Relationship between MNA and SF-36 in a free-living elderly population aged 70 to 75.

BACKGROUND: Within a larger study of social network and nutrition, we investigated measurements of nutritional status and health related quality of life. OBJECTIVE: To relate a well-established questionnaire of nutritional status (MNA) to a likewise well-established questionnaire of health related quality of life (SF-36) in community dwelling, free-living and, healthy 70-75 years old persons. DESIGN: Before an interview, the MNA and SF-36 questionnaires were filled in by 128 participants from a sample of 262 subjects. RESULTS: The MNA worked well as a measurement in this sample. Many MNA aspects correlated with the SF-36 scales. The correlations between MNA total score and the eight SF-36 scales varied from .27 to .62. DISCUSSION: This correlation was partly due to the fact that MNA has questions of health but also to the fact that there is an empirical relation between nutrition and health. CONCLUSION: The MNA measurement is applicable to a healthy, free-living elderly population and parts of the MNA can be interpreted as measurements of health related quality of life. Low values of SF-36 could also be used as predictors of risk of malnutrition, although further studies are required to confirm this result.

Cross-cultural analysis of longevity among Swedish and American elders: the role of social networks in the Gothenburg and Missouri longitudinal studies compared.

This paper reports the results of a cross-national comparison of the 'H70' longitudinal study of elders in Gothenburg, Sweden, with the 'Rural Missouri Elders' longitudinal study in Missouri, USA. Analysis of the combined data sets focused on the question of how longevity was affected by culturally divergent forms of social network participation. The H70 study was a representative, systematic 3/10 sample of 70-year-old (in 1971) men and women living in Gothenburg. Follow-up data was gathered when the respondents were 75, 79, 81, 82, 83, 85, 88, 90 and 95 years of age. Face-to-face interviews and physical medical examinations were the major source of data. The Missouri study involved a representative cluster proportional-to-size sample of all rural Missourians 65 years of age and older. Face-to-face interviews were conducted in 1966, 1974 and 1987. Logistic regression and cross-tabular analyses revealed that social networks were important predictors of longevity for both samples. However, marital status and participation in formal organizations predicted longevity for the Americans, whereas contact with children emerged as the predictor variable for the Swedes. Specific functions of the different network patterns in the two countries are discussed.

Gender, social networks and survival time: a 20-year study of the rural elderly.

The study design is a 20-year panel of 1700 rural elderly individuals who were interviewed in 1966, 1974 and in 1986-1987. The dependent variable was survival time. Proportional hazards and time dependent covariates were used to analyze the data. Gender differences in survival were explored. Participation in formal social networks predicted survival time. The findings support Durkheim's theory of social integration and call into question genetic differences as the explanation for the differential survival time of men and women.

Power and change: the case of the Swedish Commission of Inquiry on Health and Sickness Care.

This paper reviews the work of the Swedish Commission of Inquiry formed in 1975 to propose a new law governing medical care. Based on interviews with commission members, the interests and goals of participating groups are identified. These are compared to the outcome as published in the final report in 1980. Consumer interests gained few of their objectives, while physicians gained almost all of theirs. For others, results were mixed.

Power and change: primary health care at the crossroads in Sweden.

This paper is based on in-depth interviews with members of Sweden's medical interest groups involved in a national effort to control health care costs. Sweden is faced with escalating costs due primarily to a growing high technology hospital sector. Simultaneously, consumer demand for primary care services and for gerontological care is rising rapidly. The Swedish way of changing the health care system is described and an analysis of the power struggle between physicians, health care bureaucrats and politicians is presented.

Citizen participation in neighborhood health centers for the poor: the politics of reform organizational change, 1965-77.

Through a longitudinal study of neighborhood health centers for the poor in the United States, this paper presents an analysis of the political economy of change within reform organizations. In the final accounting, we seek to explain the shift in the role of poor people participating in health care decision making from that of program developer and change agent to the role of program restrictor. We conceptualize the neighborhood health center (NHC) as a reform organization whose initial objective was to use health care as a tool for achieving political and economic development within low-income rural and urban communities. The analysis, based on a prospective study of NHCs between 1965 and 1977, using interviews with citizen board members, NHC project administrators, NHC physicians, HEW decision elites, and oral history interviews with former Office of Economic Opportunity (OEO) administrators and directors, exemplifies the generic social organizational problem of how social, political, economic, and ideological forces shape the emergence and performance of a new reform organization.

Consumer evaluation of health services: implications for methodology and health care policy.

Consumer evaluation research is defined and analyzed as an experimental model for establishing a link between social science research and public policy. The paper reports the results of an 18-month longitudinal study of an experimental citizen evaluation group. Participant observation was the method used to organize the data. The impact of the model on methodological issues, such as objectivity, researcher autonomy, and control over research decision-making are discussed. Implications of the consumer evaluation model for integrating social research and health policy formulation are analyzed and principles of citizen evaluation research are presented.