Suchergebnisse

This paper uses the 1995 Guatemalan Survey of Family Health (EGSF) to analyze the relationship between child illness and health seeking behavior. The EGSF contains detailed calendar data on the nature and timing of illness and treatment behavior for children age five and below; extensive information about the characteristics of mothers, families and communities; and data on the accessibility of traditional and biomedical providers within and near the community. The analysis is based on 870 children who began a diarrheal or respiratory illness during a two-week period prior to interview. Estimates are derived from a multinomial model of the probability of seeing a specific type of provider on a given day of illness, as a function of characteristics of the illness, child, mother, and community. The results indicate that modern medical care plays a major role in the treatment of infectious illness among children in rural Guatemala. The symptoms associated with the illness, their perceived severity, and mother's beliefs about their causes are important determinants of whether a child is brought to a provider and the type of provider visited. Poverty is a serious constraint on a family's choices about how to treat children's illnesses, whereas education and ethnicity have little effect on treatment behavior when income is held constant. In addition, the availability of modern health facilities within the community – both government-sponsored facilities and private doctors – has a substantial impact on the type of providers sought to treat children's illnesses.

SummaryData from an historical population in which fertility control was minimal and modern health services were mostly unavailable are used to show that there appears to have been a strong association between previous birth interval length and infant mortality, especially when the previous child survived. Although only imperfect proxies for breast-feeding practices and other potentially confounding factors are available for this population, the results suggest that the association between previous interval length and infant mortality in this population is not solely, or primarily, a function of differences in breast-feeding behaviour or socioeconomic status. Other factors, e.g. maternal depletion or sibling competition, are more likely to explain the observed association.

AbstractPhysically demanding work at later ages, which is especially prevalent among disadvantaged groups, is associated with long-term health outcomes and may contribute to health inequality over the life course. Past studies of these issues have relied on occupational characteristics from the Occupational Information Network (O*NET), but few have assessed how O*NET compares to survey reports when measuring occupational exposures in analyses of socioeconomic status, work conditions, and health. We compare Health and Retirement Study (HRS, N = 16,683 working respondents) and O*NET measurements of general physical activity, frequency of lifting/handling objects, and frequency of stooping-related postures required at work. Pearson correlations between the HRS items and corresponding O*NET items vary from weak to moderate for lifting/handling and stooping-related postures to relatively large for general physical activity. Though they are measured on different scales, both the HRS and O*NET measures of physical demands reveal similar sex, racial/ethnic, and educational differentials in exposure to physically strenuous work. We fit random effects Poisson models to assess how these measures predict accumulation of functional limitations, a potential long-term consequence of strenuous working conditions. Comparable HRS and O*NET measures have similar associations with functional limitations. We also consider an average of physical demand items available in O*NET, finding that this measure has similar associations with functional limitations as the O*NET measure of general physical activity. These results suggest that O*NET characteristics and HRS respondent reports produce comparable disparities in physical work exposures (PWEs) and associations between physically demanding work and declines in physical functioning.