[EQ] Is the association between childhood socioeconomic circumstances and cause-specific mortality established?

Is the association between childhood socioeconomic circumstances and cause-specific mortality established?
Update of a systematic review

B Galobardes¹, J W Lynch², G Davey Smith¹

¹ Department of Social Medicine, University of Bristol, UK
² Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada

Journal of Epidemiology and Community Health - May 2008 - Volume 62, Number 5

Website: http://jech.bmj.com/cgi/content/full/62/5/387

Objective: To update a systematic review on the association between childhood socioeconomic circumstances and cause-specific mortality. Studies published since 2003 include a far greater number of deaths than was previously available justifying an update of the previous systematic review.

Methods: Individual-level studies examining childhood socioeconomic circumstances and adult overall and cause-specific mortality published between 2003 and April 2007.

Results and conclusions: The new studies confirmed that mortality risk for all causes was higher among those who experienced poorer socioeconomic circumstances during childhood. As already suggested in the original systematic review, not all causes of death were equally related to childhood socioeconomic circumstances. A greater proportion of new studies included women and showed that a similar pattern is valid for both genders. In addition, the new studies show that this association persists among younger birth cohorts, despite temporal general improvements in childhood conditions across successive birth cohorts. The difficulties of establishing a particular life-course model were highlighted

What this paper adds

        - The association between childhood socioeconomic circumstances and cause-specific mortality is present in men and women.
        - This association persists in younger cohorts despite them not having been exposed to the same sort of childhood hardships as previous cohorts
        - Education is an important mediator between early life socioeconomic position and adult mortality

 Policy implications

This systematic review provides strong evidence that poor socioeconomic circumstances during childhood are associated with higher mortality among men and women and that this association persists among younger cohorts. Tackling health inequalities from the start of life needs to be a policy priority if we are to reduce adult health inequalities.

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[EQ] Enhancing global capacity in the surveillance, prevention, and control of chronic diseases

Enhancing global capacity in the surveillance, prevention, and control of chronic diseases:
seven themes to consider and build upon

B C K Choi¹, D V McQueen², P Puska³, K A Douglas⁴, M Ackland⁵, S Campostrini⁶, A Barceló⁷, S Stachenko⁸, A H Mokdad⁹, R Granero¹⁰, S J Corber¹¹, A-J Valleron¹², H A Skinner¹³, R Potemkina¹⁴, M C Lindner¹⁵, D Zakus¹⁶, L M de Salazar¹⁷, A W P Pak¹⁸, Z Ansari¹⁹, J C Zevallos²⁰, M Gonzalez²¹, A Flahault²², R E Torres²³

Journal of Epidemiology and Community Health - May 2008 - Volume 62, Number 5

Website: http://jech.bmj.com/cgi/content/full/62/5/391

Background: Chronic diseases are now a major health problem in developing countries as well as in the developed world. Although chronic diseases cannot be communicated from person to person, their risk factors (for example, smoking, inactivity, dietary habits) are readily transferred around the world. With increasing human progress and technological advance, the pandemic of chronic diseases will become an even bigger threat to global health.

Methods: Based on our experiences and publications as well as review of the literature, we contribute ideas and working examples that might help enhance global capacity in the surveillance of chronic diseases and their prevention and control. Innovative ideas and solutions were actively sought.

Results: Ideas and working examples to help enhance global capacity were grouped under seven themes, concisely summarised by the acronym "SCIENCE": Strategy, Collaboration, Information, Education, Novelty, Communication and Evaluation.

Conclusion: Building a basis for action using the seven themes articulated, especially by incorporating innovative ideas, we presented here, can help enhance global capacity in chronic disease surveillance, prevention and control. Informed initiatives can help achieve the new World Health Organization global goal of reducing chronic disease death rates by 2% annually, generate new ideas for effective interventions and ultimately bring global chronic diseases under greater control.

“….This paper extends the ideas set forth in a previous paper on chronic disease surveillance in the Americas.²¹ In that paper, seven important themes were recommended for enhancing capacity in the surveillance of chronic disease, themes that can be remembered through the acronym
"SCIENCE": Strategy, Collaboration, Information, Education, Novelty, Communication and Evaluation.
This paper discusses these themes within a context that adds prevention and control……”

 

¹ Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada (PHAC), Government of Canada, Ottawa, Ontario; Department of Public Health Sciences, University of Toronto, Toronto, Ontario; Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
² National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (DHSS), Atlanta, GA, USA
³ National Public Health Institute (KTL), Helsinki, Finland
⁴ Nyon, Switzerland
⁵ Communicable Disease Control Unit, Public Health Branch, Victorian Department of Human Services, Melbourne, Australia
⁶ Department of Statistics, University of Venice, Venice, Italy
⁷ Disease Prevention and Control, Pan American Health Organization (PAHO/WHO), Washington DC, USA
⁸ Public Health Agency of Canada, Government of Canada, Ottawa, Ontario, Canada
⁹ Behavioral Surveillance Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Coordinating Center for Health Promotion, Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services (DHSS), Atlanta, GA, USA
¹⁰ ASCARDIO and Ministry of Health and Social Development; Americas’ Network for Chronic Disease Surveillance (AMNET), Barquisimeto, Venezuela
¹¹ Health Sciences, Simon Fraser University, Burnaby, BC, Canada
¹² Doctoral School of Public Health and Information Science, Université Pierre et Marie Curie, Paris, France
¹³ Faculty of Health, York University, Toronto, Ontario, Canada
¹⁴ State Research Centre for Preventine Medicine, Ministry of Health and Social Development of Russian Federation, Moscow, Russia
¹⁵ Department of Clinical Laboratory, Clinical Hospital, Faculty of Medicine, Universidad de la República Oriental del Uruguay; Ministry of Public Health, Montevideo, Uruguay
¹⁶ Centre for International Health; Department of Public Health Sciences and Department of Health Policy, Management Evaluation, Faculty of Medicine, University of Toronto,  Ontario, Canada
¹⁷ Center for Evaluation of Public Health, Policies, Programs and Technologies, CEDETES; School of Public Health, Universidad del Valle, Cali, Colombia
¹⁸ Ottawa, Ontario, Canada
¹⁹ Health Surveillance, Chronic Disease Surveillance and Epidemiology, Rural and Regional Health and Aged Care Services, Victorian Department of Human Services, Melbourne, Australia
²⁰ Endowed Health Services Research Center, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
²¹ Observatory of Chronic Diseases, National Institute of Health of Colombia; Diagnosis/Intervention  Cardiovascular and Chronic Disease Risk Factors in the Population, Nat. Fed.Coffee Growers      of Colombia, Bogotá, Colombia
²² WHO Collaborating Centre for Electronic Surveillance of Diseases, Paris; French School of Public Health, Rennes, France
²³ Oficina General de Estadística e Informática, Non-Communicable Diseases, Ministry of Health, Lima, Peru

 

 

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[EQ] Retooling for an Aging America: Building the Health Care Workforce

Retooling for an Aging America: Building the Health Care Workforce

 

Committee on the Future Health Care Workforce for Older Americans, Institute of Medicine,  April 14, 2008

 

Health Care Work Force Too Small, Unprepared For Aging Baby Boomers;
Higher Pay, More Training, And Changes In Care Delivery Needed To Avert Crisis

 

Available online at: http://www.nap.edu/catalog.php?record_id=12089

 

The Institute of Medicine charged the ad hoc Committee on the Future Health Care Workforce for Older Americans to determine the health care needs of Americans over 65 years of age and to assess those needs through an analysis of the forces that shape the health care workforce, including education and training, models of care, and public and private programs.

 

The committee concludes that the definition of the health care workforce must be expanded to include everyone involved in a patient’s care: health

care professionals, direct-care workers, informal caregivers (usually family and friends), and patients themselves. All of these individuals must have the

essential data, knowledge, and tools to provide high-quality health care.

 

The committee proposes a concurrent three-prong approach:

• Enhance the geriatric competence of the entire workforce

• Increase the recruitment and retention of geriatric specialists and caregivers

• Improve the way care is delivered


Summary

1 Introduction

2 Health Status and Health Care Service Utilization

3 New Models of Care

4 The Professional Health Care Workforce

5 The Direct-Care Workforce

6 Patients and Informal Caregivers

Appendix A Committee Biographies

Appendix B Commissioned Papers

Appendix C Workshop Presentations

 

 

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