[The social and health variables associated with the self-perception of the health status of the adult population of Gran Canaria (Canary Islands)]. / Variables sociales y sanitarias asociadas a la autopercepción del estado de salud en la población adulta de Gran Canaria (Islas Canarias).

AIM: To find out how the adult population in one municipality of the Canary Islands perceives its state of health, and how this is related to social and health variables. DESIGN: Descriptive cross-sectional study. PLACE: Telde (Gran Canaria). SUBJECTS: The municipality has a population census of 79,000 inhabitants. The sample was multistepped and selected randomly. It included 2626 people with a population variance of p = q = 50%, standard error +/- 4% with a confidence interval of 95.5%. Participation rate was of 82.5%. MEASUREMENT AND RESULTS: Data on aspects of socio-demography, morbidity, medication, use of public health facilities and lifestyles were collected via personal questionnaire. The relationship between different variables and people's perception of their health was calculated by odds ratio using logistic regression. Almost 50% of the sample perceived their state of health to be excellent or good. Subjects over the age of 45 (OR, 2.89), or who were unemployed, perceived themselves to be in a worse state of health (OR, 1.34). Contrastingly, those who had received higher education (OR, 0.39), or who, in the previous 15 days, had not been confined to bed (OR, 0.22), had not been on sick leave (OR, 0.23) or had not visited the doctor (OR, 0.38) had a better perception of their health. CONCLUSION: People's perception of their health is related to their quality of life and self-esteem and continues to be a useful indicator in the evaluation of their general state of health, reflecting aspects of both social level and health.

Mortality trends and past and current dietary factors of breast cancer in Spain.

Spain had one of the lowest breast cancer mortality (BCM) rates in Europe a decade ago but this is no longer the case. A study of the trends of breast cancer mortality in Spain during the last 30 years, and an analysis, at the ecological level, of the current and past dietary patterns associated with breast cancer mortality have been conducted. Age standardized rates and standardized mortality rates (SMR) for this period were calculated. Dietary information about 20 different groups of foods for the 50 Spanish provinces was obtained from two National Household Budget and Expenditure Surveys, conducted in 1964-1965 and 1980-1981. Simple correlation coefficients were calculated, and multiple regression (dependent variables: BCM and breast cancer SMR) with a stepwise procedure was performed. Trends of breast cancer mortality in Spain for the last 35 years indicated a 100% increase in the 35-64 years group. Results indicate important changes in food consumption patterns in Spain, departure from the traditional Spanish diet, and the association of breast cancer mortality with past (15 years period) consumption of beef and total meat and the current consumption of vegetable oils, among other features of interest. Past consumption of meat and particularly beef meat seems to be associated with current breast cancer mortality rates in Spain. However, results at ecological level need to be confirmed in individuals.

Changes in diet and mortality from selected cancers in southern Mediterranean countries, 1960-1989.

Mortality trends of breast, colorectal, ovarian and prostate cancer in Spain, Italy, Greece, Yugoslavia, and England and Wales are presented. Figures are discussed with regard to patterns of consumption of fat-containing foods in these countries. An increase of all cancer site mortality is shown in southern European countries, whereas in England and Wales a decrease in ovarian and colorectal cancer among women is observed. Consumption of milk, meat and animal fat products increased in all Mediterranean countries but decreased in England and Wales. Some differences regarding cancer mortality and food consumption patterns among southern European countries are pointed out. This markedly divergent fat consumption pattern between northern and southern Europe appears to antedate and be associated with their substantial differences in ovarian and colorectal cancer mortality trends, and to a lesser extent with breast cancer.

Communication of results of necropsies in north east Thames region.

OBJECTIVE: To evaluate the adequacy of reporting of results of necropsy to referring clinicians and to general practitioners. DESIGN: Questionnaire survey of referring clinicians and general practitioners of deceased patients in four districts in North East Thames region. Patients were selected by retrospective systematic sampling of 50 or more necropsy reports in each district. SETTING: One teaching hospital, one inner London district general hospital, and two outer London district general hospitals. PARTICIPANTS: 70 consultants and 146 general practitioners who were asked about 214 necropsy reports; coroners' reports were excluded. MAIN OUTCOME MEASURES: Time taken for dispatch of final reports after necropsy, consultants' recognition of the reports, general practitioners' recognition of the reports or of their findings, and consultants' recall of having discussed the findings with relatives. RESULTS: Only two hospitals dispatched final reports including histological findings (mean time to dispatch 144 days and 22 days respectively). 42 (60%) consultants and 83 (57%) general practitioners responded to the survey. The percentage of reports seen by consultants varied from 37% (n = 13) to 87% (n = 36); in all, only 47% (39/83) of general practitioners had been informed of the findings by any method. Consultants could recall having discussed findings with only 42% (47/112) of relatives. CONCLUSIONS: Communication of results of necropsies to hospital clinicians, general practitioners, and relatives is currently inadequate in these hospitals. IMPLICATIONS AND ACTION: A report of the macroscopic findings should be dispatched immediately after necropsy to clinicians and general practitioners; relatives should routinely be invited to discuss the necroscopic findings. One department has already altered its practice.