The ‘Healthy Smoker’: A Phenomenon of Health Selection?

Respiration ◽  
1990 ◽  
Vol 57 (3) ◽  
pp. 137-144 ◽  
Author(s):  
Margaret R. Becklake ◽  
U. Lalloo
Keyword(s):  
Healthy Smoker ◽  
Health Selection

scholarly journals MIP-T3 Expression Associated with Defects of Ciliogenesis in Airway of COPD Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Wen-Jun Wang ◽  
Shi-Fang Yang ◽  
Zhi-Rui Gao ◽  
Ze-Ru Luo ◽  
Yuan-Ling Liu ◽  
...  
Keyword(s):  
Protein Expression ◽  
Bronchial Epithelium ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Healthy Smoker ◽  
Necrosis Factor Alpha ◽  
Copd Patients ◽  
Structural Abnormalities ◽  
Abnormal Cilia ◽  
Nonsmoker Group

Introduction. Some studies have found that cilia were shorter in COPD smokers than in nonsmokers or healthy smokers. However, the structural abnormalities of cilia and the cause of such abnormalities in COPD patients still remain unknown. Tumor necrosis factor alpha receptor 3 interacting protein 1 (MIP-T3) may play an important role in the progress of ciliary protein transporting. Objectives. This study aimed at exploring the dominated structural abnormalities of cilia and the involvement of MIP-T3 in the pathogenesis of cilia of COPD patients. Methods. Patients who accepted pulmonary lobectomy were divided into 3 groups: the chronic obstructive pulmonary disease (COPD) smoker group, the healthy smoker group, and the nonsmoker group, according to smoking history and pulmonary function. The ultrastructure of cilia and the percentage of abnormal cilia were analyzed using a transmission electron microscope. Real-time PCR, immunohistochemical staining, and western blotting in bronchial epithelium were used to determine MIP-T3 mRNA and protein expression. The relationship between the percentage of abnormal cilia and lung function and MIP-T3 protein expression was analyzed. Results. Patients in the COPD smoker group had increased percentage of abnormal cilia comparing to both the healthy smoker group and the nonsmoker group (both P values <0.05). MIP-T3 expression was significantly declined in the COPD smoker group (P value <0.05). Moreover, the percentage of abnormal cilia was negatively correlated with FEV1, FEV1/FVC ratio, and FEV1%pred (all P values <0.05). Moreover, the MIP-T3 protein expression was positively correlated with the percentage of abnormal cilia (P value <0.05). Conclusions. Our results suggested that the abnormal ciliary ultrastructure, which was common in COPD patients, might be due to MIP-T3 downregulation.

Musical Creativity and Suicide

2001 ◽  
Vol 89 (3) ◽  
pp. 719-727 ◽  
Author(s):  
Antonio Preti ◽  
Francesca De Biasi ◽  
Paola Miotto
Keyword(s):  
Mental Disorders ◽  
Protective Effect ◽  
Visual Artists ◽  
Health Selection ◽  
Artistic Creativity ◽  
Suicide Rates ◽  
Musical Creativity

The different abilities involved in artistic creativity may be mirrored by differences among mental disorders prevalent in each artistic profession, taking poets, painters, and composers as examples. Using suicide rates as a proxy for the prevalence of mental disorders in groups of artists, we investigated the percentage of deaths by suicide in a sample of 4,564 eminent artists who died in the 19th and 20th centuries. Of the sample, 2,259 were primarily involved in activities of a linguistic nature, e.g., poets and writers; 834 were primarily visual artists, such as painters and sculptors; and 1,471 were musicians (composers and instrumentalists). There were 63 suicides in the sample (1.3% of total deaths). Musicians as a group had lower suicide rates than literary and visual artists. Beyond socioeconomic reasons, which might favour interpretations based on effects of health selection, the lower rate of suicides among musicians may reflect some protective effect arising from music.

scholarly journals Dynamics of Health Among Adults in South Africa

2020 ◽  
Author(s):  
Usengimana Shadrack Mutembereza
Keyword(s):  
South Africa ◽  
Social Determinants Of Health ◽  
Health Inequality ◽  
Social Determinants ◽  
National Income ◽  
Determinants Of Health ◽  
Health Campaigns ◽  
Health Selection ◽  
Policy Makers ◽  
The Poor

Abstract BackgroundThis paper estimates trend of health mobility in South Africa using National Income Dynamic Study (NIDS) and investigate whether the patterns of health mobility differs within socioeconomic groups created by income and gender. Health is measured by SRHS, which correlates with mortality and morbidity; thus, it is the best measure of health. MethodsUsing five waves of NIDS and various econometric models, this research estimates health mobility in the period between 2007 and 2017. This study will use transition matrix as descriptive analysis of health mobility and Conditional Maximum Likelihood Estimations to analyse health mobility, trend of health mobility and relationship between health mobility and health inequality within NIDS. ResultsThe study shows that, among poor males, health mobility neither follows a health selection or health constraint mobility trend; the high health mobility with ambiguous trends has not decreased health inequality. Among the poor females, a negative health mobility trend is observed; this research also found that health inequality has not creased. Among the non-poor males, it is found that health mobility follows a gradient constraint trend which has decreased health inequality. Among non-poor females, it is found that health mobility follows a health selection trend which has not decreased health inequality. The results suggest that policy makers should target both social determinants of health and health campaigns to deal with health inequality among the poor males. ConclusionsThe trend of health mobility among poor females suggest that policy makers should target the social determinants of health to combat health inequality. The trend of health mobility among the non-poor males suggests that health mobility will eliminate health inequality. Lastly, the trend of health mobility suggests that policymakers should target health campaigns to deal with health inequality.

scholarly journals Health and educational aspirations in adolescence: a longitudinal study in Finland

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Henrik Dobewall ◽  
Pirjo Lindfors ◽  
Sakari Karvonen ◽  
Leena Koivusilta ◽  
Mari-Pauliina Vainikainen ◽  
...  
Keyword(s):  
Academic Achievement ◽  
Educational Aspirations ◽  
Multinomial Logistic Regression ◽  
Poor Health ◽  
Health Complaints ◽  
Health Selection ◽  
Selection Hypothesis ◽  
Self Rated Health ◽  
Health Factors

Abstract Background The health selection hypothesis suggests that poor health leads to low educational attainment during the life course. Adolescence is an important period as poor health might prevent students from making the best educational choices. We test if health in adolescence is associated with educational aspirations and whether these associations persist over and above sociodemographic background and academic achievement. Methods Using classroom surveys, a cohort of students (n = 5.614) from the Helsinki Metropolitan Region was followed from the 7th (12–13 years,) up to the 9th grade (15–16 years) when the choice between the academic and the vocational track is made in Finland. Health factors (Strengths and Difficulties Questionnaire (SDQ), self-rated health, daily health complaints, and long-term illness and medicine prescribed) and sociodemographic background were self-reported by the students. Students’ educational aspirations (applying for academic versus vocational track, or both) and their academic achievement were obtained from the Joint Application Registry held by the Finnish National Agency for Education. We conducted multilevel multinomial logistic regression analyses, taking into account that students are clustered within schools. Results All studied health factors were associated with adolescents’ educational aspirations. For the SDQ, daily health complaints, and self-rated health these associations persisted over and above sociodemographic background and academic achievement. Students with better health in adolescence were more likely to apply for the academic track, and those who were less healthy were more likely to apply for the vocational track. The health in the group of those students who had applied for both educational tracks was in between. Inconsistent results were observed for long-term illness. We also found robust associations between educational aspirations and worsening health from grade 7 to grade 9. Conclusions Our findings show that selection by health factors to different educational trajectories takes place at early teenage much before adolescents choose their educational track, thus supporting the health selection hypothesis in the creation of socioeconomic health inequalities. Our findings also show the importance of adolescence in this process. More studies are needed to reveal which measures would be effective in helping students with poor health to achieve their full educational potential.

scholarly journals Sick leave absence and the relationship between intra-generational social mobility and mortality: health selection in Sweden

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sunnee Billingsley
Keyword(s):  
Sickness Absence ◽  
Social Mobility ◽  
Event History Analysis ◽  
Upward Mobility ◽  
Poor Health ◽  
Downward Mobility ◽  
Health Selection ◽  
Average Marginal Effects ◽  
The Relationship ◽  
Related Mortality

Abstract Background Poor health could influence how individuals are sorted into occupational classes. Health selection has therefore been considered a potential modifier to the mortality class gradient through differences in social mobility. Direct health selection in particular may operate in the short-term as poor health may lead to reduced work hours or achievement, downward social mobility, unemployment or restricted upward mobility, and death. In this study, the relationship between social mobility and mortality (all-cause, cancer-related, cardiovascular disease-related (CVD), and suicide) is explored when the relationship is adjusted for poor health. Methods Using Swedish register data (1996–2012) and discrete time event-history analysis, odds ratios and average marginal effects (AME) of social mobility and unemployment on mortality are observed before and after accounting for sickness absence in the previous year. Results After adjusting for sickness absence, all-cause mortality remained lower for men after upward mobility in comparison to not being mobile (OR 0.82, AME -0.0003, CI − 0.0003 to − 0.0002). Similarly, upward mobility continued to be associated with lower cancer-related mortality for men (OR 0.85, AME -0.00008, CI − 0.00002 to − 0.0002), CVD-related mortality for men (OR 0.76, AME -0.0001, CI − 0.00006 to − 0.0002) and suicide for women (OR 0.67, AME -0.00002, CI − 0.000002 to − 0.00003). The relationship between unemployment and mortality also persisted across most causes of death for both men and women after controlling for previous sickness absence. In contrast, adjusting for sickness absence renders the relationship between downward mobility and cancer-related mortality not statistically different from the non-mobile. Conclusions Health selection plays a role in how downward mobility is linked to cancer related deaths. It additionally accounts for a portion of why upward mobility is associated with lower mortality. That health selection plays a role in how social mobility and mortality are related may be unexpected in a context with strong job protection. Job protection does not, however, equalize opportunities for upward mobility, which may be limited for those who have been ill. Because intra-generational upward mobility and mortality remained related after adjusting for sickness absence, other important mechanisms such as indirect selection or social causation should be explored.

scholarly journals Distribution of sickness absence risk across different levels and patterns of drinking: findings from the Stockholm Public Health Cohort

2020 ◽  
pp. 145507252097230
Author(s):  
Jonas Landberg ◽  
Mats Ramstedt
Keyword(s):  
Public Health ◽  
Alcohol Use ◽  
Sickness Absence ◽  
Selection Bias ◽  
Risk Function ◽  
Heavy Episodic Drinking ◽  
Confounding Factors ◽  
Health Selection ◽  
Moderate Drinking

Aim: This study estimated (i) the risk function between different indicators of alcohol use and long-term sickness absence, adjusting for possible confounding factors, (ii) whether the risk function between average volume of consumption and sickness absence is modified by heavy episodic drinking (HED), and (iii) to what extent the risk for sickness absence among abstainers is due to health selection bias. Data and methods: The study was based on data from the Stockholm Public Health Cohort 2006, with an analytical sample of 16,477 respondents aged 18–64 years. The outcome included register-based long-term (> 14 days) sickness absence. Negative binominal regression was used to estimate the association between sickness absence and average weekly volume of consumption, frequency of HED, and both in interaction. Results: Abstainers, chronic heavy drinkers and respondents with the highest frequency of HED had approximately two-fold higher rates of sickness absence relative to the reference groups, i.e., moderate drinkers and those with HED one to 6 times per year. Adjustment for confounding factors did not materially affect the shape of the risk function. After exclusion of abstainers with alcohol-related problems, or poor health, the estimates for abstainers became non-significant. Moderate drinkers with HED did not have significantly higher rates of sickness absence than moderate drinkers without HED. Conclusions: Our results suggest a significant association between alcohol use and sickness absence. There were indications that the U-shaped risk function may largely be due to health selection bias among abstainers. We found no indication of effect modification of HED on moderate drinking.

scholarly journals Do patients who die from an alcohol-related condition ‘drift’ into areas of greater deprivation? Alcohol-related mortality and health selection theory in Scotland

2017 ◽  
Vol 72 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Andrew Pulford ◽  
Ruth Gordon ◽  
Lesley Graham ◽  
James Lewsey ◽  
Gerry McCartney ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Area Deprivation ◽  
Downward Mobility ◽  
Health Selection ◽  
Related Condition ◽  
Logistic Regression Models ◽  
Initial Area ◽  
The Difference ◽  
Index Of Multiple Deprivation ◽  
Related Mortality

BackgroundHealth selection has been proposed to explain the patterning of alcohol-related mortality by area deprivation. This study investigated whether persons who die from alcohol-related conditions are more likely to experience social drift than those who die from other causes.MethodsDeaths recorded in Scotland (2013, >21 years) were coded as ‘alcohol-related’ or ‘other’ and by deprivation decile of residence at death. Acute hospital admissions data from 1996 to 2012 were used to provide premortality deprivation data. χ² tests estimated the difference between observed and expected alcohol-related deaths by first Scottish Index of Multiple Deprivation (SIMD) decile and type of death. Logistic regression models were fitted using type of death as the outcome of interest and change in SIMD decile as the exposure of interest.ResultsOf 47 012 deaths, 1458 were alcohol-related. Upward and downward mobility was observed for both types of death. An estimated 31 more deaths than expected were classified ‘alcohol-related’ among cases whose deprivation score decreased, while 204 more deaths than expected were classified ‘alcohol-related’ among cases whose initial deprivation ranking was in the four most deprived deciles. Becoming more deprived and first deprivation category were both associated with increased odds of type of death being alcohol-related after adjusting for confounders.ConclusionThis study suggests that health selection appears to contribute less to the deprivation gradient in alcohol-related mortality in Scotland than an individual’s initial area deprivation category.

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