A norm-referenced population health status index based on life expectancy and disability

This paper describes a population health status index for health services research and planning purposes. The H-index uses data on average life expectancy at birth and percent of the population free from disability, however defined. It is useful in comparing the health status of health services areas relative to that of the more healthy areas selected to serve as the norm. The statistical procedure used in deriving the H-index is centour analysis, by means of which the Euclidian distances of the service areas in the study sample in two-dimensional space to the centroid of the normative areas are reflected in the H values computed. The farther away from the centroid, the less resemblance the service area has to the norm and the lower its health status. A computational example with seven normative states and 10 states in the study sample is given.     

Examination of the status of health of population in Poland

"This article presents sources of information about the health status of the Polish population...; the number and causes of deaths, the morbidity due to more important diseases and average life expectancy.... At the same time this situation is compared with those in some European countries."     

Assessment of health status of population in north and west Poland on the basis of measures related to pollution and degradation of environment. Trends in mortality

"The objective of this study is to make a cross-sectional assessment of the health status of the population inhabiting West and North Poland, using a set of negative measures of health related to the intensity of environmental factors, and to evaluate mortality trends in the same area that express changes in the rate of morbidity leading to death....The measures assumed in the analysis suggest that the population inhabiting 15 voivodeships in West and North Poland is characterised by a poorer health status than in the other area, both urban and rural."     

Seven measures for population control announced in Guangzhou

On 7 October 1988, the Municipal Government of Guangzhou, China, announced the following Decision: "First, great efforts should be made to strengthen education on the situation and tasks of the family planning programme. Second, family planning work is included in the target responsibility system of leaders at all levels during their terms of office and whether it is good or bad for the fulfillment of their family planning tasks will be considered as one of the criteria for the assessment of cadres in their work to link up with rewards and punishments. Third, the current family planning policies must be resolutely and unswervingly carried out. For those units where family planning policies have not been well carried out and where family planning work has long been stagnant, competent authorities should send capable cadres to help them improve their work within a definite period of time. Fourth, the principle of 'three priorities' (i.e., priority of publicity and education to economic restriction, priority of contraceptive measures to induced abortions, and priority of day-to-day work to shock work) must be adhered to while technical service and work of transforming the backward situation in some places should be done. Fifth, the family planning organizations at all levels must be perfected and ranks of family planning workers be strengthened with the stress on those at the township, town, and street neighbourhood levels. Moreover, the family planning offices should be set up or full-time family planning workers be staffed for enterprises and undertakings in the cities. Sixth, funds for the family planning work must be guaranteed. Seventh, the management of family planning for [the] floating population must be strengthened and a management group for [the] floating population, which consists of representatives from the Municipal Government and departments concerned, must be established."     

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.     

The socio-economic status of migrant populations in regional and rural Australia and its implications for future population policy

The migrant population living in regional and rural Australia has been growing, partly because of the introduction and expansion of a number of state-specific and regional migration programs by the Australian Government over the period since 1995. The programs were created in response to both the skill shortages in regional and rural Australia and environmental and social critiques of urban migration. This study uses data from the 2006 Census of Population and Housing in Australia to compare five socio-economic measures: labour force participation, unemployment, income, educational attainment, and occupational status, between the migrant and Australia-born populations. The results reveal that the migrant population in regional and rural Australia now records similar values for the labour force participation rate, unemployment rate, median individual weekly income, and proportion in high skill level occupations to the Australia-born population. The most notable difference is that migrants have a substantially higher level of education, particularly university education. The differences between men and women on these socio-economic measures are wider for the migrant population than for the Australia-born. Recently-arrived migrants are significantly more educated, more highly skilled and higher paid than their longer-standing counterparts. The study also discusses the differences between the larger migrant groups living in regional and rural Australia. The improvement in the socio-economic outcomes experienced by the migrant population of regional and rural Australia and their broad similarity to those of the Australia-born living in these regions strengthen the case for increasing the proportion of migrant settlers going to these regions.     

Segregation and diversity measures in population distribution

"The purposes of the present paper are to show the relationship between measures of population diversity and measures of segregation, to describe the salient properties of these indexes, and to demonstrate the empirical interrelationships among them." Some measures not frequently used in population studies are considered, and empirical illustrations are given of the significance of using one measure rather than another. In particular, the author stresses proportional reduction of error interpretations for an index and considers its ability to handle more than two groups. The primary geographic focus is on the United States. The "introductory section of the paper treats conceptual issues in more detail. The second section reviews selected measures and recent critical viewpoints, while the third section tests their empirical performance. The conclusion makes some recommendations about the selection of an index. A detailed bibliography follows."     

Self-perceived health status,gender, and work status

ABSTRACT

This study analyzes the relationship between gender and self-perceived health status in Spanish retirees and housewives from a sample of 1,106 community-dwelling older adults. A multivariate linear regression model was used in which self-perceived health status was measured by the EQ-5D visual analogue scale and gender according to work status (retired men and women and housewives). Retired males reported a significantly better health status than housewives. Self-perceived health status was closely associated with physical, mental, and functional health and leisure activities. Finally, being a woman with complete dedication to domestic work is associated with a worse state of self-perceived health.     

Female status among soviet central Asian nationalities: The melding of Islam and Marxism and its implications for population increase

Summary Marxist ideology has emphasized the rights of women to a degree perhaps unparalleled among political movements, whereas Islamic ideology has confined women to the traditional role of wife and mother. In Soviet Central Asia these two ideologies have clashed for more than 50 years. Data from the 1959 and 1970 censuses of the U.S.S.R. are used to show three aspects of the position of Soviet women of Islamic nationality as compared with the position of Soviet women of non-Islamic nationality, namely, educational attainment relative to men, non-agricultural labour force participation relative to men, and the burden of child dependency. The hypothesis is put forward that the status of women among Soviet Islamic nationalities should be lower than among Soviet non-Islamic nationalities, but that the difference between the two groups in the various aspects of female status should diminish over time. The position of women among the Soviet Islamic nationalities was also compared with that of women in various Islamic nations with the hypothesis that female status should be higher among the former than the latter. The predictions were upheld, with the notable exception of two of the three pedictions concerning the burden of child dependency occasioned by the finding that child dependency increased substantially, from 1959 to 1970 for Islamic nationalities but not for non-Islamic, and by 1970 was higher for Soviet Islamic nationalities than for the Islamic nations of the Middle East and North Africa. Several possible explanations are advanced for the above-mentioned unpredicted findings.     

Estimating historic population data for small geographies using census housing information

Historical population data for small geographies (e.g. blocks, block-groups, and census tracts) are not available for periods earlier than 1980. In this research note, we propose a geographically-constrained housing unit method (GHUM) to estimate historic population for small geographies using housing age data available in the 1980–2000 censuses. The GHUM is a two-stage method. The first stage follows a traditional housing unit method and provides initial household and group quarter population estimates for small geographies. The second stage takes advantage of the availability of historic data for larger geographies (e.g. counties, states) to adjust the first stage estimates and to provide final estimates. The GHUM is used to estimate 1940–1990 county population and census tract population in Kentucky. The quality of the population estimates is assessed. A two-sample Kolmogorov–Smirnov test indicates that these estimates are statistically reliable at the 10 % significance level.     

A comprehensive population health index based on mortality and disability data

Two versions of a new population health index based on the mortality and disability experiences of nations or communities are proposed for comparing their overal health status. One version is the ratio of the mean mortality rate of selected population groups to the mean disability free rate of survivors. The other version is a composite of these variables, transformed to stabilize their variances, that are so weighted as to maximize the probability of correctly differentiating ‘healthy’ and ‘unhealthy’ nations. Problems with application of the index are briefly discussed.     

The effects of child health on marital status and family structure

The purpose of this paper is to provide evidence on the effect of child health on marital stability and family structure in an economic framework. We use the 1988 National Health Interview Survey's Child Health Supplement, with a sample of about 9,000 families, to test whether having an unhealthy child decreases the mother's chance of being married and whether it increases her chance of living in an extended family. Using two different measures of child health, we find that having an unhealthy child decreases the mother's likelihood of being married. Our results imply that children in poor health are more likely to face obstacles beyond their illness because they also are more likely to suffer the consequences of poverty and the poor schooling outcomes that result from being raised in a female-headed household. The only mitigating factor is that unhealthy white children are more likely than their healthy counterparts to be living in an extended family.     

The education effect on population health: a reassessment

Demographic research frequently reports consistent and significant associations between formal educational attainment and a range of health risks such as smoking, drug abuse, and accidents, as well as the contraction of many diseases, and health outcomes such as mortality—almost all indicating the same conclusion: better-educated individuals are healthier and live longer. Despite the substantial reporting of a robust education effect, there is inadequate appreciation of its independent influence and role as a causal agent. To address the effect of education on health in general, three contributions are provided: 1) a macro-level summary of the dimensions of the worldwide educational revolution and a reassessment of its causal role in the health of individuals and in the demographic health transition are carried out; 2) a meta-analysis of methodologically sophisticated studies of the effect of educational attainment on all-cause mortality is conducted to establish the independence and robustness of the education effect on health; and 3) a schooling-cognition hypothesis about the influence of education as a powerful determinant of health is developed in light of new multidisciplinary cognitive research.     

Marital status and mortality: The role of health

Prior literature has shown that married men live longer than unmarried men. Possible explanations are that marriage protects its incumbents or that healthier men select themselves into marriage. Protective effects, however, introduce the possibility of adverse selection: Those in poor health have an incentive to marry. In this paper we explore the role of health in explaining mortality and marriage patterns, and distinguish protective effects from two types of selection effects. We find adverse selection on the basis of health (unhealthy men tend to (re)marry sooner) and positive selection on the basis of unmeasured factors that both promote good health and encourage marriage.     

The application of quantitative indices for health planning to regional health service areas in vermont

Health System Agencies (HSAs) are expected to collect and analyze data on the health care delivery systems in their respective geographic areas for the purpose of preventing unnecessary dupplication of health resources and promoting the development of manpower and facilities which meet identified needs and reduce documented inefficiencies. The purpose of this paper is to present the results of a feasibility study of health services in Vermont using a profile system of individual manpower and facility types and summary indices of adequacy and efficiency. The profile system and indices make use of data already available in most health service areas. Profile and the values of summary indices are presented for each of the service areas of Vermont, using state provider/population and facility/population ratios as norms. Profiles and indices based on national norms are also presented for certain types of health professionals. Caveats are given in the interpretation of the results of applying the profile system and indices by health planners.     

Demographic data and geographic information systems for decision making: The case of public health

Recent changes in the United States health care system include a broadened definition of health and renewed focus on public health. Increasingly, demographic analyses are incorporated into public health decision-making. Analysts also are using geographic information more routinely, because Geographic Information System (GIS) software is becoming easier to use. The paper describes three cases in which demographers used GIS to analyze the spatial distribution of public health data. The first case, from Santa Clara County, California, focuses on adolescent sexually transmitted diseases in secondary school districts. The second case, also from Santa Clara County, maps preventable hospitalizations of senior citizens. The third examines the distribution of premature births in Tennessee counties. The researchers applied demographic techniques and perspectives in each case, and each case produced information that is being used by officials who plan health education campaigns and services.     

India's National Family Health Survey provides new information on maternal and child health and AIDS awareness

Teams surveyed a sample of 88,562 households, drawn from 99% of the population of India in 24 states plus the National Capital Territory of Delhi, between April 1992 and September 1993 to collect a basic set of information on all 500,492 household members, with more details on the 89,777 women in the households who had ever been married and were aged 13-49 years. This National Family Health Survey (NFHS) collected information from the women on a range of health topics including child immunization, women's knowledge of AIDS, services and facilities use during pregnancy and childbirth, infant feeding and treatment for diarrhea, and infant, child, and maternal mortality. Levels of infant and child mortality declined in India, but 8% of all children still die before their first birthday and 11% die before reaching age 5. As for maternal mortality, there are an estimated 420 maternal deaths per 100,000 live births annually. That rate implies that at least 100,000 Indian women die each year due to causes related to pregnancy and childbirth. Survey results indicate the need to strengthen vaccination programs and teach women about proper infant feeding practices. They also highlight the need to increase antenatal care and other medical services. In all of these areas, the NFHS results indicate wide variation among India's regions and states. Furthermore, a general lack of AIDS awareness suggests that the government's AIDS awareness campaign, relying primarily upon electronic media, has not yet reached the majority of India's population.     

Life change,health status and life satisfaction: A reconsideration

Recent research has suggested that life changes may be unrelated to health status indices and to overall satisfaction with life. Yet research has also reported that life changes appear to be related to measures of psychological distress. To attend further to clarification of the role of life change as a predictor of health status and life satisfaction, this paper examines the relationship between negative life change self-reports and indices of health status and life satisfaction. The data come from a survey of 1423 Northwestern Wisconsinites interviewed in 1974 by the Wisconsin Survey Research Laboratory. The findings indicate that self-reports of negative life changes were related to overall life satisfaction, controlling for health status, feelings of alienation/attachment, and personal disruption. Implications of the findings are discussed in conclusion.     

Quality of life indicators and health: Current status and emerging conceptions

Quality of life is an increasingly common theme in the health status and health promotion literatures. Six approaches that consider quality of life and health are reviewed. These are (a) health-related quality of life; (b) quality of life as social diagnosis in health promotion; (c) quality of life among persons with developmental disabilities; (d) quality of life as social indicators; (e) the Centre for Health Promotion (University of Toronto) model, and (f) Lindstrom's quality of life model. Each approach is considered as to its emphasis on objective or subjective indicators, individual or system-level measurement, value-laden or value-neutral assumptions, and potential relationship to social policy and social change goals. The links among the social indicators, quality of life, and health promotions areas are examined.