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Aims: This study aims to investigate whether those individuals exposed to certain socioeconomic events (e.g. unemployment or early retirement) are more at risk of experiencing financial strain if they are also exposed to some limiting long-term illness., Methods: This is a cross-sectional study using a Swedish sample of 41,497 individuals between the ages of 25 and 65 selected from the Survey of Living Conditions of Statistics Sweden. The measure of association used in the study is the prevalence odds ratio, and interaction analyses are performed in order to assess differential susceptibility to experience financial strain., Results: The results show that young persons, living in poor households, unemployed or early retired, reporting a high degree of impairment, present a greater probability of experiencing financial strain. Severe impairment has proved to be a component in the possible causal chain leading to the experience of financial strain, which interacts with the factors studied, increasing significantly the probability of certain groups experiencing financial hardship., Conclusion: The results sustain the hypothesis that social consequences of illness, such as financial strain, might contribute to aggravate inequalities between socioeconomic groups under certain conditions such as unemployment and poverty.

Objective: The DAta Food NEtworking (DAFNE) initiative was conceived in the 1980s and aims at using data already collected in the context of household budget surveys (HBSs) for the assessment of dietary patterns across Europe., Design: HBSs are country-representative surveys conducted, with similar methodology, at regular time intervals by the National Statistical Offices of almost all European countries. DAFNE focuses at the designation of comparable, between European countries, categories of food and socio-demographic data, and the estimation of daily per capita food availability. With food and socio-demographic data classified into common categories, comparisons of food habits between European countries become possible., Setting: Fifteen European countries with one or more HBS all undertaken during the period 1981-1999., Subjects: Representative population samples in 15 European countries., Results: DAFNE HBS data are comparable and allow a wide range of dietary analyses. Preliminary data document differences in food habits among European countries and provide insights into the socio-demographic determinants of food preferences., Conclusion: The DAFNE databank, if properly expanded and exploited, could become a valuable tool for national food and nutrition policy planning across Europe and for the identification of groups at higher risk for developing nutrition-related conditions.

Purpose: Although socioeconomic position has been identified as a determinant of cardiovascular disease among employed men and women in the U.S., the role of economic sector in shaping this relationship has yet to be examined. We sought to estimate the combined effects of economic sector-one of the three major sectors of the economy: finance, government and production-and socioeconomic position on cardiovascular mortality among employed men and women., Methods: Approximately 375,000 men and women 25 years of age or more were identified from selected Current Population Surveys between 1979 and 1985. These persons were followed for cardiovascular mortality through use of the National Death Index for the years 1979 through 1989., Results: In men, the lowest cardiovascular mortality was found for professionals in the finance sector (76/100,000 person/years). The highest cardiovascular mortality was found among male non-professional workers in the production sector (192/100,000 person years). A different pattern was observed among women. Professional women in the finance sector had the highest rates of cardiovascular mortality (133/100,000 person years). For both men and women, the professional/non-professional gap in cardiovascular mortality was lower in the government sector than in the production and finance sectors. These associations were strong even after adjustment for age, race and income., Conclusions: Characteristics of government, finance and production work differentially influence the risk of cardiovascular disease mortality. Men, women, professionals and non-professionals experience this risk differently.

Background: A number of disease conditions are influenced by deprivation. Geographical measurement of deprivation can provide an independent contribution to individual measures by accounting for the social context. Such a geographical approach, based on deprivation indices, is classical in Great Britain but scarcely used in France. The objective of this work was to build and validate an index readily usable in French municipalities and cantons., Methods: Socioeconomic data (unemployment, occupations, housing specifications, income, etc.) were derived from the 1990 census of municipalities and cantons in the Doubs departement. A new index was built by principal components analysis on the municipality data. The validity of the new index was checked and tested for correlations with British deprivation indices., Results: Principal components analysis on municipality data identified four components (explaining 76% of the variance). Only the first component (CP1 explaining 42% of the variance) was retained. Content validity (wide choice of potential deprivation items, correlation between items and CP1: 0.52 to 0.96) and construct validity (CP1 socially relevant; Cronbach's alpha=0.91; correlation between CP1 and three out of four British indices ranging from 0.73 to 0.88) were sufficient. Analysis on canton data supported that on municipality data., Conclusion: The validation of the new index being satisfactory, the user will have to make a choice. The new index, CP1, is closer to the local background and was derived from data from a French departement. It is therefore better adapted to more descriptive approaches such as health care planning. To examine the relationship between deprivation and health with a more etiological approach, the British indices (anteriority, international comparisons) would be more appropriate, but CP1, once validated in various health problem situations, should be most useful for French studies.

Objective: Epidemiological studies and interventions to reduce inequalities in community health require the assignation of exhaustive and easy-to-obtain social indicators. Occupation and education are two of the most often used. In this study we attempt to evaluate the association between education and occupation among adult working population because if, in the absence of one of these two variables, it will be feasible to use the remaining with the lesser lost of socio-economic information., Design: From a representative sample (n = 3091) of general population (18-65 years old) drawn out from a prevalence survey on chronic disease risk factors performed in the Region of Murcia, a log-lineal analysis has been made between education and occupation among working people (65.8% of males and 34.2% of females from the original sample)., Results: Men present significant association between managerial positions and university education. The association drops between clerks and high school graduates to increase among all manual workers with or without primary schooling education. Among women--with a lesser number of participants--the education/occupation association describes the same pattern but with higher magnitudes in the positive associations between managerial positions and university education. For both genders, the greatest associations are found in both diagonals of the education by occupation tables indicating: better occupation, more education, and the opposite., Conclusions: The classification of working people according to education and occupation presents association, internal consistency and gradient. In absence of comprehensive information regarding occupation, education could be an alternative as socio-economic indicator.

Objective: To determine the effect of sumatriptan on migraine-related workplace productivity loss., Patients and Methods: In this randomized, double-blind, placebo-controlled, parallel-group trial, adult migraineurs self-injected 6 mg of sumatriptan or matching placebo to treat a moderate or severe migraine within the first 4 hours of a minimum of an 8-hour work shift. Outcome measures included productivity loss and number of patients returning to normal work performance 2 hours after injection and across the work shift, time to return to normal work performance, and time to headache relief., Results: A total of 206 patients underwent screening, 140 (safety population) of whom returned for clinic treatment. Of these 140 patients, 119 received migraine treatment in the workplace (intent-to-treat population), 116 of whom comprised the study population. Of these 116 patients, 76 self-administered sumatriptan, and 40 self-administered placebo. Sumatriptan treatment tended to reduce median productivity loss 2 hours after injection compared with placebo (25.2 vs 29.9 minutes, respectively; P = .14). Significant reductions in productivity loss were obtained across the work shift after sumatriptan treatment compared with placebo (36.8 vs 72.6 minutes, respectively; P = .001). Significantly more sumatriptan-treated patients vs placebo-treated patients experienced shorter return to normal work performance at 2 hours (53/76 [70%] vs 12/40 [30%], respectively) and across the work shift (64/76 [84%] vs 23/40 [58%], respectively; P < .001). Significantly more sumatriptan-treated patients experienced headache relief 1 hour after injection compared with placebo-treated patients (48/76 [63%] vs 13/40 [33%], respectively; P = .004)., Conclusion: Across an 8-hour work shift, sumatriptan was superior to placebo in reducing productivity loss due to migraine.

The health risk of various job groups in Norway was estimated by ranking them according to the annual occupational insurance costs per capita. This was done by dividing the costs of work-related injury and disease from 1991 to 1996 in various job groups by the number of workers in these groups. Occupational groups were also ranked according to total annual costs. The five occupational groups with the highest total costs were metalworkers, woodworkers, nursing-related workers, fisheries workers, and teachers. The groups with the highest annual cost per worker were shoe and leather workers, oil and gas extractors, fisheries workers, miners and quarry workers, and ship's officers. Fisheries workers and ship's officers were ranked among the top 10 positions on both lists and deserve priority in preventive measures.

The correlation between poverty and ill-health is undeniably strong. Ill-health reduces the earning capacity, and increases the risk of families with ill members to drift down the social and economic ladder. In this article, we present a simulation model of how a poor rickshaw puller in Bangladesh copes with illness, in particular tuberculosis (TB). We first analyze the various coping mechanisms that are set in motion when he starts to suffer from tuberculosis; the impact on household assets, income and food intake will be studied. The simulation model is then used to analyse the effects on his household of a specific health intervention, namely the Directly Observer Treatment Short Course (DOTS) treatment. It shows that DOTS offers positive improvements of the overall well-being of the household by restoring the working capacity of the rickshaw puller in one treatment course and minimizing lost income. Assets and food consumption would be preserved significantly more in the presence of DOTS, rendering the household both financially and physically less vulnerable. The probability of death of the sick rickshaw puller is also significantly reduced, improving household's welfare over the long run.

Objective: Following revision of the international standard classification (ISCO88), to update and validate on health data an occupationally derived indicator of socio-economic status (SES) adapted to changing occupational and demographic conditions., Method: The development of the New Zealand Socioeconomic Index (NZSEI) is based on a 'returns to human capital' model of the stratification process and uses data from the 1991 New Zealand Census (n = 1,051, 926) to generate scores for 97 occupational groups. The construct validation of the scale is carried out on data from the 1992-93 nationwide Household Health Survey (n = 3,000) using three health indicators (self-assessed health, cigarette smoking, general practitioner visits)., Results: In general, the results are consistent with expected socio-economic patterns drawn from the literature for the three indicators., Conclusions: While further work is required on a number of methodological and conceptual issues, the NZSEI provides a robust, standardised and internationally comparable occupational scale of SES for both males and females in either full- or part-time employment., Implications: The NZSEI can be used on routinely collected occupational data. It has a clear conceptual rationale, updates existing SES scales, and provides a link to international standards in SES and occupational classification.

In the latter half of the nineteenth century, all emigrants travelling out to the Australian colonies experienced a range of measures designed for their protection. As well as physical protection, the future roles of single emigrant women, as paid domestic labour or, ultimately, as unpaid wives and mothers, required that the care accorded to them also took on social and moral concerns. This paper discusses the shipboard structures, particularly spatial arrangements, that were designed both to protect emigrant women in transit to the colonies and to protect the colonial investment.