Self-reported health status and access to health services in a sample of prisoners in Italy

<p>Abstract</p> <p>Background</p> <p>Self-reported health status in underserved population of prisoners has not been extensively explored. The purposes of this cross-sectional study were to assess self-reported health, quality of life, and access to health services in a sample of male prisoners of Italy.</p> <p>Methods</p> <p>A total of 908 prisoners received a self-administered anonymous questionnaire pertaining on demographic and detention characteristics, self-reported health status and quality of life, access to health services, lifestyles, and participation to preventive, social, and rehabilitation programs. A total of 650 prisoners agreed to participate in the study and returned the questionnaire.</p> <p>Results</p> <p>Respectively, 31.6% and 43.5% of prisoners reported a poor perceived health status and a poor quality of life, and 60% admitted that their health was worsened or greatly worsened during the prison stay. Older age, lower education, psychiatric disorders, self-reported health problems on prison entry, and suicide attempts within prison were significantly associated with a perceived worse health status. At the time of the questionnaire delivery, 30% of the prisoners self-reported a health problem present on prison entry and 82% present at the time of the survey. Most frequently reported health problems included dental health problems, arthritis or joint pain, eye problems, gastrointestinal diseases, emotional problems, and high blood pressure. On average, prisoners encountered general practitioners six times during the previous year, and the frequency of medical encounters was significantly associated with older age, sentenced prisoners, psychiatric disorders, and self-reported health problems on prison entry.</p> <p>Conclusions</p> <p>The findings suggest that prisoners have a perceived poor health status, specific care needs and health promotion programs are seldom offered. Programs for correction of risk behaviour and prevention of long-term effects of incarceration on prisoners' health are strongly needed.</p

Alcohol Consumption Among Older Adults in Primary Care

BACKGROUND: Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients. OBJECTIVES: To determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients. DESIGN: Cross-sectional analysis of multisite screening data from 6 VA Medical Centers, 2 hospital-based health care networks, and 3 Community Health Centers. PARTICIPANTS: Patients, 43,606, aged 65 to 103 years, with scheduled primary care appointments were approached for screening; 27,714 (63.6%) consented to be screened. The final sample of persons with completed screens comprised 24,863 patients. MEASUREMENTS: Quantity and frequency of alcohol use, demographics, social support measures, and measures of depression/anxiety. RESULTS: Of the 24,863 older adults screened, 70.0% reported no consumption of alcohol in the past year, 21.5% were moderate drinkers (1–7 drinks/week), 4.1% were at-risk drinkers (8–14 drinks/week), and 4.5% were heavy (>14 drinks/week) or binge drinkers. Heavy drinking showed significant positive association with depressive/anxiety symptoms [Odds ratio (OR) (95% CI): 1.79 (1.30, 2.45)] and less social support [OR (95% CI): 2.01 (1.14, 2.56)]. Heavy drinking combined with binging was similarly positively associated with depressive/anxiety symptoms [OR (95%): 1.70 (1.33, 2.17)] and perceived poor health [OR (95% CI): 1.27 (1.03, 1.57)], while at-risk drinking was not associated with any of these variables. CONCLUSIONS: The majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/anxiety symptoms and perceived poor health

Demographic and health characteristics of elderly smokers: results from established populations for epidemiologic studies of the elderly.

Although smoking has been shown to be associated with excess morbidity and mortality, most studies have focused on young and middle-aged rather than elderly smokers. We examined the demographic characteristics and physical and psychological health of elderly cigarette smokers in four population-based studies (N = 3,673, 3,811, 2,811, and 4,165) of persons 65 years of age and older. Although there was substantial geographic variation in the percentages of smokers, the demographic and health characteristics of smokers were similar across the sites. Most women had never smoked, but most men were former or current smokers. The percentage of never smokers was highest in the "oldest old." Among the elderly ever smokers, men were more likely to have quit than women, and the relative percentage of former smokers increased with age. Current smokers were generally more likely to consume alcohol than never smokers. In this age group, cigarette smoking was typically associated with higher rates of physical disease and symptoms, poorer self-perceived health status, and higher levels of depressive symptoms. Based on these four large geographically diverse population surveys, cigarette smoking remains an important health burden and public health challenge among the elderly

Demographic and health characteristics of elderly smokers: results from established populations for epidemiologic studies of the elderly.

Although smoking has been shown to be associated with excess morbidity and mortality, most studies have focused on young and middle-aged rather than elderly smokers. We examined the demographic characteristics and physical and psychological health of elderly cigarette smokers in four population-based studies (N = 3,673, 3,811, 2,811, and 4,165) of persons 65 years of age and older. Although there was substantial geographic variation in the percentages of smokers, the demographic and health characteristics of smokers were similar across the sites. Most women had never smoked, but most men were former or current smokers. The percentage of never smokers was highest in the "oldest old." Among the elderly ever smokers, men were more likely to have quit than women, and the relative percentage of former smokers increased with age. Current smokers were generally more likely to consume alcohol than never smokers. In this age group, cigarette smoking was typically associated with higher rates of physical disease and symptoms, poorer self-perceived health status, and higher levels of depressive symptoms. Based on these four large geographically diverse population surveys, cigarette smoking remains an important health burden and public health challenge among the elderly