75,621 research outputs found

    Health Inequality

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    There are many reasons why poverty matters, but it is especially troubling that it affects such fundamental outcomes as health and access to health care. If poverty did not bring about all manner of health risks, we would likely be somewhat less troubled by it. But of course poverty and other forms of social and economic disadvantage do often translate into deficits in health and health care. The purpose of this brief is to examine long-term trends in American health and to lay out the current state of evidence on the extent to which health and health care are unequally distributed. We also note how the recent economic downturn affected these trends and disparities. The key backdrop to this assessment is the tripling of U.S. health expenditures since the 1960s. In 2012, per capita expenditures on health were $8,915, more than double those from 1995, though growth has slowed in the past 4 years.1 Some of this rise is attributable to population aging. Costs associated with Medicare, a program established in 1965 to subsidize health care for those aged 65 and older, have grown as the elderly population constitutes an ever-larger portion of the U.S. population. Still, overall U.S. health expenditures have increased faster than the growth of the elderly population and faster than health expenditures in other OECD countries.2 It is possible that such rising costs have led to a more unequal distribution of health and health care. At the same time, health inequalities may also be affected by the economy (e.g., recessions), changes in how insurance is provided, and any number of other factors. In this brief, our objective is not to attempt to tease out the causes of any possible changes in health inequalities, but rather to provide a descriptive summary of the current evidence on trends in (a) health, (b) foregone health care and insurance coverage, and (c) health risk factors. To preview our results, we find first that some health indicators, such as life expectancy, show an overall improvement. But not all indicators are improving. For example, an increasing number of Americans report delaying or foregoing health care, particularly during the recent economic recession. Second, economic and racial disparities in health indicators are often substantial, and when changes in these disparities are observed, they usually take the form of an increase in absolute size. Third, a large proportion of Americans still remain uninsured in 2012 (i.e., 15 percent), although the proportion of children who are uninsured declined by nearly 2 percentage points between the late 1990s and 2012

    State of the Statesā€™ Health

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    Inequalities in access to health and health care are especially important forms of inequality because they speak to who lives long and who lives well. It is well known that, even though the United States spends more on health care per capita than any other country, it has some of the worst access and outcome results among wealthy nations.1 While important, such cross-country comparisons hide substantial health inequality within the United States. Even a cursory inspection of the data suggests that some states are indeed better performers on key health measures. For example, only one in ten adults in Utah smoke, whereas more than one in four do so in West Virginia. The purpose of this brief is to examine whether state differences of this magnitude are commonly found across various other health measures. We focus not just on average levels of health access, behaviors, and outcomes, but also on how unequally they are distributed. Although everyone would presumably prefer a state with high average health scores, it also matters whether the health disparities between the poor and relatively well-off are very large. If a state has a high mean level of health but also subjects its poor residents to a large ā€œhealth penalty,ā€ then anyone who is at risk of being poor would presumably want to avoid that state (at least insofar as the penalty is large enough to render them worse off than their counterparts in other states). Therefore, we examine two important features of a stateā€™s health profile: the average level of health, behavioral, or access problems in the state; and the variation in the distribution of these outcomes by income

    Resilienceā€“Recovery Factors in Post-traumatic Stress Disorder Among Female and Male Vietnam Veterans: Hardiness, Postwar Social Support, and Additional Stressful Life Events

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    Structural equation modeling procedures were used to examine relationships among several war zone stressor dimensions, resilience-recovery factors, and post-traumatic stress disorder symptoms in a national sample of 1,632 Vietnam veterans (26% women and 74% men). A 9-factor measurement model was specified on a mixed-gender subsample of the data and then replicated on separate subsamples of female and male veterans. For both genders, the structural models supported strong mediation effects for the intrapersonal resource characteristic of hardiness, postwar structural and functional social support, and additional negative life events in the postwar period. Support for moderator effects or buffering in terms of interactions between war zone stressor level and resiliencerecovery factors was minimal

    Blunting the Spike: the CV Minimum Period

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    The standard picture of CV secular evolution predicts a spike in the CV distribution near the observed short-period cutoff P_0 ~ 78 min, which is not observed. We show that an intrinsic spread in minimum (`bounce') periods P_b resulting from a genuine difference in some parameter controlling the evolution can remove the spike without smearing the sharpness of the cutoff. The most probable second parameter is different admixtures of magnetic stellar wind braking (at up to 5 times the GR rate) in a small tail of systems, perhaps implying that the donor magnetic field strength at formation is a second parameter specifying CV evolution. We suggest that magnetic braking resumes below the gap with a wide range, being well below the GR rate in most CVs, but significantly above it in a small tail.Comment: 5 pages, 4 figures; accepted for publication in MNRA

    The relationship of dementia prevalence in older adults with intellectual disability (ID) to age and severity of ID

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    Background: Previous research has shown that adults with intellectual disability (ID) may be more at risk of developing dementia in old age than expected. However, the effect of age and ID severity on dementia prevalence rates has never been reported. We investigated the predictions that older adults with ID should have high prevalence rates of dementia that differ between ID severity groups and that the age-associated risk should be shifted to a younger age relative to the general population. Method: A two-staged epidemiological survey of 281 adults with ID without Down syndrome (DS) aged >60 years; participants who screened positive with a memory task, informant-reported change in function or with the Dementia Questionnaire for Persons with Mental Retardation (DMR) underwent a detailed assessment. Diagnoses were made by psychiatrists according to international criteria. Prevalence rates were compared with UK prevalence and European consensus rates using standardized morbidity ratios (SMRs). Results: Dementia was more common in this population (prevalence of 18.3%, SMR 2.77 in those aged >65 years). Prevalence rates did not differ between mild, moderate and severe ID groups. Age was a strong risk factor and was not influenced by sex or ID severity. As predicted, SMRs were higher for younger age groups compared to older age groups, indicating a relative shift in age-associated risk. Conclusions: Criteria-defined dementia is 2ā€“3 times more common in the ID population, with a shift in risk to younger age groups compared to the general population

    Multi-axis manual controllers: A state-of-the-art report

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    A literature search was carried out to examine the feasibility of a six degree of freedom hand controller. Factors addressed included related areas, approaches to manual control, applications of manual controllers, and selected studies of the human neuromuscular system. Results are presented

    Design and development of a six degree of freedom hand controller

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    The design objectives of a six degree of freedom manual controller are discussed with emphasis on a space environment. Details covered include problems associated with a zero-g environment, the need to accommodate both 'shirt sleeve' and space suited astronauts, the combination of both manipulator operation and spacecraft flight control in a single device, and to accommodate restraints in space. A variable configuration device designed as a development tool in which rotational axes can be moved relative to one another, is described and its limitations discussed. Two additional devices were developed for concept testing. Each device combines the need for good quality with its ability achieve a wide range of adjustments
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