsumption, physical activity, interleukin-6, C-reactive protein,homocysteine, and sex hormones. After full adjustment, lowervBMD was associated with greater CAC score among women (P <0.002) and greater AAC score among women (P = 0.004) and men(P < 0.001). After adjustment, vBMD quartile was inverselyassociated with CAC prevalence (P-trend = 0.05) in women andAAC prevalence (P-trend < 0.01) in men. Partially and fullyadjusted models showed similar results. Though modest, thesesignificant, independent associations suggest that atherosclerosisand bone loss may be related. aging; arteries; atherosclerosis; bone and bones; bone density; calcium; coronary vessels; ethnic groups     

Impact of a population‐wide mental health promotion campaign on people with a diagnosed mental illness or recent mental health problem

Objectives : To determine the impact of the Act‐Belong‐Commit mental health promotion campaign on people with a diagnosed mental illness or who had sought professional help for a mental health problem in the previous 12 months. Method : In 2013 and 2014, 1,200 adults in Western Australia were interviewed by telephone. The questionnaire measured campaign reach, impact on beliefs about mental health and mental illness and behavioural impact. Results : Campaign impact on changing the way respondents thought about mental health was significantly higher among those with a mental illness or who had sought help (41.4% vs 24.2%; p<0.001), as was doing something for their mental health as a result of their exposure to the campaign (20.5% vs 8.7%; p<0.001). Conclusions : The campaign appears to empower people with a mental illness or who recently sought help to take steps of their own to enhance their mental health.     

Gender Differences in Work Modifications and Changed Job Characteristics During the Return-To-Work Process: A Prospective Cohort Study

Objectives To describe gender differences in work modifications and changed job characteristics during return-to-work after sickness absence. Methods A 13 month prospective cohort study was performed among 119 employees (54 women and 65 men) who had reported sick for more than 1 month due to mental or musculoskeletal disorders. Men and women were of comparable ages and educational levels, worked in similar sectors, at corresponding functional levels, and were experiencing the same types of health disorders. They were interviewed bi-monthly. Work modifications and job characteristics were assessed at return-to-work. Job characteristics were also assessed upon the employee’s inclusion in the study. Results Work modifications occurred in 77.4% of the return-to-work attempts (no gender differences); reduced working hours, reduced work pace, or task reassignments were most frequent. Compared to men, reduced hours and pace were more often used for women between 12 and 20 weeks of absence (P > 0.001 and 0.01 < P < 0.001 respectively) and reduced hours also during the whole period (0.01 < P < 0.001). Applying reduced hours related to type of disorder in men and applying different time-schedules in women. Upon return to work both women and men reported increased job autonomy and emotional demands (P < 0.001); women reported more job satisfaction (P < 0.001). Conclusions Work modifications were widely applied during the return-to-work process and predominantly aimed at reduction of pressure at work. Women had a few more work modifications. The marginal gender differences may be due to male and female respondents having similar characteristics. Upon return to work some job characteristics improved.     

Health status of caregivers of children with cerebral palsy

Background and Aims While a ‘Family‐Centered’ approach to care is accepted as best practice in the context of childhood disability, it may lead to increased demands on family members by requiring them to be active participants in their child's care. This may impact upon the physical and mental health of the caregiver and therefore needs to be investigated. This study aimed to assess the health status of caregivers of children with cerebral palsy (CP) in Ireland and to identify vulnerable subgroups. Methods A cross‐sectional postal survey was conducted using a questionnaire incorporating the SF‐36v2.0. The sample consisted of male and female caregivers of children with CP, representing all levels of ability. Two questionnaires were sent to each child's home; a total of 312 questionnaires were sent to the homes of 156 children. Results Completed questionnaires were returned by 161 caregivers (100 women, 61 men) of 101 children, giving a response rate of 65%. Caregivers of children with CP were found to have poorer health than the Irish general population, for whom normative data exist. Female caregivers had poorer health than male caregivers in both the physical (P < 0.05) and mental health (P < 0.001) domains of the SF‐36. Caregivers spending more time caring had significantly poorer mental health than those spending less time caring (P < 0.05). There was no difference in the health of caregivers of ‘more independent’ versus ‘more dependent’ children, apart from the latter group reporting higher levels of bodily pain (P < 0.05). Conclusion This study provides evidence of the inferior health status of caregivers of children with CP in Ireland, particularly that of women.     

Health status and occupation: use of a health status index to measure the health of occupations

A total of 4466 employed persons completed the short AucklandUniversity Health Status Index (AUHSI) questionnaire and a healthscore was assigned to each individual on the basis of theirresponses. This health score was found to have statisticallysignificant associations with a number of health-related measures,including socio-economic status (P<0.001), and with occupationalgroup: administrative, clerical/sales/service, skilled tradesand unskilled labour (P<0.001). Within the occupational groups,3361 employees could be assigned to 42 specific occupationshaving 19 or more members each. After controlling for age andgender, significant differences in mean health score for specificoccupation were found in the clerical/sales/service (P<0.05),skilled trades (P=0.002) and unskilled manual (P<0.005) groups.It is postulated that these differences may be due to the natureof the specific occupation. Some possible reasons are listed.It is concluded that a global measure of health status suchas this may be useful in the planning and evaluation of occupationalhealth services.     

Light to Moderate Alcohol Consumption and Disability: Variable Benefits by Health Status

In adults, light to moderate alcohol consumption is associatedwith lower risks for heart disease, diabetes, and mortality.This study examined whether light to moderate alcohol use isalso associated with lower risk of incident physical disabilityover two 5-year periods in 4,276 noninstitutionalized adultsin the United States, aged 50 years or older, by using datafrom 3 waves of the National Health and Nutrition ExaminationSurvey Epidemiologic Follow-up Study surveys from 1982 to 1992.Light/moderate drinking (<15 drinks per week and <5 perdrinking day or 4 per drinking day for women) was associatedwith reduced risk for incident disability or death over 5 years,compared with abstention (adjusted odds ratio = 0.77; P = 0.008).Among survivors, light/moderate drinking was associated withlower risk for incident disability, compared with abstention(adjusted odds ratio = 0.75; P = 0.009). In stratified analyses,disability risk decreased with light/moderate drinking in adose-dependent fashion in men and women with good or betterself-reported health but not in men or women with fair or worseself-reported health. Alcohol consumption in moderation mightreduce the risk of developing physical disability in older adultsin good health but not in those in poor health. activities of daily living; alcohol drinking; longitudinal studies     

Smoking Habits in Early Pregnancy Related to Age of Smoking Debut

During 1 year, 187 general practitioners in western Norway recruited530 daily smoking, pregnant women for a smoking cessation study.At the first medical check-up in pregnancy each woman filledin a questionnaire. Women who had started smoking within 15years of age reported more heavy smoking the last 3 months beforepregnancy (P<0.0001) and at the first check-up in pregnancy(P<0.01) than those who had started smoking later. They alsoreported less reduction in smoking habits during earlier pregnancies(P<0.0001) and more serious tobacco addiction judged by startingsmoking early in the morning (P<0.005). However, even thosewho had started smoking before 15 years of age reported a reductionof 30% in cigarette consumption during the first few weeks ofthe present pregnancy. In addition to in creasing the antismokingefforts among pregnant women, health education among girls 12–15years of age to prevent smoking initiation should be intensified.     

BMI, lipid profile, physical fitness and smoking habits of young male adults and the association with parental education

Background: Few studies have focused on the potential relationshipbetween parental educational level and cardiovascular risk factorsamong young male adults. The aim of this study was to investigatecardiovascular disease risk factors among young men and whetherbody mass index (BMI), serum lipids, physical fitness and smokinghabits were related to paternal and maternal education. Methods: In this cross-sectional study 750 18- to 26-year-oldmale recruits participated. Results: Linear regression analyses showed that the paternaleducation was inversely associated with BMI (P = 0.035) andthe concentration of total cholesterol (P = 0.003) and low-densitylipoprotein (LDL) (P = 0.014). Running performance was inverselyrelated to cigarette smoking (P = 0.022) and the concentrationof triacylglycerol (P = 0.001). BMI was positively related tothe concentration of LDL (P = 0.002), total cholesterol/high-densitylipoprotein (HDL) ratio (P < 0.001) and inversely relatedto the concentration of HDL (P < 0.001), running performance(P < 0.001) and muscular strength (P = 0.011). Recruits withlow BMI, both high and low fitness, had a significantly betterlipid profile than recruits with high BMI and low fitness (P 0.016). A lower concentration of triacylglycerol (P 0.001)and a higher concentration of HDL (P = 0.034) were further shownamong recruits with high BMI/high fit compared to recruits withhigh BMI/low fit. Conclusions: High paternal educational level was associatedwith a lower BMI and a better lipid profile among young adultmen. Furthermore, men with low BMI, both high and low fit, hada better lipid profile than those with high BMI/low fit. Menwith high BMI/high fit had a better lipid profile that thosewith high BMI/low fit.     

Use of condoms: intention and behaviour of adolescents living in juvenile rehabilitation centres

The aim of the present study was to identify the psychosocialfactors explaining intention and behaviour regarding condomuse among a sample of 152 adolescents (44 F; 108 M) living injuvenile rehabilitation centres. At baseline, the variablesderived from psychosocial theories were assessed by questionnaire.The self-report of condom use was obtained 3 months later. Thevariability in intention (R² = 0.76; P < 0.001) was explainedby personal principles guiding adoption of the behaviour (ß= 0.44, P < 0.001), perceived control in adopting the behaviour(ß = 0.36, P < 0.001) and habit of using condomsin the previous 3 months (ß = 0.15, P < 0.01).Prediction of condom use yielded an R² of 0.49 (P < 0.001),the interaction terms formed by intention and perceived behaviouralcontrol (P < 0.01) and habit of using condoms by perceivedbehavioural control (P < 0.001) being the significant predictors.MANOVA analyses revealed important differences between highand low intenders on each of the items of the personal principlescale and the perceived control sub-scales. The results suggestthat the promotion of condom use among adolescents experiencingsocial adaptation difficulties should focus on developing thepersonal social responsibility that each individual has regardingthe adoption of a responsible sexual behaviour, as well as developingthe personal skills and resources necessary to overcome thepsychological and physical barriers of using condoms.     

IDENTIFYING HAZARDOUS OR HARMFUL ALCOHOL USE IN MEDICAL ADMISSIONS: A COMPARISON OF AUDIT, CAGE AND BRIEF MAST

Two hundred and forty new medical inpatients received the AlcoholUse Disorders Identification Test (AUDIT), CAGE and brief MichiganAlcoholism Screening Test (brief MAST) questionnaires. Sensitivitieswhen identifying weekly drinkers of>14 units (women) or>21units (men) were 93, 79 and 35%, respectively (P<0.001).Sensitivities to>21 units (women) or>28 units (men) were100%, 94% and 47%. Routine screening of medical admissions withthe AUDIT (cut-off score 8) is recommended.     

Empowering women to obtain high quality care: evidence from an evaluation of Mexico's conditional cash transfer programme

Objectives To evaluate the impact of Mexico's conditional cashtransfer programme on the quality of health care received bypoor women. Quality is measured by maternal reports of prenatalcare procedures received that correspond with clinical guidelines. Methods The data describe retrospective reports of care receivedfrom 892 women in poor rural communities in seven Mexican states.The women were participating in an effectiveness study and randomlyassigned to incorporation into the programme in 1998 or 1999.Eligible women accepted cash transfers conditional on obtaininghealth care and nutritional supplements, and participated inhealth education sessions. Results Oportunidades beneficiaries received 12.2% more prenatalprocedures compared with non-beneficiaries (adjusted mean 78.9,95% Confidence Interval (CI): 77.5–80.3; P < 0.001). Conclusion The Oportunidades conditional cash transfer programmeis associated with better quality of prenatal care for low-income,rural women in Mexico. This result is probably a manifestationof the programme's empowerment goal, by encouraging beneficiariesto be informed and active health consumers.     

Relationship of abdominal obesity with alcohol consumption at population scale

Background The high energy content of alcohol makes its consumption a potential contributor to the obesity epidemic. Aim of the study To determine whether alcohol consumption is a risk factor for abdominal obesity, taking into account energy underreporting. Methods The subjects were Spanish men (n = 1491) and women (n = 1563) aged 25–74 years who were examined in 1999–2000, in a population-based cross-sectional survey in northeastern Spain (Girona). Dietary intake, including alcohol consumption, was assessed using a food frequency questionnaire. Anthropometric variables were measured. Results The mean consumption of alcohol was 18.1 ± 20.7 g/d in men and 5.3 ± 10.4 g/d in women. 19.3% of men and 2.3% of women reported alcohol consumption of more than 3 drinks per day. The consumption of alcohol was directly associated with total energy intake in men (P < 0.001) and women (P = 0.001). The proportion of energy underreporting significantly (P < 0.001) decreased with higher amounts of alcohol drinking in both genders. Multiple logistic regression analysis, controlled for energy underreporting, smoking, educational level, leisure-time physical activity, energy, and diet quality, revealed that consuming more than 3 drinks of alcohol (>30 g ethanol) was significantly associated with the risk of abdominal obesity (Odds ratio 1.80; 1.05, 3.09) and exceeding recommended energy consumption (Odds ratio 1.97; 1.32, 2.93) in men. A very small number (2.13%) of women in this population reported high levels of alcohol consumption. Conclusions Alcohol consumption in elevated amounts was associated with risk of abdominal obesity in men, independent of energy underreporting.     

Compliance with the Swiss Society for Nutrition's Dietary Recommendations in the Population of Geneva,Switzerland: A 10-Year Trend Study (1999-2009)

The trends in compliance with the dietary recommendations of the Swiss Society for Nutrition in the Geneva population were assessed for the period from 1999 to 2009 using 10 cross-sectional, population-based surveys (Bus Santé study) with a total of 9,320 participants aged 35 to 75 years (50% women). Dietary intake was assessed using a self-administered, validated, semi-quantitative food frequency questionnaire. Trends were assessed by logistic regression adjusting for age, smoking status, education, and nationality using survey year as the independent variable. After excluding participants with extreme intakes, the percentage of participants with a cholesterol intake of <300 mg/day increased from 40.8% in 1999 to 43.6% in 2009 for men (multivariate-adjusted P for trend=0.04) and from 57.8% to 61.4% in women (multivariate-adjusted P for trend=0.06). Calcium intake >1 g/day decreased from 53.3% to 46% in men and from 47.6% to 40.7% in women (multivariate-adjusted P for trend<0.001). Adequate iron intake decreased from 68.3% to 65.3% in men and from 13.3% to 8.4% in women (multivariate-adjusted P for trend<0.001). Conversely, no significant changes were observed for carbohydrates, protein, total fat (including saturated, monounsaturated, and polyunsaturated fatty acids), fiber, and vitamins D and A. We conclude that the quality of the Swiss diet did not improve between 1999 and 2009 and that intakes deviate substantially from expert recommendations for health promotion and chronic disease risk reduction.     

INCREASED FEMALE DRINKING IN ACCORDANCE WITH POST-INDUSTRIAL URBANIZATION IN JAPAN

We studied the relationship between living in an urban areaand the alcohol-consumption habits of young mothers in lightof the recent increase of the female drinking population inJapan, particularly among those from 20 to 39 years of age.We conducted a survey in four areas in and around Tokyo, eacharea representing a different level of urbanization. The studypopulation consisted of 6418 mothers of 3-year-old children;an 84.9% response rate was obtained. Thirty-eight per cent ofthe respondents had drunk at least four units of alcohol (about44 g of pure ethanol) during the most recent month The proportionof current drinkers in a more-urbanized area was greater thanthat in a less-urbanized area, and this tendency was significant(P<0.001). Current workforce participation was significantlypositively associated with current drinking (P<0.01). Youngerage significantly increased chances of current drinking (P<0.05)Effects of living in a more-urbanized area on current drinkingof mothers of 3-year-old children after excluding the effectsof workforce participation and age was significantly positive(P<0.001). An increase in female drinking in Japan was consideredto be due to acculturation associated with urbanization in apost-industrial society.     

Factors affecting workforce participation and healthy worker biases in U.S. women and men

PurposeTo investigate potential attenuation of healthy worker biases in populations in which healthy women of reproductive age opt out of the workforce to provide childcare.MethodsWe used 2013–2015 data from 120,928 U.S. women and men aged 22–44 years participating in the Gallup-Healthways Well-Being Index. We used logistic regression to estimate adjusted prevalence odds ratios (PORs) and 95% confidence intervals (CIs) for associations between health and workforce nonparticipation.ResultsWomen and men reporting poor health were more likely to be out of the workforce than individuals reporting excellent health (POR: 3.7, 95% CI: 3.2–4.2; POR: 6.7, 95% CI: 5.7–7.8, respectively), suggesting potential for healthy worker bias. For women (P < .001) but not men (P = .30), the strength of this association was modified by number of children in the home: POR: 7.3 (95% CI: 5.8–9.1) for women with no children, decreasing to POR: 0.9 (95% CI: 0.6–1.5) for women with four or more children.ConclusionsThese results are consistent with attenuation of healthy worker biases when healthy women opt out of the workforce to provide childcare. Accordingly, we might expect the magnitude of these biases to vary with the proportion of women with differing numbers of children in the population.     

A comparison of the health-related quality of life in patients with diabetic foot ulcers,with a diabetes group and a nondiabetes group from the general population

Objective: The aim of this study was to describe health-related quality-of-life (HRQL) in patients with diabetic foot ulcers by comparing their HRQL with that of a sample from the general population without diabetes (general population) and a subgroup with diabetes (diabetes population), and to examine the differences between groups by sociodemographic characteristics and lifestyle factors. Design and methods: A cross-sectional study was made of 127 adults with current diabetic foot ulcer, recruited from six hospital outpatient clinics, a control sample categorized as a diabetes population (n = 221) from the Norwegian Survey of Level of Living, and a sample from the general population (n = 5903). Data on sociodemographic characteristics (sex, age, cohabitation, education and employment) and lifestyle (body mass index [BMI] and smoking status) and HRQL (SF-36) were obtained. Results: In all the SF-36 subscales and in the two SF-36 summary scales, the patients with diabetic foot ulcer reported significantly poorer HRQL than the diabetes population. The most striking differences were for role limitation-physical (32.1 vs. 62.2, p < 0.001), physical functioning (57.5 vs. 77.3, p < 0.001) and role limitation-emotional (57.4 vs. 72.0, p < 0.001). The patients with foot ulcer had significantly lower HRQL than the general population on all scales, and in particular on role limitation-physical (32.1 vs. 74.3, p < 0.001), physical functioning (57.5 vs. 85.2, p < 0.001) and general health (50.1 vs. 74.3, p < 0.001). The most important sociodemographic characteristic that differed between the diabetic foot ulcer patients and the diabetes population was that significantly more of the foot ulcer patients were men living alone. The largest differences between the foot ulcer patients and the general population were that more of the foot ulcer patients were men, older, living alone, less well educated, and not working. The diabetic foot ulcer patients, the diabetes population and the general population differed in BMI: 28 kg/m² in the foot ulcer patients, 27 kg/m² in the diabetes population and 25 kg/m² in the general population. Conclusion: Diabetic foot ulcer patients had much worse HRQL compared with the diabetes population and the general population, especially in physical health. Foot ulcer patients were more often men living alone, and obesity was a problem in both the foot ulcer patients and the diabetes population.