How strongly related are health status and subjectivewell-being? : Systematic Review and Meta-Analysis

Background: Health status is widely considered to be closely associated with subjective well-being (SWB), yet this assumption has not been tested rigorously. The aims of this first systematic review and meta-analysis are to examine the association between health status and SWB and to test whether any association is affected by key operational and methodological factors.Methods: A systematic search (January-1980 to April 2017) using Web of Science, Medline, Embase, PsycInfo and Global health was conducted according to Cochrane and PRISMA guidelines. Meta-analyses using a random-effects model were performed. Results: 29 studies were included and the pooled effect size of the association between health status and SWB was medium, statistically significant and positive (pooled r = 0.347, 95% CI = 0.309 to 0.385; Q = 691.51, I2 = 94.99 %, p &lt; 0.001). However, the association was significantly stronger: (1) when SWB was operationalized as life satisfaction (r = 0.365) as opposed to happiness (r = 0.307); (2) among studies conducted in developing countries (r = 0.423) than it was in developed countries (r = 0.336); and (3) when multiple items were used to assess health status and SWB (r = 0.353) as opposed to single items (r = 0.326).Conclusion: Improving people’s health status may be one means by which governments can improve the SWB of their citizens. Life satisfaction might be preferred to happiness as a measure of SWB because it better captures the influence of health status. <br/

Predictors of low cervical cancer screening among immigrant women in Ontario, Canada

<p>Abstract</p> <p>Background</p> <p>Disparities in cervical cancer screening are known to exist in Ontario, Canada for foreign-born women. The relative importance of various barriers to screening may vary across ethnic groups. This study aimed to determine how predictors of low cervical cancer screening, reflective of sociodemographics, the health care system, and migration, varied by region of origin for Ontario's immigrant women.</p> <p>Methods</p> <p>Using a validated billing code algorithm, we determined the proportion of women who were not screened during the three-year period of 2006-2008 among 455 864 identified immigrant women living in Ontario's urban centres. We created eight identical multivariate Poisson models, stratified by eight regions of origin for immigrant women. In these models, we adjusted for various sociodemographic, health care-related and migration-related variables. We then used the resulting adjusted relative risks to calculate population-attributable fractions for each variable by region of origin.</p> <p>Results</p> <p>Region of origin was not a significant source of effect modification for lack of recent cervical cancer screening. Certain variables were significantly associated with lack of screening across all or nearly all world regions. These consisted of not being in the 35-49 year age group, residence in the lowest-income neighbourhoods, not being in a primary care patient enrolment model, a provider from the same region, and not having a female provider. For all women, the highest population-attributable risk was seen for not having a female provider, with values ranging from 16.8% [95% CI 14.6-19.1%] among women from the Middle East and North Africa to 27.4% [95% CI 26.2-28.6%] for women from East Asia and the Pacific.</p> <p>Conclusions</p> <p>To increase screening rates across immigrant groups, efforts should be made to ensure that women have access to a regular source of primary care, and ideally access to a female health professional. Efforts should also be made to increase the enrolment of immigrant women in new primary care patient enrolment models.</p