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Self-reported health (SRH) tends to decline slower as people age compared to the decline of their objective health. If individuals believe they are in good health but actually are in poor health, their perceived susceptibility to disease may be low. Consequently, those individuals may feel less compelled to improve their health, which would make them a higher risk population. This project aims to examine the association of SRH and Metabolic Syndrome (MetS) in senior women, and whether personal and interpersonal dimensions help explain the degree to which SRH corresponds with MetS. Data are from the Kingston Senior Women Study (KSWS, n=100, 65 years of age and older). KSWS participants completed a questionnaire on their social background, psychosocial conditions, health behaviours, and SRH. Participants also provided physiological measures and medical information, so that MetS could be assessed, following the harmonized definition. MetS is a cluster of at least three of the following criteria: obesity, elevated blood pressure, low level of HDL cholesterol, raised triglycerides, and fasting plasma glucose. Two categories represented the correspondence between SRH and MetS: those who have a congruent perception of their health and those who overestimated it. Greater physical activity was associated with higher SRH (OR: 1.10; 95%CI: 1.01 – 1.20) and lower odds of MetS (OR: 0.64, 95%CI: 0.47 – 0.88) among the participants. However, only social network size was associated with lower odds of health overestimation (OR: 0.46, 95%CI: 0.26 – 0.80). Larger social networks may give access older women to a greater source of information about their own health, leading possibly to more accurate assessments of health. Such information can be conveyed as feedback from close ties. This information can also be conveyed as a more accurate perception of the health of their reference group when self-assessing their own health. Findings of this study may help identify women who are at greater risk of cardiovascular disease but who may be less likely to participate in health promotion programs. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2014-05-21 00:14:26.427

Background: To throw light on the under-researched association between socioeconomic position (SEP) and health in Cuba, this study examined SEP gradients in health and their underlying mechanisms among urban Cuban adults aged 18-65. Methods: By applying linear regressions to data from the 2010 National Survey on Risk Factors and Chronic Diseases, the analysis explored the SEP-health gradient along three SEP dimensions-education, occupation, and skin colour-using ten health measures: Self-reported health (SRH), general and abdominal obesity, hypertension, high glucose, high cholesterol, high triglycerides, low high-density lipoprotein cholesterol, metabolic syndrome, and cumulative risk factors. Regressions also included behaviours and health-related risk perceptions (tobacco and alcohol consumption, diet, physical activity, and risk-related behaviours). It thus investigated the SEP-health gradient and its underlying mechanisms via both behaviours and health-related risk perceptions. Results: Once controlling for gender, age, marital status, region and provincial dummies, the analysis detected educational gradients in SRH (estimated coefficient [95% CI]: Middle-level education = 3.535 [1.329, 5.741], p < 0.01; high-level education = 5.249 [3.050, 7.448], p < 0.01) that are partially explainable by both health-affecting behaviours (tobacco and alcohol consumption, diet, physical and sedentary activity) and risk perceptions. Using objective measures of health, however, it found no SEP-health gradients other than hypertension among people identified as having Black skin color (adjusted for demographic variables, 0.060 [0.018, 0.101], p < 0.01) and high cholesterol among those identified as having Mulatto or Mestizo skin color (adjusted for demographic variables,-0.066 [-0.098,-0.033], p < 0.01). Conclusions: In terms of objective health measures, the study provides minimal evidence for an SEP-health gradient in Cuba, results primarily attributable to the country's universal healthcare system-which offers full coverage and access and affordable medications- A nd its highly developed education system.

Promoting population health is an essential task for sustainable development. This study explores the association between socioeconomic status and perceived health in the United States, with special attention on the influence of living arrangements. It also improves the existing explanations of causal mechanisms underlying the impact of SES on health among Americans over 50. Using the first and seventh waves of Health and Retirement Study to run ordered logistic regression, this research addresses the importance of living arrangements and social capital on self-reported health. Income and education are both important predictors of self-reported health. In addition, living arrangements and household social capital also affects self-reported health after controlling individuals’ characteristics and SES indicators. These effects do not appear to mediate the socioeconomic effects on self-reported health. Future research should highlight better measures of living arrangements and social capital, as well as explore longitudinal analyses.

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Elderly Black and Hispanic adults have poorer overall health, higher disability rates, and lower life expectancies than elderly Whites and other racial and ethnic minority group members. There are also sex differences in health, with women more likely to suffer from non-life threatening chronic conditions and men more likely to suffer from acute conditions. Health pathways, or the processes to good or poor health, are shaped by race, SES, and sex. This study focuses on the race and SES literature, framing race and SES inequalities within a cumulative advantage lens. Using Hierarchical Linear Modeling techniques to examine data from the Health and Retirement Survey, this study finds that there are racial differences in health through health problems, health insurance, and health care treatment, and that Black, Hispanic, and other racial and ethnic minority group members have worse self-reported health than Whites in old age. This study also finds evidence of cumulative advantage through friends in the neighborhood, and finds evidence of cumulative disadvantage through health problems and hospital and nursing home treatment. There are also cumulative disadvantages for women, who have more functional limitations in old age than their male counterparts, and these disadvantages grow over time. This study adds support to the race literature, by furthering understandings of race and SES as interconnected but not interchangeable systems of inequality. In lieu of the findings, this study provides implications for future research and ways to reduce racial health disparities in old age. / Ph. D.

Stress är ett växande problem i dagens samhälle, allt fler barn och ungdomar mår sämre på grund av den ökande stressnivån. Barn och ungdomar befinner sig stora delar av sin vakna tid i skolan. Inom denna arena är stress vanligt förekommande, vilket utgör vikten att arbeta mot den ökande stressnivån. Studier och rapporter visar på att den psykiska ohälsan och stress har ökat och då främst inom skolan. En lagom mängd stress gör att prestationen ökar vilket är en positiv följd av stress. Dock är nivåerna av stress höga och blir inte hanterbara för barn och ungdomar som vistas i stressiga miljöer. Syftet med studien är att undersöka förekomsten och könsfördelningen av stress bland ungdomar i Västmanlands län samt eventuella samband mellan stress och sömnbesvär respektive självskattad hälsa. För att besvara syftet användes data från Liv och hälsa ung Västmanland 2012 undersökning, vilket är en hälsoundersökning som omfattar 6675 studenter i årskurs 7 och 9 samt årskurs 2 på gymnasiet. Studiens resultat visar att stress är vanligt förekommande, där nästan en tredjedel (29.5 %) ofta eller mycket ofta känner sig stressade, vilket motsvarar drygt 2000 barn och ungdomar. Resultatet visar på samband mellan ökad stress och ökade sömnbesvär och mellan ökad stress och sämre självskattad hälsa. Som teoretisk anknytning för stress användes krav/kontroll/stöd-modellen. Coping som förklarande teori användes för att tolka sambandet mellan stress och sömnbesvär. Känsla av sammanhang (KASAM) användes för att tolka sambandet mellan stress och självskattad hälsa. / Stress is a growing problem in today's society, more and more children and adolescents are feeling bad because of the increased stress levels. Children and adolescents spend most of their time in school. Stress is one of the most common problems in this arena, which makes it crucial to work preventive against stress in schools. Studies have shown that the mental illness and stress has increased, primarily within schools. Low levels of stress enhance performance and are therefore a positive aspect of stress. However the levels of stress are high and not manageable for the children and adolescents who spend time in stressful environments. The purpose of the study was to investigate the prevalence and gender distribution of stress among adolescents in Västmanlands län, and potential relation between stress and insomnia respective self-reported health. Data from Liv och Hälsa Ung Västmanland 2012, which investigates health among students, has been used. Data includes 6675 students in grade 7 and 9 in elementary school and grade 2 in upper secondary school. The results shows that stress is a common problem, where almost a third of the participants (29.5 %) often or very often feel stressed, which corresponds to about 2000 adolescents. Results show a significant relation between stress and increased insomnia as well as between stress and self-reported health. The demand/control/support model was used as a theoretical explanation for stress. Coping as an explaining theory was used to interpret the relation between stress and insomnia. Sense of Coherence was used to explain the relation between stress and self-reported health.

Background South Africa is experiencing a massive HIV epidemic that together with the new epidemic of non-communicable diseases is directly affecting the health and wellbeing of older people. For policy makers, there is a crucial need for information on how this dual epidemic is evolving and how this may affect older people's health, mortality and health care needs. 2. Aims To better understand factors that influence the health, wellbeing and survival of older people, and their need for care in rural South Africa at a time of a growing dual epidemic of chronic diseases (non-communicable and communicable). To provide information which may assist in the planning of health services for older people. 3. Methods Applying the WHO Study on Global Ageing and Adult Health (SAGE) and a study on HIV and non-communicable diseases (NCD), we investigated the health, wellbeing and mortality of the population 50 years and older in the Agincourt sub-district in north-east South Africa which is underpinned by health and demographic surveillance. A random sample of the population 50 years and older was selected for the SAGE survey. A random sample of the population 15 years and older was selected for the HIV and NCD study. All available adults 50 plus were invited to participate in the SAGE module in the 2006 census round. We assessed self-reported health, anthropometric measures, blood pressure and HIV status using dried blood spots. Statistical analysis included simple frequencies, univariate and multivariate analysis and Cox proportional hazard models. 4. Findings The usual pattern of mortality, of increasing death rates with age, is not observed in this population, where those in their 50s have higher mortality compared to older age groups. The high prevalence of HIV in this age group (50 to 59) appears to be the main explanation for the observed pattern. Hypertension affects two thirds of this older population and, although there are no differences by gender, women are more aware of their condition. This is reflected in more women attending primary health care services. Reporting lower quality of life and greater disability are associated with higher likelihood of death. We observed gender differences in the process of ageing with women reporting higher prevalence of mortality risk factors but living longer than men, a phenomenon known as the "survival paradox".

Background: Research points in different directions when looking at possible increases in mental health problems among adolescents. Findings in favor of an increase are questioned due to methodological problems. Aim: Investigating whether mental health problems among young adolescents are increasing over time in Europe and North America. If so, does the trend apply both to mean levels of symptoms and to the proportion of adolescents with substantial problems? Are the time-trends similar over sex and age-categories?                                                                                                    Method: A total of 401 089 adolescents from a total of 38 countries are included in the analysis. Based on the eight health variables on self-rated health provided by the HBSC study, a measurement of mental health problems was created using factor analysis in SPSS. Results: Increases of mental health problems were found in Europe and North America. Increases were found both in terms of mean levels of symptoms and to the proportion of adolescents with substantial problems. Increases were seen in all age groups and among both girls and boys. Conclusion: Reasons behind the discovered increases are not known and should be further investigated as extensive research point to severe consequences of mental health problems in adolescence for later life.       Key words   Adolescents, mental health problems, trends, self-reported health (SRH), psychological health complaints (PHC)

Physical activity in youth has many benefits, but parallel to these benefits, sport related injuries pose considerable risks.  It is important to public health to address sport related injuries, particularly those affecting young people, who comprise the majority of participants in organised sport in Sweden.  The first study in this research showed that inspections of local sport environments, where injuries often occur, did not occur uniformly. Two additional studies pointed out the need for better surveillance of injuries, and described the use of ambulance attendance reports as a possible improvement to current surveillance systems, with a possibility to improve safety for youth and other sport participants. Two other studies identify risk factors that were specific to football and climbing sports, which can be used to guide targeted safety interventions for the young participants of these sports.  The studies, taken as a whole, provide new information about the factors associated with sport related injuries, particularly for young people, and point out the need for better sport injury surveillance, improved inspection strategies for fields maintained by organised sport clubs in local communities, and the need to address risk factors specific to different sport activities.