Social Networks and Depression Among the Elderly: Metropolitan/Nonmetropolitan Comparisons*

Contradictory findings have been reported about depression in the elderly living in metropolitan and nonmetropolitan regions of the United States. Additionally, the extent to which the same sets of variables are predictive of depression among the elderly living in metropolitan and nonmetropolitan environments is unknown. We examined these issues using the Center for Epidemiologic Studies Depression Scale (CES-D) and a national sample of elderly respondents. Findings indicated no differences in the average depression scores of metropolitan and nonmetropolitan elderly. Differences were observed in the social network variables found to be predictive of depression within each subgroup. Among the metropolitan elderly, intimate social relations were found to be independently associated with depression, while secondary social attachments were related to depression among the nonmetropolitan elderly. An examination of the buffering effect of social ties upon the relationship between stress and depression revealed that a simple additive model may not be adequate to describe the association between social network elements and depression among the elderly.     

Same‐level fall injuries in US workplaces by age group,gender, and industry

Background

As the workforce ages, occupational injuries from falls on the same level will increase. Some industries may be more affected than others.

Methods

We conducted a cross‐sectional study using data from the Bureau of Labor Statistics to estimate same‐level fall injury incidence rates by age group, gender, and industry for four sectors: 1) healthcare and social assistance; 2) manufacturing; 3) retail; and 4) transportation and warehousing. We calculated rate ratios and rate differences by age group and gender.

Results

Same‐level fall injury incidence rates increase with age in all four sectors. However, patterns of rate ratios and rate differences vary by age group, gender, and industry. Younger workers, men, and manufacturing workers generally have lower rates.

Conclusions

Variation in incidence rates suggests there are unrealized opportunities to prevent same‐level fall injuries. Interventions should be evaluated for their effectiveness at reducing injuries, avoiding gender‐ or age‐discrimination and improving work ability.

     

Structural Equation Modeling of Pesticide Poisoning,Depression, Safety,and Injury

ABSTRACT

The role of pesticide poisoning in risk of injuries may operate through a link between pesticide-induced depressive symptoms and reduced engagement in safety behaviors. The authors conducted structural equation modeling of cross-sectional data to examine the pattern of associations between pesticide poisoning, depressive symptoms, safety knowledge, safety behaviors, and injury. Interviews of 1637 Colorado farm operators and their spouses from 964 farms were conducted during 1993–1997. Pesticide poisoning was assessed based on a history of ever having been poisoned. The Center for Epidemiologic Studies—Depression scale was used to assess depressive symptoms. Safety knowledge and safety behaviors were assessed using ten items for each latent variable. Outcomes were safety behaviors and injuries. A total of 154 injuries occurred among 1604 individuals with complete data. Pesticide poisoning, financial problems, health, and age predicted negative affect/somatic depressive symptoms with similar effect sizes; sex did not. Depression was more strongly associated with safety behavior than was safety knowledge. Two safety behaviors were significantly associated with an increased risk of injury. This study emphasizes the importance of financial problems and health on depression, and provides further evidence for the link between neurological effects of past pesticide poisoning on risk-taking behaviors and injury.     

Work-Related Injuries and Fatalities on Dairy Farm Operations—A Global Perspective

ABSTRACT

Agriculture is among the most hazardous sectors for workers globally, and dairy farming has been associated with a high risk of injury among workers in several countries. The purpose of this paper is to provide an update on what is known about modern dairy farms and related injuries and fatalities in different regions of the world. As in other sectors of agriculture, fatalities appear to be associated with heavy equipment usage, whereas injuries occur at higher rates with animal production, specifically cattle and milk production. Dairy farming is associated with higher rates of injury as compared with other industrial sectors, but a lack of work-related injury reporting continues to be an issue in several countries. Worker fatality associated with heavy equipment use is not a new observation (e.g., tractors); however, manure-handling systems, livestock handling, and quad bike operation continue to be associated with worker injuries and fatalities on modern farms. Opportunities exist for improvement of safety-related equipment to reduce injury and fatality risk during worker interactions with large animals and farm equipment.     

Enhancing surveillance of injuries and disease among agricultural youth

Public health surveillance is fundamental to monitoring trends and for planning, implementation, and evaluation of health conditions in order to develop appropriate prevention and control programs. Farms and ranches are places where work and home life intersect in a unique way where risks are shared between work, home, and leisure. Public health surveillance systems have not been adapted to include agricultural youth as a subset at high risk of injuries and illnesses. Occupational health surveillance is used to monitor work-related illnesses and injuries but most have not allowed for continuous monitoring of agricultural-related illnesses, injuries, and disability. Limited evaluation of data sets available for surveillance or periodic reporting of disease, disability, medical care utilization, and risk factors relevant for youth living and working on farms and ranches other than traumatic injuries has been published. The purpose of this paper is to discuss the current most commonly used databases and their limitations, and to list potentially relevant databases and their limitations, as well as making recommendations to augment their usefulness in monitoring trends among youth living and working on farms and ranches.     

Prevalence of disability among adolescents and adults in rural China

BackgroundDisability affects health status and quality of life; however, insufficient research has been done in developing countries using internationally accepted measurements.ObjectiveWe investigated disabilities, sociodemographics, health indicators, and health behaviors using a sample of rural residents in northern China. We reported disability prevalence by age for our study sample and for a sample of rural residents who participated in the 1999-2002 Colorado Disability Survey.MethodsFace-to-face interviews were conducted in 2008, and complete questionnaires were obtained from 2199 individuals 15 years old or older. The definition of disability was conceptually based on the International Classification of Functioning, Disability and Health.ResultsOf those who completed the survey, 154 (7.0%) reported having disabilities. The prevalence was 2.3% for limitations in activities of daily living (ADL) and 3.1% for limitations in instrumental activities of daily living (IADL). Significant differences in the disability prevalence were found across the categories of education, age, and marital status. Among individuals with disabilities, 54.6% rated their health status as poor or very poor compared to 13.4% of people without a disability. A strong association was seen between disability status and injury. A large proportion (79.9%) of persons with disabilities, as well as 82.2% of persons without disabilities, reported paying for their medical expenses out-of-pocket. The age pattern of disabilities (ADL and IADL) was similar to that seen in a rural Colorado population.ConclusionsMany rural Chinese individuals with disabilities report poor general health and may face further limitations in their daily activities and social participation without accessible and affordable health care.     

The use and abuse of subgroup analysis in epidemiological research

Most epidemiology involves the analysis of subgroups. In observational studies, identification of associations within particular subgroups is the usual method of investigation, while in experimental studies the purpose is to compare the rate of occurrence of the outcome of interest in treated and control groups. Problems can arise through failure to specify the subgroups of interest a priori and through examining large numbers of subgroups after the fact, i.e., through multiple testing. Rules for interpretation of findings in subgroups are suggested, and the value of the systematic application of criteria for judgement of the causal significance of any associations that may be observed is noted.     

The dangers of dairy farming: the injury experience of 600 workers followed for two years.

In order to better understand the work-related injuries sustained on central New York dairy farms, we undertook a two-year population-based study of 600 farmers and farm workers on 201 dairy farms. During the observation period, 1984-1986, 151 persons had 200 injuries, giving an injury rate of 16.6%/year (166 injuries/1,000 workers/year). Men were injured more often than women (p less than or equal to 0.01). Injured workers were older (p less than or equal to 0.01), worked more hours (p less than or equal to 0.001), and had heavier workloads than noninjured workers (p less than or equal to 0.001). The growing and harvest seasons had the most injuries; winter the fewest. More than 2/3 of the injuries occurred in the afternoon. Owners/operators, often the most experienced, knowledgeable people on the farms, were most often hurt. Those working more than 60 hours/week, with greater than 30 acres under tillage/worker, had a relative risk of 2.76 compared with all other workers. The attributable risk for this group was 51%. There were two fatalities, both involved owner/operators. Our findings suggest that previous studies may have underestimated the risks faced by farmers. Dairy farming in central New York is very dangerous work. Those who own and operate these dairy farms are most often hurt and killed. Analysis of events on individual farms will be reported separately.