This thesis described socioeconomic inequalities in fruit and vegetable consumption in Stockholm County. A comparative descriptive analysis was carried out with the use of secondary data from the 2006 Stockholm County Public Health Survey. The data was analyzed through cross tabulations that were conducted in SPSS. The findings showed that people with high socioeconomic position consumed fruit and vegetables more frequently than those of low socioeconomic position. Differences in fruit and vegetable consumption were found for the three measures of socioeconomic position; education, occupation and income. These differences were pronounced to a larger extent across different education levels compared to levels of occupation and income. Further research is needed to investigate which factors may explain the observed differences.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2008. / Härtill 5 uppsatser.

Introdução As recentes mudanças nos arranjos familiares e o envelhecimento populacional acarretam em novas demandas de saúde. Conhecer os arranjos familiares nos quais estão inseridos os idosos e a sua relação com o uso de serviços de saúde para a prevenção de doenças é de extrema importância para o planejamento de serviços e políticas públicas. Objetivo - Descrever os arranjos familiares aos quais pertencem os idosos do Município de São Paulo, SP, segundo características sociodemográficas e de saúde. Metodologia Estudo de base populacional com dados do Inquérito de Saúde de São Paulo ISA-Capital 2008. Participaram 920 idosos residentes da área urbana do Município de São Paulo. As variáveis de análise foram sociodemográficas, o tipo de arranjo familiar e uso de serviço de saúde consulta odontólogica; serviço de saúde; realização de papanicolau; mamografia; exame para prevenção câncer de próstata; exame para prevenção de câncer de intestino. A análise dos dados se deu por meio do teste de Chi-Quadrado de Pearson através dos softwares SPSS 18.0, módulo Complex Sample e STATA 11.0, módulo Survey. Resultados 31,4 por cento dos idosos moravam com cônjuge e descendência; 26,0 por cento só com cônjuge; 19,8 por cento só com descendência; 14,8 por cento sozinhos. Os idosos que moravam com cônjuge e descendência e só com o cônjuge foram os que mais realizaram exames preventivos para câncer de próstata e intestino, consultaram mais serviços odontológicos e de saúde na ausência de morbidades. Discussão - Idosos que moravam somente com descendentes foram que apresentaram piores condições socioeconômicas e os que menos fizeram exames preventivos, sugerindo que devem ser alvo de mais atenção e de campanhas para prevenção de doenças e agravos. / Background: Recent changes in family structure and population aging lead to new health demands. Cognize the family arrangements in which are embedded the elderly and its relationship to the use of health services for disease prevention is extremely important for service planning and public policies. Objective: Describe family arrangements which elderly belong in the city of São Paulo, according to sociodemographic and health characteristics. Methods: Population-based study with data from Health Survey in São Paulo, ISA-Capital 2008. The study was carried out with 920 elderly residents in São Paulo urban area. Analysis variables were sociodemographic, types of family arrangements and the use of health service for \'dental appointment\', \'health service\', \'Pap smear\', \'mammography\', \'prostate cancer prevention test\'; \'bowel prevention cancer test\'. Data analyses were conducted by Chisquare Test, SPSS 18.0 software, Complex Sample and STATA 11.0, Survey. Results: 31.4 per cent of the elderly used to live with spouse and offspring, 26.0 per cent with spouse only, 19.8 per cent with only offspring, 14.8 per cent alone. Elderly living with spouse and offspring, and only with their spouse performed more preventive screenings for prostate cancer and bowel, searched for more dental and health services when in absence of comorbidities. Discussion: Elderly living alone with offspring presented worst socioeconomic conditions and also performed less preventive tests, suggesting that they should be targeted for more attention and diseases prevention campaigns.

Magister Public Health - MPH / Ethiopia has achieved its target for Millennium Development Goal 4 by recording 69 %reduction in its under-five mortality. The proportion of fully immunized children in Ethiopia has increased from 14 % in 2000 to 24 % in 2011. Though progress has been made, about 3 out of 4 children still remain incompletely immunized. The purpose of this study is to determine the socio-demographic and socioeconomic factors associated with incomplete immunization among children aged 12-23 months in Ethiopia. This study is based on secondary analysis of the 2011 Ethiopia Demographic and Health Survey. Information on 1,889 mothers of children aged 12–23 months were extracted from the children dataset. Records from vaccination cards and mothers’ self-reported data were used to determine vaccine coverage. The association between child immunization status and determinants of non-utilization of immunization services was assessed using bivariate and multivariate analyses. The findings of this study showed that the prevalence of incompletely immunized children is 70.9%. Children of mothers from the poor (AOR = 2.27; 95 % CI: 1.34 – 3.82) wealth quintile were more likely to be incompletely immunized. Children of mothers from Affar (AOR = 15.80; 95 % CI: 7.12 – 35.03), Amhara (AOR = 4.27; 95 %CI: 2.31 – 7.88), Oromiya (AOR = 8.10; 95 % CI: 4.60 – 14.25), Somali (AOR = 4.91;95 % CI: 2.65 – 9.10), Benishangul-Gumuz (AOR = 4.20; 95% CI: 2.34 – 7.57),Southern Nations Nationalities and Peoples’ (AOR = 4.76; 95 % CI: 2.53 – 8.94), Gambela (AOR = 7.75; 95 % CI: 3.68 – 16.30) and Harari (AOR = 3.22; 95 % CI: 1.77 –5.89) regions were more likely to be incompletely immunized. Mothers with inadequate exposure to media (AOR = 1.60; 95% CI: 1.21 – 2.14), who are not aware of community conversation programme (AOR = 1.80; 95% CI: 1.40 – 2.32) and who attended no antenatal care (AOR = 2.21; 95% CI: 1.72 – 2.83) were more likely to have incompletely immunized children. Despite efforts to increase rates of childhood immunization, the proportion of children with incomplete immunization in Ethiopia is considerably high. Therefore, targeted interventions at the identified socio-demographic factors are needed to increase immunization rates.

The usefulness of secondary exposure and health data to improve public health in South Africa will be assessed. Given the tremendous health impact of air pollution exposure the focus of this thesis is on primary prevention, that is the identification of outdoor air pollution and the use of dirty fuels (wood, animal dung, crop residues, coal, paraffin) for cooking and heating as risk factors, whilst controlling for confounding. Hourly averaged outdoor PM10 mass, NO2, NO, SO2, O3 data (1 August 1998 - 31 July 2003) from Cape Town were analysed in a nonparametric Spearman’s Rho correlation analysis to determine the seasonal spatial correlation between the monitoring sites. Trend and descriptive analyses were conducted on the outdoor hourly and daily PM10 mass data to investigate the current and future health implications in the Khayelitsha sub-district, Cape Town. The 1998 South African Demographic and Health Survey (SADHS) data were analysed. The survey involved 13 826 individuals in 12763 households. Univariate and multivariate logistic regression analyses generated crude and adjusted odds ratios and 95% confidence intervals in order to assess the influence of dirty fuel use for cooking and heating on adult (> 15 years) respiratory health, childhood (< 59 months) respiratory health and 1-59 month mortality. It was found that outdoor air pollution is not homogenously distributed in Cape Town during all seasons. Elevated PM10 mass concentrations are frequently present in the Khayelitsha sub-district. There is a strong case for acknowledging the large public health risk arising from air pollution exposure in South Africa, despite the limitations of the 1998 SADHS data. Not much progress has been made in air pollution epidemiology in the country during this investigation due to the identified limitations. Secondary exposure and health data are thus only useful in improving public health in South Africa by supplying baseline data for trend analysis or hypotheses generation. It is recommended that the country must develop environmental public health tracking networks, which incorporates various data sources from multi-sectoral collaborative intervention projects with analytic study designs, in all major cities in the country. / Thesis (PhD)--University of Pretoria, 2006. / School of Health Systems and Public Health (SHSPH) / PhD / Unrestricted

Cancer fatalism, which can be understood as the belief that cancer is a death sentence, has been found to be a deterrent to preventive cancer screening participation. This study examines factors associated with breast cancer fatalism among women. We analyzed data from a 2003 survey of women 40 years of age. The survey collected information about respondents' knowledge and attitudes regarding breast health. Analyses compared the characteristics of women who reported and those who did not report a fatalistic attitude. omen with a fatalistic attitude were more likely to be African American, to have a family history of breast cancer, to rate their quality of care as fair or poor, to believe that not much could be done to prevent breast cancer, to believe that breast cancer could not be cured if found early, and to believe that treatment could be worse than the disease.

COPD has a profound impact on daily life, yet remains underdiagnosed and undertreated. We set out to develop a brief, reliable, self-scored questionnaire to identify individuals likely to have COPD. COPD-PS™ development began with a list of concepts identified for inclusion using expert opinion from a clinician working group comprised of pulmonologists (n = 5) and primary care clinicians (n = 5). A national survey of 697 patients was conducted at 12 practitioner sites. Logistic regression identified items discriminating between patients with and without fixed airflow obstruction (AO, postbronchodilator FEV1/FVC < 70%). ROC analyses evaluated screening accuracy, compared scoring options, and assessed concurrent validity. Convergent and discriminant validity were assessed via COPD-PS and SF-12v2 score correlations. For known-groups validation, COPD-PS differences between clinical groups were tested. Test-retest reliability was evaluated in a 20% sample. Of 697 patients surveyed, 295 patients met expert review criteria for spirometry performance; 38% of these (n = 113) had results indicating AO. Five items positively predicted AO (p < 0.0001): breathlessness, productive cough, activity limitation, smoking history, and age. COPD-PS scores accurately classified AO status (area under ROC curve = 0.81) and reliable (r = 0.91). Patients with spirometry indicative of AO scored significantly higher (6.8, SD = 1.9; p < 0.0001) than patients without AO (4.0, SD = 2.3). Higher scores were associated with more severe AO, bronchodilator use, and overnight hospitalization for breathing problems. With the prevalence of COPD in the studied cohort, a score on the COPD-PS of greater than five was associated with a positive predictive value of 56.8% and negative predictive value of 86.4%. The COPD-PS accurately classified physicianreported COPD (AUC = 0.89). The COPD-PS is a brief, accurate questionnaire that can identify individuals likely to have COPD.

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第21033号 / 社医博第87号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 中山 健夫, 教授 木原 正博, 教授 西渕 光昭 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

To be able to participate fully in the great adventure of life requires a high degree of physical and mental well-being. In order to acquire this high state of efficiency, each new individual must adjust himself to his environment, to his friends, and to his prevailing economic status. This, of course, requires the aid and knowledge required by those who have gone before, and any new know ledge which can readily be applicable to our present situation. The new born child must have the best of care and guidance from its mother and others in order to make the proper adjustments to life. The child's habits must be watched carefully to insure proper guidance, to make adjustments to changing conditions of life, and to protect the individual from numerous disease epidemics. So it is with the number of new educational institutions that are springing up throughout the country.

Asthma is one of the most common respiratory diseases in Canada. It not only brings pain to more than 7.8% of Canadians but it also costs millions of dollars every year. In this project we study the influence that environmental factors have on asthma based on the data from the National Population Health Survey (NPHS) conducted by Statistics Canada. A descriptive analysis is done first to get an initial understanding of the environmental factors' effects on asthma. Then we do a x2-test to test for the homogeneity of asthma distribution across the levels of each environmental factor. Most of the factors included in our study are significant except those representing whether living in the metropolitan areas of Montreal or Vancouver, the number of persons living in the household, and whether there are small children in the household. For ordinal variables we test for trend on asthma prevalence. The trend tests indicate that there are significant trends between asthma and most of the ordinal factors except for a few, including the number of bedrooms in the household and the number of cigarettes smoked daily by the daily smokers. Then odds ratio and relative risk analyses are done to obtain statistical insights on the relative risk of the factors. The result shows that living in Nova Scotia, Ontario and Quebec, urban areas, engaged in finance, community services, personal service, young, attend physical activities, born in Canada, white, single or widowed, separated, divorced, start smoking early, do not own the dwelling living in, female adult, male children, and overweight and underweight adult, are all contributing factors for asthma. To model and investigate the joint effect of factors on asthma prevalence, we use logistic and log-linear regression models. To avoid collinearity problems, a reduced number of predictors is used. The results suggest that environmental factors have a significant joint influence on asthma prevalence. / Thesis / Master of Science (MS)