Gender differences in accessing cardiac surgery across England: a cross-sectional analysis of the health survey for England.
Journal - Social science & medicine (1982) (ENGLAND )
OBJECTIVE: To examine gender differences in access to cardiac surgery in a nationally representative sample. DESIGN: Nationwide cross sectional household based survey (Health Survey for England). SETTING: Private households in England around 1993 and 1994. SUBJECTS: 1708 subjects reporting a history of either doctor diagnosed angina or heart attack from a stratified random sample of 32 378 people aged 16 and above. OUTCOME MEASURE: The proportion reporting having had cardiac surgery or on a waiting list. RESULTS: 13.5% reported previous (n = 206) or pending (n = 25) cardiac surgery. Men were more likely than women to have had or to be waiting for cardiac surgery (19.1% of men versus 6.8% of women, chi2 54.7, P<0.001). This finding was consistent regardless of age group and across three regional areas. The unadjusted odds ratio for cardiac surgery for men versus women was 3.3 (95% Cl 2.3, 4.5, P<0.001) and was only slightly attenuated to 2.8 (95% CI 1.9, 4.0. P<0.001), after adjustment for other factors. The gender difference remained even when analysis was restricted to subjects reporting a previous heart attack, and after statistical adjustment for disease severity. CONCLUSION: Women are less likely than men to receive cardiac surgery across all age groups and regional areas. These results include private operations and adjust for individual behavioural data. Neither disease severity or co-morbidity explains these discrepancies. Further studies are required to determine why this inequality occurs and how it can be addressed.
|ISSN : ||0277-9536|
|Mesh Heading : ||Adolescent Adult Cardiac Surgical Procedures England Female Humans Male Sex Factors|
|Mesh Heading Relevant : ||Health Care Surveys Health Services Accessibility utilization|
Blood pressure in women using oral contraceptives: results from the Health Survey for England 1994.
Journal - Journal of hypertension (ENGLAND )
OBJECTIVE: To assess whether the blood pressure is higher among women who take oral contraceptives than it is among those who do not. DESIGN: A cross-sectional survey of a stratified random sample of English adults (aged > or = 16 years). SETTING: Non-institutionalized households in England during 1994. PARTICIPANTS: From this sociodemographically representative sample of English adults, 3545 premenopausal women, of whom 892 were current users of oral contraceptives, were evaluated. INTERVENTIONS: An interviewer-administered questionnaire determined details of menopausal status, use of oral contraceptives and antihypertensive agents and other sociodemographic variables. Measurements of the weight, height and blood pressure (the mean of the last two of three readings taken with a Dinamap 8100 device) were recorded. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressures adjusted for potential confounders by oral-contraceptive-user status. RESULTS: Mean blood pressures adjusted for age were significantly higher among oral contraceptive users (125/70 mmHg) than they were among non-users (123/68 mmHg, P < 0.001 both for systolic and for diastolic blood pressures). These results remained unchanged after further adjustment for the body mass index, alcohol intake, physical activity and hypertension treatment. Blood pressure differences tended to be larger among older oral contraceptive users. Oral contraceptives containing progestogen only were not associated with higher blood pressures. CONCLUSIONS: Despite the fact that most combined oral contraceptives in current use in England contain low doses of oestrogen, slightly but significantly higher blood pressures were observed among oral contraceptive users. Blood pressures should be screened before oral contraceptives are supplied and should be monitored regularly during oral contraceptive use.
|ISSN : ||0263-6352|
|Keywords : ||Biology Blood Pressure Contraception Contraceptive Methods--side effects Developed Countries Diseases England Europe Evaluation Family Planning Hemic System Hypertension Northern Europe Oral Contraceptives, Combined--side effects Oral Contraceptives--side effects Physiology Research Report Risk Assessment Risk Factors United Kingdom Vascular Diseases|
|Mesh Heading : ||Adolescent Adult Blood Pressure Contraceptives, Oral Cross-Sectional Studies England Female Humans Hypertension Middle Aged Questionnaires Random Allocation Regression Analysis Retrospective Studies physiology epidemiology epidemiology physiopathology|
|Mesh Heading Relevant : ||Health Surveys drug effects pharmacology|
Mortality study of construction workers in the UK.
Journal - International journal of epidemiology (ENGLAND )
BACKGROUND. Construction is one of the most dangerous industries in the world. However, there has been little literature on occupational epidemiology in this field. A study of the mortality experience over a 13-year period among construction workers in the UK was carried out. METHOD. This was based on 15,007 death certificates of members of the Building and Civil Engineering Holiday and Benefit Scheme, who had died during 1975 to 1987 aged 20-64 years. Proportional mortality ratio (PMR) and mortality odds ratio techniques were used. RESULTS. Significantly elevated PMR were found for deaths from all cancers, including cancer of the lung and stomach, and for accidental deaths. Associations were demonstrated between several job categories and an increased risk of cancer mortality. Occupational exposures to hazardous substances may have contributed to the elevated cancer mortality, although the study findings should be interpreted with caution. Inadequate supervision of safety procedures, together with a high proportion of young and inexperienced workers, may be associated with the high number of accidental deaths. CONCLUSIONS. The results support the hypothesis that working in the construction industry is associated with a high risk for accidental death and probably also for malignant diseases including lung, mesothelium and stomach cancers. Further epidemiological studies among construction workers are needed to support policies aimed at improving occupational health, including the prevention of accidents.
|ISSN : ||0300-5771|
|Mesh Heading : ||Accidents, Occupational Adult Death Certificates Great Britain Humans Male Middle Aged Mortality Neoplasms Occupational Diseases Occupational Exposure Odds Ratio Software epidemiology trends etiology etiology adverse effects|
|Mesh Heading Relevant : ||Facility Design and Construction mortality mortality mortality|