The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, ...The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.展开更多
Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searc...Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searching engines included Cumulative Index to Nursing Allied Health Literature (CINAHL), Pro Quest, MEDLINE, Google Scholar, SAGE Journals, Wiley on Line Library, and Science Direct electronic databases from 2010 to 2018. Fifteen research articles assessed the main variables and their associations with demographic and clinical variables. Results: Different methodologies and samples were analyzed: analytic descriptive, systematic review, a randomized control trial, retrospective cohort, a prospective Cohort, cross-sectional, and correlational designs. The fifteen studies showed that the patients with ACS have inadequate health literacy. Patients’ ability to understand basic and complex information or to accurately assess health risks was impaired and may hinder patients’ engagement in self-care. Low HL in patients having ACS is consistently associated with poor QoL. Physical domain of QoL remained the significant outcome of both self-care behavior and health literacy after adjusting for demographics and clinical variables in patients with ACS. Conclusion: The literature pointed to the importance of considering health literacy and self-care behaviors as predictors of quality of life among patients with ACS. However, there has been no previous evidence on the best process of the association between these three variables.展开更多
Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobeha...Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.展开更多
Health checks are key features of primary and secondary disease prevention. The aim of this study was to examine the sex- and age-specific association of social status and health-related behaviors with health check at...Health checks are key features of primary and secondary disease prevention. The aim of this study was to examine the sex- and age-specific association of social status and health-related behaviors with health check attendance in eligible persons. Data were derived from the Kanazawa Study 2011 (n = 12,781), a cross-sectional study which investigated all the residents in model areas of Kanazawa City, Ishikawa Prefecture, Japan. We selected participants aged 23 years or older with National Health Insurance (n = 4920). Attendance at health checks was the outcome. We used social status and health-related behaviors as predictor variables. We analyzed them by sex and applied stratified analyses by age groups for each sex. The bivariate analyses were conducted by means of cross-tabs. We calculated health check attendance rates by each variable. We used Pearson’s χ2-test to examine statistically significant differences. We fitted logistic regression models to estimate adjusted odds ratios (ORs) of attendance in the past one year. We computed ORs in a logistic regression model containing all variables described above. Workingmen and women aged 23 to 39 years and aged 40 to 64 years had significantly increased ORs for health check attendance compared with non-working persons. Men, men aged 23 to 39 years and men aged 65 years or older with more physical activity had significantly increased ORs for health check attendance. Male ex-smokers, female ex- and non-smokers, male ex-smokers aged 65 years or older, and female non-smokers aged 40 to 64 years had significantly increased ORs. The findings suggest that population groups with lower social status or increased risks of adverse health effects are less likely to attend health checks than those with higher social status or decreased risks in particular sex and age groups. It indicates that diverse approaches are required to realize the full benefit of health checks.展开更多
Background:Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade.It is therefore important to understand the effectiveness of recent nati...Background:Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade.It is therefore important to understand the effectiveness of recent national health policies(such as the National Rural Health Mission and the National Urban Health Mission)in addressing the varied needs of the heterogeneous population of India.Methods:We use datasets from the National Sample Surveys carried out in 2004 and 2014 to understand the change in the health seeking behavior as a result of these policies.The choice of health care facilities and the associated expenditures are compared through descriptive analyses.A multinomial logistic regression is used to identify the significant parameters which contribute towards the share of health care providers in India.The health status of two economically disparate Indian states(Bihar and Kerala)are also compared through specific metrics of performance.Results:It is seen that due to increased availability of facilities in close proximity,both rural and urban residents prefer to avail of those facilities which will result in minimization of transportation cost.The effectiveness of national health policies is found to vary on a regional scale.Literacy and health status have a strong correlation,thereby reinforcing that Bihar still lags far behind Kerala in terms of access to equitable health care.Conclusion:Therefore,a hierarchical system,incorporating medical pluralism and tailor-made policies targeted at diverse health care demands,needs to be put in place to achieve Goal 3 of the Sustainable Development Goals as decreed by the United Nations,i.e.,“health for all”.展开更多
文摘The focus of this paper is to investigate the role self-employment conceptualized as a lifestyle factor on health, access to health care, and health behaviors. We analyze rich data on 13,435 working adults in the US, who are either selfemployed or salaried workers. Outcomes include physical and mental health perception, validated indexes of physical and mental health, and medical conditions;access-to-care measures such as a barrier to obtaining necessary health care;and health behaviors such as smoking, physical activity and body mass index. Instrumental variables methods are used to correct for selection into self-employment. We find that self-employment is positively associated with perceived physical health, and is negatively associated with having diabetes, high blood pressure, high cholesterol and arthritis. No mental health outcome is significantly associated with self-employment. There is no significant difference between self-employed and wage-earning individuals with regard to access to care. Self-employed individuals are less likely to smoke, and are more likely to participate in physical activity and have normal-weight. We conclude that despite lack of health insurance, self-employed persons in the US are as healthy as wage-earners, do not experience a greater barrier to access to care, and are more likely to engage in healthy behavior.
文摘Purpose: The review aimed to find the best evidence on the relationship between health literacy, self-care behavior and perceived quality of life (QoL) among patients with acute coronary syndrome (ACS). Methods: Searching engines included Cumulative Index to Nursing Allied Health Literature (CINAHL), Pro Quest, MEDLINE, Google Scholar, SAGE Journals, Wiley on Line Library, and Science Direct electronic databases from 2010 to 2018. Fifteen research articles assessed the main variables and their associations with demographic and clinical variables. Results: Different methodologies and samples were analyzed: analytic descriptive, systematic review, a randomized control trial, retrospective cohort, a prospective Cohort, cross-sectional, and correlational designs. The fifteen studies showed that the patients with ACS have inadequate health literacy. Patients’ ability to understand basic and complex information or to accurately assess health risks was impaired and may hinder patients’ engagement in self-care. Low HL in patients having ACS is consistently associated with poor QoL. Physical domain of QoL remained the significant outcome of both self-care behavior and health literacy after adjusting for demographics and clinical variables in patients with ACS. Conclusion: The literature pointed to the importance of considering health literacy and self-care behaviors as predictors of quality of life among patients with ACS. However, there has been no previous evidence on the best process of the association between these three variables.
文摘Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.
文摘Health checks are key features of primary and secondary disease prevention. The aim of this study was to examine the sex- and age-specific association of social status and health-related behaviors with health check attendance in eligible persons. Data were derived from the Kanazawa Study 2011 (n = 12,781), a cross-sectional study which investigated all the residents in model areas of Kanazawa City, Ishikawa Prefecture, Japan. We selected participants aged 23 years or older with National Health Insurance (n = 4920). Attendance at health checks was the outcome. We used social status and health-related behaviors as predictor variables. We analyzed them by sex and applied stratified analyses by age groups for each sex. The bivariate analyses were conducted by means of cross-tabs. We calculated health check attendance rates by each variable. We used Pearson’s χ2-test to examine statistically significant differences. We fitted logistic regression models to estimate adjusted odds ratios (ORs) of attendance in the past one year. We computed ORs in a logistic regression model containing all variables described above. Workingmen and women aged 23 to 39 years and aged 40 to 64 years had significantly increased ORs for health check attendance compared with non-working persons. Men, men aged 23 to 39 years and men aged 65 years or older with more physical activity had significantly increased ORs for health check attendance. Male ex-smokers, female ex- and non-smokers, male ex-smokers aged 65 years or older, and female non-smokers aged 40 to 64 years had significantly increased ORs. The findings suggest that population groups with lower social status or increased risks of adverse health effects are less likely to attend health checks than those with higher social status or decreased risks in particular sex and age groups. It indicates that diverse approaches are required to realize the full benefit of health checks.
文摘Background:Health policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade.It is therefore important to understand the effectiveness of recent national health policies(such as the National Rural Health Mission and the National Urban Health Mission)in addressing the varied needs of the heterogeneous population of India.Methods:We use datasets from the National Sample Surveys carried out in 2004 and 2014 to understand the change in the health seeking behavior as a result of these policies.The choice of health care facilities and the associated expenditures are compared through descriptive analyses.A multinomial logistic regression is used to identify the significant parameters which contribute towards the share of health care providers in India.The health status of two economically disparate Indian states(Bihar and Kerala)are also compared through specific metrics of performance.Results:It is seen that due to increased availability of facilities in close proximity,both rural and urban residents prefer to avail of those facilities which will result in minimization of transportation cost.The effectiveness of national health policies is found to vary on a regional scale.Literacy and health status have a strong correlation,thereby reinforcing that Bihar still lags far behind Kerala in terms of access to equitable health care.Conclusion:Therefore,a hierarchical system,incorporating medical pluralism and tailor-made policies targeted at diverse health care demands,needs to be put in place to achieve Goal 3 of the Sustainable Development Goals as decreed by the United Nations,i.e.,“health for all”.
