Comparison of the detection rates of preconception health risks among Chinese couples of reproductive age in 2013 and 2019 / 中华健康管理学杂志

Objective:To assess the detection rates of preconception health risks among couples of reproductive age in China and analyze the differences between 2013 and 2019.Methods:In this cross-sectional study, the preconception health examination data of 9 153 916 couples of 20-49 years who participated in the National Free Preconception Health Examination Project in 2013 or 2019 were consecutively selected. The health risks involved eight aspects in women (genetic risk, reproductive risk, chronic disease risk, infectious risk, nutritional risk, behavioral risk, environmental risk and psychosocial risk) and seven aspects in men except for reproductive risks were assessed. The t test and χ2 test were used to compare the differences in demographic characteristics between the couples of reproductive age. The detection rates and 95% CI of each preconception health risk were calculated and the χ2 test was used to compare the differences in the detection rates of risk factors. Results:In 2019, the proportion of couples of reproductive age in China who were 35 years or older, had an education background of high school and above, workers, and held non-agricultural registered residence were all higher than those in 2013 (15.18% vs 6.22%, 52.12% vs 29.78%, 8.33% vs 7.17%, 12.39% vs 6.64%), while the proportion of farmers was significantly lower than that in 2013 (60.95% vs 76.87%) (all P<0.001). In 2013, the three health risks with the highest detection rate among Chinese women of reproductive age was nutritional risk (37.50%), infectious risk (16.95%) and psychosocial risk (11.62%), respectively; while in 2019, it was nutritional risk (38.07%), infectious risk (12.82%), and chronic disease risk (11.12%), respectively. The detection rate of nutritional risk in Chinese women of reproductive age in 2019 was significantly higher than that in 2013 (38.07% vs 37.50%), while the detection rates of infectious risk and psychosocial risk were both lower than those in 2013 (12.82% vs 16.95% and 7.37% vs 11.62%) (all P<0.001). In 2013, the top three risks detected in men of reproductive age was behavioral risk (44.87%), nutritional risk (36.81%) and psychosocial risk (13.43%), respectively; and in 2019, it was nutritional risk (45.47%), behavioral risk (38.76%) and psychosocial risk (9.18%), respectively. The detection rates of nutritional risk in men of reproductive age in 2019 was significantly higher than that in 2013 (45.47% vs 36.81%), while the detection rates of behavioral risk and psychosocial risk were both lower than those in 2013 (38.76% vs 44.87%, 9.18% vs 13.43%) (all P<0.001). Conclusions:The detection rate of nutritional risk in couples of reproductive age and genetic risk in men in 2019 in China are higher than those in 2013, and the exposure to the other preconception health risks is decreasing. The nutritional risk, infection risk, psychosocial risk and chronic disease risk are the main risk factors for women of reproductive age, while the nutritional risk, behavioral risk and psychosocial risk are the main risk factors for men.

Desnutrición aguda en menores de cinco años en el Departamento de Boyacá (Colombia), 2017-2021 / Epidemiological surveillance of acute malnutrition in children under 5 years of age in the Department of Boyacá, Colombia, 2017 to 2021 / Desnutrição aguda em crianças com menos de cinco anos de idade no Departamento de Boyacá (Colômbia), 2017-2021

Introducción: La desnutrición es un problema de salud pública que afecta a los menores de cinco años. En Colombia, en 2021, se notificaron al Sistema de Vigilancia en Salud Pública 15 924 casos de desnutrición aguda, con una prevalencia de 0,41 por cada 100 niños menores de 5 años; mientras que el Departamento de Boyacá tuvo una prevalencia de 0,54 por cada 100 menores de 5 años. Por ello, es importante estudiar factores de riesgo de la des-nutrición para generar información que permita la toma de decisiones en el departamento. Objetivo: Describir el comportamiento epidemiológico de la desnutrición aguda en menores de cinco años en el Departamento de Boyacá durante el periodo 2017-2021. Materiales y métodos: Se realizó un estudio observacional descriptivo de corte trasversal analítico. Se calcularon fre-cuencias absolutas y porcentajes, medidas de tendencia central y dispersión y odds ratio como medida de asociación.Resultados: De los 2254 datos analizados, el 55,37 % correspondieron al sexo masculino, el 88,08 % pertenecía al régimen subsidiado, el 50,80 % vivía en áreas rurales dispersos y el estrato socioeconómico 1 aportó el 51,33 % de la información. Se identificaron como factores de riesgo de desnutrición aguda severa la lactancia materna menor a 6 meses (OR = 1,96; 1,61-2,39) y el inicio de la alimentación complementaria antes de los 6 meses (OR = 2,12; 1,72-2,59). Conclusión: Es importantefortalecer los programas y políticas en salud con el fin de velar por la atención integral y oportuna de los menores de cinco años.

Introduction: Malnutrition is a public health problem that affects children under five years of age. In Colombia in 2021, 15,924 cases of acute malnutrition were reported to the public health surveillance system, with a prevalence of 0.41 per 100 children under 5 years of age, while the department of Boyacá had a prevalence of 0.54 per every 100 children under 5 years of age. In this way, the impor-tance of studies of risk factors for malnutrition is determined to generate strategies that favor public health and improve the nutritional conditions of the child population. Objective: To describe the epidemiological behavior of acute malnutrition in children under 5 years of age in the department of Boyacá during the period 2017 to 2021. Materials and methods: An analytical cross-sectional descriptive observational study was carried out, absolute frequencies and percentages were calculated, measures central tendency and dispersion and OR as a measure of association. Results: Of the 2254 data analyzed, 55.37% were male, 88.08% are from the subsidized regime, 50.80% are dispersed rural area and socioeconomic stratum 1 contributed 51.33%. Breastfeeding for less than 6 months (OR = 1.96; 1.61-2.39) and the start of complementary feeding before 6 months (OR = 2.12; 1.72-2.59) were identified as risk factors for severe acute malnutrition. Conclusion: It is important to strengthen health programs and policies in order to ensure comprehensive and timely care for children under five years of age

Introdução: A desnutrição é um problema de saúde pública que afeta crianças com menos de cinco anos de idade. Na Colômbia, em 2021, 15.924 casos de desnutrição aguda foram notificados ao Sistema de Vigilância em Saúde Pública, com uma prevalência de 0,41 por 100 crianças com menos de 5 anos de idade, enquanto o Departamento de Boyacá teve uma prevalência de 0,54 por 100 crianças com menos de 5 anos de idade. Portanto, é importante estudar os fatores de risco para a desnutrição a fim de gerar informações para a tomada de decisões no Departamento. Objetivo: descrever o comportamento epidemiológico da desnutrição aguda em crianças com menos de cinco anos de idade no Departamento de Boyacá durante o período de 2017 a 2021. Materiais e métodos: Foi realizado um estudo observacional descritivo, transversal, analítico. Foram calculadas frequências absolutas e porcentagens, medidas de tendência central e dispersão e odds ratio como medida de associação. Resultados: Dos 2.254 dados analisados, 55,37% eram do sexo masculino, 88,08% pertenciam ao regime subsidiado, 50,80% viviam em áreas rurais dispersas e o estrato socioeconômico 1 representa-va 51,33% das informações. O aleitamento materno por menos de 6 meses (OR = 1,96; 1,61-2,39) e o início da alimentação complementar antes dos 6 meses (OR = 2,12; 1,72-2,59) foram identificados como fatores de risco para desnutrição aguda grave. Conclusão: É importante fortalecer os progra-mas e as políticas de saúde para garantir atendimento abrangente e oportuno para crianças menores de cinco anos

COVID-19 en Costa Rica: análisis longitudinal de las tasas de contagio y de fallecimiento desde el enfoque de la desigualdad social

Introducción: este artículo aborda la relación entre las tasas brutas de contagio y las tasas netas de fallecimiento por la COVID-19 -variables de estudio-, con indicadores socioeconómicos y de la salud -variables de contraste- en cuatro momentos de observación durante el primer año de la sindemia en Costa Rica. Los objetivos del trabajo fueron a) identificar los momentos de observación a partir de la cantidad de casos acumulados por semana epidemiológica; b) establecer la correlación estadística entre las tasas brutas de contagio y las variables de contraste; c) establecer la correlación estadística entre las tasas netas de fallecimientos y las variables de contraste; d) describir el desarrollo de las tasas de contagio y fallecimiento a nivel cantonal; e) caracterizar socioeconómicamente los cantones con valores muy altos en dichas tasas. Metodología: se desarrolló un estudio con enfoque cuantitativo mediante el método estadístico y la aplicación de pruebas de hipótesis de tipo bivariado, a saber, correlaciones Pearson y Spearman. Resultados: los principales resultados indicaron que el contagio está estrechamente vinculado, mayoritariamente, con factores socioeconómicos -densidad poblacional, índice de desarrollo social (IDS), índice de desarrollo humano (IDH) y tasas de delito contra el patrimonio-, mientras que los fallecimientos se asocian a factores biológicos como las tasas de enfermedades -hipertensión y respiratorias- Conclusiones: se demuestra la relación existente entre la enfermedad y las desigualdades sociales, es decir, cómo estas últimas se reproducen en el campo de la salud.

Introduction: This article addresses the relationship between the gross rates of transmission and the net death rates from COVID-19 -study variables-, with socioeconomic and health indicators -contrast variables- at four moments of observation during the first year of the syndemic in Costa Rica. The objectives of the research work are: a) identify the moments of observation based on the number of accumulated cases per epidemiological week; b) establish the statistical correlation between the crude rates of transmission and the contrast variables; c) establish the statistical correlation between the net death rates and the contrast variables; d) describe the development of transmission and death rates at the cantonal level, and e) socioeconomically characterize the cantons with very high values in those rates. Methods: A study with a quantitative approach is developed through the statistical method and the application of hypothesis tests at a bivariate level, namely, Pearson and Spearman correlations. Results: The main results indicate that transmission is closely related, mostly, to socioeconomic factors -population density; Social Development Index (IDS); Human Development Index (HDI) and crime rates against property-, while deaths they are related to biological factors such as the rates of diseases -hypertension and respiratory-. Conclusion: The study demonstrates the relationship between disease and social inequalities, that is, how social inequality is reproduced in the field of health.

Prevenção do câncer de colo de útero: fatores associados a não realização do exame Papanicolaou em participantes da Coorte de Universidades Mineiras (projeto CUME) / Prevention of cervical cancer: factors associated with not having a Pap smear in participants of the Cohort of Universities of Minas Gerais (CUME project)

Introdução: As neoplasias são a segunda causa de morte em todo o mundo, com destaque para o câncer de colo do útero entre a população feminina. Ressalta-se que umas das formas de prevenção, diagnóstico e detecção de lesões precursoras desse tipo de câncer é a realização do exame de Papanicolaou, preconizado no Brasil para as mulheres de 25 a 64 anos. Ainda que a proporção de mulheres que se submetem a esse exame seja alta no país, se faz importante conhecer quais fatores se associam a sua não realização entre o público-alvo, com o intuito de ampliar a cobertura. Objetivo: Analisar os fatores relacionados à não realização do exame Papanicolau de mulheres da faixa etária de 25 a 64 anos participantes do estudo Coorte de Universidades Mineiras (CUME). Métodos: Trata-se de um estudo transversal com dados da linha de base da CUME. Foram estudadas todas as mulheres na faixa etária alvo do rastreio, totalizando 2.898 participantes. Inicialmente, avaliou-se a prevalência de não realização do exame de Papanicolaou segundo as características sociodemográficas, comportamentais e de saúde das mulheres. Em seguida, foi realizada a uma análise multivariada para identificar os fatores independentemente associados à não realização do exame por meio da regressão logística múltipla. O nível de significância estatística foi fixado em 5% e todas as análises de dados foram realizadas por meio do software Stata® versão 13. Resultados: A prevalência de não realização do exame de Papanicolaou foi de 11,8%. Os fatores associados ao aumento da chance de não realização do Papanicolaou foram: cor da pele preta (OR: 2,16; IC 95%: 1,37-3,42) ou parda (OR: 1,44; IC 95%: 1,11-1,87) e graduação em curso que não fosse da área da saúde (OR: 1,45; IC 95%: 1,10-1,91). Já os fatores associados à diminuição da chance de não realização do exame foram: idade, com destaque para a faixa etária de 45 a 54 anos (OR: 0,40; IC 95%: 0,22-0,72); ser casada/união estável (OR: 0,27; IC 95%: 0,19-0,39) ou separada/divorciada (OR: 0,38; IC 95%: 0,15-0,93); apresentar especialização (OR: 0,62; IC 95%: 0,44-0,87), mestrado (OR: 0,69; IC 95%: 0,51-0,93), doutorado/pós-doutorado (OR: 0,63; IC 95%: 0,39-0,99); renda de 05 a 10 salários mínimos (OR: 0,59; IC 95%: 0,41-0,84) e maior que 10 salários mínimos (OR: 0,27; IC 95%: 0,10-0,68); ser fumante (OR: 0,53; IC 95%: 0,30-0,92) ou ex-fumante (OR: 0,45; IC 95%: 0,26-0,78); já ter vivenciado alguma gestação ao longo da vida (OR: 0,55; IC 95%: 0,36-0,85); ser ativa fisicamente (OR: 0,71; IC 95%: 0,53-0,94). Conclusões: Os resultados deste estudo mostraram uma alta cobertura do Papanicolaou e os fatores associados à não realização do exame foram semelhantes àqueles evidenciados em investigações prévias para a população geral brasileira. Tais achados demostram que mesmo em um público de alta escolaridade, estratégias de ampliação da realização do exame de rastreamento do câncer cérvico-uterino envolvem questões passíveis de modificação, tais como a própria escolaridade, a renda e, potencialmente, o racismo estrutural, além de ações de educação em saúde para mulheres que não se graduaram na área da saúde.

Câncer de próstata em homens atendidos em uma unidade de alta complexidade em saúde: perfil epidemiológico / Prostate cancer in men treated at a high-complexity healthcare unit: epidemiological profile / Cáncer de próstata en hombres atendidos en una unidad de salud de alta complejidad: perfil epidemiológico

Objetivo: caracterizar o perfil epidemiológico do câncer de próstata em homens atendidos em uma unidade de alta complexidade em saúde na Bahia, Brasil. Método: Estudo descritivo, transversal, quantitativo, realizado em uma unidade de alta complexidade de referência em um município da Bahia, Brasil. Realizou-se busca exploratória de dados primários coletados em prontuários de pacientes com câncer que que estavam iniciando e/ou em tratamento, entre janeiro de 2013 a dezembro de 2015. A amostra foi composta de 662 registros, os quais foram submetidos à análise estatística. Resultados: Mais de 60% dos pacientes residiam na área urbana, cerca de 90% são atendidos pelo Sistema Único de Saúde (SUS). O câncer de próstata obteve maior prevalência em homens com idade acima de 60 anos, principalmente na faixa etária 70-79 anos. A análise histológica da biópsia indicou que a maioria dos pacientes já se encontravam na escala G2, classificado como médio risco, havendo a possibilidade de avançar para o escore G3 - alto risco. Conclusão: O perfil epidemiológico indicou prevalência elevada para o câncer de próstata, com recorte etário avançado, perfil histológico relevante para a vigilância dos pacientes e expressiva cobertura de atenção à saúde na esfera pública

Objective: to characterize the epidemiological profile of prostate cancer in men treated at a high-complexity healthcare unit in Bahia, Brazil. Method: Descriptive, cross-sectional, quantitative study, carried out in a high-complexity reference unit in a municipality in Bahia, Brazil. An exploratory search of primary data collected from medical records of cancer patients who were starting and/or undergoing treatment was carried out between January 2013 and December 2015. The sample consisted of 662 records, which were submitted to statistical analysis. Results: More than 60% of patients lived in urban areas, about 90% are assisted by the Unified Health System (SUS). Prostate cancer was more prevalent in men over 60 years of age, especially in the 70-79 age group. The histological analysis of the biopsy indicated that most patients were already in the G2 scale, classified as medium risk, with the possibility of advancing to the G3 score - high risk. Conclusion: The epidemiological profile indicated a high prevalence of prostate cancer, with an advanced age range, relevant histological profile for patient surveillance and significant coverage of health care in the public sphere.

Objetivo: caracterizar el perfil epidemiológico del cáncer de próstata en hombres atendidos en una unidad de salud de alta complejidad en Bahía, Brasil. Método: estudio descriptivo, transversal, cuantitativo, realizado en una unidad de referencia de alta complejidad en un municipio de Bahía, Brasil. Entre enero de 2013 y diciembre de 2015 se realizó una búsqueda exploratoria de datos primarios recolectados de historias clínicas de pacientes oncológicos que estaban iniciando y / o en tratamiento. La muestra estuvo conformada por 662 registros, que fueron sometidos a análisis estadístico. Resultados: Más del 60% de los pacientes vivían en áreas urbanas, alrededor del 90% son atendidos por el Sistema Único de Salud (SUS). El cáncer de próstata fue más prevalente en hombres mayores de 60 años, especialmente en el grupo de edad de 70 a 79 años. El análisis histológico de la biopsia indicó que la mayoría de los pacientes ya se encontraban en la escala G2, clasificada como riesgo medio, con posibilidad de avanzar a la puntuación G3 - riesgo alto. Conclusión: El perfil epidemiológico indicó una alta prevalencia de cáncer de próstata, con rango de edad avanzado, perfil histológico relevante para la vigilancia del paciente y cobertura significativa de atención de salud en la esfera pública.

Estado de salud de primeros molares permanentes en adolescentes. Secundaria Básica Luis Pérez Lozano. Cienfuegos / First permanent molars´ health status in adolescents. Secondary School Luis Pérez Lozano. Cienfuegos

Introducción: el conocimiento del estado de salud bucal de la población escolar resulta una premisa indispensable para el desarrollo de una correcta planificación, organización y control de la atención estomatológica. Objetivo: determinar el estado de salud de los primeros molares permanentes en estudiantes de la Secundaria Básica “Luis Pérez Lozano”, del Área 7, Cienfuegos, de enero a diciembre de 2015. Materiales y Métodos: estudio observacional-descriptivo en un universo constituido por 197 niños de 7mo grado. El muestreo fue bietápico, combinando aleatorio, estratificado, proporcional y simple. Los datos se obtuvieron a través del examen bucal. Se tuvieron en cuenta las variables edad, sexo, estado de salud, y ubicación de los molares afectados. Resultados: el mayor porcentaje de primeros molares permanentes cariados correspondió al primer molar mandibular derecho e izquierdo para 11,9 % en el sexo masculino y el sexo femenino con primer molar permanente izquierdo para 11,6 %. Las obturaciones de los primeros molares mandibulares izquierdo predominó con un 16,6 % en el masculino y el mandibular derecho con un 13,9 % en las féminas. El mayor número de molares permanentes perdidos resultó en los inferiores, mandibular izquierdo en las niñas para 9,3 % y el molar mandibular derecho en los varones (7,1 %). Ambos sexos igualmente afectados con diferencia porcentual del 1%. El índice de Cluné obtuvo que los molares sanos para el sexo masculino representan 52,3 % y 53,4 % del femenino. Conclusiones: El estado de salud de los primeros molares permanentes en general se clasifica de regular pues existe un número considerable de afectados (AU).

Introduction: the knowledge of the school population´s oral health is a necessary premise for carrying out a correct planning, organization and control of the dental care. Objective: to determine the health status of the first permanent molars in students of the secondary school “Luis Pérez Lozano” of the health area 7, Cienfuegos, from January to December 2015. Materials and methods: an observational, descriptive study applied in a universe of 197 seventh-grade children. The sampling was two-staging, combining the randomized, stratified, proportional and simple sampling. The sample was obtained through the oral examination. The variables taken into account were age, sex, health status, and location of the affected molars. Results: the higher percentage of carious permanent first molars corresponded to the right and left mandibular first molar for 11,9 % in male sex and to the first left permanent molar in female sex with 11,6 %. The fillings of the first left mandibular molars predominated with 16,6 % in the male sex, and the right mandibular one in women with 13,9 %. The highest number of lost permanent molars was found among the lower ones, the left mandibular in girls (9,3 %) and the right mandibular in boys (7,1 %). Both sexes were equally affected, with a 1 % percent difference. The Clune’s index showed that healthy molars are 52,3 % for the male sex and 53,4 % for the female sex. Conclusions: in general, the first permanent molars´ health status is classified as regular because there is a substantial number of carious ones (AU).

Study on the ability of New Rural Cooperative Medical Scheme to reduce health risk factors in Anhui province / 中国卫生政策研究

Objective: To describe the degree of poverty caused by diseases among farmers who have joined New Rural Cooperative Medical Scheme( NRCMS) in Anhui province, and analyze the ability of NRCMS to reduce health risk factors in Anhui province, in order to provide suggestions for improving the NRCMS strategy. Methods: This paper randomly selects three counties to conduct comparative analysis on the NRCMS strategic changes from the aspects of registration rates, funding levels and compensation ratios between 2013 and 2014, in order to analyze the ability of NRCMS to reduce health risk factors from the aspects of the rate of poverty caused by diseases, the resolving degree of poverty caused by diseases, the alleviation degree of poverty caused by diseases, etc. Results: The ability of NRCMS to reduce health risk factors in Anhui province has improved between 2013 and 2014 , but the improve-ment is limited. Conclusions:In order to reduce the incidence of poverty caused by diseases among the farmers, gov-ernment should reform the payment methods, control the outflow of patients and improve the multi-level security sys-tem, in order to gradually reduce the poverty caused by diseases among farmers.

Consultorio de Atención Pediátrica Ambiental en un hospital de alta complejidad / Clinic of environmental pediatric care in a high complexity hospital

La Organización Mundial de la Salud considera la salud ambiental infantil como uno de los principales retos de la salud pública del siglo XXI y promueve el desarrollo de programas que permitan abordar, divulgar o mitigar el impacto en la salud de los contaminantes ambientales en todos los niveles de atención pediátrica. El consultorio de Atención Pediátrica Ambiental (APA) que funciona en el Hospital de Pediatría "Prof. Dr. Juan P. Garrahan" se organizó con el objetivo de atender las demandas de aquellos pacientes con sospechada o comprobada exposición a riesgos ambientales. Se utilizó una historia clínica ambiental pediátrica, elaborada para tal fin

Children environmental health is considered by The World Health Organization as one of the main challenges of Public Health during the Century XXI. They promote the development of programs that allow approaching, disclosure or mitigation of the impact of polluting agents on health at every level of pediatric attention. The Children Hospital "Prof. Dr. Juan P. Garrahan" has created an Environmental Health Office in order to address the demands of those patients with suspected or verified exposure to environmental risks. An Environmental Clinical History has been elaborated with this purpose.

Analysis of disease and health risk factors among teachers in one university of Chongqing / 重庆医学

Objective To understand the teachers′health status of one university in Chongqing to provide the basis for the healthcare of this group.Methods The teachers′health examination information in1 303 cases of physical healthy examination was retrospectively analyzed.The data were analyzed by the SPSS17.0 statistical software.Results The main detected diseases were conj unctivitis,fatty liver,cataract,refractive error,eyeground arteriosclerosis and hypertension.The top-5 health risk factors includ-ed dyslipidemia,overweight,hyperpiesia,increased uric acid and fasting blood glucose abnormality.The detection rates of conj uncti-vitis,fatty liver,eyeground arteriosclerosis,overweight,hyperpiesia,increased uric acid,fasting blood glucose abnormality examined in males were obviously higher than those in females(P0.05).Apart from the increased uric acid(P=0.740),the morbidity and risk factors in dif-ferent ages were markedly different(P<0.01).The case rate of diabetes and hypertension was lower than the national average. Conclusion The eye health status of teachers in this university is not optimistic;there were many health risk factors.The health knowledge education of overweight,dyslipidemia,pathoglycemia and hyperpiesia should be carried out aiming at this group.

Association between Health Risk Factors and Mortality over Initial 6 Year Period in Juam Cohort / 農村醫學 地域保健

OBJECTIVES: This study was conducted to investigate the association between health risk factors and mortality in Juam cohort. METHODS: The subjects were 1,447 males and 1,889 females who had been followed up for 68.5 months to 1 January 2001. Whether they were alive or not was confirmed by the mortality data of the National Statistical Office. A total of 289 persons among them died during the follow-up period. The Cox's proportional hazard regression model was used for survival analysis. RESULTS: Age, type of medical insurance, self cognitive health level, habit of alcohol drinking, smoking, exercise and BMI level were included in Cox's proportional hazard model by gender. The hazard ratio of age was 1.07(95% CI: 1.05-1.10) in men, 1.09(95% CI: 1.06-1.12) in women. The hazard ratio of medical aid(lower socioeconomic state) was 1.43(95% CI 1.02-2.19) in women. The hazard ratios of current alcohol drinking and current smoking were respectively 1.69(95% CI: 1.01-2.98), 1.52(95% CI: 1.02-2.28) in women. The hazard ratio of underweight was 1.56(95% CI 1.08-2.47) in men. The hazard ratios of underweight, normoweight, overweight, and obesity were respectively 1.63(95% CI: 1.02-2.67), 1.0(referent), 0.62(95% CI: 0.32-1.63), 1.27(95% CI: 0.65-3.06), which supported the U-shaped relationship between body mass index and mortality among the men over 65. CONCLUSIONS: The health risk factors increasing mortality were age, underweight in male, age, lower socioeconomic state, current alcohol drinking, current smoking in female. To evaluate long-term association between health risk factors and mortality, further studies need to be carried out.

Effects of Sociodemographic Factors on the Stage of Behavior Change Among Employees of Small to Medium Sized Enterprises / 대한산업의학회지

OBJECTIVES: This research attempts to investigate the relationship between health risk factors and workers'behavioral changes based on individual worker's characteristics to allow the development of more effective health promotion programs in businesses places. METHODS: A questionnaire survey was conducted with 282 workers employed in small to medium sized enterprises in the Kyong-in area of Korea. The questionnaire was composed of general characteristics, a health risk assessment and an evaluation of the stage of behavior change for health promotion strategy in the workplace. RESULTS: The health risk assessment revealed that 65.7 % of male workers smoke, 70.5% of male workers do not exercise on a regular basis, 86.1 % of female workers do not exercise at all, and 78.6 % of male workers and 50 % of female workers drink alcohol. In addition, the survey identified that 29.5% of male workers are addicted to excessive drinking, as are 11.1% of female workers. Based on the four stages of behavioral changes that lead to health, the pre-contemplation stage, contemplation stage, action stage, and maintenance stage, 40.5 %, 23.7 %, 12.1 % and 23.7 % of workers are in these stages, respectively, with regards to quitting smoking. As for regular exercises, 18.4 %, 37.6 %, 17.7 %, and 26.3 % of workers belong to each stage, respectively. As for moderation in drinking, 20.9 %, 15.4 %, 10.0 %, and 53.7 % are in each stage, respectively. The rate of health managers in the active stage of quitting smoking is significantly higher than that of general workers. Among the workers who do not exercise on a regular basis, workers over 50 years-old and blue color workers are more common in the precontemplation stage than any other worker groups. CONCLUSIONS: The results of this study suggest that the stages of behavioral change vary with worker characteristics. An awareness of the effects of the high risk factors is essential for promoting workers'attendance in health promotion programs.