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Shabila NP, Mahmood KA, M-Amin KM, Mahmood KI, Saleh AM. Healthcare-seeking behavior and out-of-pocket payments in Erbil, Kurdistan Region of Iraq. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:127. [PMID: 39160610 PMCID: PMC11334525 DOI: 10.1186/s41043-024-00616-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 08/11/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Understanding healthcare-seeking behavior and examining health expenditures can help determine possible barriers to accessing healthcare and direct more effective and inclusive healthcare systems. This study aimed to evaluate healthcare-seeking behavior and out-of-pocket healthcare expenditure in a sample of the population in Erbil, Iraq. METHODS We conducted this cross-sectional study in Erbil, Kurdistan Region of Iraq, from October to December 2023. A convenience sample of 414 adults completed a self-administered online survey. The following data were collected: recent illness, sociodemographic characteristics, type of healthcare received, and cost of healthcare. RESULTS The most common health conditions reported were communicable diseases (16.3%), musculoskeletal problems (13.1%), and noncommunicable diseases (12.7%). Approximately 85% of patients with health conditions requiring care sought healthcare; most visited private clinics (46.3%) and private hospitals (18.6%). The median total out-of-pocket healthcare expenditure in US dollars was 117.3 (interquartile range (IQR) = 45.6-410.0). The median total cost was much greater for participants who first visited a private health facility (USD 135.5, IQR = 57.3-405.6) than those who first visited a public facility (USD 76.8, IQR = 16.1-459.7). Participants ≥ 60 years spent significantly more than those < 14 years (USD 332, 95% CI = 211-453, p < 0.001). Evermarried participants spent significantly more than unmarried (USD 97, 95% CI = 1 to 192, p = 0.047). Health expenditures were significantly greater for noncommunicable diseases than infectious diseases (USD 232, 95% CI = 96-368, p = 0.001). After adjusting for covariates, age ≥ 60 years was independently associated with higher spending (USD 305, 95% CI = 153-457, p < 0.001). CONCLUSIONS Most participants sought care from formal health services, preferring the private sector. Seeking care from private facilities incurred significantly higher costs than seeking care from public ones, which suggests potential barriers to accessing healthcare, particularly affordability. The findings underscore the importance of evaluating existing healthcare policies to enhance effectiveness and identify areas for improvement. This study can help policymakers and healthcare providers design effective interventions, allocate resources efficiently, and improve healthcare delivery.
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Affiliation(s)
- Nazar P Shabila
- College of Health Sciences, Catholic University in Erbil, Erbil, Iraq.
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
| | | | - Karwan M M-Amin
- Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq
| | - Kazhan I Mahmood
- Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq
| | - Abubakir M Saleh
- Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
- Department of Nursing, College of Nursing, Tishk International University, Erbil, Iraq
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Gray A, Alemohammad SY, Ramírez-Ortiz D, Trepka MJ. A Systematic Review of Factors Associated with COVID-19 Vaccine Uptake, Hesitancy, and Acceptability Among Adults with HIV: Implications for Integrating COVID-19 Immunization into HIV Care. AIDS Patient Care STDS 2024. [PMID: 39058653 DOI: 10.1089/apc.2024.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 virus, once a public health emergency, is now endemic. Immunization remains an important measure for mitigating high levels of disease, morbidity, and mortality related to COVID-19 infection. People with HIV (PWH), in particular, benefit from COVID-19 vaccination because of increased risk for severe COVID-19 infection. However, previous data suggest vaccine hesitancy among this population. Given this context and the evolving epidemiology of COVID-19, this review examines factors associated with COVID-19 vaccine hesitancy, acceptability, and uptake among adults with HIV. Through a systematic search of electronic databases, we identified 56 peer-reviewed articles published between the years 2020 and 2023 that matched the objectives of our review out of a total of 797 screened citations. Among our final sample of articles, nearly all global regions were represented, and 61% of studies recruited only PWH. We identified eight categories of factors associated with COVID-19 vaccination outcomes, including HIV-specific factors (e.g., CD4 count), vaccine attitudes (e.g., vaccine confidence), factors related to the COVID-19 virus (e.g., concern about infection), factors specific to the COVID-19 vaccine (e.g., accessibility), social norms and peer factors (e.g., subjective norms), mental health (e.g., anxiety/depression) and other psychological factors (e.g., substance use), demographic characteristics (e.g., age), and health factors (e.g., vaccination history). Reflecting on these factors, we discuss populations in need of vaccine promotion, modifiable targets for intervention, and integrating immunization into HIV care. Public health efforts to promote COVID-19 immunization among PWH must include educational/informational, peer, and structural interventions and must now consider uptake of COVID-19 booster doses.
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Affiliation(s)
- Aaliyah Gray
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Seyedeh Yasaman Alemohammad
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
- Research Center in Minority Institutions, Florida International University, Miami, Florida, USA
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Bae S, Ju Y, Nam S, Jin Y, Kang S, Ryu JK, Hong I. The association between self-rated health, number of family members, and cognitive function in community-dwelling older adults: Mediating role of depression. PLoS One 2024; 19:e0306907. [PMID: 38980869 PMCID: PMC11232972 DOI: 10.1371/journal.pone.0306907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 06/24/2024] [Indexed: 07/11/2024] Open
Abstract
With the increasing number of older adults, research on cognitive function has expanded. However, studies examining the mediating effect of depression on the association between complex factors and cognitive function in older adults are still insufficient. Additionally, there is a lack of studies that have investigated these relationships by integrating multiple factors related to the cognitive function of older adults. Therefore, our study investigated the association between the number of family members, self-rated health, depression, and cognitive function in community-dwelling older adults and highlighted the mediating role of depression in these relationships. We used data from 218 older adults aged over 65 collected in a previous study. The independent variables were the number of family members and self-rated health, and the dependent variable was cognitive function measured by the cognitive impairment screening test (CIST). The mediation variable was depression measured by the Patient Health Questionnaire-9 (PHQ-9). Structural equation modeling was used to examine the association between the independent, dependent, and mediation variable. The mean ages of the participants were 81.71 (standard deviation [SD] = 6.00) years, with 198 females (90.83%) and 20 males (9.17%). The structural equation model demonstrated a good model fit (chi-square value = 33.375; degrees of freedom = 24; p-value = 0.0964; RMSEA = 0.042; CFI = 0.970; TLI = 0.956; SRMR = 0.042). Self-rated health and the number of family members were not directly associated with cognitive function; however, depression had significant indirect effects (self-rated health to cognitive function: coefficient = -0.023, p-value = 0.017; number of family members and cognitive function: coefficient = 0.012, p-value = 0.030). Our findings indicated that depression plays a crucial mediating role between self-rated health, number of family members, and cognitive function. The results highlight the need for comprehensive strategies for mental health care to support cognitive health in older adults.
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Affiliation(s)
- Suyeong Bae
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Yumi Ju
- Human Development and Rehabilitation, Graduate School of Education Service Science, Dongguk University, Seoul, Republic of Korea
| | - Sanghun Nam
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Yeonju Jin
- Department of Occupational Therapy, Graduate School, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
| | - Sura Kang
- Convergence Research Center for Artificial Intelligence, Dongguk University, Seoul, Republic of Korea
| | - Jeh-Kwang Ryu
- Human Development and Rehabilitation, Graduate School of Education Service Science, Dongguk University, Seoul, Republic of Korea
- Convergence Research Center for Artificial Intelligence, Dongguk University, Seoul, Republic of Korea
- Department of Physical Education, College of Education, Dongguk University, Seoul, Republic of Korea
| | - Ickpyo Hong
- Department of Occupational Therapy, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju-si, Gangwon-do, Republic of Korea
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Pellón-Elexpuru I, Van Dijk R, Van der Valk I, Martínez-Pampliega A, Molleda A, Cormenzana S. Divorce and physical health: A three-level meta-analysis. Soc Sci Med 2024; 352:117005. [PMID: 38824838 DOI: 10.1016/j.socscimed.2024.117005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 06/04/2024]
Abstract
Divorce is often considered a major and stressful life transition. Given that divorcees are overrepresented in primary care and there is a association between individuals' physical health and psychological adjustment, potential post-divorce health problems are of concern. Yet, empirical evidence is lacking on the magnitude of the overall physical health risk after divorce, on possible differences across specific pathologies, and on factors that may increase or reduce this risk. The current meta-analysis addresses these issues. We identified 94 studies including u = 248 relevant effect sizes, based on N = 1,384,507 participants. Generally, compared to married individuals, divorcees showed significantly worse self-reported health (OR = 1.20, [1.08-1.33]), experienced more physical symptoms (OR = 1.34, [1.17-1.53]), and had a higher risk for diabetes (OR = 1.18 [1.05-1.33]), joint pathologies (OR = 1.24, [1.14-1.34]), cardiovascular (OR = 1.24, [1.09-1.41]) and cerebrovascular conditions (OR = 1.31, [1.14-1.51]), and sexually transmitted diseases (OR = 2.48, [1.32-4.64]). However, they had no increased risk of hypertension, hypercholesterolemia, cancer and cancer development, disabilities or limitations, or cognitive pathologies. Nor did divorcees significantly differ from married individuals when aggregating all pathologies to measure overall physical health problems (OR = 1.14, [0.85 to 1.54]). Yet, moderation analyses revealed that being female, unemployed, childless, or having a lower education constitutes a higher risk for overall physical health problems after divorce. The same applied to having a heavy alcohol consumption, lack of exercise, and being overweight. Our meta-analysis shows that divorcees are at heightened risk of certain pathologies, with sexually transmitted diseases as a particular post-divorce hazard. These findings call for more awareness among counsellors and physicians on divorcees' health conditions and the characteristics that make divorcees even more vulnerable to health problems.
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Affiliation(s)
| | - Rianne Van Dijk
- Youth&Family Department, Utrecht University, Utrecht, the Netherlands
| | - Inge Van der Valk
- Youth&Family Department, Utrecht University, Utrecht, the Netherlands
| | | | - Asier Molleda
- Deusto FamilyPsych, Deusto University, Bilbao, Spain
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Thomas M, Verma V, Gheshlaghi N, Esdaile J, Avina-Zubieta A, Barnabe C, Harrison M, De Vera MA. Reporting of determinants of health inequities and participant characteristics in randomized controlled trials of systemic lupus erythematosus in Canada: A scoping review. Lupus 2024; 33:462-469. [PMID: 38339797 PMCID: PMC10955787 DOI: 10.1177/09612033241233032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To report participant characteristics relevant to identifying health inequities in systemic lupus erythematosus (SLE) randomized controlled trials conducted in Canada. METHODS We conducted a scoping review by searching MEDLINE (Ovid) and Embase (1990 to June 2023), and CENTRAL (inception to June 2023). Eligible studies: used an RCT design; evaluated interventions (pharmacologic and non-pharmacologic) among SLE patients aged ≥18 years; and were conducted in Canada. Data extraction was guided by the Campbell and Cochrane Equity Methods Group's PROGRESS-Plus framework on 11 factors leading to health inequities (Place of residence; Race, culture, ethnicity, and language; Occupation; Gender and sex; Religion; Education; Socioeconomic status; Social capital; Plus: Personal characteristics associated with discrimination; Features of relationships; and Time-dependent relationships). RESULTS Of 1901 unique records, 6 met the inclusion criteria. Sex and age were the only PROGRESS factors that were reported in all studies. The majority of participants were female (84.4% to 100%), and mean ages of participants ranged from 42 to 52.3 years. Place of residence, race, education, and social capital were reported in three studies. Socioeconomic status was reported in two studies, and occupation was reported in one study. Religion, features of relationships, and time-dependent relationships were not reported in any included studies. CONCLUSION Limited reporting of determinants of health inequities in RCTs for SLE in Canada suggests the need for reporting standards to support equity, diversity, and inclusion practices in research.
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Affiliation(s)
- Megan Thomas
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
| | - Vanay Verma
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Niloofar Gheshlaghi
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - John Esdaile
- Arthritis Research Canada, Vancouver, BC, Canada
| | | | - Cheryl Barnabe
- Arthritis Research Canada, Vancouver, BC, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mark Harrison
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
| | - Mary A De Vera
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, BC, Canada
- Arthritis Research Canada, Vancouver, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
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De Luca GD, Lin X. The role of health and health systems in promoting social capital, political participation and peace: A narrative review. Health Policy 2024; 141:105009. [PMID: 38350755 DOI: 10.1016/j.healthpol.2024.105009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 02/15/2024]
Abstract
High levels of violence and insecurity are highly detrimental for societies. United Nations Sustainable Development Goal 16 is advocating for peaceful, accountable and inclusive institutions as one powerful channel to foster global development. Investing in health and health policies can potentially contribute achieving these objectives. After providing a conceptual framework, this article reviews the existing literature on the evidence of the role of health and health systems in promoting social capital and trust, political engagement and participation, and peace that closely relate to the objectives of Sustainable Development Goal 16. We provide evidence of a systematically positive impact of better physical and mental health on social capital, and on political participation, both contributing to the sustainability of inclusive democratic institutions. We also document that health and health systems can help supporting peace, both via the reduction of social inequality and grievances, and by reducing the disruptive effects of epidemic shocks. Overall, the study provides evidence that health and health systems can generate co-benefits outside the health domain by promoting social capital, political participation and peace.
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Affiliation(s)
| | - Xi Lin
- University of York, Heslington, YO105DD York, UK
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Zhang J, Xu Z, Han P, Fu Y, Wang Q, Wei X, Wang Q, Yang L. Exploring the Modifying Role of GDP and Greenness on the Short Effect of Air Pollutants on Respiratory Hospitalization in Beijing. GEOHEALTH 2024; 8:e2023GH000930. [PMID: 38505689 PMCID: PMC10949333 DOI: 10.1029/2023gh000930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
It is unclear whether Gross Domestic Product (GDP) and greenness have additional modifying effects on the association between air pollution and respiratory system disease. Utilizing a time-stratified case-crossover design with a distributed lag linear model, we analyzed the association between six pollutants (PM2.5, PM10, NO2, SO2, O3, and CO) and 555,498 respiratory hospital admissions in Beijing from 1st January 2016 to 31st December 2019. We employed conditional logistic regression, adjusting for meteorological conditions, holidays and influenza, to calculate percent change of hospitalization risk. Subsequently, we performed subgroup analysis to investigate potential effect modifications using a two-sample z test. Every 10 μg/m3 increase in PM2.5, PM10, NO2, SO2, and O3 led to increases of 0.26% (95%CI: 0.17%, 0.35%), 0.15% (95%CI: 0.09%, 0.22%), 0.61% (95%CI: 0.44%, 0.77%), 1.72% (95%CI: 1.24%, 2.21%), and 0.32% (95%CI: 0.20%, 0.43%) in admissions, respectively. Also, a 1 mg/m3 increase in CO levels resulted in a 2.50% (95%CI: 1.96%, 3.04%) rise in admissions. The links with NO2 (p < 0.001), SO2 (p < 0.001), O3 (during the warm season, p < 0.001), and CO (p < 0.001) were significantly weaker among patients residing in areas with higher levels of greenness. No significant modifying role of GDP was observed. Greenness can help mitigate the effects of air pollutants, while the role of GDP needs further investigation.
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Affiliation(s)
- Jiawei Zhang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Zhihu Xu
- Department of Occupational and Environmental Health SciencesPeking University School of Public HealthBeijingChina
| | - Peien Han
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Yaqun Fu
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Quan Wang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
- Brown SchoolWashington University in St. LouisSt. LouisMOUSA
| | - Xia Wei
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
- Department of Health Services Research and PolicyLondon School of Hygiene & Tropical MedicineLondonUK
| | - Qingbo Wang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
| | - Li Yang
- Department of Health Policy and ManagementPeking University School of Public HealthBeijingChina
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Lindström M, Pirouzifard M, Rosvall M, Fridh M. Marital status and cause-specific mortality: A population-based prospective cohort study in southern Sweden. Prev Med Rep 2024; 37:102542. [PMID: 38169998 PMCID: PMC10758969 DOI: 10.1016/j.pmedr.2023.102542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
The aim was to investigate associations between marital status and mortality with a prospective cohort study design. A public health survey including adults aged 18-80 was conducted with a postal questionnaire in southern Sweden in 2008 (54.1% participation). The survey formed a baseline that was linked to 8.3-year follow-up all-cause, cardiovascular (CVD), cancer and other cause mortality. The present investigation entails 14,750 participants aged 45-80. Associations between marital status and mortality were investigated with multiple Cox-regression analyses. A 72.8% prevalence of respondents were married/cohabitating, 9.1% never married, 12.2% divorced and 5.9% widows/widowers. Marital status was associated with age, sex, socioeconomic status (SES) by occupation, country of birth, chronic disease, Body Mass Index (BMI), health-related behaviors and generalized trust covariates. Never married/single, divorced, and widowed men had significantly higher hazard rate ratios (HRRs) of all-cause mortality than the reference category married/cohabitating men throughout the multiple analyses. For men, CVD and other cause mortality showed similar significant results, but not cancer. No significant associations were displayed for women in the multiple analyses. Associations between marital status and mortality are stronger among men than women. Associations between marital status and cancer mortality are not statistically significant with low effect measures throughout the multiple analyses among both men and women.
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Affiliation(s)
- Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö and Centre for Primary Health Care Research, Lund University, S-205 02 Malmö, Sweden
| | - Mirnabi Pirouzifard
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö and Centre for Primary Health Care Research, Lund University, S-205 02 Malmö, Sweden
| | - Maria Rosvall
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö and Centre for Primary Health Care Research, Lund University, S-205 02 Malmö, Sweden
- Department of Community Medicine and Public Health, Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Sweden
| | - Maria Fridh
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö and Centre for Primary Health Care Research, Lund University, S-205 02 Malmö, Sweden
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Ndlovu K, Ramalepe LM, Nwogwugwu NC, Olutola BG. Is There an Association between the Use of Social Media and Self-Rated Health? Behav Sci (Basel) 2023; 13:777. [PMID: 37754055 PMCID: PMC10526054 DOI: 10.3390/bs13090777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/03/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
This study sought to determine the association between social media and self-rated health. This study used the 2022 Health Information National Trends Survey for American adults. A statistical analysis was conducted using Chi-square and multivariable logistic regression. Of the 6018 study participants, the majority reported that they were in excellent/very good and good health (82.9%, n = 4930). More than half (58.2%, n = 3268) of the respondents reported that they visited a social media site almost every day in the past 12 months, while 76.8% (n = 4843) reported that they never interacted with people who had similar health or medical issues on social media. There was no association between everyday visits to a social media site, interaction with people with similar health/medical issues on social media, or watching a health-related video on social media and self-rated health. Those who had full-time employment were more likely to rate their health as excellent/very good/good (AOR: 2.394, 95% Conf. Int: 1.820-3.149) compared to those with no full-time employment. Marital status, confidence in taking care of oneself, education, and current smoking were associated with self-rated health. This study showed that the use of social media which included the watching of health-related videos was not associated with self-rated health.
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Affiliation(s)
- Kholisani Ndlovu
- School of Engineering, Science and Health, The Independent Institute of Education (IIEMSA), 144 Peter Rd, Ruimsig, Roodepoort 1724, Gauteng, South Africa; (K.N.); (N.C.N.)
| | - Lebogang M. Ramalepe
- School of Social Science, The Independent Institute of Education (IIEMSA), 144 Peter Rd, Ruimsig, Roodepoort 1724, Gauteng, South Africa;
| | - Nwamaka C. Nwogwugwu
- School of Engineering, Science and Health, The Independent Institute of Education (IIEMSA), 144 Peter Rd, Ruimsig, Roodepoort 1724, Gauteng, South Africa; (K.N.); (N.C.N.)
| | - Bukola G. Olutola
- School of Engineering, Science and Health, The Independent Institute of Education (IIEMSA), 144 Peter Rd, Ruimsig, Roodepoort 1724, Gauteng, South Africa; (K.N.); (N.C.N.)
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Sabri MF, Said MA, Magli AS, Pin TM, Rizal H, Thangiah N, Ithnin M, Abdul Majid H, Ismail R, Su TT, Husniyah AR. Exploring the Relationships of Financial Literacy and Financial Behaviour with Health-Related Quality of Life (HRQOL) among the Low-Income Working Population in Malaysia during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12520. [PMID: 36231818 PMCID: PMC9566270 DOI: 10.3390/ijerph191912520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
This cross-sectional study examined the relationships of financial literacy (FL) and financial behaviour (FB) with health-related quality of life (HRQOL) during the COVID-19 pandemic among low-income working population (20-60 years old) in Malaysia. A self-administered questionnaire survey was used with HRQOL data were gathered using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) tool. A generalised linear model was employed to examine the hypothesised relationships between the constructs. From 1186 respondents, the majority were employed (73.9%), had a monthly household income of less than RM 2500 (74.5%), and did not have any chronic medical conditions (74.5%). The mean (SD) values of FL, FB, and EQ-5D-5L were 5.95 (1.48), 22.08 (4.79), and 0.96 (0.10), respectively. The results of the adjusted model revealed lower age group, Malay ethnicity, Indian ethnicity, and increased FB score as significant determinants of higher EQ-5D-5L scores. With the addition of the chronic medical condition factor into the saturated model, the lower age group, ethnicity, and no chronic medical condition were significant determinants of higher HRQOL. The effects of FB on QOL were confounded by chronic diseases, implying that interventions that focus on improving FB for those with chronic medical condition may help to improve the QOL among the low-income working population.
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Affiliation(s)
- Mohamad Fazli Sabri
- Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Mas Ayu Said
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Amirah Shazana Magli
- Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Tan Maw Pin
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Hussein Rizal
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Centre for Population Health c/o, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Nithiah Thangiah
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Centre for Population Health c/o, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Muslimah Ithnin
- Corporate Communication Unit, Ministry of Health Malaysia, Putrajaya 62000, Malaysia
| | - Hazreen Abdul Majid
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Centre for Population Health c/o, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Rozmi Ismail
- Psychology and Human Wellbeing Research Centre, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi 43600, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO) & Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia
| | - Abdul Rahim Husniyah
- Department of Resource Management and Consumer Studies, Faculty of Human Ecology, Universiti Putra Malaysia, Serdang 43400, Malaysia
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11
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Do characteristics of family members influence older persons' transition to long-term healthcare services? BMC Health Serv Res 2022; 22:362. [PMID: 35303891 PMCID: PMC8933970 DOI: 10.1186/s12913-022-07745-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/08/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Future demographic and economic changes warrant a better understanding of older persons' need for health-related long-term care services (LTC). LTC uptake among older people is likely to be influenced by the presence or absence of family members, but there is scarce research on the role played by partners with different caregiving potential. There is even less research on the contributions of adult children and their caregiving potential. The current study examines the extent to which transitions into LTC in older men and women differ according to the presence and caregiving potential of partners and children. METHODS Linked registry data for Norway on older persons (aged 65+), their partners, and their adult children are used to examine how characteristics of these family members influence transitions into LTC from 2010 to 2016, using logistic discrete-time hazard regression models. We observed around 215,000 transitions to LTC, corresponding to around 26.3% of individuals and 5.4% of the total person-years (4.0 million). Caregiving potential is measured in terms of employment, income, health and educational attainment for partners and education and geographical proximity for children. RESULTS Personal, partner and child(ren)'s resources are all associated with older persons' LTC uptake. Unpartnered and/or childless older people are more likely to use LTC than those with partners and/or child(ren). Older persons with resourceful partners and children are the least likely to transition into LTC. The geographical proximity of adult children appears to have only a minor influence on LTC use among older people. CONCLUSIONS Population ageing and strained public resources will likely challenge the future provision of formal old-age care. The role of family networks in the future provision of formal old-age care is expected to become progressively important in the years to come. Inequalities in the health, care and welfare of older persons with and without resourceful family members are likely to increase.
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12
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Kang E, Lee H, Hong KJ, Yun J, Lee JY, Hong YC. General public’s perspectives on telemedicine during the COVID-19 pandemic in Korea: an analysis of the nationwide survey. Epidemiol Health 2022; 44:e2022020. [PMID: 35130418 PMCID: PMC9117104 DOI: 10.4178/epih.e2022020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/04/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES We investigated the awareness, experience, approval, intention to use, and the desired type of telemedicine among Korean general public. METHODS From November to December 2020, we conducted an online self-reported survey on awareness, experience, approval, and intent to use telemedicine services among Korean residents aged 20 years or older. A total of 2,097 participants completed the survey. RESULTS Of the 2,097 participants, 1,558 (74.3%) were aware of, 1,198 (57.1%) approved of, and 1,474 (70.3%) had the intention to use telemedicine. Participants from regions other than the Seoul metropolitan area and Daegu–Gyeongbuk Province (adjusted odds ratio [aOR], 1.29; 95% confidence interval [CI], 1.02 to 1.63), households with a monthly household income of US$6,000 or more (aOR, 1.44; 95% CI, 1.01 to 2.08), participants who had a college/university or associate’s degree (aOR, 1.35. 95% CI, 1.04 to 1.75) or a master’s degree or above (aOR, 1.73; 95% CI, 1.20 to 2.50), and housewives (aOR, 1.30; 95% CI, 1.03 to 1.64) had higher odds of approval. Elderly participants, those with a chronic disease (aOR, 1.26; 95% CI, 1.04 to 1.54), those who had experienced delays of healthcare services (aOR, 1.94; 95% CI, 1.27 to 2.96), and those who had experience with telemedicine (aOR, 4.28; 95% CI, 1.69 to 10.82) were more likely to intend to use telemedicine services. Regarding types of telemedicine, teleconsultation between doctors showed the highest approval rate (73.1%). CONCLUSIONS In the context of the coronavirus disease 2019 pandemic, more than 70% of participants had already used or intended to use telemedicine at some point. Groups with a substantial need for telemedicine were more in favor of telemedicine.
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Affiliation(s)
- EunKyo Kang
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Family Medicine, National Cancer Center, Goyang, Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jieun Yun
- Department of Pharmaceutical Engineering, Cheongju University, Cheongju, Korea
| | - Jin Yong Lee
- ublic Healthcare Center, Seoul National University Hospital, Seoul, Korea
- HIRA Research Institute, Health Insurance Review and Assessment Service, Wonju, Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Correspondence: Jin Yong Lee Public Healthcare Center, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea E-mail:
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Korea
- Co-correspondence: Yun-Chul Hong Department of Preventive Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea E-mail:
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13
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Downward P, Rasciute S, Kumar H. Mental health and satisfaction with partners: a longitudinal analysis in the UK. BMC Psychol 2022; 10:15. [PMID: 35086553 PMCID: PMC8793196 DOI: 10.1186/s40359-022-00723-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 01/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Current UK health policy stresses treating health as an asset to underpin and promote a more inclusive and productive society. The quality of personal relationships is essential for overall quality of life. The social determinants of health (SDH) literature shows that poor mental health and well-being are linked to weaker personal and social connections for individuals, families, and society. The causal impact that mental health has on satisfaction with partners is less understood but requires investigation. METHODS The causal relationship between mental health and satisfaction with partners is examined drawing on the United Kingdom's British Household Panel Survey from 1991 to 2008. A total sample of 9,024 individuals in dyadic couples comprising 42,464 observations was analysed using fixed-effects and instrumental variable fixed-effects panel data estimation. RESULTS Lower mental health is associated with a lower satisfaction with partners. However, some causal evidence of lower mental health reducing satisfaction with partners is present for males. DISCUSSION For females, relationship satisfaction is more likely to influence mental health. For males there is a potential 'vicious circle' between satisfaction with partners and mental health. CONCLUSIONS Investment in mental health provision can improve satisfaction with partners which in turn will further enhance health and well-being.
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Affiliation(s)
- Paul Downward
- School of Sport, Exercise and Health Sciences, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK.
| | - Simona Rasciute
- School of Business and Economics, Loughborough University, Ashby Road, Loughborough, LE11 3TU, UK
| | - Harish Kumar
- Department of Economics, Policy and International Business, Manchester Metropolitan University, Manchester, M15 6BH, UK
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14
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ASSUNÇÃO LRDS, FAGUNDES FAU, KUKLIK HH, FERREIRA FDM, FRAIZ FC. Different dimensions of oral health literacy are associated with social determinants of health in Brazilian adults. Braz Oral Res 2022; 36:e0122. [DOI: 10.1590/1807-3107bor-2022.vol36.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 05/17/2022] [Indexed: 12/09/2022] Open
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15
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Ikhar M, Banerjee S, Bandyopadhyay K, Tiwari MK, Kumar M, Deshmukh P. Magnitude and determinants of "Social Capital" among women in reproductive age group - A cross-sectional study from rural Wardha, Central India. J Family Med Prim Care 2021; 10:3606-3610. [PMID: 34934654 PMCID: PMC8653486 DOI: 10.4103/jfmpc.jfmpc_2496_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 06/11/2021] [Accepted: 06/24/2021] [Indexed: 11/04/2022] Open
Abstract
Context Social capital reflects the trust, norms, values and social processes that governs interaction among people. Aim This study was conducted to estimate the magnitude and determinants of social capital among women of reproductive age group in selected village of rural Wardha, Central India. Materials and Methods It was a community based cross-sectional study where two stage cluster sampling technique was used to select 300 participants from 22 villages. Data were collected using a pre-designed interviewer administered questionnaire by house-to-house survey. Social capital was measured using the core set of Integrated Questionnaire for the Measurement of Social Capital developed by World Bank. Statistical Analysis Multivariate linear regression was applied to find out determinants of social capital. Results Most of the participants had poor social capital score (women having lowest and middle tertile scores were 36.0% and 45%, respectively). social capital poorer in younger women, women with lower educational qualification, not involved in gainful occupation, belonging to below poverty line and unmarried compared to their counterparts. Having at least one son was positively associated with higher social capital. In adjusted analysis, age, education, occupation, marital status, and whether the woman has son were revealed as significant determinants of social capital. Conclusion The study findings reflect the need of improving education and job opportunity among rural women to improve their social capital. Increase of social capital among women having male child reflects the need to percolate the message of gender equity and gender sensitive education.
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Affiliation(s)
- Madhuri Ikhar
- Mahatma Gandhi Fuji-Guruji Social Work Study Center, Mahatma Gandhi Aantarrashtriya Hindi Vishwavidyalaya, Wardha, Maharashtra, India
| | - Sitikantha Banerjee
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Kajari Bandyopadhyay
- Mahatma Gandhi Fuji-Guruji Social Work Study Center, Mahatma Gandhi Aantarrashtriya Hindi Vishwavidyalaya, Wardha, Maharashtra, India
| | - Mithilesh K Tiwari
- Mahatma Gandhi Fuji-Guruji Social Work Study Center, Mahatma Gandhi Aantarrashtriya Hindi Vishwavidyalaya, Wardha, Maharashtra, India
| | - Manoj Kumar
- Mahatma Gandhi Fuji-Guruji Social Work Study Center, Mahatma Gandhi Aantarrashtriya Hindi Vishwavidyalaya, Wardha, Maharashtra, India
| | - Pradeep Deshmukh
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
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16
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Kang E, Lee H, Sohn JH, Yun J, Lee JY, Hong YC. Impact of the COVID-19 Pandemic on the Health Status and Behaviors of Adults in Korea: National Cross-sectional Web-Based Self-report Survey. JMIR Public Health Surveill 2021; 7:e31635. [PMID: 34653017 PMCID: PMC8629347 DOI: 10.2196/31635] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 12/19/2022] Open
Abstract
Background The COVID-19 pandemic has radically shifted living practices, thereby influencing changes in the health status and behaviors of every person. Objective The aim of this study was to investigate the impact of COVID-19 on the self-reported health status and health behaviors along with any associated factors in adults in the Republic of Korea wherein no stringent lockdown measures were implemented during the pandemic. Methods We conducted a web-based self-reported survey from November 2020 to December 2020. The study participants (N=2097) were identified through quota sampling by age, sex, and geographical regions among residents aged 19 years or older in Korea. The survey collected information on basic demographics, changes in self-reported health status, and health behaviors during the COVID-19 pandemic. Self-reported health status and health behaviors were categorized into 3 groups: unchanged, improved, or worsened. A chi-square test and logistic regression analyses were conducted. Results With regard to changes in the self-reported health status, the majority (1478/2097, 70.5%) of the participants reported that their health was unchanged, while 20% (420/2097) of the participants reported having worser health after the COVID-19 outbreak. With regard to changes in health behaviors, the proportion of participants who increased tobacco consumption was similar to that of those who decreased tobacco consumption (110/545, 20.2% vs 106/545, 19.5%, respectively), while the proportion of those who decreased their drinking frequency was more than twice as many as those who increased their drinking frequency (578/1603, 36.1% vs 270/1603, 16.8%, respectively). Further, those who decreased their exercising frequency were more than those who increased their exercising frequency (333/823, 15.9% vs 211/823, 10%, respectively). The factor that had the greatest influence on lifestyle was age. In the subgroup analysis, the group aged 20-29 years had the highest number of individuals with both a worsened (100/377, 26.5%) and an improved (218/377, 15.7%) health status. Further, individuals aged 20-29 years had greater odds of increased smoking (6.44, 95% CI 2.15-19.32), increased alcohol use (4.64, 95% CI 2.60-8.28), and decreased moderate or higher intensity aerobic exercise (3.39, 95% CI 1.82-6.33) compared to individuals aged 60 years and older. Younger adults showed deteriorated health behaviors, while older adults showed improved health behaviors. Conclusions The health status and the behavior of the majority of the Koreans were not found to be heavily affected by the COVID-19 outbreak. However, in some cases, changes in health status or health behavior were identified. This study highlighted that some groups were overwhelmingly affected by COVID-19 compared to others. Certain groups reported experiencing both worsening and improving health, while other groups reported unchanged health status. Age was the most influential factor for behavior change; in particular, the younger generation’s negative health behaviors need more attention in terms of public health. As COVID-19 prolongs, public health interventions for vulnerable groups may be needed.
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Affiliation(s)
- EunKyo Kang
- National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.,Department of Family Medicine, National Cancer Center, Goyang, Republic of Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jee Hoon Sohn
- Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatrics, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jieun Yun
- Department of Pharmaceutical Engineering, Cheongju University, Cheongju, Republic of Korea
| | - Jin Yong Lee
- Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Republic of Korea.,Health Insurance Review and Assessment Service Research Institute, Health Insurance Review and Assessment Service, Wonju, Republic of Korea
| | - Yun-Chul Hong
- Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
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17
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Guan A, Kim-Mozeleski JE, Vyas P, Stewart SL, Gildengorin G, Burke NJ, Ma K, Pham AT, Tan J, Lu Q, McPhee SJ, Tsoh JY. Neighborhood Ethnic Composition and Self-rated Health Among Chinese and Vietnamese American Immigrants. J Immigr Minor Health 2021; 23:574-582. [PMID: 32617753 PMCID: PMC8208464 DOI: 10.1007/s10903-020-01041-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Immigrants tend to live in areas with higher co-ethnic density, and the effect of neighborhood ethnic composition could be particularly salient for health. This study explored associations between neighborhood ethnic composition and self-rated health among Asian immigrants. We analyzed data collected at baseline from 670 Chinese and Vietnamese immigrants enrolled in a lifestyle intervention trial. Residential addresses were geocoded and combined with neighborhood socio-demographic profiles based on census data. We used generalized estimating equations to examine neighborhood ethnic composition and self-rated health. Independent of individual-level factors, living in neighborhoods more densely populated by whites was associated with poor/fair self-rated health. Neighborhood household income and density of participants' own ethnic group were not associated with poor/fair self-rated health. More research is warranted to disentangle reasons why Chinese and Vietnamese immigrants living in white-concentrated neighborhoods reported poorer self-rated health, including investigating effects of discrimination, relative deprivation, and availability of social resources.
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Affiliation(s)
- Alice Guan
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Jin E Kim-Mozeleski
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Priyanka Vyas
- Center for Tobacco Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Susan L Stewart
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Nancy J Burke
- Department of Public Health, University of California Merced, Merced, CA, USA.,Asian American Research Center on Health, San Francisco, CA, USA
| | - Kris Ma
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Amber T Pham
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Judy Tan
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen J McPhee
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Janice Y Tsoh
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA. .,Asian American Research Center on Health, San Francisco, CA, USA.
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18
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Park S, Kang Y, Surkan PJ. Types of social capital in relation to self-rated health: Gender differences in a nationally representative cross-sectional study of South Korean adults. Glob Public Health 2021; 17:1365-1378. [PMID: 34008461 DOI: 10.1080/17441692.2021.1924221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Socio-economic and cultural transformations in South Korea have led to societal heterogeneity, potentially changing the role of social capital. We examined whether six factors (i.e. group membership, out-group trust, civic responsibility, acceptance, political activism, and institutional trust) that represent bonding, bridging, and linking social capital are associated with self-rated health (SRH), and whether these associations vary by gender. We analysed data from 8,000 adults in the Korea Social Integration Survey. We first conducted exploratory and confirmatory analyses to create and verify a social capital scale. Then, we performed multivariable logistic regression analyses to study how each type of social capital was related to SRH, adjusting for survey design and sampling weights. High levels of group membership and civic responsibility were associated with good SRH among men only, while high levels of out-group trust, acceptance, and institutional trust were associated with good SRH only for women. High levels of political activism were negatively related to good SRH for both men and women. Overall, associations between different types of social capital and SRH differed by gender in the South Korean context; thus, men and women may benefit from health interventions that enhance different forms of social capital.
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Affiliation(s)
- Soim Park
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Yunhee Kang
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
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19
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Sander S, Strizzi JM, Øverup CS, Cipric A, Hald GM. When Love Hurts - Mental and Physical Health Among Recently Divorced Danes. Front Psychol 2020; 11:578083. [PMID: 33329227 PMCID: PMC7734469 DOI: 10.3389/fpsyg.2020.578083] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/09/2020] [Indexed: 11/25/2022] Open
Abstract
The last decades of research have consistently found strong associations between divorce and adverse health outcomes among adults. However, limitations of a majority of this research include (a) lack of “real-time” research, i.e., research employing data collected very shortly after juridical divorce where little or no separation periods have been effectuated, (b) research employing thoroughly validated and population-normed measures against which study results can be compared, and (c) research including a comprehensive array of previously researched sociodemographic- and divorce-related variables. The current cross-sectional study, including 1,856 recently divorced Danes, was designed to bridge these important gaps in the literature. Mental and physical health were measured using the Short Form 36 (SF-36)-2. Analyses included correlational analyses, t-test comparisons, and hierarchical multiple regression analyses. The study found that the health-related quality of life of Danish divorcees was significantly worse than the comparative background population immediately following divorce. Across gender, higher levels of divorce conflict were found to predict worse mental health, and worse physical health for women, even when controlling for other socio-demographic variables and divorce characteristics. Among men, lower age and higher income predicted better physical health, while more children, more previous divorces, participant divorce initiation, new partner status, and lower levels of divorce conflict predicted better mental health. Among women, higher income, fewer previous divorces, new partner status, and lower levels of divorce conflict predicted better physical health while higher income, participant divorce initiation, new partner status, and lower levels of divorce conflict predicted better mental health. The findings underscore the relevance of providing assistance to divorcees who experience higher levels of divorce conflict immediately following divorce, in seeking to reduce potential long-term negative health effects of divorce.
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Affiliation(s)
- Søren Sander
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Camilla S Øverup
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ana Cipric
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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20
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Reyes J, Sweet J, MacLean M, Poirier A, VanTil L. Characterization of occupational, demographic and health determinants in Canadian reservists veterans and the relationship with poor self-rated health. Health Qual Life Outcomes 2020; 18:274. [PMID: 32778105 PMCID: PMC7418300 DOI: 10.1186/s12955-020-01516-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 07/29/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Self-rated health is an useful indicator of the general health in specific populations and used to propose interventions after service in the military context. However, there is scarce literature about self- rated health (SRH) in the Canadian Veterans of the Reserve Force and its relationship with demographic, health and occupational characteristics of this specific group. The aims of this research were to determine the SRH in Canadian Reserve Force Veterans and to explore the relationship between demographic, military service and health factors by reserve class. METHODS Data from the individuals was collected from the Life After Service (LASS) 2013 survey, including Veterans with Reserve Class C (n = 922) and Class A/B (n = 476). Bivariate and multivariate analysis using logistic regression models, were used to assess the association between the demographic characteristics, physical health, mental health, and military service characteristics and the self-rate health by both reserve classes. RESULTS The overall prevalence of poor SRH in Reserve Class C Veterans was 13.1% (CI:11.08-15.4) and for Reserve Class A/B was 6.9% (CI:5.0-9.1). Different degrees of associations were observed during the bivariate analysis and two different models were produced for each reserve class. Veterans of Reserve Class C showed that being single was (OR = 2.76, CI: 1.47-5.16), being 50-59 years old (OR = 4.6, CI: 1.28-17.11), reporting arthritis (OR = 2.49, CI: 1.33-4.67), back problems (OR = 3.02, CI:1.76-5.16), being obese (OR = 1.96, CI: 1.13-3.38), depression (OR = 2.34, CI: 1.28-4.20), anxiety (OR = 4.11, CI: 2.00-8.42), PTSD (OR = 2.1 CI: 0.98-4.47), PTSD (OR = 20.9, CI:0.98-4.47) and being medically released (OR = 4.48, CI: 2.43-8.24) were all associated with higher odds of poor SRH. The Reserve Class A/B model showed that completing high school (OR = 4.30, CI: 1.37-13.81), reporting arthritis (6.60, CI: 2.15-20.23), diabetes (OR = 11.19, CI: 2.72-46.0), being obese (OR = 3.37, CI: 1.37-8.27), daily smoking (OR = 2.98, CI: 1.05-8.38), having anxiety (OR = 9.8, CI: 3.70-25.75) were associated with higher odds of poor SRH. CONCLUSIONS These results suggested that the relationship of poor SRH with demographic, health and military occupation domains varied depending on the class on the Reserve Force Service. Different strengths of association showed different risk compositions for both populations. This can be used to better understand the health and well-being of Veterans of the Reserve Force.
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Affiliation(s)
- Julian Reyes
- Veterans Affairs Canada, Charlottetown, PE C1A 1N2 Canada
| | - Jill Sweet
- Veterans Affairs Canada, Charlottetown, PE C1A 1N2 Canada
| | | | - Alain Poirier
- Veterans Affairs Canada, Charlottetown, PE C1A 1N2 Canada
| | - Linda VanTil
- Veterans Affairs Canada, Charlottetown, PE C1A 1N2 Canada
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21
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Sander S, Hald GM, Cipric A, Øverup CS, Strizzi JM, Gad Kjeld S, Lange T. A Randomised Controlled Trial Study of the Effects of a Digital Divorce Platform on Mental and Physical Health. Appl Psychol Health Well Being 2020; 12:863-886. [PMID: 32767636 DOI: 10.1111/aphw.12213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Two decades of divorce research has consistently documented adverse mental and physical health effects of divorce. Responding to calls for evidence-based online divorce interventions, this study tests effects of the "Cooperation after Divorce" (CAD) digital intervention platform on divorcees' mental and physical health. METHODS Randomised control trial 12-month longitudinal study using a sample of 1,856 newly divorced Danes. Mental and physical health were measured using the SF-36 at baseline and 3, 6, and 12 months from baseline. Intervention effects were investigated using linear mixed effect models and Cohen's (d) for effect sizes. RESULTS The study found significant treatment effects of the CAD intervention on mental and physical health. These effects were evident across all eight health domains constituting the mental and physical health components. The study also found that the intervention group had significantly better mental health than the control group at subsequent 6- and 12-month assessments from baseline while for physical health, the intervention group had significantly better physical health at the 6-month assessment from baseline only. CONCLUSION The results indicate that digital solutions allowing for individually tailored user experiences may hold great potential in reducing well-known adverse health effects of divorce. PRACTITIONER'S POINTS The study finds highly significant treatment effects of the "CAD" digital divorce intervention on mental and physical health indicating that online interventions may be successfully integrated into help offered to divorcees post-divorce.
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22
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Gryth K, Persson C, Näslund I, Sundbom M, Näslund E, Stenberg E. The Influence of Socioeconomic Factors on Quality-of-Life After Laparoscopic Gastric Bypass Surgery. Obes Surg 2020; 29:3569-3576. [PMID: 31190262 DOI: 10.1007/s11695-019-04028-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Patients with low socioeconomic status have been reported to experience poorer outcome after several types of surgery. The influence of socioeconomic factors on health-related quality-of-life (HRQoL) after bariatric surgery is unclear. MATERIALS AND METHODS Patients operated with a primary laparoscopic gastric bypass procedure in Sweden between 2007 and 2015 were identified in the Scandinavian Obesity Surgery Register. Patients with a completed assessment of health-related quality-of-life based on the Obesity-related Problem Scale (OP Scale) were included in the study. Socioeconomic status was based on data from Statistics Sweden. RESULTS A total of 13,723 patients (32% of the 43,096 operated during the same period), with complete OP scores at baseline and two years after surgery, were included in the study. Age, lower preoperative BMI, male gender, higher education, professional status and disposable income as well as not receiving social benefits (not including retirement pension), and not a first- or second-generation immigrant, were associated with a higher postoperative HRQoL. Patients aged 30-60 years, with lower BMI, higher socioeconomic status, women and those born in Sweden by Swedish parents experienced a higher degree of improvement in HRQoL. Postoperative weight-loss was associated with higher HRQoL (unadjusted B 16.3, 95%CI 14.72-17.93, p < 0.0001). CONCLUSION At 2 years, a strong association between weight loss and improvement in HRQoL was seen, though several factors influenced the degree of improvement. Age, sex, preoperative BMI and socioeconomic status all influence the postoperative HRQoL as well as the improvement in HRQoL after laparoscopic gastric bypass surgery.
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Affiliation(s)
- Karin Gryth
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden
| | - Carina Persson
- Department of Community Medicine and Public Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department for Sustainable Development, Region Örebro County, Örebro, Sweden
| | - Ingmar Näslund
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Näslund
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden.
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Maharlouei N, Cobb S, Bazargan M, Assari S. Subjective Health and Happiness in the United States: Gender Differences in the Effects of Socioeconomic Status Indicators. ACTA ACUST UNITED AC 2020; 4:8-17. [PMID: 32568256 DOI: 10.29245/2578-2959/2020/2.1196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Education, employment, and marital status are among the main socioeconomic status (SES) indicators that are associated with subjective health and happiness. The effects of these SES indicators may, however, be different for various demographic groups. Aims To understand if SES indicators differently impact men and women, we tested gender differences in the effects of education, employment, and marital status on the subjective health and happiness of American adults. Methods This cross-sectional study used data of the General Social Survey (GSS), a series of nationally representative surveys between 1972 and 2018 in the US. Our analytical sample included 65,814 adults. The main independent variables were education attainment, marital status, and employment. Outcomes were self-rated health (SRH) and happiness measured using single items. Age and year of the study were covariates. Gender was the moderator. Results Overall, high education, being employed, and being married were associated with better SRH and happiness. We, however, found significant interactions between gender and educational attainment, marital status, and employment on the outcomes, which suggested that the effect of high education and marital status were stronger for women. In comparison, the effect of employment was stronger for men. Some inconsistencies in the results were observed for SRH compared to happiness. Conclusions In the United States, while education, employment, and marital status are critical social determinants of subjective health and happiness, these effects vary between women and men. Men's outcomes seem to be more strongly shaped by employment, while women's outcomes are more strongly shaped by education and marital status.
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Affiliation(s)
- Najmeh Maharlouei
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA.,Department of Family Medicine, UCLA, Los Angeles, CA
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
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Self-Perceived Health, Objective Health, and Quality of Life among People Aged 50 and Over: Interrelationship among Health Indicators in Italy, Spain, and Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072414. [PMID: 32252321 PMCID: PMC7178192 DOI: 10.3390/ijerph17072414] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 11/17/2022]
Abstract
It is well known that self-perceived health (SPH), even if it is a subjective health indicator, is significantly associated with objective health and quality of life (QoL) in the general population. Whether it can be considered an indicator of cognitive functioning and quality of life in the elderly is still an open issue. This study used a data-driven approach to investigate the interrelationship among SPH, non-communicable diseases (NCDs), QoL, and cognitive functioning to answer this question. The study sample included information about 12,831 people living in Italy, Spain, and Greece, extracted from the Survey on Health, Aging, and Retirement in Europe, in the year 2015. The additive Bayesian networks methodology was used to identify the best directed acyclic graphs (DAG) for SPH, QoL, and NCDs. Results were given as posterior estimates of generalized linear models (GLM) coefficients, with 95% credibility intervals. Good SPH was associated with a decreasing number of chronic diseases in Italy (coeff = −0.52, 95%CI: [−0.59, −0.44]), Spain (coeff = −0.53, 95%CI: [−0.60, −0.46]) and Greece (coeff = −0.57, 95%CI: [−0.64, −0.50]). Age and Body Mass Index were determinants of NCDs in all countries. QoL of elderly was associated with SPH in Italy (coeff = 0.12, 95%CI: [0.10, 0.14]), Spain (coeff = 0.16, 95%CI: [0.15, 0.18]), and Greece (coeff = 0.18, 95%CI: [0.16, 0.20]). The number of NCDs was higher for people who were not employed in Spain (coeff = 0.45, 95%CI: [0.37, 0.53]) and was decreasing for a unitary increase in years of education in Greece (coeff = −0.12, 95%CI: [−0.14, −0.09]). As a general rule, the framework of the interrelationship among NCDs, SPH, and QoL was similar for Italy, Spain, and Greece. The connections found among indicators could be proposed to identify strategies for health promotion and healthy aging among people aged 50 and above, which are viable in general and at a country level. Reinforcing strategies targeted at some health indicators could have relevant effects on other related indicators.
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Abstract
The purpose of this study is to examine how much variance in self-rated health is attributable to household and administrative-area levels. Additionally, the study investigates the association between physical activity and self-rated health while adjusting for various covariates at the individual, household, and district levels in Seoul, South Korea. A cross-sectional study of the 2009 Seoul Welfare Panel Study conducted by Seoul Welfare Foundation was utilized. The final sample included 7,761 individuals within 3,617 households in 25 administrative areas. Three-level random intercept logistic models were fitted. The results showed that a small proportion (3.52%) of variance in self-rated health was attributed to the administrative-area level, while a relatively large proportion (33.78%) was attributed to the household level. This study also found a positive association between physical activity and self-rated health, even after controlling for covariates at multiple levels. The results indicated that public health interventions promoting physical activity may have a beneficial effect on individual health. Additionally, public health interventions for improving individual health may not be efficient if directed only at the administrative-area level, as only a small portion of variance in self-rated health was attributable to this level.
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Affiliation(s)
- Sehee Han
- Institute of Social Sciences, Kookmin University, Seongbuk-Gu, South Korea
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Aliyas Z. Social Capital and Physical Activity Level in an Urban Adult Population. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1691092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tenani CF, De Checchi MHR, Bado FMR, Ju X, Jamieson L, Mialhe FL. Influence of oral health literacy on dissatisfaction with oral health among older people. Gerodontology 2019; 37:46-52. [PMID: 31746043 DOI: 10.1111/ger.12443] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 10/04/2019] [Accepted: 10/19/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the influence of oral health literacy (OHL) and associated factors on dissatisfaction with oral health (DOH) among older people. BACKGROUND Oral health literacy is a recent field of research that has been considered an important mediator between socioeconomic variables and oral health outcomes. However, there are few studies with older people. MATERIALS AND METHODS A cross-sectional study was conducted with 535 non-institutionalised older people aged 60-100 years from Brazil. Individuals completed a questionnaire on general health, sociodemographic information and usual reason for dental visit. OHL was assessed using the Health Literacy in Dentistry questionnaire (HeLD-14), validated in Brazil. DOH was the outcome of interest. Poisson regression with robust standard errors was applied as a statistical model to estimate bivariate and multivariable relationships of DOH with OHL after adjusting for sex, age, social characteristics and general health using the P-value of ≤ .05. RESULTS The overall prevalence of DOH was 21.1%. Multivariable regression analysis showed that older people with low OHL (HeLD-14 score ≤35) had 1.28 times the odds of having DOH than those with high OHL (HeLD14 score >46), after adjusting for sociodemographic, economic and health outcomes. CONCLUSIONS Dissatisfaction with oral health in older people is a complex issue associated with OHL, social and behavioural factors. Health services should give greater attention to developing health literacy competences in older adults in order to empower them to achieve optimal oral health.
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Affiliation(s)
- Carla Fabiana Tenani
- Department of Community Dentistry, Piracicaba Dental School, Area of Health Education and Health Promotion, University of Campinas, Piracicaba, Brazil
| | - Maria Helena Ribeiro De Checchi
- Department of Community Dentistry, Piracicaba Dental School, Area of Health Education and Health Promotion, University of Campinas, Piracicaba, Brazil
| | - Fernanda Maria Rovai Bado
- Department of Community Dentistry, Piracicaba Dental School, Area of Health Education and Health Promotion, University of Campinas, Piracicaba, Brazil
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, SA, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, SA, Australia
| | - Fábio Luiz Mialhe
- Department of Community Dentistry, Piracicaba Dental School, Area of Health Education and Health Promotion, University of Campinas, Piracicaba, Brazil
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Tetteh J, Kogi R, Yawson AO, Mensah G, Biritwum R, Yawson AE. Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization's study on global AGEing and adult health, Wave 2. PLoS One 2019; 14:e0224327. [PMID: 31689325 PMCID: PMC6830754 DOI: 10.1371/journal.pone.0224327] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/10/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Functional difficulty assessment has been proven as a key factor in the health evaluation of adults. Previous studies have shown a reduction in health and functional difficulties with increasing age. This analysis was conducted to quantify the effect of poor self-rated health on functional difficulty among older adults in Ghana. METHOD This analysis was based on the World Health Organization Study on Global AGEing and Adult Health in Ghana for older adults 50 years and above. Fifteen standard functioning difficulty tools were extracted and used for the analysis. Three predictive models with the Coarsened Exact Matching method involving Negative Binomial, Logistics and Ordered logistic regression were performed using Stata 14. RESULTS Overall, the prevalence of poor Self-rated health was 34.9% and that of functional difficulties among older adults in Ghana was 69.4%. Female sex, increasing age, being separated, having no religious affiliation, not currently working and being underweight were associated with and significantly influence poor Self-rated health [AOR(95%CI)p-value = 1.41(1.08-1.83)0.011, 3.85(2.62-5.64)0.000, 1.45(1.08-1.94)0.013, 2.62(1.68-4.07)0.000, 2.4(1.85-3.12)0.000 and 1.39(1.06-1.81)0.017 respectively]. In addition, poor Self-rated health and geographical location (rural vs. urban)significantly influence functioning difficulties among older adults in Ghana as predicted by the three models [Negative Binomial: PR(95%CI) = 1.62(1.43-1.82), Binary logistic: AOR(95%CI) = 3.67(2.79-4.81) and ordered logistic: AOR(95%CI) = 2.53(1.14-2.03)]. CONCLUSION Poor SRH is more pronounced among older adult females in Ghana. Some determinants of poor SRH include; age, geographical location (urban vs. rural), marital status, religion, and employment status. This provides pointers to important socio-demographic determinants with implications on the social function of older adults in line with the theme of the national aging policy of 2010, 'ageing with security and dignity' and ultimately in the national quest to achieve the Sustainable Development Goals by 2030.
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Affiliation(s)
- John Tetteh
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- National Cardiothoracic Centre, Korle-Bu Teaching Hospital, Accra, Ghana
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kogi
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - George Mensah
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Richard Biritwum
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
- Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
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Abstract
BACKGROUND Living alone has become more common in today's societies. Despite the high number of the population living alone, research directed towards the mental wellbeing issues related to living alone has been limited. This systematic literature review aimed to assess the association between living alone and positive mental health. METHODS We conducted searches in Medline, Web of Science, Cochrane Library, CINAHL, PsycINFO, and other complementary databases from January 1998 to May 2019. Randomised trials and observational studies investigating adults over 18 years of age and living alone (defined as living in a single household or a household size of one person) were eligible. The primary outcome was positive mental health, defined as comprising both hedonic and eudaimonic elements of mental wellbeing, and it was measured with the Warwick-Edinburgh Mental Well-being Scale and/or theWHO-5 Index. Two reviewers independently screened and selected data; one reviewer extracted data, and the second checked the extracted data. A narrative synthesis described the quality and content of the evidence. Included studies were appraised using relevant Joanna Briggs Institute checklist. RESULTS A total of 4 cross-sectional studies (22,591 adult participants) were included after screening of 341 titles and abstracts and 46 full-text articles. These studies were conducted in Europe and were published between 2014 and 2017. The studies differed in their measurements of positive mental health (WHO-5 Well-Being Index, 3 studies; WEMWBS, 1 study), sources of data (1 regional, 1 national, and 2 European-level studies), and study populations (regional study, adults over 65 years of age; national-level study, mental health nurses over 21 years of age; European-level studies, employees between 15 and 65 years of age and adults over 18 years of age). A potential association between living alone and low positive mental health was found in three out of the four studies. Our findings were limited as the number of included studies was low and the quality of evidence varied across studies. CONCLUSIONS This review allows a limited look at the association between living alone and positive mental health. Because the number of included studies was low and the quality of evidence varied across studies, further research is warranted.
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Henning-Smith C, Gonzales G. The Relationship Between Living Alone and Self-Rated Health Varies by Age: Evidence From the National Health Interview Survey. J Appl Gerontol 2019; 39:971-980. [PMID: 30894044 DOI: 10.1177/0733464819835113] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite growing attention to the connection between living arrangements and health, less is known about how the health of individuals living alone varies by age. Using data from the 2016 National Health Interview Survey (N = 30,079), we estimated logistic regression models stratified by age group, comparing health by living arrangement and controlling for sociodemographic characteristics. Middle-aged adults living alone had higher odds of poor/fair self-rated health, compared with adults living with others (35-64 years of age: adjusted odds ratio [AOR] = 1.19, p < .05). In contrast, older adults (65 years and older) living alone had significantly lower odds of reporting poor/fair health than their counterparts living with others (AOR = .70, p < .001). The direction of association between self-rated health and other covariates did not differ by age group. The relationship between living alone and health varies by age and policies and programs designed to support the growing population of people living alone should be tailored accordingly.
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Niemelä MS, Kangas M, Ahola RJ, Auvinen JP, Leinonen AM, Tammelin TH, Vaaramo ES, Keinänen-Kiukaanniemi SM, Korpelainen RI, Jämsä TJ. Dose-response relation of self-reported and accelerometer-measured physical activity to perceived health in middle age-the Northern Finland Birth Cohort 1966 Study. BMC Public Health 2019; 19:21. [PMID: 30612541 PMCID: PMC6322295 DOI: 10.1186/s12889-018-6359-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 12/21/2018] [Indexed: 11/20/2022] Open
Abstract
Background Regular physical activity (PA) promotes health and decreases mortality. The positive relationship between PA and perceived health (PH) is well known. However, previous research in the field has often used self-reported PA measures. The aim of this population-based NFBC1966 birth cohort study was to assess the relationship between both self-reported and objectively measured PA and PH in midlife. Methods A sample group of 6384 participants (2878 men, 3506 women, response rate 62%) aged 46 completed a questionnaire on PH and health behaviors, including items on weekly leisure time physical activity (LTPA) and daily sitting time (ST). PH was dichotomized as good (very good or good) and other (fair, poor, or very poor). PA was measured with a wrist-worn Polar Active (Polar Electro, Finland) accelerometer for 14 days (n = 5481, 98%) and expressed as daily average time spent in moderate to vigorous intensity PA (MVPA). Odds ratios (OR) and 95% confidence intervals for good PH were calculated using binary logistic regression and adjusted for relevant demographic, socioeconomic, and health characteristics, and ST. Results The level of PA was positively associated with PH after adjustments with covariates and ST. There was a dose-response relationship across the PA quartiles according to the adjusted multivariable models. Self-reported LTPA was more strongly associated with good PH (OR from 1.72 to 4.33 compared to lowest PA quartile) than objectively measured PA (OR from 1.37 to 1.66 compared to lowest PA quartile). Conclusions In this large population-based birth cohort study, we for the first time show a positive dose-response relationship of both self-reported and objectively measured PA to PH, the relationship being stronger for self-reported LTPA. Despite the cross-sectional design of this study, the results from this large sample suggest that both self-reported and objectively measured physical activity are strongly associated with PH, which is a predictor of morbidity and mortality, and regular PA should be encouraged in midlife.
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Affiliation(s)
- Maisa S Niemelä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, PO Box 5000, 90014, Oulu, Finland. .,Infotech, University of Oulu, Oulu, Finland. .,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Maarit Kangas
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, PO Box 5000, 90014, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | | | - Juha P Auvinen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Anna-Maiju Leinonen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, PO Box 5000, 90014, Oulu, Finland.,Infotech, University of Oulu, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland
| | - Tuija H Tammelin
- LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland
| | - Eeva S Vaaramo
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Sirkka M Keinänen-Kiukaanniemi
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Health Center of Oulu, Oulu, Finland.,Healthcare and Social Services of Selänne, Pyhäjärvi, Finland
| | - Raija I Korpelainen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Oulu, Finland
| | - Timo J Jämsä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, PO Box 5000, 90014, Oulu, Finland.,Infotech, University of Oulu, Oulu, Finland.,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.,Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
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The Effects of Health Status on Life Insurance Holdings in 16 European Countries. SUSTAINABILITY 2018. [DOI: 10.3390/su10103454] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examines the relationships among three health status indicators (self-perceived health status, objective health status, and future health risk) and life insurance holdings in 16 European countries. Our results show that households with poor self-perceived health status and high future health risk are less likely to purchase life insurance in the entire sample as well as in the subsample for countries with a national health system (NHS). In non-NHS countries, those households that have high future health risk are less inclined to purchase life insurance. In terms of preferences for types of life insurance policies (term life, whole life, both, or none) in the whole sample, poor self-perceived health status and high future health risk are less inclined to hold only term life insurance policy. In addition, poor self-perceived health status and high future health risk have a negative impact on holdings of both types of life insurance. Our findings reveal that there is no adverse selection problem in the life insurance market, especially in European countries with NHS.
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Partnership trajectories and cardiovascular health in late life of older adults in England and Germany. SSM Popul Health 2018; 6:26-35. [PMID: 30128350 PMCID: PMC6098208 DOI: 10.1016/j.ssmph.2018.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives Previous studies have shown marital status differences in incidence and prevalence of cardiovascular disease and cardiovascular mortality. This study examines the consequences of partnership on biomarkers related to cardiovascular health of older men and women in Germany and England (C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol). Methods Data used is from older adults (60 +) from the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership trajectory. OLS for C-reactive protein, logistic regressions for systolic and diastolic blood pressure, and multinomial logistic regressions for cholesterol are used to investigate the associations between life course partnership characteristics and biomarkers, accounting for early age socioeconomic and health conditions. Results Timing of first partnership is associated with poor cardiovascular health in England, number of partnership transitions with poor health in Germany, and partnership trajectories are associated with cardiovascular health both in Germany and England. Men in trajectories with multiple marriages have higher CRP, and are more likely to have elevated systolic and diastolic BP. Trajectories containing single marital disruption for men and women are no longer associated with poor health after accounting for selection effects of childhood conditions. Respondents in widowed partnership trajectories have poorer cardiovascular health compared to those in intact committed relationships, whereas cohabitation trajectories do not differ in the associations with biomarkers from those in intact marriage. Conclusion The results offer better understanding of the pathways through which family events and processes are linked to health and support the hypothesis that adversity related to partnerships over the life course accumulates and contributes to worse cardiovascular health in later life measured by objective health measures. This study investigates the longitudinal accumulated effects of partnership on cardiovascular health using haemostatic and inflammatory biomarkers in later-life, C-reactive protein, HbA1c, systolic and diastolic blood pressure; and total cholesterol. Based on life course theory of cumulative disadvantage, the study finds support that the benefits and risks of marital status accumulate over the life-course. The effects are visible on biomarkers of older adults in both Germany and England in models that account for conditions in early life, health behaviors in adult life and sociodemographic factors. Data used is from older adults (60 +) form the German Survey of Health and Retirement Europe SHARE (n=955) and the English Longitudinal Study of Ageing ELSA (n=9707). Life course partnership is measured using the timing (age at first partnership), quantum (number of partnerships) and partnership sequence type.
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Jalali-Farahani S, Amiri P, Karimi M, Vahedi-Notash G, Amirshekari G, Azizi F. Perceived social support and health-related quality of life (HRQoL) in Tehranian adults: Tehran lipid and glucose study. Health Qual Life Outcomes 2018; 16:90. [PMID: 29747652 PMCID: PMC5946411 DOI: 10.1186/s12955-018-0914-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/27/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Several studies have demonstrated the positive association between perceived social support and health-related quality of life (HRQoL) in certain groups; however, few studies have assessed this relationship in general population and between genders. This study aimed to investigate associations between socio-demographic factors, perceived social support and HRQoL among an urban Iranian population. METHODS The study population were 1036 adults who had participated in Tehran Lipid and Glucose Study (TLGS). Data on socio-demographic information, perceived social support and HRQoL were collected using standard questionnaires by trained interviewers. Perceived social support and HRQoL were assessed using Iranian versions of the Multidimensional Scale of Perceived Social Support (MSPSS) and Short-Form 12-Item Health Survey version 2 (SF-12v2) respectively. Data on sets of associations among socio-demographic factors, perceived social support and quality of life were analyzed using Structural Equation Modeling (SEM) with IBM SPSS AMOS software. RESULTS Mean ages were 50.3 ± 16.3 and 49.6 ± 14.0 years in men and women respectively and 40.9% of participants were male. In terms of perceived social support scores, except for family subscale scores (p = 0.003), there were no significant differences between men and women. However, men had significantly higher HRQoL scores, compared to women in all subscales. The findings of SEM analysis demonstrated that being married in both genders (p < 0.001) and lower age in men (p < 0.05) were significantly associated with higher level of perceived social support. In terms of physical HRQoL, being single and higher perceived social support in both genders and lower age and not having any chronic diseases, only in women were associated with higher physical HRQoL. However, for mental HRQoL, age and perceived social support had significant direct associations with mental HRQoL in both genders (p < 0.001); in women, being single (p < 0.05) and not having chronic diseases (p < 0.001) were also significantly associated with better mental HRQoL. CONCLUSION Perceived social support was found to be both directly and indirectly associated with physical and mental aspects of HRQoL in both genders. Current structural models provide beneficial information for planning health promotion programs aimed at improving HRQoL among Tehranian adults.
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Affiliation(s)
- Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran.
| | - Mehrdad Karimi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran.,Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Golnaz Vahedi-Notash
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, IR, Iran
| | - Golshan Amirshekari
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Self-Rated Health and Its Determinants in Female Population in Iran: A Community-Based Study. HEALTH SCOPE 2018. [DOI: 10.5812/jhealthscope.68258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fonta CL, Nonvignon J, Aikins M, Nwosu E, Aryeetey GC. Predictors of self-reported health among the elderly in Ghana: a cross sectional study. BMC Geriatr 2017; 17:171. [PMID: 28760156 PMCID: PMC5537992 DOI: 10.1186/s12877-017-0560-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-reported health is a widely used measure of health status across individuals. As the ageing population increases, the health of the elderly also becomes of growing concern. The elderly go through life facing social, economic and financial hardships. These hardships are known to affect the health status of people as they age. The purpose of this study is to assess social and health related factors of self-reported health among the elderly in Ghana. METHODS A multivariate regression analysis in form of a binary and ordinal logistic regression were used to determine the association between socioeconomic, demographic and health related factors, on self-reported health. The data used for this study was drawn from the World Health Organization (WHO) Study on Global Ageing and Adult Health (SAGE) Wave 1. RESULTS In total, out of 2613 respondent, 579 (20.1%) rated their health status as poor and 2034 (79.9%) as good. The results showed that the odds of reporting poor health was 2.5 times higher among the old-old compared to the young old. The elderly with one or more than one chronic condition had the odds of 1.6 times and 2 times respectively, of reporting poor health. Engaging in mild to moderate exercise increased the chances of reporting poor health by 1.8 times. The elderly who had never worked in a lifetime were 2 times more likely to report poor health. In the same way, residents of Eastern and Western parts of Ghana were 2 times more likely to report poor health compared to those in the Upper West region. Respondents with functional limitations and disabilities were 3.6 times and 2.4 times respectively, more likely to report poor health. On the other hand, the odds of reporting poor health was 29, 36 and 27% less among respondents in the highest income quintiles, former users of tobacco and those satisfied with certain aspects of life respectively. Also, current alcohol users were 41% less likely to report poor health. CONCLUSION The health status of the elderly is to an extent determined by the circumstances in which they are born, grow and live. The findings suggest that addressing social issues faced by individuals in youthful age will go a long way to achieving good health in the future. People with physical limitations and disabilities are most vulnerable to unmet healthcare needs and support system from government, policy makers and family.
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Affiliation(s)
- Cynthia Lum Fonta
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
- West African Science Service Center on Climate Change and Adapted Land Use, WASCAL Competent Center, Blvd Mouammar Kadhafi, 06, Ouagadougou, BP 9507 Burkina Faso
| | - Justice Nonvignon
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
| | - Moses Aikins
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
| | - Emmanuel Nwosu
- Department of Economics, University of Nigeria Nsukka, Enugu State, Nigeria
| | - Genevieve Cecilia Aryeetey
- Department of Health Policy Planning and Management, School of Public Health, University of Ghana, Legon, Accra LG 13 Ghana
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Syse A, Lyngstad TH. In sickness and in health: The role of marital partners in cancer survival. SSM Popul Health 2016; 3:99-110. [PMID: 29349208 PMCID: PMC5769016 DOI: 10.1016/j.ssmph.2016.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/02/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022] Open
Abstract
Married cancer patients enjoy a survival advantage, potentially attributable to better health at diagnosis, earlier contact with health personnel, and/or access to resources to ensure more optimal treatment. These mechanisms only invoke the mere presence of a partner, but partners bring varying amounts of resources into the household. It is likely that also spousal resources contribute to differentials in survival net of own resources, as gradients in survival by the latter are well documented. Our aim is to examine the combined roles of own and spouses’ socioeconomic characteristics (SES) and age for cancer survival. Almost 268,000 married patients diagnosed with a first cancer after age 50 during 1975–2007 were identified from the Norwegian Cancer Registry and other national registers. In a sequence of hazard models, differences in survival by patients' own education, income and age and the role of spouses' characteristics were assessed. Furthermore, we also assessed the importance of homogamy/heterogamy along the same dimensions. Partners’ characteristics clearly matter for survival. The relative survival of patients with highly educated partners, net of their own education, is significantly higher than that of patients with lesser-educated partners. Somewhat similar effects are observed for income, net of education. A less consistent pattern is observed for age, although non-normative heterogamy patterns in age and income appear to be associated with a survival disadvantage. The naïve perspective of only considering the presence of partners may thus conceal important differences in cancer survival. Health personnel may take advantage of such knowledge in interactions with patients and their families, and gather information on resources in immediate networks that may impact prognosis favorable and/or unfavorable and help patients utilize these resources to improve prognosis. For married cancer patients, survival is influenced by the resources of spouses. As such, who you marry play a role for your survival. Having a highly educated and/or a high earning spouse appears to be beneficial. But, non-normative spousal patterns in age and SES appear to be disadvantageous. Married patients’ spousal resources may help shed light on inequalities in survival.
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Affiliation(s)
- Astri Syse
- Statistics Norway, Dep. of Research, P.O. Box 8131 Dep., N-0033 Oslo, Norway
| | - Torkild Hovde Lyngstad
- University of Oslo, Department of Sociology and Human Geography, P.O. Box 1096 Blindern, N-0317 Oslo, Norway
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Santos-Lozada AR. Self-rated mental health and race/ethnicity in the United States: support for the epidemiological paradox. PeerJ 2016; 4:e2508. [PMID: 27688982 PMCID: PMC5036069 DOI: 10.7717/peerj.2508] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/26/2016] [Indexed: 11/25/2022] Open
Abstract
This paper evaluates racial/ethnic differences in self-rated mental health for adults in the United States, while controlling for demographic and socioeconomic characteristics as well as length of stay in the country. Using data from the 2010 National Health Interview Survey Cancer Control Supplement (NHIS-CCS), binomial logistic regression models are fit to estimate the association between race/ethnicity and poor/fair self-reported mental health among US Adults. The size of the analytical sample was 22,844 persons. Overall prevalence of poor/fair self-rated mental health was 7.72%, with lower prevalence among Hispanics (6.93%). Non-Hispanic blacks had the highest prevalence (10.38%). After controls for socioeconomic characteristics are incorporated in the models, Hispanics were found to have a lower probability of reporting poor/fair self-rated mental health in comparison to non-Hispanic whites (OR = 0.70; 95% CI [0.55–0.90]). No difference was found for other minority groups when compared to the reference group in the final model. Contrary to global self-rated health, Hispanics were found to have a lower probability of reporting poor/fair self-rated mental health in comparison to non-Hispanic whites. No difference was found for non-Hispanic blacks when they were compared to non-Hispanic whites. Self-rated mental health is therefore one case of a self-rating of health in which evidence supporting the epidemiological paradox is found among adults in the United States.
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Affiliation(s)
- Alexis R Santos-Lozada
- Department of Sociology and Criminology, Pennsylvania State University , State College , PA , United States
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Liu GG, Xue X, Yu C, Wang Y. How does social capital matter to the health status of older adults? Evidence from the China Health and Retirement Longitudinal Survey. ECONOMICS AND HUMAN BIOLOGY 2016; 22:177-189. [PMID: 27235837 DOI: 10.1016/j.ehb.2016.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 04/08/2016] [Accepted: 04/11/2016] [Indexed: 05/20/2023]
Abstract
This paper uses longitudinal data from China to examine the causal relationship between structural social capital and health among Chinese older adults. We employ various econometric strategies to control for the potential endogeneity of social capital and account for the possible contextual confounding effects by including community-level social capital. We use three indicators to measure individuals' general, physical, and mental health. Results indicate that social capital has a significant and positive effect on general and physical health. Based on our primary IV findings, a one standard-deviation increase in social capital leads to a 4.9 standard-deviation decrease in the probability of having bad health and a 2.2 standard-deviation decrease in physical activity limitations. Our results are robust to a series of sensitivity checks. Further analysis suggests heterogeneous effects by age but not by gender or area of residence.
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Affiliation(s)
- Gordon G Liu
- National School of Development, Peking University, China
| | - Xindong Xue
- School of Public Administration, Zhongnan University of Economics and Law, China.
| | - Chenxi Yu
- Woodrow Wilson School of Public and International Affairs, Princeton University, United States
| | - Yafeng Wang
- Institute of Social Science Survey, Peking University, China
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Cau BM, Falcão J, Arnaldo C. Determinants of poor self-rated health among adults in urban Mozambique. BMC Public Health 2016; 16:856. [PMID: 27553080 PMCID: PMC4995828 DOI: 10.1186/s12889-016-3552-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 08/18/2016] [Indexed: 11/17/2022] Open
Abstract
Background Self-rated health is a measure expressing the general condition of health of individuals. Self-rated health studies are common in developed countries and in some developing regions. Despite increasing proportion of adult and older population in sub-Saharan Africa and poor population health indicators, there is a dearth of studies on self-rated health in the region. This study examines factors associated with poor self-rated health among adult individuals in Maputo metropolitan area in Mozambique. Methods Data for this study come from a survey of 1768 individuals aged 18 years or more carried out in Maputo metropolitan area, Mozambique, in 2015. Employing multiple logistic regression, the study used a subsample of 677 female and male respondents aged 40 years or more to estimate the determinants of poor self-rated health. Results About 54 % of respondents aged 40 years or more believed that their health status was poor. Female respondents [Odds Ratios (OR) = 3.43, p <0.01], single (OR = 4.71, p < 0.05), widow (OR = 1.81, p < 0.05), separated or divorced (OR = 2.08, p < 0.05) and those believing that hypertension or heart problem was a major community health problem (OR = 1.56, p < 0.05) displayed higher odds of reporting poor health than their peers, net of other factors. Furthermore, individuals aged 40–49 years (OR = 0.45, p < 0.01), or 50–59 years (OR = 0.59, p < 0.05), those whose work involves intensive physical activity (OR = 0.60, p < 0.05) and those from households treating drinking water (OR = 0.49, p < 0.01) showed lower odds of reporting poor health, adjusting for other factors. Conclusion Overall, the results point to the importance of age, gender, marital status, socioeconomic circumstances, individuals’ health behaviors and perceived community health problems as key determinants of poor self-rated health among adults in Maputo metropolitan area. Given the growing number of adult and older people in sub-Saharan Africa, the rising importance of non-communicable diseases and the scarcity of studies on determinants of poor self-rated health among adults in the region, our findings may have implications for a better understanding of the drivers of poor health among adults in urban sub-Saharan Africa
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Affiliation(s)
- Boaventura M Cau
- Departamento de Geografia, Universidade Eduardo Mondlane (UEM), C.P. 257, Maputo, Mozambique. .,Centro de Pesquisa em População e Saúde (CEPSA), Maputo, Mozambique.
| | - Joana Falcão
- Centro de Pesquisa em População e Saúde (CEPSA), Maputo, Mozambique
| | - Carlos Arnaldo
- Departamento de Geografia, Universidade Eduardo Mondlane (UEM), C.P. 257, Maputo, Mozambique.,Centro de Pesquisa em População e Saúde (CEPSA), Maputo, Mozambique
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von der Lippe E, Rattay P. Association of partner, parental, and employment statuses with self-rated health among German women and men. SSM Popul Health 2016; 2:390-398. [PMID: 29349156 PMCID: PMC5757937 DOI: 10.1016/j.ssmph.2016.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 04/26/2016] [Accepted: 05/11/2016] [Indexed: 10/28/2022] Open
Abstract
The association of partner, parental, and employment statuses with health is usually discussed in terms of either the multiple role burden hypothesis or the multiple role attachment hypothesis. The first hypothesis states that combining work and family roles increases the burden of responsibility, which in turn increases the pressure and stress associated with competing roles, leading to poorer health. The multiple role attachment hypothesis argues that multiple responsibilities provide attachment to broader networks, which then provide social support and resources that enhance health. We analyzed pooled data from the German Health Update carried out by the Robert Koch Institute in 2009, 2010, and 2012. The data were collected by computer-assisted telephone interviews. The sample comprised 28,086 people aged 30-54 years. The data were assessed with logistic regression analysis and interaction models. The gender-differentiated analysis of partnership, parenthood, and employment, after adjusting for social and demographic characteristics, revealed small interaction effects among all three social roles with self-rated health in women and men. Non-employment showed the strongest relationship with poor self-rated health. It was significantly associated with lower self-rated health in both men and women in most of the family arrangements. These associations were higher in men than in women. Furthermore, in all family arrangements, female part-time employees were as healthy as female fulltime employees. A more subtle association was found in men: the odds of reporting poorer self-rated health were greater among non-parents employed part time than among those employed full time, but lower than among those who were non-employed. Among fathers, part-time employees did not have statistically better health than full-time employees.The findings support somewhat the multiple role attachment hypothesis, rather than the multiple role burden hypothesis. Because employment has great importance for both women's and men's health, the compatibility of work and family roles should be improved.
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Affiliation(s)
| | - Petra Rattay
- Robert Koch Institute, General-Pape Str. 62, 12101 Berlin, Germany
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Moreira TR, Giatti L, Cesar CC, Andrade EIG, Acurcio FDA, Cherchiglia ML. Health self-assessment by hemodialysis patients in the Brazilian Unified Health System. Rev Saude Publica 2016; 50:10. [PMID: 27143610 PMCID: PMC4891181 DOI: 10.1590/s1518-8787.2016050005885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 06/09/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine whether the level of complexity of the services structure and sociodemographic and clinical characteristics of patients in hemodialysis are associated with the prevalence of poor health self-assessment. METHODS In this cross-sectional study, we evaluated 1,621 patients with chronic terminal kidney disease on hemodialysis accompanied in 81 dialysis services in the Brazilian Unified Health System in 2007. Sampling was performed by conglomerate in two stages and a structured questionnaire was applied to participants. Multilevel multiple logistic regression was used for data analysis. RESULTS The prevalence of poor health self-assessment was of 54.5%, and in multivariable analysis it was associated with the following variables: increasing age (OR = 1.02; 95%CI 1.01–1.02), separated or divorced marital status (OR = 0.62; 95%CI 0.34–0.88), having 12 years or more of study (OR = 0.51; 95%CI 0.37–0.71), spending more than 60 minutes in commuting between home and the dialysis service (OR = 1.80; 95%CI 1.29–2.51), having three or more self-referred diseases (OR = 2.20; 95%CI 1.33–3.62), and reporting some (OR = 2.17; 95%CI 1.66–2.84) or a lot of (OR = 2.74; 95%CI 2.04–3.68) trouble falling asleep. Individuals in treatment in dialysis services with the highest level of complexity in the structure presented less chance of performing a self-assessment of their health as bad (OR = 0.59; 95%CI 0.42–0.84). CONCLUSIONS We showed poor health self-assessment is associated with age, years of formal education, marital status, home commuting time to the dialysis service, number of self-referred diseases, report of trouble sleeping, and also with the level of complexity of the structure of health services. Acknowledging these factors can contribute to the development of strategies to improve the health of patients in hemodialysis in the Brazilian Unified Health System.
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Affiliation(s)
- Tiago Ricardo Moreira
- Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa, MG, Brasil
| | - Luana Giatti
- Departamento de Nutrição Clínica e Social, Escola de Nutrição, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brasil
| | - Cibele Comini Cesar
- Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Eli Iola Gurgel Andrade
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Francisco de Assis Acurcio
- Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Mariângela Leal Cherchiglia
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Smoking Cessation After Acute Myocardial Infarction in Relation to Depression and Personality Factors. Int J Behav Med 2015; 23:234-42. [DOI: 10.1007/s12529-015-9514-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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44
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Demographic and socioeconomic inequalities for self-rated health and happiness in elderly: The situation for Turkey regarding World Values Survey between 1990 and 2013. Arch Gerontol Geriatr 2015; 61:224-30. [DOI: 10.1016/j.archger.2015.06.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 06/15/2015] [Accepted: 06/18/2015] [Indexed: 11/17/2022]
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Chung W, Kim R. Are Married Men Healthier than Single Women? A Gender Comparison of the Health Effects of Marriage and Marital Satisfaction in East Asia. PLoS One 2015; 10:e0134260. [PMID: 26230841 PMCID: PMC4521890 DOI: 10.1371/journal.pone.0134260] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 07/01/2015] [Indexed: 12/03/2022] Open
Abstract
Background Although Asian societies are remarkably different from Western societies in terms of sociocultural characteristics, little is known about the gender differences in the health effects of marriage and marital satisfaction in Asian countries. Methodology/Principal Findings Using a randomly sampled dataset from the 2006 East Asian Social Survey comprising 8528 individuals from China, Japan, Taiwan, and South Korea, this study performs analyses using a multivariate logistic regression model to predict the probability for a man or a woman to report poor health. Our results differ quite significantly from those of most studies focusing on Western countries. Considering marital satisfaction, there may be no health benefits from marriage for a specific gender in a given country, because the health loss associated with a dissatisfied marriage usually supersedes the health benefits from marriage. Moreover, women may reap greater health benefits from marriage than men. Additionally, those most likely to report poor health are found to be married and dissatisfied men or women, rather than never-married individuals. Conclusion/Significance The present study argues the need to design and carry out a gender- and country-specific social health policy approach to target individuals suffering from poor health, thereby reducing the gender differences in health status.
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Affiliation(s)
- Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Roeul Kim
- National Tobacco Control Center, Korea Health Promotion Foundation, Seoul, Korea
- * E-mail:
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Eifert EK, Wideman L, Oberlin DJ, Labban J. The relationship between physical activity and perceived health status in older women: findings from the Woman's College Alumni Study. J Women Aging 2015; 26:305-18. [PMID: 25133943 DOI: 10.1080/08952841.2014.906878] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Using data collected from the Woman's College (WC) Alumni Study, the purpose of this study was to determine whether perceived health status is related to physical activity in older women. A multiple linear regression analysis was conducted to examine the relationship between amounts of physical activity and self-reported health status. The results of the current study reveal that the level of physical activity is significantly correlated with perceived health status. The findings of this study have implications for the assessment of older individuals' health and may lead to interventions that are tailored to increase physical activity among older women.
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Affiliation(s)
- Elise K Eifert
- a Department of Public Health Education , University of North Carolina at Greensboro , Greensboro , NC
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Ploubidis GB, Silverwood RJ, DeStavola B, Grundy E. Life-Course Partnership Status and Biomarkers in Midlife: Evidence From the 1958 British Birth Cohort. Am J Public Health 2015; 105:1596-603. [PMID: 26066911 DOI: 10.2105/ajph.2015.302644] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined the association between trajectories of partnership status over the life course and objectively measured health indicators in midlife. METHODS We used data from 4 waves (1981, 1991, 2000, and 2002-2004) of the British National Child Development Study (NCDS), a prospective cohort study that includes all people born in Britain during 1 week in March 1958 (n = 18 558). RESULTS After controlling for selection attributable to early-life and early-adulthood characteristics, we found that life-course trajectories of partnership status were associated with hemostatic and inflammatory markers, the prevalence of metabolic syndrome and respiratory function in midlife. Never marrying or cohabiting was negatively associated with health in midlife for both genders, but the effect was more pronounced in men. Women who had married in their late 20s or early 30s and remained married had the best health in midlife. Men and women in cohabiting unions had midlife health outcomes similar to those in formal marriages. CONCLUSIONS Partnership status over the life course has a cumulative effect on a wide range of objectively measured health indicators in midlife.
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Affiliation(s)
- George B Ploubidis
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
| | - Richard J Silverwood
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
| | - Bianca DeStavola
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
| | - Emily Grundy
- George B. Ploubidis is with the Centre for Longitudinal Studies, UCL - Institute of Education, University College London, London, UK. Richard J. Silverwood and Bianca DeStavola are with the Centre for Statistical Methodology, Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London. Emily Grundy is with the Department of Social Policy, London School of Economics and Political Science, London
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Chung W, Kim R. Does marriage really matter to health? Intra- and inter-country evidence from China, Japan, Taiwan, and the Republic of Korea. PLoS One 2014; 9:e104868. [PMID: 25118189 PMCID: PMC4130618 DOI: 10.1371/journal.pone.0104868] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 07/17/2014] [Indexed: 11/18/2022] Open
Abstract
Background The health benefits of marriage have been demonstrated mainly by studies on Western populations. This study aims to test whether the benefits are also valid in East Asian populations. Methodology/Principal Findings Individuals (n = 8,538) from China, Japan, Taiwan, and the Republic of Korea were sampled from the 2006 East Asian Social Survey. The association between self-rated health status and two marriage-related independent variables was analyzed using multivariate logistic regression models. In a two-level analysis for individuals from all countries, married individuals were more likely to report very good or good health compared to their never-married counterparts [odds ratio (OR) 1.56; 95% confidence interval (95% CI) 1.16−2.10]. However, the addition of marital satisfaction disintegrated the significant association of marriage with self-rated health. Married individuals in satisfying marriages were more likely to report very good or good health compared with never-married individuals (OR 1.85; 95% CI 1.37−2.50). In contrast, married individuals in dissatisfying marriages were as likely to report very good or good health as never-married individuals (OR 0.78; 95% CI 0.50−1.24). In a one-level analysis for each country, the importance of marital satisfaction varied greatly across countries. Unlike in other countries, in Japan, married individuals in dissatisfying marriages were about half as likely to report very good or good health as never-married individuals (OR 0.51, 95% CI 0.31−0.83), thereby showing no significant benefits from marriage with regard to self-rated health. Conclusion/Significance The present study of East Asian countries suggests that marital satisfaction is of greater importance in determining self-rated health than marriage itself, and that the importance of marital satisfaction varies across countries. Further research is required to better understand the relationship between marital satisfaction and self-rated health in different socio-cultural settings, and to establish effective social policies aiming at improving public health.
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Affiliation(s)
- Woojin Chung
- Department of Health Policy and Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
- Institute of Health Services Research, Yonsei University, Seoul, Korea
| | - Roeul Kim
- Institute of Health Services Research, Yonsei University, Seoul, Korea
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
- * E-mail:
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Social capital and self-rated health among older adults: a comparative analysis of Finland, Poland and Spain. AGEING & SOCIETY 2014. [DOI: 10.1017/s0144686x13001025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTThe aim of this paper is to investigate the association between structural and cognitive aspects of social capital and self-rated health among adults aged 50 or more, living in three countries: Finland, Poland and Spain. The study, which was based on data from the European Social Survey (2008/09), was a part of the EU research project COURAGE in Europe. More specifically the paper assesses the association between social capital indicators – informal social network and general trust – and good self-rated health through single-level and joint effects analyses. The results showed that Finland was a country of high social capital, in terms of both social networks and general trust, while Spain showed low levels of general trust and Poland low levels of informal social networks. As to the association between social capital and self-rated health, high levels of general trust and high networks were found to be associated with good health among all countries' respondents. Older persons living in partnerships, with higher education, higher levels of engagement in informal networks and general trust, were found to be more likely to show good self-rated health. Our comparative analyses revealed different associations between social capital and health according to country.
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Self-rated health and its determinants in Japan and South Korea. Public Health 2013; 127:834-43. [DOI: 10.1016/j.puhe.2012.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 10/12/2012] [Accepted: 12/21/2012] [Indexed: 11/21/2022]
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