Impact of health and fitness-related behavior on quality of life

While the relationships between (a) health behavior and health status and (b) health status and perceived quality of life (QOL) have received some attention, the association between health behaviors and QOL has not been determined. The primary objective of this study was to assess the effects of health behaviors on QOL that are independent of the effects of health status. A sample of approximately 5 000 randomly selected U.S. Navy personnel was split into halves and analyses performed on each to establish the replicability of the findings. At step one of a multiple regression procedure, health status variables were forced into the equation; next, health behavior variables were entered. As expected, the block of health status variables was significantly related to QOL: self-assessed health and fitness status and lower reporting of physical symptoms accounted for 16% and 18% of the variance in QOL for the two subsamples. After controlling for health status, two behavioral measures made unique contributions to the prediction of QOL: behaviors related to avoiding unnecessary risks as a driver or pedestrain and avoiding or minimizing accidents. Wellness maintenance behaviors also were associated with QOL in one subsample. After controlling for health status, health behavior measures contributed an additional 11% and 6% of the explained variance in QOL for the two subsamples. Results indicate that health behaviors influence QOL independently of health status.     

Health and quality of life of older people,a replication after six years

Replicating a survey of 875 people 55 years old or more undertaken in September 1999 throughout the former Northern Interior Health Region (NIHR) of British Columbia, in September 2005 a sample of 656 people completed a 22-page questionnaire. The average age of the respondents was 68, with a range running from 55 to 96 years, and 64% were women. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 76.1. This mean was a bit higher than the 74.4 mean of 1999. For male respondents aged 65 and older the mean was 69.0, which was also higher than the 68.3 mean of 1999. For females aged 55–64, the mean score for 8 dimensions was 73.1, versus 73.0 in 1999. For female respondents aged 65 and older, the mean score was 67.0, versus 65.4 in 1999. Based on these mean scores for the 8 dimensions, then, it is fair to say that the overall health status of males and females aged 55 years and older in the region in 2005 was at least as good as (i.e., the same as or better than) that in 1999. Comparing 28 average figures for the 2005 respondents on satisfaction with specific domains of life (e.g., financial security, health, sense of meaning) and three global indicators (satisfaction with life as a whole and with the overall quality of life, and happiness) with those of the 1999 respondents, we found that the scores for the 2005 sample were at least as high as those of the other sample. Thus, it seems fair to say that the perceived quality of life of older people in the former NIHR so far as it is revealed in domain and global satisfaction and happiness scores, is at least as good as the perceived quality of life of a similar sample in 1999. Although a large majority perceived increases in crime in the 2 year periods prior to both surveys, smaller percentages of the 2005 sample than of the 1999 sample thought that crime had increased over the past two years, avoided going out at night, feared for their safety, had crime-related worries, engaged in crime-related defensive behaviours and were actually the victims of any crimes. Therefore, it seems fair to say that, so far as crime-related issues are concerned for the two samples of seniors responding to our surveys, there is more evidence of improvement than of deterioration. Applying stepwise multiple regression, each of the eight dependent variables was explained on the basis of four clusters of predictors separately and then a final regression was run using only the statistically significant predictors from the four clusters. Broadly speaking, 7 SF-36 health status scales explained from 28% to 45% of the variance in the 8 dependent variables, running from satisfaction with the overall quality of life (28%) to the single item measure of general health (45%). The seven predictors in the Social Relations cluster explained from 7% of the variance in the SF-36 General Health scale scores to 57% of the variance in the Life Satisfaction scores. The four predictors in the Problems cluster explained from 10% of the variance in the SF-36 General Health scale scores to 24% of the variance in the SWLS scores. The 11 predictors in the Domain Satisfaction cluster explained from 14% of the variance in the SF-36 General Health scale scores to 64% of the variance in the SWB scores. Putting all the significant predictors together for each dependent variable, in the weakest case, 4 of 11 potential predictors explained 33% of the variance in the SF-36 General Health scale scores and in the strongest case, 9 of 15 potential predictors explained 70% of the variance in Life Satisfaction scores. Among other things, these results clearly show that respondents’ ideas about a generally healthy life are different from, but not independent of, their ideas about a happy, satisfying or contented life, or about the perceived quality of their lives or their subjective wellbeing. Finally, the 7 core discrepancy predictors of MDT plus incomes were used to explain the eight dependent variables. From 13% of the variance in the SF-36 General Health scale scores to 57% of the variance in SWLS scores was explained using those predictors. Based on an examination of the Total Effects scores for the predictors of the 8 dependent variables, the most influential predictors were Self-Wants, followed by Self-Others and then Self-Best. In other words, the most influential discrepancy predictors of respondents’ overall life assessments were those between what respondents have versus what they want, followed by what they have versus what others of the same age and sex have, and then by what they have versus the best they ever had in the past. We would like to thank the Social Sciences and Humanities Research Council of Canada for support of this research with funds granted to Alex C. Michalos through the Gold Medal Award in 2004.     

Using quality of life information to set priorities in health policy

Health care has as primary objectives extending life expectancy and improving quality of life in years prior to death. This paper offers a General Health Policy Model as a method for quantifying these outcomes. The model adjusts life expectancy for diminished quality of life, which is measured using a standardized instrument known as the Quality of Well-being (QWB) scale. The Well-year or Quality Adjusted Life Year (QALY) results from these analyses and serves as a single quantitative expression of health benefit. QALY units integrate side effects and benefits of treatment by combining into a single number, mortality, morbidity, and duration of each health state. Examples show the application of the model relevant to a variety of medical and public health problems, including diabetes, arthritis, AIDS, neonatal circumcision, and tobacco tax. It is suggested that the General Health Policy Model has advantages for guiding both individual and public health decisions.     

Changes in the quality of life of Durban’s people

Durban, the busiest port and second largest industrial hub in South Africa, has a developmental vision that sees its residents living in ‚acceptably serviced housing’ and enjoying a ‚generally high quality of life that can be sustained’. This vision is in response to South Africa’s transitional aspirations to move from an inequitable apartheid state to a democratic society with greater socio-economic parity. Since 1998 the eThekwini Municipality, which is the local authority responsible for the city of Durban, has conducted annual surveys to monitor the changes in the quality of life of Durban’s people. Structured questionnaire interviews were administered in 14 300 dwellings between 1998 and 2005. The samples drawn each year were representative of the city’s demographics and covered a wide range of housing types. Results indicate that parity of life satisfaction between race groups is as far apart in 2005 as it was in 1998. The paper undertakes trend analysis, from a local government perspective, of key objective and subjective variables in the surveys. It identifies the domains that have the greatest impact on satisfaction with life, and reports the salient issues for black householders, who have the lowest level of life satisfaction.The Research Locale:  Durban, which is a port city on the east coast of South Africa, has a population of over 3 million people. The population is comprised of the following groups: Asian (20%), black (68%), coloured (3%) and white (9%). It is Africa’s busiest port and is South Africa’s second largest industrial hub. It provides key trade linkages to Johannesburg, which is South Africa’s largest industrial hub. The major economic sectors are manufacturing, tourism, finance and transport. The complex topography is intersected by 19 rivers that flow to 98 kms of coastline.     

Perception of health,well-being,and quality of life in female caregivers: Comparative study of a sample of adult and older women in Spain

In a study on informal or unpaid care, it is difficult to identify the consequences and effects of care provision on the caregiver’s daily life. Thus, it is important to analyze the perceptions of the individual caregiver. This study describes the perceptions of health, well-being, support networks, and quality of life of 13 women aged between 45 and 70 years after completing an intervention program. The data indicate that caregivers’ health and quality of life worsen with the intervention, and their well-being and social relations (through new technologies) improve.     

提高人口质量是防止艾滋病泛滥的有效途径

文章从国内外两个方面论述了艾滋病与人口质量之间的互动关系,指出在中国目前阶段,提高人口质量是防止艾滋病泛滥的有效途径。     

Gender differences in health promotion behaviors and quality of life among community-dwelling elderly

The differences of basic attributes, health promotion behaviors, and quality of life between elderly males and females in Taiwan were compared. Several scales were used to examine the gender differences and the factors associated with quality of life. Regression analysis revealed that gender, education level, depression level, and healthy diet were key factors influencing the overall quality of life. The education level of females was lower, and their depression level was higher; however, females had healthier diets. With regards to their satisfaction in the quality of life, elderly males scored higher than females in both the physical and psychological domains.     

Leisure and quality of life in an international and multicultural context: what are major pathways linking leisure to quality of life?

This paper aims at advancing the conceptualization of leisure as a contributor to quality of life (QOL) in an international and multicultural context, based on an extensive and critical review of literature on leisure and QOL from a global, international perspective. Given the central role of culture in conceptualizing this notion, this paper gives attention to various cultural contexts world-wide. To illustrate the diversity of our societies, examples are introduced specifically from three culturally unique contexts in this paper – i.e., Asian, Middle-East, and Indigenous contexts. Also, some examples are drawn from other cultural groups in global and international contexts, particularly, in non-western contexts. Then, the final section of this paper aims at integrating and synthesizing the knowledge gained from this review to develop a tentative/working proposition about how leisure can contribute to QOL from international and cross-cultural perspectives. Specifically, based on such integration, this paper identifies and describes major pathways linking leisure to QOL. Overall, an overarching theme common to almost all cultural contexts examined appears to be the role of leisure-like activities as a context or space for creating meanings which then help to promote the quality of people’s lives. Major pathways or mechanisms that can facilitate meaning-making and life-quality-enhancement highlighted in this review include: (a) positive emotions and well-being experienced from leisure, (b) positive identities and self-esteem gained from leisure, (c) social and cultural connections and a harmony developed through leisure, and (d) leisure’s contribution to learning and human development across the life-span. Also, emphasized in this paper is the role of leisure as a context for realizing and utilizing human strengths and resilience. It is important, however, to stress that in people’s quest for a meaningful life, the benefits of meaning-making through leisure involve both “remedying the bad” and “enhancing the good,” as shown throughout this paper. Despite these benefits, we should not ignore that leisure experiences are socially and culturally constructed and shaped by the inequalities of society. Thus, the reality of power imbalance and inequalities should be acknowledged and appropriately addressed socially, culturally, and politically. Particularly, providing culturally relevant and meaningful leisure opportunities for less privileged population groups world-wide is clearly a top priority.     

Quality of life as a mediator of leisure activity and perceived health among older women

Despite consistent evidence to suggest that participating in leisure is associated with perceived health status among older adults, there have been few attempts to determine the possible underlying mechanisms in this relationship, including the role of quality of life (QoL). This study examined the role of perceived quality of life in the relationship between leisure and perceived health in older women. Correlations, regression, and mediation analysis were conducted on data from the Woman’s College Alumnae Women’s Health Study. Results indicate that QoL partially mediates the relationship between leisure and perceived health in older women. Findings further establish the link between leisure and perceived health with QoL playing an important role in the relationship.     

Changing mortality and morbidity rates and the health status and life expectancy of the older population

This paper demonstrates the consequences of changes in mortality and health transition rates for changes in both health status life expectancy and the prevalence of health problems in the older population. A five-state multistate life table for the mid-1980s provides the baseline for estimating the effect of differing mortality and morbidity schedules. Results show that improving mortality alone implies increases in both the years and the proportion of dependent life; improving morbidity alone reduces both the years and the proportion of dependent life. Improving mortality alone leads to a higher prevalence of dependent individuals in the life table population; improving morbidity alone leads to a lower percentage of individuals with problems in functioning.     

Nativity and older women's health: constructed reliance in the health and retirement study

Gender and nativity are known risk factors for physical and economic dependency. Immigrant women are particularly disadvantaged because of their greater lack of social and economic resources. In this study, we investigate how women immigrants coordinate and utilize various support systems as they approach retirement age, as well as how choices and constraints affect their physical wellbeing. Experiences throughout the life course play a role in the maintenance of health, but the pre-retirement years are particularly crucial to the establishment of patterns of reliance to be used in later life. We examine the effects of economic resources, social support, and family ties (as well as several exogenous variables) on women's physical health using data from the Health and Retirement Survey. For the women in this study, demographic characteristics, such as Hispanic ethnicity and low education are strong risk factors for poor health. Findings also indicate that reliance patterns across resource domains do not differ significantly by nativity and that both economic and familial resource access significantly lessens the risk of poor health for both native and foreign born women.     

Introduction: the need to address older women's mental health issues

Women are the primary consumers of mental health services. Ironically, research addressing their unique needs lags behind that of men's issues. The aging process introduces an important variable that accentuates the relative lack of information and specific treatment guidelines for older women who are confronted by mental health problems. This volume offers a comprehensive overview for the health professional who is seeking a greater depth of understanding with respect to the study of mental health problems in general, and how these issues pertain specifically to women and the aging process. A second goal of this project is to provide the practicing therapist and counselor with a research update and a broad clinical perspective offered by seasoned clinicians. Using current psychiatric diagnosis as a framework, the contributions address the range of mental health problems, including dementia and cognitive impairment, schizophrenia, alcohol abuse, mood and anxiety disorders, traumatic and dissociative conditions, sexual and eating disorders, and personality disorders. It is hoped that this book will inform, inspire and encourage students and health professionals in their work with middle aged and older women who are facing mental health challenges.     

Linking green space to health: a comparative study of two urban neighbourhoods in Ghent, Belgium

This paper investigates the nature of the relationship between the greenness of the local environment and the health and well-being of its inhabitants by looking at a number of possible mediators within the same study: physical activity, perceived stress, ability to concentrate, social cohesion and neighbourhood satisfaction. Data were collected through a survey of residents in two neighbourhoods that differ objectively in green space provision, but which are largely similar in demographics, socio-economic factors, housing conditions and other environmental characteristics, apart from green space. Of the three dependent variables of interest: self-reported general health, bodily functioning and general well-being (happiness), it was self-reported happiness that differed significantly between the two neighbourhoods, with greater happiness in the greener neighbourhood. Amongst the possible mediators, people??s satisfaction with their neighbourhood differed significantly: those living in the greener neighbourhood were more satisfied. Mediation analysis indicated that neighbourhood satisfaction fully mediates the relationship between neighbourhood greenness and happiness. Among the specific (environmental and social) neighbourhood qualities asked about, perception of neighbourhood greenness was found to be the most important predictor of neighbourhood satisfaction. Additional analysis showed that the view from the living room??green or not green??fully mediates the relationship between neighbourhood greenness and neighbourhood satisfaction. This study underscores the importance of nearby green space for people??s overall well-being and suggests the need for green space to be evaluated in terms of visual proximity, that is, whether and how it is experienced from the street and the home.     

The impact of federal aid on the quality of life: The case of infant health

Federal grants-in-aid have been a major device for stimulating new programs for improving the quality of life in the United States. This paper assesses the impact of one such grant-in-aid (Maternal and Child Health Services) on improvements in infant health in the American states in the 1950–1964 period. The analysis indicates that how much a state's Maternal and Child Health Services grant was increased or decreased had no systematic overal impact on later changes in that state's infant, neonatal, and fetal mortality indicators. In addition, such grant changes had no major systematic impact when controlling for per capita income, changes in per capita income, population, innovation tendencies, and administrative professionalism.     

Personality and quality of life

The present study investigated a possible association between personality, mental absorption and quality of life (QOL) in a sample of young males (N=411). Mental absorption was assessed with Tellegen's Absorption Scale (ABS). Using a 6 dimensional QOL-scale we found the Millon Behavior Health Inventory (MBHI) dimensions Basic coping style, Psychogenic attitudes, Psychosomatic correlates and Prognosic indices, to be firmly related to QOL, explaining 44% of the variance of a QOL scale which was derived through factor analysis. Mental absortion was weakly related to QOL. The discussion revolves around the relationship between personality and perceptual style, health report behavior and personality as possible biasing factor in evaluative QOL-investigations.     

Subjective health,intimacy, and perceived self-efficacy after heart attack: Predicting life quality five years afterwards

Social Indicators Research - In a national sample of some 400 cardiac patients and their wives, changes in quality of life were investigated during an extended period of physical and psychosocial...     

The multistate life table method: An application to contraceptive switching behavior

In many demographic behaviors (e.g., those relating to marriage, contraception, migration, and health), people change among multiple statuses through time, sometimes leaving and then returning to the same status. Data on such behaviors are often collected in surveys as censored event histories. The multistate life table (MSLT) can be used to properly describe, in a single analysis, these complex transitions among multiple states measured in such data, but MSLT is rarely applied in the demographic literature because practical guidance is lacking on how to compute MSLTs with such data. We provide methods for computing MSLT quantities using censored event-history data: namely, transition intensities and probabilities, "state occupancy" probabilities and standard errors, average time spent in specified states, and average number of visits to specified states. Applying these methods to contraceptive use, we find high levels of switching back and forth, particularly between barrier methods and non-use, resulting in high rates of unintended pregnancy.     

Best friends: the role of confidantes in older women's health

This article explores personal, network, and community contexts in older women's friendships and health. Twenty-six older women (mean age, 67; range 55-85 years) in San Francisco were asked to choose the one individual to whom they felt the closest and then discuss how this individual contributed to their health. Their choices were numerous, diverse, contextual, and circumstantial. Other women were chosen most often; however, this belies the complexity of their choices. Confidants were chosen primarily for expressive reasons, but instrumental reasons proved important too, particularly for lower class women. Older women called upon their closest ties with physical, social, and emotional problems; they were less likely to call upon them with mental, financial, or spiritual concerns. Family members were preferred to friends for direct caregiving; however, some older women felt they would call upon their friends as well. Confidants kept older women healthy by offering advice and encouragement about diet and exercise; by providing meals and transportation; by laughing, talking, and joking with them; by keeping them happy and feeling good about themselves; and, on rare occasions, by offering spiritual guidance. Practical and policy considerations of their choices were discussed.