The existence of socially-patterned health (with poorer health generally being experienced by those in more disadvantaged circumstances) is widely recognised. Social differentials have been observed for (inter alia) respiratory disorders, and for cardiovascular disease. One possible explanation for social inequality in these areas of health posits a mediating effect of housing conditions: disadvantaged individuals may face greater exposure to residential hazards (such as dampness), which may in turn adversely influence cardiorespiratory health. However, few studies have examined a complete posited causal chain linking socioeconomic position (SEP) with health via housing. Using pre-existing data, this study constructed detailed representations of the social and residential experiences over adult life (15 to 60 years) of a sample of elderly British people. Both measures of accumulated exposure (to disadvantage, and to housing hazards), and explicit trajectories of social and residential experience, were derived. Construction of trajectories required the development of methods for condensing individuals’ diverse experiences into higher-level groups, in the interests of analytical tractability. Relationships between the derived measures of lifetime exposure and a range of outcomes expressing aspects of cardio-respiratory health in old age were assessed. No persuasive evidence was observed to support the hypothesis that lifetime residential exposures may mediate the relationship between SEP and the health outcomes examined. In addition to testing this specific conceptual model, the study examined how exposure to social disadvantage and to residential risks varied over adult life, identifying distinctive features of the exposure experience which could not readily be captured by the infrequent sampling of SEP commonly featured in health inequality research. The respective merits of such ‘sparse’ sampling and the more intensive sampling used in the study were compared. It was concluded that fully exploiting the additional information captured by intensive sampling requires confronting a number of methodological challenges. Because of this, it is argued that the collection of detailed information on exposures over time does not automatically confer genuine advantages over the hitherto dominant approach of sampling at only a small number of time points. Future development of lifecourse epidemiology will require further debate over how lifetime exposure (to both social and environmental risk factors) can most effectively be represented in quantitative analysis.

MSc(Med)Population Based Field Epidemiology, Faculty of Health Sciences, University of the Witwatersrand, 2009 / Introduction: In Africa, elderly adult mortality, just like many issues affecting the old has not been adequately addressed by research. This study explored the relationship between socioeconomic status (SES) and elderly adult mortality in an economically deprived region of rural Ghana. Methods: Data from the Navrongo DSS was used for the analysis. SES was determined from the asset data using principal component analysis. A total of 15030 adults aged over 60 years were included in the study, out of which 1315 died. We investigated the above relationship using Cox proportional hazards regression methods while controlling for other variables. Results: Socioeconomic status (SES) was found not to be a determinant of elderly mortality. Compared to the lowest SES quintile, the adjusted hazards ratios were, 0.94 (95%CI: 0.79–1.12) for second quintile, 0.91 (95%CI: 0.76–1.08) for third quintile, 0.89 (95%CI: 0.75–1.07) for fourth quintile and 1.02 (95%CI: 0.86–1.21) for the highest income quintile. However, living without a spouse [HR=1.98, 95%CI: 1.74–2.25], being male [HR=1.80, 95%CI: 1.59–2.04] and age [HR=1.05, 95%CI: 1.04– 1.05] were significant factors for elderly adult mortality. Conclusion: These results indicate that companionship, social and family ties in the health of the elderly adults are of more importance than the socioeconomic status of the household. Efforts should therefore be made to support the elderly, such as stipend for the elderly adults, especially those living alone; lowering the provision of free medical care in public hospitals to cover people over the age of 60 and not just 70 year olds and above as is currently done; encourage family care for the elderly relatives through provision of an elderly caretaker allowance among others.

This descriptive study was done 1) to explore and describe the proportional distribution of breast, cervical and colorectal cancers by stage (a proxy measure of availability, access, and utilization of secondary prevention strategies) in northern Saskatchewan First Nations and non-First Nations in comparison to southern Saskatchewan First Nations and non-First Nations; 2) to assess the impact of stage and age on the survival patterns for these cancers in northerners and First Nations whose survival patterns have been shown by previous research to be equal or poorer in comparison to southerners. Univariate and multivariate survival analyses were carried out to ascertain the impact of the different proportions of stage for each study group on survival. Stage at time of diagnosis is a proxy assessment of secondary prevention services, which include formal screening programs.<p> Data for this study was obtained from the Saskatchewan Cancer Registry, which has been maintaining cancer data since 1932. Cancer stage at time of diagnosis information is complete in the registry for different years for each cancer site. Hence data for breast cancer was for the years 1970 to 1995; cervical cancer data for the years 1980 to 1995; colorectal cancer data for the years 1990 to 1995. <p> The proportion of cancer cases for each site by TNM stage and age were compared among the four study groups. First Nation and northern populations were found to have a larger proportion of diagnoses at a later stage in comparison to the southern non-First Nation group. <p> Using Cox's proportional hazards model, both stage and age at time of diagnosis were found to be significant predictors of survival for all study groups. Age and stage adjusted relative risks were calculated and found to be significant in comparison to the southern non-First Nation group for cancer of the breast (RR =1.81 P=0.013). For cervical cancer the relative risk of dying of cervical cancer for southern First Nations in comparison to southern non­-First Nations was found to be 1.38 but this was not statistically significant (p = 0.097). For colorectal cancer, the relative risk of dying of colorectal cancer was found to be better for northern First Nations in comparison to southern non-First Nations (RR = 0.59), however this was not statistically significant (p = 0.45).<p> This study showed that despite adjusting for stage and age at time of diagnosis, there were still some unexplained differences in the survival pattern of northern First Nations, northern non-First Nations and southern First Nations in comparison to southern non-First Nations. Hypotheses as to what these unexplained differences are have been offered. These include differences in socio-economic status as well as availability, accessibility, attitudes towards and knowledge of secondary prevention strategies. Further study into these unexplained differences should be carried out.

This descriptive study was done 1) to explore and describe the proportional distribution of breast, cervical and colorectal cancers by stage (a proxy measure of availability, access, and utilization of secondary prevention strategies) in northern Saskatchewan First Nations and non-First Nations in comparison to southern Saskatchewan First Nations and non-First Nations; 2) to assess the impact of stage and age on the survival patterns for these cancers in northerners and First Nations whose survival patterns have been shown by previous research to be equal or poorer in comparison to southerners. Univariate and multivariate survival analyses were carried out to ascertain the impact of the different proportions of stage for each study group on survival. Stage at time of diagnosis is a proxy assessment of secondary prevention services, which include formal screening programs.<p> Data for this study was obtained from the Saskatchewan Cancer Registry, which has been maintaining cancer data since 1932. Cancer stage at time of diagnosis information is complete in the registry for different years for each cancer site. Hence data for breast cancer was for the years 1970 to 1995; cervical cancer data for the years 1980 to 1995; colorectal cancer data for the years 1990 to 1995. <p> The proportion of cancer cases for each site by TNM stage and age were compared among the four study groups. First Nation and northern populations were found to have a larger proportion of diagnoses at a later stage in comparison to the southern non-First Nation group. <p> Using Cox's proportional hazards model, both stage and age at time of diagnosis were found to be significant predictors of survival for all study groups. Age and stage adjusted relative risks were calculated and found to be significant in comparison to the southern non-First Nation group for cancer of the breast (RR =1.81 P=0.013). For cervical cancer the relative risk of dying of cervical cancer for southern First Nations in comparison to southern non­-First Nations was found to be 1.38 but this was not statistically significant (p = 0.097). For colorectal cancer, the relative risk of dying of colorectal cancer was found to be better for northern First Nations in comparison to southern non-First Nations (RR = 0.59), however this was not statistically significant (p = 0.45).<p> This study showed that despite adjusting for stage and age at time of diagnosis, there were still some unexplained differences in the survival pattern of northern First Nations, northern non-First Nations and southern First Nations in comparison to southern non-First Nations. Hypotheses as to what these unexplained differences are have been offered. These include differences in socio-economic status as well as availability, accessibility, attitudes towards and knowledge of secondary prevention strategies. Further study into these unexplained differences should be carried out.

Thesis--Wayne State University, Dept. of Education. / Vita. eContent provider-neutral record in process. Description based on print version record. Bibliography: leaves 224-234.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1975. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--Wayne State University, Dept. of Education. / Vita. eContent provider-neutral record in process. Description based on print version record. Bibliography: leaves 224-234.

The purposeof this study is to determine the effect of the socio-economic status of the homes of sixth-grade pupils on their arithmatic attainment. It also aims to point out the effect of social and economic factors of home environment on each of the four arithmatical abilities through a critical analysis and interpretation of the data.

Thesis (M. Phil.)--University of Hong Kong, 1980.

Infants’ gestures feature prominently in early language. The observation that accomplishments in gesture presage verbal milestones prompted the question of whether encouraging infants to gesture would bring on language gains. This thesis addressed this question, remedying many of the shortfalls of previous research. In a yearlong longitudinal study, high-SES mother-infant dyads (n = 40) were randomly allocated to one of four conditions: Symbolic Gesture training, British Sign Language (BSL) training, Verbal training and a Non-Intervention Control group. Infants’ language was continually assessed between the ages of 8 to 20 months to determine the impact of encouraged gesture on language development. With the exception of a small number of boys, encouraging gesture did not affect infants’ language development. However, the expressive language of boys who started the study with a low language ability was improved by gesture. A gesture-training intervention was delivered to low-SES mothers at a Sure Start children’s centre. Infants of mothers trained to gesture showed greater gains in their receptive and expressive vocabularies than infants of mothers who attended sessions aimed to improve general communication (without gesture instruction). Gesture helped reduce the discrepancy between the language abilities of infants from low and high-SES backgrounds. Qualitative investigations revealed how encouraging mothers to use gestures with their infants led to perceived wider, non-linguistic benefits. However, a comparison of maternal and infant stress scores revealed no difference between gesturing and non-gesturing mother-infant dyads. Infants, who because of biological and/or environmental factors have lower language abilities than their peers, stand to benefit from encouraged gesture in infancy. Through early intervention, gesture has the potential to reduce the disadvantage that children from lower-SES families face from impoverished language abilities. By changing the course of their early development, encouraged gesture could ultimately bring about lasting benefits.