Childhood social circumstances and psychosocial and behavioural factors as determinants of plasma fibrinogen.

Background: High plasma fibrinogen concentration is associated with an increased risk of coronary heart disease. We have investigated associations between plasma fibrinogen and factors operating in childhood and in adulthood, including the psychosocial characteristics.

Methods: In a cross-sectional study of Civil Servants in London, UK, 2095 men and 1202 women aged 45-55 years provided blood samples for fibrinogen measurement at the time of the Whitehall II study baseline.

Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study.

Objectives: This study sought to examine the association between the psychosocial work environment and subsequent rates of sickness absence.

Methods: The analyses were based on a cohort of male and female British civil servants (n=9072). Rates of short spells (7 days) of sickness absence were calculated for different aspects of the psychosocial work environment, as measured by self-reports and personnel managers' ratings (external assessments).

East-West mortality divide and its potential explanations: proposed research agenda.

There is a sharp divide in mortality between eastern and western Europe, which has largely developed over the past three decades and is caused mainly by chronic diseases in adulthood. The difference in life expectancy at birth between the best and worst European countries in this respect is more than 10 years for both sexes. The reasons for these differences in mortality are not clear and data currently available permit only speculation.

Psychological factors in the relationship between alcohol and cardiovascular morbidity.

Most major studies have found a U-shaped relationship between the level of alcohol consumption and all cause mortality, largely as a consequence of lower death rates from coronary heart disease (CHD) amongst moderate drinkers. Previous attempts to unravel the significance of this observation have focused on controlling for possible confounders, such as smoking, social class and the existence of previous ill-health in the group of abstainers. Our analysis of data from the Whitehall II study of British Civil Servants sought to determine whether psychological factors (GHQ, Hostility, Affect Balance, Social Supports) may be influencing the observed relationships between levels of alcohol consumption and some of the established risk factors for CHD.

Health effects of anticipation of job change and non-employment: longitudinal data from the Whitehall II study.

Objective: To assess the effect of anticipating job change or non-employment on self reported health status in a group of middle aged male and female white collar civil servants.

Design: Longitudinal cohort study (Whitehall II study). Questionnaire data on self reported health status and health behaviour were obtained at initial screening and four years later, during the period when employees of the department facing privatisation were anticipating job change or job loss.

Cancer mortality in Indian and British ethnic immigrants from the Indian subcontinent to England and Wales.

Risk of cancer mortality from 1973 to 1985 in persons born in the Indian subcontinent who migrated to England and Wales was analysed by ethnicity, and compared with cancer mortality in the England and Wales native population, using data from England and Wales death certificates. There were substantial highly significant raised risks in Indian ethnic migrants for cancers of the mouth and pharynx, gall bladder, and liver in each sex, larynx and thyroid in males, and oesophagus in females. There were also substantial raised risks in these migrants of each sex for non-Hodgkin's lymphoma and myeloma.

Sickness absence in the Whitehall II study, London: the role of social support and material problems.

Study Objective: To investigate the role of social supports, social networks, and chronic stressors: (i) as predictors of sickness absence; and (ii) as potential explanations for the socioeconomic gradient in sickness absence.

Design: A prospective cohort study (Whitehall II study) with sociodemographic factors, health and social support measured at baseline, and spells of sickness absence measured prospectively.

Setting: Twenty London based non-industrial departments of the British civil service.

Hypertensive retinopathy in Afro-Caribbeans and Europeans. Prevalence and risk factor relationships.

The prevalence of hypertension is particularly high in people of black African descent throughout the world, and the consequences of hypertension, such as hypertensive heart and renal disease and stroke, are also more common. But there is little consensus on whether hypertensive retinopathy follows a similar pattern. We determined the prevalence of hypertensive retinopathy and its relationships with resting and ambulatory blood pressure in a population study of Afro-Caribbeans and Europeans aged 40 to 64 years in London, UK.

Sickness absence as a measure of health status and functioning: from the UK Whitehall II study.

Study Objective: To investigate the relationship between self reported health status and sickness absence.

Design: Analysis of questionnaire and sickness absence data from the first phase of the Whitehall II study--a longitudinal study set up to investigate the degree and causes of the social gradient in morbidity and mortality.

Setting: London offices of 20 civil service departments.

Pressor reactions to psychological stress and prediction of future blood pressure: data from the Whitehall II Study.

Objective: To examine whether reactions of blood pressure to psychological stress predict future blood pressure.

Design: Blood pressure was recorded at a medical screening examination after which pressor reactions to a psychological stress task were determined. Follow up measurement of blood pressure was undertaken, on average, 4.

Different trends in serum cholesterol levels among rural and urban populations aged 40-59 in Japan from 1960 to 1990.

In Japan, coronary heart disease mortality is low and has been declining since 1970, despite recent increases in serum cholesterol levels which have been reported in nationwide surveys. Longitudinal and cross-sectional surveys of serum cholesterol levels in rural and urban populations from 1960 to 1990 were reviewed. In the surveys in the 1960s, serum cholesterol levels in urban populations were higher than those in rural populations.

Survival and cause of death in a cohort of patients with parkinsonism: possible clues to aetiology?

Most previous studies that have examined the survival of patients with parkinsonism have recruited them from specialist centres. No previous study has ever reported cause specific mortality. We report on the mortality of a cohort of 220 parkinsonian patients recruited between 1970 and 1972 from 40 primary health care practices all over England and Wales and matched to 421 controls.

Work characteristics and psychiatric disorder in civil servants in London.

Study Objective: To describe the association between self reported and externally assessed work characteristics and psychiatric disorder.

Design: Analysis of questionnaire data collected from the first phase of the Whitehall II study, a cohort study of an employed population.

Setting: Twenty civil service departments in London.

Sickness absence for psychiatric illness: the Whitehall II Study.

Over the past 20 years, rates of sickness absence have increased and psychiatric disorders have become an important cause of sickness absence. The socio-demographic associations for psychiatric sickness absence are reported from the Whitehall II study, a longitudinal survey of 10,308 London-based male and female civil servants between 35-55 years. Short spells (< or = 7 days), long spells (> 7 days) and very long spells (> 21 days) of sickness absence were examined in 5620 civil servants for whom reason for absence was available in civil service records.

Fat intake: implications of changes in distribution for setting dietary goals in the UK.

Study Objective: To examine (a) changes in the shape of the distribution of dietary fat intake as the mean dietary fat intake of the population shifts and (b) implications for setting national dietary goals.

Design: Data on the percentage of energy from total fat, saturates, monounsaturates, polyunsaturates, and the P:S ratio were analysed for two dietary intervention trials and six cross sectional dietary surveys. The nutrient distributions from each study were described in terms of the mean, standard deviation (SD), coefficient of variation (CV), and skewness statistic.

Child development risk factors for adult schizophrenia in the British 1946 birth cohort.

Schizophrenia has been linked with childhood psychological abnormalities since it was first described, but studies of associations have not used population samples and so may be subject to bias. We have studied associations between adult-onset schizophrenia and childhood sociodemographic, neurodevelopmental, cognitive, and behavioural factors within a cohort of 5362 people born in the week March 3-9, 1946. Childhood data were gathered prospectively and case ascertainment was independent of routine follow-up of this cohort.

Echocardiographic measures of left ventricular structure and their relation with rest and ambulatory blood pressure in blacks and whites in the United Kingdom.

Objectives: This study attempted to determine whether people of black African descent have more left ventricular hypertrophy than those of white European descent and whether this can be explained by rest or ambulatory blood pressure.

Background: Mortality associated with hypertension is higher in black populations than among whites, but differences in morbidity and their associations with blood pressure are inconsistent.

Methods: We examined 1,166 black and white men and women 40 to 64 years old in a community survey in London, United Kingdom.

Age differences in biochemical and hematological measures during middle age.

Biochemical and hematological measures possibly associated with ageing were measured on a single occasion in 3402 male and 2152 female London Civil Servants aged from 35 to 59 years of age. These included erythrocyte sedimentation rate (ESR), blood hemoglobin and serum albumin, calcium, bilirubin, creatinine, urea, urate, high density lipoprotein (HDL), and total cholesterol. Independently and positively related to age were ESR with an estimated 47% 'increase' in men over the 15 years between ages 40 to 55 and a 40% increase in women; serum urea had a 6%/15-year increase in men and 20% in women; total cholesterol had a 6%/15-year increase in men and 18% in women; serum creatinine 'increased' by 2%/15-years in men and 5% in women.

What determines mortality risk in male former cigarette smokers?

Objectives: The purpose of this study was to examine what factors determine the mortality experience of male ex-cigarette smokers, those who no longer smoke at all and those who changed to pipe or cigar smoking.

Methods: A cohort study was undertaken with 18-year mortality data on 19,018 men.

Results: Ex-cigarette smokers had an intermediate mortality risk compared with never and current smokers.

Relationship of glucose intolerance to coronary risk in Afro-Caribbeans compared with Europeans.

Afro-Caribbeans have low mortality rates from coronary heart disease, despite a high prevalence of diabetes mellitus. We examined 1166 Afro-Caribbean and European men and women aged 40-64 years in a community survey in London, UK. Prevalence of glucose intolerance (combining impaired glucose tolerance, new and known diabetes) was 31% in Afro-Caribbeans and 14% in Europeans (p < 0.