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Wang X, Xu J, Sun X, Chen Y, Pang C, Zang S. Network analysis of the urban-rural differences in depressive symptoms among older adults with multiple chronic conditions: Evidence from a national survey. Geriatr Nurs 2024; 58:480-487. [PMID: 38968651 DOI: 10.1016/j.gerinurse.2024.06.025] [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: 02/29/2024] [Revised: 06/06/2024] [Accepted: 06/21/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Evidence on the differences in depressive symptoms among older adults with multiple chronic conditions (MCCs) in urban and rural areas is limited. METHODS Measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale-10) and demographic factors (age, gender, and urban-rural distribution) were used. RESULTS A total of 4021 older adults with MCCs were included in this study. Significant differences were observed in both network global strength (Urban: 3.989 vs. Rural: 3.703, S = 0.286, p = 0.003) and network structure (M = 0.139, p = 0.002) between urban and rural residents. CONCLUSIONS The study highlights the need for region-specific approaches to understanding and addressing depression and holds the potential to enhance understanding of the psychological health status of older adults with MCCs in urban and rural settings.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Jiayi Xu
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Xuange Sun
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Chang Pang
- Department of General Practice, The Second Affiliated Hospital of Shenyang Medical College
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China.
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2
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Sáenz-Ravello G, Contreras J, Baeza M, Silva AB, Danke K, Gonzalez S, Jara G, Gamonal J. Functional dentition and well-being among Chilean 80-year-olds. Gerodontology 2024; 41:251-262. [PMID: 37344991 DOI: 10.1111/ger.12699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The Decade of Healthy Aging 2021-2030 calls for a strengthening of the policies for older people in Latin America. An example of successful oral aging is the Japanese "8020" campaign, which achieved 50% of people aged 80 years having ≥20 teeth by 2016. OBJECTIVE To evaluate the association between having a functional dentition (≥20 teeth) and cognitive health, social participation, and quality of life in people aged ≥80 years. METHODS Cross-sectional data from 299 complete observations (weighted N = 436 981) of individuals aged ≥80 years from Chile's National Health Survey 2016-2017 were included (3% of the population; total = 5520 clinical observations/weighted N = 14 518 969). Generalised structural equation models (GSEM) evaluated the association between having a functional dentition and cognitive health, measured with the Mini-mental score, between having a functional dentition and social participation, and between having a functional dentition and quality of life, measured with the EQ-5D-3L. Models included the effect of mediators (daily fruit and vegetable consumption; oral health-related quality of life score) and controlled for the exposure-induced mediator-outcome variables: sex, educational level, and location. Data were analysed using the STATA-17 survey module. Statistical significance was set at P < .05 (95% confidence interval [CI]). RESULTS The sample was mostly female, had <8 years of education, and lived in urban areas. The prevalence of a functional dentition was 9.2% (95% CI 3.6,21.3/n = 21). GSEM demonstrated that the association between functional dentition and cognitive health was mediated by daily fruits and vegetables consumption (β = 0.12/95% CI 0.02,0.21/P = .015), with moderate strength of evidence. Additionally, there was strong evidence of an association between functional dentition and social participation frequency (β = 2.76/95% CI 0.60,4.73/P = .009). Finally, the association between functional dentition and quality of life was mediated by cognitive health (β =0.05/95% CI 0.02,0.09/P = .002) and oral health-related quality of life (β = -0.04/95% CI -0.08 to -0.01/P = .025), with strong and moderate evidence, respectively. CONCLUSION Given the beneficial implications of functional dentition in social participation, nutritional benefits and quality of life and well-being of individuals aged ≥80 years.
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Affiliation(s)
- Gustavo Sáenz-Ravello
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Johanna Contreras
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Mauricio Baeza
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Ana Beatriz Silva
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Karen Danke
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Sebastián Gonzalez
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Gisela Jara
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Jorge Gamonal
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
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Yu L, Chen C. Symptom patterns of comorbid depression and anxiety among older adults in China and their predictors. Psych J 2024; 13:494-511. [PMID: 38268089 PMCID: PMC11169763 DOI: 10.1002/pchj.729] [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: 08/18/2023] [Accepted: 12/08/2023] [Indexed: 01/26/2024]
Abstract
Comorbid depression and anxiety causes serious psychological and physiological damage for older people. This study aimed to identify heterogeneous classes of comorbid depression and anxiety (CDA) among older people in China and to ascertain predictors of latent class membership. Cross-sectional data of 10,919 cases were extracted from the Chinese Longitudinal Healthy Longevity Survey. Latent profile analysis (LPA) was used to identify symptom patterns of comorbid depression (measured by the 10-item Center for Epidemiologic Studies Depression Scale) and anxiety (measured by the Generalized Anxiety Disorder 7-item Scale). Multinomial logistic regressions following bivariate analyses were used to explore the relationship between the derived classes and individual- and social-level factors. Four patterns of CDA were identified: low symptoms of depression and anxiety (30.52%; n = 3333), mild depression only (53.26%; n = 5815), moderate depression and anxiety (13.82%; n = 1509), and severe depression and anxiety (2.40%; n = 262). Older people who are male, suffer from multimorbidity, and lack a healthy lifestyle are more likely to have problematic symptom profiles. While intimate relationships with partners and children significantly predicted CDA patterns, the effects of sibling relationships, daily life, and emotional support from the community were insignificant. LPA identified four distinct CDA patterns among a representative sample of older Chinese people. While restless sleep, lack of positive emotions, uselessness, and weak concentration are salient across all profiles, "difficult to relax" is prominent in profiles high in anxiety. In addition to individual-level variables, social-level factors, especially intimate relationships with partners and children rather than general links to siblings or the community, have unneglectable impacts on whether and to what extent older Chinese adults suffer from CDA in the cultural context of relationism, patriarchy, and filial piety.
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Affiliation(s)
- Lingling Yu
- Department of Philosophy and ScienceSoutheast University at NanjingNanjingChina
| | - Chuqian Chen
- Department of Medical HumanitiesSoutheast University at NanjingNanjingChina
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Jiang W, Yang Y, He Y, Liu Q, Deng X, Hua Y, Hayixibayi A, Ni Y, Guo L. Contribution of diversity of social participation on the mental health of humanitarian migrants during resettlement. Epidemiol Psychiatr Sci 2024; 33:e29. [PMID: 38779823 DOI: 10.1017/s2045796024000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
AIMS By the end of 2022, an estimated 108.4 million individuals worldwide experienced forced displacement. Identifying modifiable factors associated with the mental illness of refugees is crucial for promoting successful integration and developing effective health policies. This study aims to examine the associations between the changes in the diversity of social participation and psychological distress among refugees throughout the resettlement process, specifically focusing on gender differences. METHODS Utilizing data from three waves of a longitudinal, nationally representative cohort study conducted in Australia, this study involved 2399 refugees interviewed during Wave 1, 1894 individuals interviewed during Wave 3 and 1881 respondents during Wave 5. At each wave, we assessed psychological distress and 10 types of social participation across 3 distinct dimensions, including social activities, employment and education. The primary analysis employed mixed linear models and time-varying Cox models. Gender-stratified analyses and sensitivity analyses were performed. RESULTS Refugees engaging in one type or two or more types of social participation, compared with those not engaging in any, consistently had lower psychological distress scores (β = -0.62 [95% confidence interval (CI), -1.07 to -0.17] for one type of social participation; β = -0.57 [95% CI, -1.04 to -0.10] for two or more types of social participation) and a reduced risk of experiencing psychological distress (hazard ratio [HR] = 0.81 [95% CI, 0.65-0.99] for one type of social participation; HR = 0.77 [95% CI, 0.61-0.97] for two or more types of social participation) during the resettlement period. When stratifying the results by gender, these associations in the adjusted models only remained significant in male refugees. Moreover, three specific types of social participation, namely sporting activities, leisure activities and current employment status, were most prominently associated with a reduced risk of psychological distress. CONCLUSIONS The findings of this cohort study suggest that social participation was consistently associated with reduced risks of psychological distress among male refugees during resettlement. These findings highlight the significance of promoting meaningful social participation and interaction may be an effective strategy to improve the mental health of refugees and facilitate their successful integration into society, especially among male refugees.
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Affiliation(s)
- Weiqing Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yuwei Yang
- Institute of Infectious Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, People's Republic of China
| | - Yitong He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Qianyu Liu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yilin Hua
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Alimila Hayixibayi
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Yanyan Ni
- LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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5
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Cheung ESL. The Association between Residential Environment and Self-Rated Mental Health among Older Canadians: The Moderating Effects of Education and Gender. Can J Aging 2024:1-10. [PMID: 38778472 DOI: 10.1017/s0714980824000230] [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: 05/25/2024] Open
Abstract
This study examined the associations between residential environment and self-rated mental health (SRMH) among Canadians aged 65 or older (n = 16,304) and whether education and gender moderated the associations. Data came from the 2018 Canadian Housing Survey. Hierarchical multiple regressions were conducted to test the associations. Analyses revealed that increased dwelling size was associated with better SRMH among older women with high school education. Older adults with higher satisfaction with their dwelling design were more likely to report better SRMH, except for women with some college education. Feeling safer in the community was uniquely associated with better SRMH for men with high school education and women with a university degree. Results confirmed significant associations between specific home and residential environment features and SRMH for each gender-by-education group. Environmental programs designed to improve SRMH for older adult populations should consider within- and between-group diversity.
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Affiliation(s)
- Ethan Siu Leung Cheung
- Department of Family and Consumer Studies, The University of Utah, Salt Lake City, UT, USA
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Jiang Z, Liu H, Deng J, Ye Y, Li D. Influence of intergenerational support on the mental health of older people in China. PLoS One 2024; 19:e0299986. [PMID: 38635847 PMCID: PMC11025908 DOI: 10.1371/journal.pone.0299986] [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: 09/10/2023] [Accepted: 02/20/2024] [Indexed: 04/20/2024] Open
Abstract
Today, population aging is the main trend of population development. Home-based care is mainly adopted in Chinese society, and scholars have paid ample attention to the effect of intergenerational support on the mental health of older people. However, research conclusions differ. This study uses data from the 2018 China Health and Pension Tracking Survey (CHARLS), which we analyzed with STATA software to construct least squares regression and two-stage least squares regression models. The regression model included 6,647 respondents to investigate the mental health status of older people based on depression status. Intergenerational support was defined as economic support, emotional support, and daily care provided by the children of older people. We studied the impact of three aspects of intergenerational support on the mental health of the elderly. We performed a robustness test using the variable replacement and propensity score matching methods, and analyzed age, gender, and urban-rural heterogeneity. The results showed that economic support had no significant impact on the mental health of older people, while emotional support and daily care had a positive effect. The heterogeneity results indicated that the relationship between intergenerational support and mental health of older people differed significantly based on age, gender, and urban and rural areas. Therefore, children should raise their awareness of supporting their parents, pay attention to their parents' mental health, and provide emotional support and daily care. Furthermore, community work improves family relations, creates a good social environment, and encourages young people to respect and be filial to older people. The government should improve the medical security system and old-age service system, and provide policy support to help the mental health of older people.
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Affiliation(s)
- Zicheng Jiang
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, China
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, China
| | - Huan Liu
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, China
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, China
| | - Jing Deng
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, China
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, China
| | - Yizhong Ye
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, China
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, China
| | - Dexun Li
- School of Hospital Economics and Management, Anhui University of Chinese Medicine, Hefei, China
- Key Laboratory of Data Science and Innovative Development of Chinese Medicine in Anhui Province Philosophy and Social, Hefei, China
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Zhu H, Ma S, Ding Y, Xia H. Associations between employment and mental health of older workers with disparate conditions: Evidence from China. Geriatr Nurs 2024; 56:244-251. [PMID: 38387148 DOI: 10.1016/j.gerinurse.2024.02.023] [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: 11/19/2023] [Revised: 02/03/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE This study aimed to examine associations between the employment of older people and mental health across demographic characteristics, socioeconomic conditions, and health status, with a focus on pensions. METHODS This study included 4,512 participants aged 60-69 from the CLASS in 2014. A multiple linear regression was conducted to investigate the association between employment and mental health. A causal forest model was applied to estimate the heterogeneous treatment effects. RESULTS Employed individuals (n = 1,295) reported better mental health than their non-employed counterparts. This association displayed significant heterogeneity, primarily attributed to pensions. Those with lower pensions may be compelled to work due to financial reasons, thus offsetting the health-promotion effect of employment. CONCLUSION Employment may benefit the mental health of older adults, which has a more significant marginal effect on those who are men, older, urban residents, without a spouse, below primary education, receiving more pensions, and less family and friend support.
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Affiliation(s)
- Huoyun Zhu
- School of Public Administration and Emergency Management, Institute of Common Prosperity and National Governance, Jinan University, Guangzhou, China.
| | - Shilong Ma
- School of Public Administration and Emergency Management, Jinan University, Guangzhou, China
| | - Yu Ding
- School of Public Affaris, Xiamen University, Xiamen, China
| | - Huiqin Xia
- College of Political Science and Law, Jiangxi Normal University, Nanchang, China
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Wu B, Xiong G, Zhang P, Ma X. Effects of tai chi, ba duan jin, and walking on the mental health status of urban older people living alone: the mediating role of social participation and the moderating role of the exercise environment. Front Public Health 2024; 12:1294019. [PMID: 38389938 PMCID: PMC10881673 DOI: 10.3389/fpubh.2024.1294019] [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: 09/19/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
With the global trend of aging, lacking of interpersonal communication and spiritual support and companionship have had a great impact on the mental health of older people living alone. This study examines the multifaceted impacts of engaging in tai chi, ba duan jin, and walking on the mental wellbeing of older people residing alone in urban areas. Additionally, this research aims to explore the association between tai chi, ba duan jin, and walking, and the mental health status of urban older people living alone, by considering the mediating influence of social participation and the moderating influence of the exercise environment. To do so, 1,027 older people living alone in six Chinese cities were investigated using the Physical Activity Rating Scale (PARS-3), the Geriatric Health Questionnaire (GHQ-12), the Social Participation Indicator System Scale, and the Exercise Environment Scale. SPSS 25.0 was utilized for conducting mathematical statistical analysis, specifically for doing linear regression analysis. Additionally, AMOS was employed to develop the study model. We found that a significant negative correlation between tai chi, ba duan jin, and walking and mental health status; among these, tai chi had the greatest impact on the mental health status of urban older people living alone. Social participation mediated the relationship between tai chi, ba duan jin, walking, and mental health status, and the exercise environment had a moderating effect on this relationship. The findings of this study indicate that tai chi, ba duan jin, and walking have a positive impact on the mental health of urban older people living alone, which can be influenced by the mediating efficacy of social participation and the moderating effect of the exercise environment.
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Affiliation(s)
- Baoyuan Wu
- School of Wushu, Chengdu Sports University, Chengdu, China
| | - Guoyan Xiong
- School of Wushu, Chengdu Sports University, Chengdu, China
| | - Peng Zhang
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Xiujie Ma
- School of Wushu, Chengdu Sports University, Chengdu, China
- Chinese Guoshu Academy, Chengdu Sports University, Chengdu, China
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Tian Z, Guo W, Zhai M, Li H. Job preference of preventive medicine students during the COVID-19 pandemic: a discrete choice experiment survey in Shandong Province, China. BMC MEDICAL EDUCATION 2023; 23:890. [PMID: 38012762 PMCID: PMC10680353 DOI: 10.1186/s12909-023-04873-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/14/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Public health workers are a crucial part of the health workforce, particularly during the coronavirus disease (COVID-19) pandemic. They play an important role in achieving universal health coverage and sustainable development goals. Human resources in public health in China are in short supply, their distribution is unequal, and their turnover rate is high. A discrete choice experiment (DCE) was applied to investigate preventive medicine students' preferred job choice criteria and trends in trade-offs by calculating the marginal rate of substitution between these criteria. This study identified the properties of jobs primarily selected by preventive medicine students and estimated the monetary value of each attribute. METHODS Based on discussions and in-depth interviews with preventive medicine students and a literature review, we developed a DCE that assessed how students' stated preferences for a certain choice were influenced by several job attributes, including location, salary, bianzhi, career development opportunities, working environment, and workload. We applied this DCE to preventive medicine students in Shandong Province, China, using a brief, structured questionnaire. Conditional logit models were used to estimate the utility of each job's attributes. Willingness to pay (WTP) was estimated as the ratio of the value of the coefficient of interest to the negative value of the cost attribute. RESULTS A total of 307 respondents completed the questionnaire, and 261 passed the internal consistency test. All the attributes were statistically significant. Career development opportunities and work locations were the most important factors for the respondents. Preference heterogeneity existed among respondents, e.g., 3-year medical education college students placed a higher value on jobs with bianzhi compared to 5-year medical education college students. Furthermore, rural students' WTP for a job located in the county or city is much lower than that of urban students. CONCLUSIONS The heterogeneity of attributes indicates the complexity of job preferences. Monetary and nonmonetary job characteristics significantly influenced the job preferences of preventive medicine students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both job incentives and the backgrounds of preventive medicine graduates.
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Affiliation(s)
- Zhuang Tian
- School of Public Health, Jining Medical University, Jining, 272067, China
| | - Wei Guo
- Public Health Service Center in Rencheng District, Jining, 272412, China
| | - Min Zhai
- School of Public Health, Jining Medical University, Jining, 272067, China
| | - Hongmin Li
- School of Public Health, Jining Medical University, Jining, 272067, China.
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Liu J, Peng J, Chen M, Zhang T. Mediating and Moderating Effects of Internet Use on Urban-Rural Disparities in Health Among Older Adults: Nationally Representative Cross-Sectional Survey in China. J Med Internet Res 2023; 25:e45343. [PMID: 37768721 PMCID: PMC10570902 DOI: 10.2196/45343] [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: 12/26/2022] [Revised: 06/26/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The urban-rural disparities in health outcomes in China are remarkable. The internet has shown the potential to reduce the likelihood of contracting a disease by increasing disease knowledge. However, little is known about the effects of internet use in alleviating health inequities between urban and rural areas. OBJECTIVE This study aimed to examine the mediation and moderation of health disparities between urban and rural older adults through internet use. METHODS A total of 8223 respondents were selected from the China Health and Retirement Longitudinal Study 2018 data set. Basic activities of daily living, a brief Community Screening Instrument for Dementia, and the Centre for Epidemiologic Studies Depression Scale were used to measure functional disability, cognitive function, and depressive symptoms, respectively. Logistic regressions testing "internet use×urban-rural status" interactions for moderation and Karlson-Holm-Breen decomposition for mediation were performed. RESULTS Internet use moderated the urban-rural disparities in cognitive function (odds ratio 7.327, 95% CI 3.011-17.832) and depressive symptoms (odds ratio 1.070, 95% CI 1.037-1.787), but the moderating effects were significant only for those using the internet daily. Karlson-Holm-Breen results showed the suppression effects of using the internet daily (β=.012, 95% CI .002-.021) on the association between urban-rural status and cognitive function. The urban-rural inequality in depressive symptoms was partially attributed to the disparity in internet use (β=-.027, 95% CI -.043 to -.009). CONCLUSIONS The urban-rural inequalities in mental health are partially attributable to disparities in the prevalence of internet use between the 2 groups. However, using the internet is more beneficial for the psychological health of rural users, thereby alleviating the urban-rural disparities in health. Providing convenient channels for rural older adults to use the internet, improving the ability of rural users to effectively use the internet, and promoting internet popularity in rural areas are effective approaches to reducing urban-rural health inequalities.
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Affiliation(s)
- Jing Liu
- Administrative Office, Yuebei People's Hospital, Medical College, Shantou University, Shaoguan, China
| | - Junwei Peng
- Department of Chinese Integrative Medicine, Hebei Medical University, Shijiazhuang, China
| | - Minyan Chen
- Medical Insurance Department, Hangzhou Ninth People's Hospital, Hangzhou, China
| | - Tao Zhang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
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Wang B, Zhao H, Shen H, Jiang Y. Socioeconomic status and subjective well-being: The mediating role of class identity and social activities. PLoS One 2023; 18:e0291325. [PMID: 37713386 PMCID: PMC10503752 DOI: 10.1371/journal.pone.0291325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/28/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Subjective well-being has a significant impact on an individual's physical and mental health. Socioeconomic status, class identity, and social activity participation play important roles in subjective well-being. Therefore, the aim of this study was to uncover the mechanisms through which these factors influence subjective well-being. METHODS A total of 1926 valid samples were recruited using the Chinese General Social Survey 2021 (CGSS 2021). The Chinese Citizen's Subjective Well-Being Scale (SWBS-CC) was employed to assess subjective well-being. Socioeconomic status was measured using income and education, and class identity and social activity participation were measured using Likert scales. Pearson correlation analysis and the chain mediation model were conducted to explore the relationship between these factors. Finally, the Bootstrap method was used to examine the path coefficients. RESULTS A significant correlation was found between socioeconomic status, class identity, social activity, and subjective well-being (p < 0.01). The indirect effect of socioeconomic status on subjective well-being mediated by class identity was 0.351 (95% CI: 0.721, 1.587), while the indirect effect of socioeconomic status on subjective well-being mediated by social activity was 0.380 (95% CI: 0.059, 0.240). The effect mediated by both class status and social activities was 0.011 (95% CI: 0.010, 0.093). CONCLUSIONS The study showed that socioeconomic status, class identity, and social activity had significant effects on subjective well-being. Class identity and social activity partially mediated the effects of socioeconomic status on subjective well-being, and they had a chain mediating effect between socioeconomic status and subjective well-being. Therefore, policymakers have the opportunity to enhance subjective well-being in lower socioeconomic status groups by promoting individual class identity and encouraging greater social activity participation.
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Affiliation(s)
- Baoqin Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medical and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Hang Zhao
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medical and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Hao Shen
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medical and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yi Jiang
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medical and Social Development, School of Public Health, Chongqing Medical University, Chongqing, China
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Pan C, Cao N. Dual trajectories of depression and social participation among Chinese older adults. Geriatr Nurs 2023; 53:153-161. [PMID: 37540910 DOI: 10.1016/j.gerinurse.2023.07.013] [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: 06/17/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVES This study aimed to investigate the dual trajectories of social participation (SP) and depression among older adults, and explore common factors that may influence both trajectories. METHODS The study utilized data from four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011 to 2018). The dual-trajectory model was employed to estimate the dual trajectories of SP and depression. RESULTS This study identified two SP and three depression trajectories. The results revealed that the reciprocal relationship between SP and depression trajectories is confirmed in all sub-groups of the dual trajectories. Our study identified six distinct sub-groups of individuals based on their SP and depression trajectories and some commen risk factors of SP and depression trajectories. CONCLUSIONS Related intervention policies should consider the dual trajectories of SP and depression and focus on subgroups with high vulnerability, such as high depression but low SP. Additionally, attention should be given to addressing the common risk factors that underlie these trajectories.
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Affiliation(s)
- Chaoping Pan
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Na Cao
- School of Public Health and Management, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China; School of Public Health, Wuhan University, Wuhan City, Hubei Province, China.
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13
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Yan P, Li F, Nicholas S, Maitland E, Tan J, Chen C, Wang J. Impact of pension income on healthcare utilization of older adults in rural China. Int J Equity Health 2023; 22:166. [PMID: 37633941 PMCID: PMC10463592 DOI: 10.1186/s12939-023-01985-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/10/2023] [Indexed: 08/28/2023] Open
Abstract
OBJECTIVE In China, rural residents experience poorer health conditions and a higher disease burden compared to urban residents but have lower healthcare services utilization. Rather than an insurance focus on enhanced healthcare services utilization, we aim to examine that whether an income shock, in the form of China's New Rural Pension Scheme (NRPS), will affect outpatient, inpatient and discretionary over-the-counter drug utilization by over 60-year-old rural NRPS residents. METHODS Providing a monthly pension of around RMB88 (USD12.97), NRPS covered all rural residents over 60 years old. Fuzzy regression discontinuity design (FRDD) was employed to explore the NRPS causal effect on healthcare services utilization, measured by outpatient and inpatient visits and discretionary over-the-counter drug purchases. The nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 provided the data. RESULTS Without significant changes in health status and medication needs, 60-plus-year-old NRPS recipients significantly increased the probability of discretionary OTC drug purchases by 33 percentage points. NRPS had no significant effect on the utilization of outpatient and inpatient utilization. The increase in the probability of discretionary OTC drug purchases from the NRPS income shock was concentrated in healthier and low-income rural residents. Robustness tests confirmed that FRDD was a robust estimation method and our results are robust. CONCLUSION NRPS was an exogenous income shock that significantly increased the probability of discretionary over-the-counter drug purchases among over 60-year-old rural residents, but not the utilization of inpatient or outpatient healthcare services. Income remains an important constraint for rural residents to improve their health. We recommend policymakers consider including commonly used over-the-counter drugs in basic health insurance reimbursements for rural residents; provide health advice for rural residents to make discretionary over-the-counter drug purchases; and to mount an information campaign on over-the-counter drug purchasing in order to increase the health awareness of rural residents.
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Affiliation(s)
- Peizhe Yan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Fenghang Li
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, NSW, Australia
- Newcastle Business School, University of Newcastle, Newcastle, NSW, Australia
| | | | - Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China
| | - Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Hubei Province, 115 Donghu Road, Wuhan, 430079, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, Hubei Province, China.
- Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Hubei Province, Room A201, Wuhan, 430079, China.
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Chen H, Xu X, Jia C, Gu H, Zhang L, Yi Y. Household Polluting Fuel Use and Frailty among Older Adults in Rural China: The Moderating Role of Healthy Lifestyle Behaviors. Healthcare (Basel) 2023; 11:1747. [PMID: 37372865 DOI: 10.3390/healthcare11121747] [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: 04/29/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
This study worked to investigate the effect of household polluting fuel use (HPFU), as an indicator of household air pollution exposure, on frailty among older adults in rural China. Additionally, this study aimed to examine the moderating effect of healthy lifestyle behaviors on the aforementioned association. This study employed cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, which conducted nationally representative sampling of older adults from 23 provinces in mainland China. The frailty index was calculated using 38 baseline variables that assessed health deficits through questionnaire surveys and health examinations. A total of 4535 older adults aged 65 years and above were included in our study, among whom, 1780 reported using polluting fuels as their primary household cooking fuel. The results of regression analyses and multiple robustness checks indicated a significant increase in the frailty index due to HPFU. This environmental health threat was more profound among women, illiterate individuals, and low-economic-status groups. Moreover, healthy dietary and social activities had significant moderating effects on the association between HPFU and frailty. HPFU can be regarded as a risk factor for frailty among older adults in rural China, with its effects exhibiting socio-economic disparities. The adoption of healthy lifestyle behaviors can alleviate the frailty associated with HPFU. Our findings underscore the significance of using clean fuels and improving household air quality for healthy aging in rural China.
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Affiliation(s)
- Huiying Chen
- Research Center for Health Policy and Management, Nanjing University, Nanjing 210093, China
| | - Xinpeng Xu
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Cangcang Jia
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China
| | - Hai Gu
- Research Center for Health Policy and Management, Nanjing University, Nanjing 210093, China
| | - Lu Zhang
- Research Center for Health Policy and Management, Nanjing University, Nanjing 210093, China
| | - Yang Yi
- Research Center for Health Policy and Management, Nanjing University, Nanjing 210093, China
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15
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Muhammad T. Life course rural/urban place of residence, depressive symptoms and cognitive impairment among older adults: findings from the Longitudinal Aging Study in India. BMC Psychiatry 2023; 23:391. [PMID: 37268912 DOI: 10.1186/s12888-023-04911-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/29/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Given the unique socioeconomic structures, and the rural/urban differentials in the prevalence of mental illnesses in the country, this study aimed to explore the associations of childhood, adulthood and late-life rural/urban place of residence with mental health outcomes, namely depressive symptoms and cognitive impairment, among older adults in India. The study also examined the relationship between older individuals' life-course rural/urban place of residence and late-life mental and cognitive health. METHODS Utilizing data from the Longitudinal Aging Study in India (n = 28,027 older adults age 60 years and above), the study employed multivariable logistic and linear regression models to examine the association between urban/rural residential status, life-course residence, depressive symptoms and cognitive impairment among older adults. RESULTS Childhood and adulthood place of residence was not associated with depressive symptoms in older men and women. Current rural place of residence was positively associated with depressive symptoms in older women [adjusted odds ratio (aOR): 1.37, confidence interval (CI): 1.05-1.80] but not men. Childhood [aOR: 1.88, CI: 1.16-3.04], adulthood [aOR: 2.00, CI: 1.26-3.16] and current rural residence [aOR: 1.93, CI: 1.27-2.91] was positively associated with cognitive impairment in men. Only current rural residence [aOR: 1.71, CI: 1.29-2.27] was associated with cognitive impairment in women. There was no significant association between life-course place of residence and depressive symptoms except in case of lifetime rural residence Respondents with urban-urban-urban (childhood-adulthood-current) place of residence were less likely to have depressive symptoms [adjusted coefficient (aCoef.): -0.14, CI: -0.21- -0.07] compared to those with rural-rural-rural place of residence. There were significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants, showing an urban advantage in cognitive function among older adults. CONCLUSIONS This study showed significant associations between life-course residence and depressive symptoms among permanent rural/urban residents. The study also showed significant associations between life-course residence and cognitive impairment except among rural-urban-rural and urban-rural-rural migrants. Considering the rural disadvantage in mental and cognitive health among older adults, the government should continue to support policies that can improve access to education and healthcare among people residing in rural areas and women, in particular. The findings also urge social scientists and gerontologists in particular, to consider the importance of lifetime historical context while evaluating mental and cognitive health of older persons.
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Affiliation(s)
- T Muhammad
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088, India.
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16
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Sun Y. Happiness and mental health of older adults: multiple mediation analysis. Front Psychol 2023; 14:1108678. [PMID: 37179856 PMCID: PMC10169717 DOI: 10.3389/fpsyg.2023.1108678] [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: 11/26/2022] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
Introduction This study aims to explore the influence mechanism of older adult mental health. As the aging population grows, the mental health of older adults becomes a significant public health and social issue, with happiness serving as a key dimension of mental health. Methods This study utilizes public data from CGSS to investigate the relationship between happiness and mental health, with Process V4.1 used for mediating effects analysis. Results The findings suggest a positive predictive effect of happiness on mental health, with three mediating paths identified: independent mediating effect paths of income satisfaction and health, as well as a multiple mediating effects path through income satisfaction and health. Discussion The study suggests that improving the multi-subject mental health support service system for older adults and creating public values for mental health risk coping mechanisms. This helps to understand the complex relationship between aging on individual and social levels. These results provide empirical support for healthy aging among older adults and future policymaking.
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Affiliation(s)
- Yujin Sun
- School of Management, Suzhou University, Suzhou, China
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17
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Lou Y, Irakoze S, Huang S, You Q, Wang S, Xu M, Gan Y, Lu Z, Jiang Q, Cao S. Association of social participation and psychological resilience with adverse cognitive outcomes among older Chinese adults: A national longitudinal study. J Affect Disord 2023; 327:54-63. [PMID: 36739004 DOI: 10.1016/j.jad.2023.01.112] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Limited epidemiological evidence exists regarding the association of social participation and psychological resilience with cognitive health. This study aimed to comprehensively investigate the effects of social participation and psychological resilience on adverse cognitive outcomes among older adults in China. METHODS We used two waves (2011 and 2014) of data from the Chinese Longitudinal Survey of Health and Longevity (CLHLS), and 9765 respondents were eligible for the subsequent screening for the present prospective analysis. The Cox proportional hazards model was utilized to examine the association of social participation and psychological resilience with cognitive impairment, cognitive decline and greater cognitive decline. The restricted cubic spline plots were applied to clarify the dose-response relationships between them. RESULTS Compared to those with low social participation, participants with high social participation had a lower hazard ratio (HR) of 0.72 (95 % confidence interval [CI]: 0.59-0.89) for cognitive impairment, 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.78 (95 % CI: 0.67-0.90) for greater cognitive decline. Participants with high psychological resilience had an HR of 0.77 (95 % CI: 0.63-0.95) for cognitive impairment 0.85 (95 % CI: 0.76-0.94) for cognitive decline and 0.85 (95 % CI: 0.73-0.98) for greater cognitive decline compared with those with low psychological resilience. Similar effects were observed for social participation score and psychological resilience score. The dose-response analysis also showed that the risk of adverse cognitive outcomes decreased gradually with increasing social participation scores and psychological resilience scores. Additionally, the multiplicative interaction between social participation and psychological resilience was not significant. LIMITATION All information was collected by self-report, which may lead to biases in the process of information collection. CONCLUSION In this study, social participation and psychological resilience were independently associated with a lower risk of adverse cognitive outcomes, and therefore both need to be considered as broader measures to preserve cognitive health among older Chinese adults.
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Affiliation(s)
- Yiling Lou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shani Irakoze
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shen Huang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiqi You
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiqi Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minzhi Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qingqing Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Liao M, Luo N, Rand K, Yang Z. Urban/rural differences in preferences for EQ-5D-5L health states: a study of a multi-ethnic region in China. Qual Life Res 2023:10.1007/s11136-023-03394-1. [PMID: 36944783 DOI: 10.1007/s11136-023-03394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES This study aimed to compare health preferences for EQ-5D-5L health states between urban and rural populations in China. METHODS This study used pooled secondary data from two EQ-5D-5L valuation studies. Participants were recruited from Guizhou province and Chongqing municipality, China using quota sampling. Each participant was interviewed face-to-face to value a set of 15 or 16 out of 30 EQ-5D-5L health states using time trade-off (TTO) methods including composite TTO and other two variants. Regression analysis was used to compare health state preferences between urban and rural participants. RESULTS A total of 597 participants (urban: 55.44%; rural: 44.56%) completed the valuation interviews. Both univariate and multivariable linear regression analyses showed that rural participants tended to value health states lower than urban participants regardless of severity of health states. The unadjusted and adjusted overall mean differences between the two groups were - 0.041 (95% confidence interval [CI] - 0.077, - 0.004, p-value = 0.031) and - 0.040 (95% CI - 0.078, - 0.002, p-value = 0.038), respectively. Predictions for the 3125 health states based on rural participants' health preferences were lower than those based on urban participants' health preferences. CONCLUSION There were small, yet statistically significant, differences in EQ-5D-5L health states preferences between urban and rural populations in China. Future study aiming at establishing a national value set should pay more attention to the sample representativeness.
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Affiliation(s)
- Meixia Liao
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Nan Luo
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Kim Rand
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Maths in Health B.V., Rotterdam, The Netherlands
| | - Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Guiyang, China.
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Wen W, Zhang Y, Shi W, Li J. Association Between Internet Use and Physical Health, Mental Health, and Subjective Health in Middle-aged and Older Adults: Nationally Representative Cross-sectional Survey in China. J Med Internet Res 2023; 25:e40956. [PMID: 36943368 PMCID: PMC10131878 DOI: 10.2196/40956] [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: 07/13/2022] [Revised: 12/20/2022] [Accepted: 02/24/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Internet use is an important means of accessing health-related information. Identifying the associations between internet use and health outcomes could provide insight into strategies for improving public health among middle-aged and older adults (45 years and up). OBJECTIVE This study aimed to examine the relationship between internet use and health outcomes in middle-aged and older adults. METHODS Data were obtained from the 2018 China Health and Retirement Longitudinal Study. Physical, mental, and subjective health were assessed using the Activities of Daily Living (ADL) Scale, the 10-item Center for Epidemiologic Studies Depression Scale, and the 3-level Self-Rated Health Scale, respectively. The chi-square test and rank sum test were used to explore whether internet use was associated with health status. A multivariate logistic regression model was used to determine this association further after controlling for the confounding factors. RESULTS Overall, 13% (1752/13,474) of the participants used the internet. Regression analyses revealed that the prevalence of depression (odds ratio [OR] 0.59, 95% CI 0.52-0.68; P<.001), negative self-rated health (OR 0.68, 95% CI 0.61-0.76; P<.001), and difficulty with ADL (OR 0.48, 95% CI 0.39-0.60; P<.001) in the participating middle-aged and older adult was lower in those using the internet than nonusers. After controlling for confounding factors, internet use was found to be negatively associated with difficulty with ADL (urban: OR 0.44, 95% CI 0.32-0.61; P<.001 vs rural: OR 0.55, 95% CI 0.41-0.75; P<.001), depression (urban: OR 0.69, 95% CI 0.57-0.84; P<.001 vs rural: OR 0.52, 95% CI: 0.43-0.63; P<.001), and self-rated health status (urban: OR 0.70, 95% CI 0.61-0.81; P<.001 vs rural: OR 0.67, 95% CI 0.57-0.78; P<.001) among middle-aged and older adults in both urban and rural areas. CONCLUSIONS Internet use had a positive effect on the physical and mental health of middle-aged and older adults who participated in this study. However, the internet usage rate remains low among older Chinese people. Therefore, the internet penetration rate should be a priority.
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Affiliation(s)
- Wen Wen
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Yaru Zhang
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Wenjie Shi
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, China
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Yu Y, Wu Y, Huang Z, Sun X. Associations between media use, self-efficacy, and health literacy among Chinese rural and urban elderly: A moderated mediation model. Front Public Health 2023; 11:1104904. [PMID: 36969672 PMCID: PMC10034173 DOI: 10.3389/fpubh.2023.1104904] [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: 11/22/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
ObjectivesThe influence of media use on health literacy among urban and rural elderly has been unknown in China. This study aims to examine the association between media use and health literacy and to explore the mediating role of self-efficacy and the moderating role of urban-rural residency.MethodsBased on the cross-sectional study of the Psychology and Behavior Investigation of Chinese Residents (PBICR) in 2022, a total of 4,070 Chinese old people aged 60 years and above were included. We adopted the simplified New General Self-Efficacy Scale (NGSES) and the simplified Health Literacy Scale-Short Form (HLS-SF) to measure self-efficacy and health literacy. Media use was measured using a self-administrated questionnaire.ResultsResults showed that Chinese urban elderly had a higher frequency of media use than rural ones in the aspects of social activities, self-presentation, social action, leisure and entertainment, information acquisition, and business transactions through media (P < 0.001). Among all participants, self-presentation (B = 0.217, 95% CI: 0.040, 0.394), leisure and entertainment (B = 0.345, 95% CI: 0.189, 0.502), and information acquisition (B = 0.918, 95% CI: 0.761, 1.076) were significantly associated with health literacy. Self-efficacy partially mediated the effect of media use on health literacy (Bindirect = 0.045, 95% CI: 0.032, 0.058), accounting for 18.37% of the total effect. Urban-rural residency (B = 0.049, 95% CI: 0.024, 0.075) moderated the relationship between media use and self-efficacy significantly.ConclusionThe urban-rural gap in health literacy requires more attention. The promotion of media use and self-efficacy may play a role in eliminating health disparities.LimitationsAs a cross-sectional study, it could not establish cause-effect relationships.
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Affiliation(s)
- Yebo Yu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Yibo Wu
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
- Health Culture Research Center of Shaanxi, Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Xi'an, Shaanxi, China
| | - Zhen Huang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
- *Correspondence: Xinying Sun
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Li S, Wang Y, Xu L, Ni Y, Xi Y. Mental health service needs and mental health of old adults living alone in urban and rural areas in China: The role of coping styles. Geriatr Nurs 2023; 50:124-131. [PMID: 36774679 DOI: 10.1016/j.gerinurse.2023.01.012] [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: 12/14/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/12/2023]
Abstract
This study aimed to explore the level and relationship between the mental health service needs (MHSN), coping styles (CS), and mental health (MH) of old adults living alone in urban and rural, and to explore the moderating effects of coping styles. A cross-sectional study was conducted with 717 older adults living alone. The survey measured MHSN, CS, and MH. Data were analyzed using a structural equation and bootstrapping method. There were significant differences in the MHSN, CS, and MH between urban and rural old adults living alone (P < 0.05). The model of the impact of MHSN on MH in urban and rural old adults living alone showed a good fit. These findings highlighted the importance of high MHSN and positive CS as potential protective factors of mental health in old adults living alone. This provides a theoretical basis for psychological nursing for old adults living alone in the community.
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Affiliation(s)
- Shasha Li
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China.
| | - Yuecong Wang
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
| | - Lijun Xu
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
| | - Yingyuan Ni
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
| | - Yingxue Xi
- Department of Nursing, College of Medical Science, Huzhou University, 759 Second Ring Road, Huzhou District, Zhejiang 313000, China
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22
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Gu L, Yang L, Li H. Does Neighborhood Social Capital Longitudinally Affect the Nutritional Status of School-Aged Children? Evidence from China. Nutrients 2023; 15:nu15030633. [PMID: 36771340 PMCID: PMC9920281 DOI: 10.3390/nu15030633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Previous research linking social capital to child nutritional status primarily constitutes cross-sectional studies. To investigate whether a longitudinal relationship exists, by conducting fixed-effects analyses with 16,977 repeatedly measured observations of 6193 children from the 2012, 2014, 2016, and 2018 China Family Panel Studies, this study explored the longitudinal effects of neighborhood participation, bonding trust, and bridging trust on the BMI-for-age z-score (BAZ) and BMI categories of school-aged children, differentiating between urban and rural residence. We found an increasing average BAZ, a decreasing prevalence of underweight, an increasing prevalence of overweight/obesity, and a reducing urban/rural gap in nutritional status. The levels of social capital components descended faster in the urban area. Bonding trust was predictive of a lower BAZ, a higher likelihood of being underweight, and a lower likelihood of being overweight/obese. Bridging trust was predictive of a higher BAZ. The longitudinal effects of bonding trust were significant among only the rural children. Our findings indicate that neighborhood social capital may impose causal impacts on the nutritional status of children. To effectively improve child nutritional status, a more empathetic governmental approach that promotes a more supportive distal social environment is needed.
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Affiliation(s)
- Lijuan Gu
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- Correspondence:
| | - Linsheng Yang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100101, China
| | - Hairong Li
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
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23
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Nie W, Hu M, Ye X. Internet use and rural-urban mental health inequalities: Evidence from China. Front Public Health 2023; 11:1107146. [PMID: 36778581 PMCID: PMC9909550 DOI: 10.3389/fpubh.2023.1107146] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Introduction In the context of the new digital era, clarifying the relationship between Internet use and urban and rural residents' mental health is of important value for reducing rural-urban health inequalities. This paper aims to study the association between Internet use and rural-urban mental health inequalities. Methods Based on the data of the China Family Panel Studies (CFPS) in 2020, we firstly examined the existence and specific manifestation of mental health inequalities between urban and rural residents. Secondly, we examined the mediating effect of Internet use by the Bootstrap mediating effect measure. Finally, we verified the robustness of the mediating effect. Results There are significant mental health inequalities between urban and rural residents, and urban residents have better mental health than rural residents (p < 0.01). In addition, the test results for the mediating effect of Internet use on mental health inequalities between urban and rural residents were significant (p < 0.01), with a direct effect of -0.028 (p < 0.01) and an indirect effect of -0.49 (p < 0.01), and this result remained significant in the robustness test. Discussion In such a new age of the Internet, mental health inequalities between urban and rural residents objectively did exist, and the use of the internet played a positive mediation effect on the formation of mental health inequalities between urban and rural areas.
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Affiliation(s)
- Weihao Nie
- Faculty of Arts and Humanities, Philosophy, Politics and Economics of Health, University College London, London, United Kingdom
| | - Mingzheng Hu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xin Ye
- Institute for Global Public Policy, LSE-Fudan Research Centre for Global Public Policy, Fudan University, Shanghai, China,*Correspondence: Xin Ye ✉
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Song H, Sun H. Association of unmet long-term care needs with depression and anxiety among older adults in urban and rural China. Geriatr Nurs 2023; 49:115-121. [PMID: 36495793 DOI: 10.1016/j.gerinurse.2022.11.017] [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: 08/22/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
This study examined the association of unmet long-term care (LTC) needs with depression and anxiety in older adults and explored urban-rural disparities. Cross-sectional data for 1896 respondents with a mean age of 91.58 years was from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depression and anxiety were assessed using the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Unmet LTC needs were self-reported by older adults with functional limitations. Research methods included regression analyses, decomposition analyses, sensitivity analyses. Results showed that unmet LTC needs, depression, anxiety were more severe in rural older adults. Unmet LTC needs were significantly and positively related to depression and anxiety, but their associations with CESD-10 scores, depressive and anxiety symptoms were stronger in urban older adults. Urban-rural disparities in unmet LTC needs explained about 20%-40% of disparities in depression and anxiety. The findings highlighted the role of meeting LTC needs in reducing depression and anxiety, and that LTC policymakers should not ignore the needs of urban older adults and focus solely on rural older adults.
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Affiliation(s)
- Huan Song
- School of Public Administration, Nanjing Normal University, Nanjing 210023, Jiangsu, China
| | - Hui Sun
- School of Mechanical Engineering, Tianjin University, Tianjin 300350, China.
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Onishi R, Takashima R, Saeki K, Hirano M. Value of social activities and prerequisites for continued participation of rural older adults: A qualitative study. Nurs Open 2022; 10:3274-3284. [PMID: 36566085 PMCID: PMC10077408 DOI: 10.1002/nop2.1579] [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: 09/30/2021] [Revised: 10/25/2022] [Accepted: 12/10/2022] [Indexed: 12/26/2022] Open
Abstract
AIMS To explore the value of social activities and the prerequisites for continuous participation among rural older adults based on their experiences. DESIGN Qualitative, descriptive design. METHODS Individual semi-structured interviews were conducted with 14 older adults from voluntary community salons in a rural area in Japan. Participants were selected through purposeful sampling. Data were analyzed using qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used. RESULTS Four values of social activities were identified: "Mutual benefit connectedness," "Preventing and coping with aging," "Making life brilliant 'now'," and "Building a safety net." Three prerequisites for activities were identified: "Do not overreach," "Do not infringe on personal territory," and "Do not go against community norms." Social activities provide rural older adults with reciprocity ties, coping with aging, enhanced daily lives, and a social safety net. Continued participation in rural social activities requires adherence to cultural norms and moderation of relationship distances. Community and public health nurses are expected to promote social activities that incorporate these values and adhere to these prerequisites.
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Affiliation(s)
- Ryuta Onishi
- Faculty of Nursing, Toyama Prefectural University, Toyama-ken, Japan
| | - Risa Takashima
- Department of Rehabilitation Science, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kazuko Saeki
- Faculty of Nursing, Toyama Prefectural University, Toyama-ken, Japan
| | - Michiyo Hirano
- Department of Comprehensive Development Nursing, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Liao Z, Zhou H, He Z. The mediating role of psychological resilience between social participation and life satisfaction among older adults in China. BMC Geriatr 2022; 22:948. [PMID: 36482364 PMCID: PMC9733394 DOI: 10.1186/s12877-022-03635-x] [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: 04/12/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A significant correlation has been discovered between social participation and older adults' life satisfaction, but the relationships among social participation, psychological resilience, and life satisfaction remain to be confirmed. Therefore, this study aims to identify the relationship between social participation and life satisfaction for Chinese older adults and to analyse the possible mediating role of psychological resilience between these two aspects. METHODS Data on 15,779 people aged 65 years and above were extracted from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Social participation was classified into two levels: low-level involvement activities and high-level involvement activities. Hierarchical regression analysis was applied to analyse the correlations between the two levels of social participation and older adults' life satisfaction as well as the mediating effects of psychological resilience on this association. RESULTS The results indicate that two levels of social participation were each positively correlated with life satisfaction. Specifically, high-level involvement activities (β = 0.070, P < 0.001) were more strongly associated with life satisfaction than low-level involvement activities (β = 0.051, P < 0.001). Moreover, psychological resilience was found to partially mediate the association between low-level involvement activities and high-level involvement activities and life satisfaction. CONCLUSION A higher level of life satisfaction for older adults is related to participation in high-level involvement activities. Psychological resilience has a mediating effect on the association between two levels of older adults' social participation and life satisfaction. These findings suggest that the government and society should establish a more concrete understanding of the psychological resilience of older adults.
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Affiliation(s)
- Zhiliu Liao
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Hanmeng Zhou
- School of Public Affairs, Fujian Province, Xiamen University, Xiamen City, People's Republic of China
| | - Zhifei He
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, People's Republic of China.
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Wang Q, Zhang S, Wang Y, Zhao D, Zhou C. Dual Sensory Impairment as a Predictor of Loneliness and Isolation in Older Adults: National Cohort Study. JMIR Public Health Surveill 2022; 8:e39314. [PMID: 36374533 PMCID: PMC9706378 DOI: 10.2196/39314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/28/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Loneliness and social isolation are global public health challenges. Sensory impairments (SIs) are highly prevalent among older adults but are often ignored as a part of normal aging. Identifying the role of SIs in loneliness and social isolation could provide insight into strategies for improving public health among older adults. OBJECTIVE This study aims to analyze the effects of SIs on loneliness and social isolation among older adults in rural and urban China. METHODS This cohort study of 3069 older adults (aged 60+) used data from 4 waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey of adults aged 45 years or older. SIs include hearing impairment (HI), vision impairment (VI), and dual sensory impairment (DSI). DSI is defined as the co-occurrence of VI and HI. Participants with complete data on hearing, vision, social isolation, and loneliness were included in the analysis. Generalized estimating equation models adjusted for covariates were used to examine the relationships of DSI with loneliness and social isolation among older adults. RESULTS Older adults in rural areas have higher prevalence of DSI, loneliness, and social isolation than their urban counterparts. In rural areas, participants with VI only (odds ratio [OR] 1.34, 95% CI 1.12-1.62; P=.002), HI only (OR 1.32, 95% CI 1.02-1.71; P=.03), and DSI (OR 1.84, 95% CI 1.56-2.18; P<.001) were more likely to experience loneliness compared with participants without SIs. DSI showed a statistically significant association with loneliness compared with VI only (OR 1.37, 95% CI 1.22-1.54; P<.001) and HI only (OR 1.39, 95% CI 1.13-1.72; P=.002). In urban areas, participants with VI only (OR 2.44, 95% CI 1.57-3.80; P<.001), HI only (OR 2.47, 95% CI 1.41-4.32; P=.002), and DSI (OR 1.88, 95% CI 1.24-2.85; P=.003) were more likely to experience loneliness compared with participants without SIs. DSI was not associated with the increased likelihood of loneliness compared with HI only or VI only. SIs were not associated with social isolation among older adults in urban and rural areas. Until 2018, 86.97% (2669/3069) reported VI, but only 27.11% (832/3069) and 9.45% (290/3069) were treated with glasses and cataract surgery, respectively; besides, 75 individuals received both glasses and cataract surgery treatment. The prevalence of HI was 74.39% (2283/3069) in 2018, but only 0.72% (22/3069) were treated with a hearing aid. CONCLUSIONS SIs are associated with an increased risk of loneliness rather than social isolation. A compounded risk of DSI on loneliness exists in rural areas rather than in urban areas. These findings expand our knowledge about the effects of SIs on loneliness and social isolation in non-Western populations. Interventions targeting HI only and DSI might be particularly effective for mitigating loneliness of older adults in urban and rural areas, respectively. Considering the high prevalence and low treatment rate of SIs, measures should be taken to make treatment more accessible.
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Affiliation(s)
- Qiong Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Shimin Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission of China Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Xu M, Ke P, Zhou Y, Tian Q, Gan Y, Lu Z. Subjective poverty, mental health, and mortality among Chinese older people: a prospective cohort study from 2008 to 2018. Soc Psychiatry Psychiatr Epidemiol 2022; 58:795-803. [PMID: 36335472 DOI: 10.1007/s00127-022-02380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/28/2022] [Indexed: 11/08/2022]
Abstract
PURPOSE The associations of duration of subjective poverty and poverty status with mortality among older people remains inconclusive, and the underlying mechanisms of mental health on them are rarely discussed in population-based epidemiological studies. METHODS We used the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2008-2018). The Cox regression model was used to estimate hazard ratio (HR) and 95% confidence intervals (CIs) for mortality. Mediation analysis was applied to assess the effect of mental health. RESULTS When compared with participants without subjective poverty, those who reported subjective poverty at one time point (2008 or 2011) or two time points (2008 and 2011) had a higher risk of death, with multivariable-adjusted HR (95% CIs) of 1.08 (1.00-1.16) and 1.22 (1.06-1.39), respectively. For poverty status, the multivariable-adjusted HR (95% CIs) of mortality were 0.81 (0.66-0.98) for "just objective poverty" and 0.78 (0.62-0.98) for "neither subjective nor objective poverty" compared with participants who reported "just subjective poverty", while there was no statistically significant association between "poverty subjectively and objectively" and mortality (HR = 0.88, 95% CI 0.72-1.07). Besides, we found that the proportion mediated by mental health was 26.6%, and age was a significant effect modifier. CONCLUSIONS Subjective poverty may be associated with a higher risk of death among Chinese older people. This study showed that promoting mental health alone may not substantially reduce socioeconomic inequality in health. Further explorations of measures to tackle the social determinants of health are still needed.
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Affiliation(s)
- Minzhi Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Pan Ke
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Ying Zhou
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Qingfeng Tian
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, 430030, Hubei, China.
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Wang J, Liu J, Wang X, Zhu J, Bai Y, Che Y, Tao J. Association between change in social participation and improved cognitive function among older adults in China: A national prospective cohort study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4199-e4210. [PMID: 35396737 DOI: 10.1111/hsc.13814] [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: 08/10/2021] [Revised: 03/17/2022] [Accepted: 03/29/2022] [Indexed: 06/14/2023]
Abstract
We aimed to assess the association between change in social participation and long-term improved cognitive function among older adults. Data were obtained from 9648 participants aged ≥60 years in the 2011, 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, a national prospective cohort study. Cox regression models were used to calculate adjusted risk ratios (aRRs). Social participation was increased in 20.5% of the participants, decreased in 37.8% of the participants and stable in 41.7% of the participants from the 2011 wave to the 2014-2018 waves. The improved cognitive function rate was 17.9% at follow-up. Compared to individuals with decreased social participation from the 2011 wave to the 2014-2018 waves, individuals with unchanged total social participation were 59% (aRR = 1.59, 95% CI: 1.35-1.87) more likely to have improved cognitive function in the 2014-2018 waves, and individuals with increased social participation were 61% (aRR = 1.61, 95% CI: 1.43-1.82) more likely to have improved cognitive function, regardless of the baseline social participation status. As for the three forms of social participation, compared with the participants with decreased social participation, those with increased participation in organised social activities, increased participation in group leisure-time activities, unchanged informal social interactions and increased informal social interactions were 24% (aRR = 1.24, 95% CI: 1.02-1.51), 49% (aRR = 1.49, 95% CI: 1.21-1.84), 55% (aRR = 1.55, 95% CI: 1.37-1.76) and 57% (aRR = 1.57, 95% CI: 1.34-1.84) more likely to have improved cognitive function (all p < 0.05) respectively. The results were stable in the sensitivity analysis. Our findings highlight the importance of promoting social participation from a multidimensional perspective (duration, frequency and forms) to improve cognitive function among older adults, for policy makers and healthcare workers in the community.
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Affiliation(s)
- Jun Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
- Institute for Global Health and Development, Peking University, Beijing, China
- Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing, China
| | - Xueyao Wang
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, China
| | - Jingmin Zhu
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Yang Bai
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, China
| | - Yue Che
- Center for Health Policy Research and Evaluation, Renmin University of China, Beijing, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China
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Xia W, van Wijngaarden JDH, Huijsman R, Buljac-Samardžić M. Effect of Receiving Financial Support from Adult Children on Depression among Older Persons and the Mediating Role of Social Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912974. [PMID: 36232272 PMCID: PMC9566105 DOI: 10.3390/ijerph191912974] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 06/14/2023]
Abstract
Older persons are vulnerable to depression SFduring the ageing process. Financial resources and social participation are expected to have an impact on depressive symptoms. This study investigated the relationship between financial support from children and depression among Chinese older persons, as well as the mediating effect of social participation in this relationship. Data from 7163 participants aged 60 and above were extracted from wave 2015 and 2018 of the China Health and Retirement Longitudinal Survey (CHARLS). A multivariate regression analysis was performed on both cross-sectional data and two-wave longitudinal data to test our hypotheses. The results revealed that financial support from children was negatively associated with depressive symptoms in both the short-term and the long-term. In addition, this relationship was partially mediated by social participation in the short-term association and fully mediated by social participation in the long-term, where financial support was positively related to social participation, and social participation was negatively associated with depressive symptoms. This study offers an in-depth insight into the relationship between financial support from children and depression among Chinese older persons. Policies and initiatives to stimulate social participation should be promoted to improve older persons' mental health.
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Chen J, Zeng Y, Fang Y. Effects of social participation patterns and living arrangement on mental health of Chinese older adults: A latent class analysis. Front Public Health 2022; 10:915541. [PMID: 35991050 PMCID: PMC9390803 DOI: 10.3389/fpubh.2022.915541] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/14/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives The purpose of this study was to discover patterns of social participation among Chinese older individuals, investigate the links between these patterns and their living arrangements and mental health, and connect these patterns to their background characteristics. Methods Data were drawn from the 2014 and 2018 waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2537 Chinese elders aged 60 years and over at the baseline. Latent class analysis was used to determine the patterns of social participation. Multinomial logistic regression was used to explore the relationship between patterns of social participation and the sociodemographic and health characteristics of older adults. Binary logistic regression was used to explore the differences and associations between these categories and living arrangement on mental health status, represented by positive and negative emotions. Results Three patterns of social participation were identified: Low activity (17.5%, n = 443); Moderate activity (36.2%, n = 1,176); and High activity (46.3%, n = 918). At baseline, these patterns were significantly associated with mental health status. Positive and negative emotions were much better in the High activity group than in the other two groups (OR = 1.36, 95% CI = 1.05–1.76 and OR = 1.50, 95% CI = 1.16–1.93). Living arrangement only significantly affected negative emotions (OR=1.25, 95% CI = 1.02–1.53). Age, gender, education, marital status, self-rated health, and activities of daily living limitations all affected social participation patterns. Conclusions The patterns of social participation and living arrangement of Chinese older adults are significantly associated with mental health. Population-tailored interventions may help liberate older adults from domestic labor and improve social participation. Moreover, family support can decrease negative emotions' damage in old age thus promoting health.
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Affiliation(s)
- Jieyao Chen
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Yanbing Zeng
- School of Public Health, Capital Medical University, Beijing, China
- *Correspondence: Yanbing Zeng
| | - Ya Fang
- Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
- Ya Fang
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Kim J, Lee J, Park J, Kim H, Yoo I. The Impact of Physical Environment on the Cognitive Function of the Elderly: A Scoping Review of Cohort Studies. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223211058826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This review examined whether the physical environment can change the cognitive function of the elderly and categorized the specific environmental types. Four databases, CINAHL, Embase, PubMed, and PsycINFO, were searched for relevant literature published as of December 2020. The framework used was proposed by Arksey and O’Malley, which includes a 5-stage review process. A total of 12 studies were examined. The physical environments with similar characteristics, among all the environmental elements, were grouped together into 4 categories: residential density and road connectivity, limited living space, urban/rural, and care facilities. Residential density and road connectivity, limited living space, and care facilities were found to have a significant effect on the cognitive function of the elderly. However, there was no significant effect on the cognitive function of the elderly when comparing the urban and rural environments. Although studies on environments that affect the cognitive function of the elderly are still ongoing, the ones analyzing specific environments in detail are insufficient. With the increasing importance of the role played by the environment in the cognitive impairment of the elderly, detailed studies on specific environments among the various environmental factors surrounding the elderly, such as this study, should be conducted more actively.
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Affiliation(s)
- Jihye Kim
- Jeonju University, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Jiyeong Lee
- Jeonju University, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Jihye Park
- Jeonju University, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Hakseong Kim
- Jeonju University, Jeonju-si, Jeollabuk-do, Republic of Korea
| | - Ingyu Yoo
- Jeonju University, Jeonju-si, Jeollabuk-do, Republic of Korea
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Liu TY, Qiu DC, Chen T. Effects of Social Participation by Middle-Aged and Elderly Residents on the Utilization of Medical Services: Evidence From China. Front Public Health 2022; 10:824514. [PMID: 35875043 PMCID: PMC9301239 DOI: 10.3389/fpubh.2022.824514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesAim to evaluate the effect of social participation on utilization of medical services among middle-aged and elderly residents in China.MethodsWe used data from the 2018 wave of the China Health and Retirement Longitudinal Study. Social participation is classified into three types. Furthermore, to control for confounding factors, our study computed propensity score matching (PSM) to evaluate the effect of social participation on the utilization of medical services.ResultThe result of PSM indicates that social participation significantly positively affects the utilization of outpatient services, the average treatment effect on the treated (ATT = 0.038***) and the utilization of inpatient services (ATT = 0.015**) by middle-aged and elderly residents. Furthermore, the utilization of outpatient health care services was significantly positively associated with leisure activities (ATT = 0.035***), social activities to help others (ATT = 0.031***), and learning activities to gain new knowledge (ATT = 0.034***) among middle-aged and elderly residents. The utilization of inpatient health care was significantly positively associated with leisure activities (ATT = 0.015***) but had no significant association with social deeds that help others and increased new knowledge among middle-aged and elderly residents.ConclusionThus, social participation significantly positively affects healthcare utilization by middle-aged and elderly residents. Hence, the government and society should provide more conveniences and promote social participation among middle-aged and elderly residents.
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Affiliation(s)
- Tai-Yi Liu
- School of Public Health, Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
| | - De-Chao Qiu
- Jintang First People's Hospital, West China Hospital Sichuan University, Jingtang, China
| | - Ting Chen
- School of Public Health, Hubei Provincial Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China
- *Correspondence: Ting Chen
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Qiao R, Jia S, Zhao W, Xia X, Su Q, Hou L, Li D, Hu F, Dong B. Prevalence and correlates of disability among urban-rural older adults in Southwest China: a large, population-based study. BMC Geriatr 2022; 22:517. [PMID: 35739469 PMCID: PMC9229854 DOI: 10.1186/s12877-022-03193-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/03/2022] [Indexed: 02/08/2023] Open
Abstract
Background As one of the challenges of aging, older adults with disabilities are often overlooked in remote areas of many developing countries, including southwest China. Similar populations would undoubtedly benefit from a representative, high-quality survey of large samples, which would also enrich global disability data. This study aims to assess the prevalence of disability and associated factors among urban and rural older adults in a typical representative region. Method A large-scale baseline survey was conducted between March and September 2020 using face-to-face interviews with a multistage stratified random sample of 16,536 participants aged ≥ 60 years. Disability was assessed using the BI scale, with a score of 100 representing normal status, 65–95 as mild disability, 45–60 as moderate disability, and 0–40 as severe disability. The prevalence of disability was estimated by demographics and health characteristics, and their associations were explored by robust Poisson regression analysis. Results The prevalence of disability among older adults was 19.4%, and the prevalence of mild, moderate, and severe disability was 16.8%, 1.5%, and 1.1%, respectively. All variables, including older age, residence in a rural area, higher number of hospitalizations, comorbidities, poor self-rated health, falls, cognitive impairment, mental impairment, and alienation from friends and relatives, were shown to be associated with a higher adjusted prevalence of disability. Only formal education can reduce the risk of disability. Conclusion The prevalence of disability among older adults is high in both urban and rural settings in southwest China, and a number of important factors associated with disability have been identified. In addition to increased attention to the health status of older adults, further research on scientific management and effective disability interventions is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03193-2.
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Affiliation(s)
- Runjuan Qiao
- National Clinical Research Center for Geriatrics and Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Shuli Jia
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Wanyu Zhao
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Xia
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Qiaoli Su
- National Clinical Research Center for Geriatrics and Department of General Practice, West China Hospital, Sichuan University, Chengdu, China
| | - Lisha Hou
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Daiping Li
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Fengjuan Hu
- Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China
| | - Birong Dong
- National Clinical Research Center for Geriatrics and Department of General Practice, West China Hospital, Sichuan University, Chengdu, China. .,Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, China.
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Chen S, Wang Y, Zhu L, Feng Z, Gong S, Dong D. Social activity as mediator between social support and psychological quality of life among people with rare diseases: A national repetitive cross-sectional study. J Psychiatr Res 2022; 150:147-152. [PMID: 35378487 DOI: 10.1016/j.jpsychires.2022.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Considerable proportion of people with rare diseases (RDs) have suffered from severe mental health problems. However, specific attention on the psychological quality of life (QoL) of people with RDs is sparse. Evidence documented the benefits of social support and social activity on recipients' mental health and overall QoL, but no corresponding study answered how both social support and social activity work on the psychological QoL among people with RDs. This study aims to report the psychological QoL and evaluate the mediating role of social activity between social support and psychological QoL among people with RDs. METHODS Data were from two national repetitive cross-sectional surveys, conducted in China in February 2016 and February 2018. In this study, eligible people were those aged 18 or above and had clinical-diagnosed RDs. Psychological QoL was measured by the subdomain of World Health Organization Quality of Life: Brief Version. Social support was measured by the Medical Outcomes Study Social Support Survey. Social activity was measured with seven items selected from the measurement on leisure activities used by the Chinese General Social Survey. Using the mediation model, we assessed the direct and indirect (via social activity) association between social support and psychological QoL, both on overall and subtypes of RDs. We controlled for a variety of potential socioeconomic and demographic confounding factors. RESULTS Of the 2403 adults studied, their average score of psychological QoL was 42.49 out of 100. The psychological QoL was directly associated with received emotional/information support (coefficient = 0.159, 95% CI = [0.093, 0.231], p < 0.0001) and positive social interaction (coefficient = 0.159, 95% CI = [0.097, 0.221], p < 0.0001). The psychological QoL was indirectly (via social activity) associated with received tangible support (coefficient = -0.035, 95% CI = [-0.046, -0.025], p < 0.0001) and positive social interaction (coefficient = 0.056, 95% CI = [0.040, 0.074], p < 0.0001). Above results by subtypes of RDs were also reported. LIMITATIONS The causal inference was not able to be investigated due to the cross-sectional study design. CONCLUSION People with RDs suffered from a low psychological QoL. Social activity mediated the association between social support and psychological QoL, but its mediating role depended on the subscales of social support as well as the subtypes of RDs. Customized measures based on the type of RDs and support that will be provided could perhaps improve the psychological QoL of people with RDs directly and indirectly.
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Affiliation(s)
- Shanquan Chen
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Yuqi Wang
- Department of Mathematics, Imperial College London, London, United Kingdom
| | - Liling Zhu
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhanchun Feng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiwei Gong
- Department of Pharmacy Business and Administration, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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Li SS, Zhang JY, Wu CW, Lu YW, Xu LJ, Ni YY, Liu XJ. The mediating effect of coping style on the relationship between perceived stress and mental health in Chinese rural older adults living alone: A cross-sectional study. Geriatr Gerontol Int 2022; 22:523-528. [PMID: 35504596 DOI: 10.1111/ggi.14392] [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: 08/25/2021] [Revised: 03/10/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
AIM Older adults living alone is becoming the main family structure in rural China. This study aimed to explore the mediating effect of coping style on the relationship between perceived stress and mental health in rural older adults living alone in China. METHODS 356 rural older adults living alone were recruited in Huzhou, China. Subjects were investigated using the Chinese Perceived Stress Scale (CPSS), Chinese Coping Style Questionnaire (CCSQ), and Mental Health Questionnaire (MHQ). Data were analysed using a structural equation. Bootstrapping was used to validate the mediation effects. RESULTS Mental health showed significant correlations with a sense of nervousness, of uncontrollability, and with positive and negative coping styles (P < 0.05). The results of structural equation modeling showed a good fit for the total sample (χ2 /df = 2.684, NFI = 0.927, GFI = 0.944, RMSEA = 0.069). Perceived stress (sense of nervousness and uncontrollability) impacted the mental health of rural older adults living alone mainly through two mediating variables, including positive and negative coping styles. The double mediating contribution rates were 42.11%, and 61.82%. CONCLUSION Coping style partially mediated the relationship between perceived stress and mental health of rural older adults living alone in China. Consequently, to improve the mental health of rural older adults living alone, perceived stress and coping styles should be the focus. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Sha-Sha Li
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Jia-Yuan Zhang
- Department of Nursing, University of Harbin Medical, Daqing, Heilongjiang, China
| | - Cong-Wen Wu
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Yu-Wei Lu
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Li-Jun Xu
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Ying-Yuan Ni
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
| | - Xiao-Jing Liu
- Department of Nursing, College of Medical Science, Huzhou University, Zhejiang, China
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Muhammad T, Srivastava S, Hossain B, Paul R, Sekher TV. Decomposing rural-urban differences in successful aging among older Indian adults. Sci Rep 2022; 12:6430. [PMID: 35440788 PMCID: PMC9018817 DOI: 10.1038/s41598-022-09958-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
The modernization and shift towards urbanized lifestyles have triggered several diseases, and the context of aging varies in urban and rural settings in India. The study aimed to investigate the urban-rural differences in successful ageing among older adults in India and the contributing factors in those differences. The study utilizes data from nationally representative Longitudinal Ageing Study in India (LASI, 2017-18). The analytical sample size for the study was 31,464 older adults aged 60 years and above. Descriptive statistics and bivariate analysis were carried out to present the initial results. Multivariable logistic regression and decomposition analysis was used to find the associations between explanatory variables and successful aging and to identify the contributions of covariates that explain the rural-urban differences in successful ageing. A proportion of 32% and 24% of older adults from rural and urban areas were successful agers with an urban disadvantage. Urban-dwelling older adults had 0.67 times [95% confidence interval (CI): (0.64, 0.71)] lower unadjusted odds of successful ageing than rural older adults. Again, after adjusting for the effect of other explanatory variables, urban older adults had 0.92 times [CI: (0.87, 0.98)] lower odds of being successful agers than their rural counterparts. The major contributors to the rural-urban inequality in successful aging were differences in regional distribution (17% contribution), waist circumference (16%), working status (16%), body mass index (13%) and physical activity (8%) among rural and urban older adults. The urban disadvantage in aging successfully may reflect the higher prevalence of adverse lifestyle behaviours in urban dwellers and under-diagnosis and under-reporting of many diseases in rural areas, particularly non-communicable diseases, suggesting the need for further investigation.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India.
| | - Babul Hossain
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
| | - T V Sekher
- International Institute for Population Sciences, Mumbai, Maharashtra, 400088, India
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Kang X, Du M, Wang S, Du H. Exploring the Effect of Health on Migrants' Social Integration in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084729. [PMID: 35457596 PMCID: PMC9024569 DOI: 10.3390/ijerph19084729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 12/11/2022]
Abstract
There are 376 million migrants, which account for more than 25% of the population in China according to the newest national demographic census, most of whom are from undeveloped areas to developed urban regions. Migrants’ social integration was one of the most important issues when the country aimed to build an inclusive society. As a form of human capital, the effect of migrants’ health status on social integration has rarely been explored until now, especially empirically. Previous studies have usually ignored health indicators when discussing the determinants of migrants’ social integration, and understanding the role of migrants’ physical health and mental health on their social integration is significant for efforts to ensure inclusive urbanization. For filling this research gap, the China Migrants Dynamic Survey dataset was used to uncover the role of migrants’ health status, including physical health and mental health, in their degree of social integration, and a further comparison of impact was conducted among rural–urban and urban–urban migrants. Through the empirical analysis, our results indicated the following. First, both better physical and mental health lead to higher social integration levels, and a one-point increase in physical and mental health improves the odds of good social integration by 33.27% and 5.98% for belonging and 66.05% and 6.35% for harmony, respectively. Second, health status is equally important for rural–urban and urban–urban migrants’ social integration, and the significant positive effect was consistent across groups, although some other impact factors may exhibit differences. Third, the effect of health status on social integration was moderated by social participation, which was more obvious for mental health than physical health. According to our findings, we discuss the measures to promote migrants’ health status and additional countermeasures to improve their social integration level.
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Affiliation(s)
- Xiang Kang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Mingxi Du
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
- Correspondence: (M.D.); (H.D.)
| | - Siqin Wang
- School of Economics and Finance, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Haifeng Du
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
- Correspondence: (M.D.); (H.D.)
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Urbanization and Population Aging: Converging Trends of Demographic Transitions in Modern World. Arch Gerontol Geriatr 2022; 101:104709. [DOI: 10.1016/j.archger.2022.104709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Zhang Y, Su D, Chen Y, Tan M, Chen X. Effect of socioeconomic status on the physical and mental health of the elderly: the mediating effect of social participation. BMC Public Health 2022; 22:605. [PMID: 35351078 PMCID: PMC8962021 DOI: 10.1186/s12889-022-13062-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous studies have demonstrated the effect of socioeconomic status on the health status of the elderly. Nevertheless, the specific dimensions of the effect and the mechanism await further investigation. In this study, socioeconomic status was divided into three dimensions and we used social participation as the mediation variable to investigate the specific path of effect. METHODS Using the 2018 Waves of Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset, a total of 10,197 effective samples of the elderly over 65 years old were screened out. Socioeconomic status included income, education level, and main occupation before retirement. The physical health and mental health of the elderly was measured by the Instrumental Activities of Daily Living Scale and the Minimum Mental State Examination, respectively. The social participation of the elderly was the mediation variable, including group exercise, organized social activities and interacting with friends. Omnibus mediation effect analysis was adopted to examine the mediation effect and mediation analysis was completed using the SPSS PROCESS program. RESULTS First, the results showed that when the income gap between the elderly reached a certain level, there was a significant difference in health status. Significant differences existed in health status amongst with different education levels. There was no sufficient evidence to show that occupation has a significant effect on the physical health. But when the dependent variable was mental health, the effect was significant. Second, group exercise mediated 64.11% (aib = 0.24, 95% CI [0.17,0.3]) and up to 20.44% (aib = 0.12, 95% CI [0.07,0.17]) of the disparity in physical and mental health due to income gap, respectively. And it could mediate the effect up to 56.30% (aib = 0.62, 95% CI [0.52,0.73]) and 17.87% (aib = 0.50, 95% CI [0.4,0.61]) of education on physical and mental health status, respectively. The proportion of relative mediation effect of occupation was up to 28.74% (aib = 0.19, 95% CI [0.13,0.25]) on mental health. Interacting with friends mediated only on the path that the education affected the health status of the elderly. The proportion was up to 33.72% (aib = 0.29, 95% CI [0.16,0.44]). The relative mediation effect of organized social activities on the health gap caused by income or education level gap was significant at some levels. The proportion was up to 21.20% (aib = 0.33, 95% CI [0.26,0.4]). CONCLUSION The SES of the elderly including relatively large income gap, different education levels and occupational categories could indeed have a significant effect on health status of the elderly, and the reason why this effect existed could be partly explained by the mediation effect of social participation. Policymakers should pay more attention to the social participation of the elderly.
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Affiliation(s)
- Yunfan Zhang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dai Su
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yingchun Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. .,Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China.
| | - Min Tan
- First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xinlin Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
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Zhang T, Lu B, Wang X. Urban-Rural Disparity in Cognitive Performance Among Older Chinese Adults: Explaining the Changes From 2008 to 2018. Front Public Health 2022; 10:843608. [PMID: 35400051 PMCID: PMC8984104 DOI: 10.3389/fpubh.2022.843608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives This study aims to identify the dynamic changes in cognitive performance differentials between urban and rural older adults in China from 2008 to 2018 and decomposes determinants affecting such changes. Methods Two waves (2008 and 2018) of data were extracted from the Chinese Longitudinal Healthy Longevity Survey. The cognitive function was tested using the Chinese Mini-Mental State Examination (MMSE). The effects of the explanatory variables (demographic, economic, neighborhood, environmental events and social and cultural domains) on the changes in the urban-rural inequality of cognitive performance were divided into two components using the Juhn–Murphy–Pierce (JMP) decomposition: quantity effect and price effect. Results A total of 14,628 (urban respondents: 5,675, rural respondents: 8,953) and 10,311 older adults (urban respondents: 5,879, rural respondents: 4,432) for 2008 and 2018, respectively, were included in our study. A narrowing of 0.071 in the urban-rural disparity in cognitive function score of the older adults from 2008 to 2018 was identified. Quantity and price effects of explanatory variables contributed 65.21 and 46.84%, respectively, to the observed components in explaining the narrowed disparity. Quantity effects of age (35.71%), exercise (56.72%), self-rated economic status (33.19%) and price effect of homeownership (54.97%) contributed significantly to the reduced urban-rural gap. Contrastingly, inequality in pension (−27.31%) and social security (−23.11%) between urban and rural widened cognitive performance differentials. Furthermore, effects of hunger in childhood (−10.53%) and less years of schooling (−77.20%) on the increase in urban-rural inequality seemed to be stronger over time. Conclusion Economic development and reform of the rural health system are responsible for the decline in the urban-rural disparity in the cognitive performance of older adults. Equalizing the distribution of social security and welfare between urban and rural must be highlighted for eliminating cognitive ability disparity. Additionally, rural older adults who endured hunger and poor education in childhood also deserve further policy interventions.
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Jia P, Zhuang J, Vaca Lucero AM, Li J. Does the energy consumption revolution improve the health of elderly adults in rural areas? Evidence from China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:150755. [PMID: 34619215 DOI: 10.1016/j.scitotenv.2021.150755] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
About 2.8 billion people around the world still depend on biomass as their primary energy source. This traditional custom affects the environment and severely impacts the health and life quality of the rural residents, especially in the elderly group. Based on the published data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018, this paper carefully explores the impact of the energy consumption revolution on the health of rural elderly adults and its response mechanism. The results from the empirical analysis show that: (1) The positive response of rural families to the energy consumption revolution can significantly improve the elderly adults' health condition; (2) The energy consumption revolution can improve the rural elderly adults' health by enhancing the home environmental sanitation (home environmental effect) and life satisfaction (psychological effect); (3) In the process of energy consumption revolution affecting the rural elderly's health, the factor age plays a negative regulatory role, in other words, the older the elderly, the lower the marginal effect of energy consumption revolution on their health improvement. This paper uses the propensity score matching method to deal with the endogenous problem of the regression model, and uses a placebo test and the substitution estimation method to check the robustness of the empirical results. As well, this research puts forward some policy suggestions, such as increasing investment in energy infrastructure in rural areas, reducing the cost of using clean energy, combining environmental energy protection with increasing energy income, and improving medical security conditions in rural areas.
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Affiliation(s)
- Peng Jia
- School of Management, Jiangsu University, Zhenjiang 212013, China
| | - Jincai Zhuang
- School of Management, Jiangsu University, Zhenjiang 212013, China
| | | | - Juan Li
- School of Business, Guilin University of Electronic Technology, Guilin 541004, China
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Matsumoto D, Takatori K, Miyata A, Yamasaki N, Miyazaki M, Imanishi A, Moon JS. Association between neighborhood walkability and social participation in community-dwelling older adults in Japan: A cross-sectional analysis of the keeping active across generations uniting the youth and the aged study. Geriatr Gerontol Int 2022; 22:350-359. [PMID: 35118801 DOI: 10.1111/ggi.14354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/24/2021] [Accepted: 01/15/2022] [Indexed: 12/22/2022]
Abstract
AIM This study investigated neighborhood walkability using Walk Score® and social participation in districts within a city among older Japanese adults. METHODS This study was a cross-sectional study using baseline data of older adults from the Keeping Active across Generations Uniting the Youth and the Aged study. In total, 2750 participants (1361 men and 1389 women, mean age 72.8 ± 6.4 years) were included in the analysis. The questionnaire included socioeconomic status, self-rated health, medical history, depressive symptoms, instrumental activities of daily living and social participation. We used the Walk Score® as neighborhood walkability and a walk score <50 was categorized as a "car-dependent" area and a score ≥50 as a "walkable" area. A Poisson regression analysis stratified by sex was performed to investigate the association of neighborhood walkability with social participation. Prevalence ratios were calculated and their 95% confidence intervals. RESULTS We found that dwelling in car-dependent areas (prevalence ratio 0.78, 95% confidence interval 0.64-0.94) had a significant negative effect on women's social participation, unlike men. CONCLUSIONS Our study showed that neighborhood walkability and social participation were associated with older Japanese women after adjusting for the covariates. These findings might provide helpful information for public health interventions targeted to promote social participation among older adults. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Daisuke Matsumoto
- Department of Physical Therapy, Faculty of Health Sciences, Kio University, Nara, Japan.,Health Promotion Center, Kio University, Nara, Japan
| | - Katsuhiko Takatori
- Department of Physical Therapy, Faculty of Health Sciences, Kio University, Nara, Japan.,Health Promotion Center, Kio University, Nara, Japan
| | - Akiho Miyata
- Department of Rehabilitation, Izumi City General Hospital, Osaka, Japan
| | - Naomi Yamasaki
- Department of Nursing, Faculty of Health Sciences, Kio University, Nara, Japan
| | - Makoto Miyazaki
- Learning Technology Laboratory, Teikyo University, Tokyo, Japan
| | - Aya Imanishi
- Division of Care and Welfare, Koryo Town, Nara, Japan
| | - Jong-Seong Moon
- Health Promotion Center, Kio University, Nara, Japan.,Department of Nursing, Faculty of Health Sciences, Kio University, Nara, Japan
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Sanchez-Lara E, Lozano-Ruiz A, Rute-Perez S, Saez-Sanz N, Bombin I, Caracuel A. Participation Predicts Cognitive Functioning in Older Adults Using the PART-O Transformed Scores Systems. J Appl Gerontol 2022; 41:1081-1089. [PMID: 35114842 DOI: 10.1177/07334648211057096] [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: 11/15/2022] Open
Abstract
Participation has been shown to be a protective factor for cognition in older adults, but instruments to assess it are limited. The main objective was to determine the validity of two scoring systems (direct vs transformed) for the Participation Assessment with Recombined Tools-Objective (PART-O) by applying structural equation modeling to the relationship between the subscales and the cognitive functions, in a sample of 245 people over 60 years of age. The transformed scores model showed stronger relationships and larger explained variance in overall participation (55.4% vs 37.4%), especially in the Social Relations subscale (31.4% vs 14.6%). Participation was a direct predictor of cognitive functions in both models. Age and depression inversely influenced participation in the transformed scores model. The proposed score transformation for the PART-O provides a more appropriate measurement of the older adults' participation. Participation has a mediating role in the relationship between cognition and both age and depression.
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Affiliation(s)
| | - Alvaro Lozano-Ruiz
- Mind, Brain, and Behavior Research Center (CIMCYC), 16741University of Granada, Granada, Spain.,Department of Personality, Evaluation, and Psychological Treatment, 16741University of Granada, Granada, Spain
| | - Sandra Rute-Perez
- Mind, Brain, and Behavior Research Center (CIMCYC), 16741University of Granada, Granada, Spain.,Department of Developmental and Educational Psychology, 16741University of Granada, Granada, Spain
| | - Noelia Saez-Sanz
- Mind, Brain, and Behavior Research Center (CIMCYC), 16741University of Granada, Granada, Spain
| | - Igor Bombin
- Reintegra Foundation, Centro de Rehabilitación Neurologica, Oviedo, Spain
| | - Alfonso Caracuel
- Mind, Brain, and Behavior Research Center (CIMCYC), 16741University of Granada, Granada, Spain.,Department of Developmental and Educational Psychology, 16741University of Granada, Granada, Spain
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Lu J, Liu L, Wang Y, Zhou Z. Social Engagement and Urban-Rural Disparity in Self-Management Behaviors: Study of Middle-Aged and Older Chinese Hypertension Patients. Front Public Health 2022; 9:801307. [PMID: 35155352 PMCID: PMC8828651 DOI: 10.3389/fpubh.2021.801307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study examines the effect of social engagement on urban-rural disparities in self-management behaviors (medication use, self-monitoring, physical activity, and tobacco and alcohol avoidance) among middle-aged and older Chinese patients with hypertension. METHODS Data from 2011 to 2018 were extracted from the four latest waves of the China Health and Retirement Longitudinal Study. Chi-square tests and t-tests were performed to examine urban-rural gaps in self-management behaviors. Random-effects panel logit regression models were adopted to confirm the effect of social engagement on urban-rural disparity in self-management behaviors and to explore whether this effect has narrowed or widened with "bilateral flow" between urban and rural residents. A Fairlie decomposition technique was also used to calculate the extent to which social engagement reflects urban-rural disparities. RESULTS There was significant urban-rural disparity in medication use and tobacco avoidance behaviors among the sampled patients. Medication use behavior (p < 0.001) among urban middle-aged and older patients was significantly better, whereas tobacco avoidance behavior (p < 0.05) was significantly lower compared with the rural population. Social engagement significantly enlarged the urban-rural gap in tobacco avoidance behavior (p < 0.01), but significantly narrowed the urban-rural gap in medication use behavior (p < 0.001). The Fairlie decomposition revealed that ~75.000% and 29.412% of the explained urban-rural gap in tobacco avoidance and medication use, respectively, could be attributed to social engagement. The negative effect of social engagement on urban-rural disparity in medication use increased when urban residents moved to rural areas (p < 0.05). CONCLUSIONS The urban-rural disparities in self-management behaviors of middle-aged and older Chinese hypertensive patients were mainly manifested in medication use and tobacco avoidance behaviors. The gaps in these two behaviors partly changed with social engagement, while the migration of urban population to rural areas weakens the positive role of social engagement in narrowing the urban-rural gap in medication use behavior. The insights of this paper on social engagement and urban-rural disparity in self-management behaviors, and the effect of urban-rural migration thereof, deserve the attention of health policymakers and researchers.
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Affiliation(s)
- Jiao Lu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Linhui Liu
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Yuan Wang
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
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An R, Li S, Li Q, Luo Y, Wu Z, Liu M, Chen W. Oral Health Behaviors and Oral Health-Related Quality of Life Among Dental Patients in China: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:3045-3058. [PMID: 36387048 PMCID: PMC9651070 DOI: 10.2147/ppa.s385386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Oral health plays an important role in overall health. But little is known about the problems with oral health behaviors and oral health-related quality of life (OHRQoL) among dental patients in China. This study aimed to investigate oral health behaviors and OHRQoL, as well as to examine the effects of oral health behaviors and associated factors on OHRQoL among dental patients. METHODS This cross-sectional study was conducted from June 2022 to July 2022 in the Department of Stomatology of the First Mobile General Hospital of Armed Police, Hebei, China. The five-item short form of the Oral Health Impact Profile (OHIP-5) was used to evaluate OHRQoL. Oral health behaviors were assessed by a 16-items oral health behavior questionnaire, and socio-demographic data were collected by a socio-demographic questionnaire. The t-test, one-way ANOVA, and multiple linear regression analysis were used to investigate the associations between the study variables. RESULTS 186 participants were included in the study. The average age of the participants was 24.62 years (SD = 10.67). The mean OHIP-5 score was 4.31 (SD =3.35). Oral health-related quality of life differed significantly by smoking history, history of alcohol consumption, work status, economic pressure, self-rated oral health status, daily brushing frequency, dental caries condition, and whether they take the initiative to learn about oral health. Multivariate analysis found that the self-rated oral health status and work status were significantly associated with the OHIP scores. The retired people and those with poor self-rated oral health displayed poor OHRQoL. CONCLUSION In general, dental patients' oral health needs to be improved, the majority of patients reported practicing poor oral health behaviors, among which the retired population and hose with poor self-rated oral health showed poor OHRQoL. OHRQoL in dental patients is a complex issue associated with social and behavioral factors.
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Affiliation(s)
- Ran An
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Siyu Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China
| | - Qianqian Li
- The First Mobile Corps Hospital of the Chinese People’s Armed Police Force, Baoding, Hebei Province, People’s Republic of China
| | - Yuan Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Zitong Wu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Meizi Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China
| | - Wenfeng Chen
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University
- Correspondence: Wenfeng Chen, Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, No. 87 Xiangya Road, Kaifu District, 410008, Email
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The associations between infertility-related stress, family adaptability and family cohesion in infertile couples. Sci Rep 2021; 11:24220. [PMID: 34930989 PMCID: PMC8688530 DOI: 10.1038/s41598-021-03715-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
To explore the association between infertility-related stress, family adaptability and family cohesion in infertile couples and the determinants of infertility-related stress in infertile couples. Fertility Problem Inventory (FPI) and Family Adaptability and Cohesion Evaluation Scales (FACESII-CV) were used to measure the infertility-related stress and family adaptability and cohesion of infertile couples. T-test, ANOVA and multiple comparisons (LSD) were conducted to compare the FPI scores of different demographic characteristics subgroups. Stepwise multivariate linear regression was used to explore the determinants of infertility-related stress. Women had greater global stress than men (P < 0.001). Women scored higher on desired family adaptability, cohesion dissatisfaction and adaptive dissatisfaction than men (P = 0.039, P = 0.036, P = 0.008). FPI scores were higher in men and women who lived in rural (P < 0.001, P < 0.001). Family cohesion and education level was negatively correlated with infertility-related stress in men. Family adaptability and education level was negatively correlated with infertility-related stress in women. Healthcare providers should pay more attention and give more support to infertile couples who lived in rural or with low education level, and provide easier medical accessing for them. Moreover, healthcare providers should value more the family function and family support in intervention of reducing infertility-related stress.
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Yang S, Li J, Zhao D, Wang Y, Li W, Li J, Li Z, Wei Z, Yan C, Gui Z, Zhou C. Chronic Conditions, Persistent Pain, and Psychological Distress Among the Rural Older Adults: A Path Analysis in Shandong, China. Front Med (Lausanne) 2021; 8:770914. [PMID: 34796190 PMCID: PMC8593003 DOI: 10.3389/fmed.2021.770914] [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: 09/05/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022] Open
Abstract
Psychological distress were found to be associated with chronic conditions and persistent pain. However, few studies explored the underlying pathways between them. This study aimed to analyze the path of chronic conditions and persistent pain on psychological distress through sleep quality and self-rated health. A total of 2,748 rural older people in Shandong, China were included in this study. Path analysis was performed by using Mplus 8.3 to examine the associations between chronic conditions, persistent pain, sleep quality, self-rated health, and psychological distress after adjusting for age, gender, education, and household income. The prevalence of psychological distress among the older adults in this study was 47.49%. Chronic conditions and persistent pain were indirectly associated with psychological distress through six mediating pathways: (1) the path from chronic conditions to psychological distress through sleep quality (β = 0.041, 95%CI: 0.015-0.067) and self-rated health (β = 0.064, 95%CI: 0.038-0.091), respectively, and a chain mediation existed (β = 0.007, 95% CI: 0.000-0.014); (2) the path of persistent pain and psychological distress through sleep quality (β = 0.058, 95% CI: 0.014-0.102) and self-rated health (β = 0.048, 95% CI: 0.000-0.096), respectively, also the chain mediation found (β = 0.009, 95% CI: 0.005-0.014). Psychological distress was associated with chronic conditions and persistent pain through decreased sleep quality and self-rated health among Chinese rural older people. Multi-pronged targeted intervention should be taken for older adults with chronic conditions and persistent pain.
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Affiliation(s)
- Shijun Yang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wenjuan Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhixian Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhen Wei
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chen Yan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhen Gui
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Committee (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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Wang C, Feng L, Qi Y. Explainable deep learning predictions for illness risk of mental disorders in Nanjing, China. ENVIRONMENTAL RESEARCH 2021; 202:111740. [PMID: 34329635 DOI: 10.1016/j.envres.2021.111740] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
Epidemiological studies have revealed the associations of air pollutants and meteorological factors with a range of mental health conditions. However, little is known about local explanations and global understanding on the importance and effect of input features in the complex system of environmental stressors - mental disorders (MDs), especially for exposure to air pollution mixture. In this study, we combined deep learning neural networks (DLNNs) with SHapley Additive exPlanation (SHAP) to predict the illness risk of MDs on the population level, and then provided explanations for risk factors. The modeling system, which was trained on day-by-day hospital outpatient visits of two major hospitals in Nanjing, China from 2013/07/01 through 2019/02/28, visualized the time-varying prediction, contributing factors, and interaction effects of informative features. Our results suggested that NO2, SO2, and CO made outstanding contributions in magnitude of feature attributions under circumstances of mixed air pollutants. In particular, NO2 at high concentration level was associated with an increase in illness risk of MDs, and the maximum and mean absolute SHAP value were approximated to 10 and 2 as a local and global measure of feature importance, respectively. It presented a marginally antagonistic effect for two pairs of gaseous pollutants, i.e., NO2 vs. SO2 and CO vs. NO2. In contrast, CO and SO2 displayed the opposite direction of feature effects to the rise of observed concentrations, but an apparent synergistic effect was obviously captured. The primary risk factors driving a sharp increase in acute attack or exacerbation of MDs were also identified by depicting prediction paths of time-series samples. We believe that the significance of coupling accurate predictions from DLNNs with interpretable explanations of why a prediction is completed has broad applicability throughout the field of environmental health.
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Affiliation(s)
- Ce Wang
- School of Energy and Environment, Southeast University, Nanjing, 210096, PR China; State Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing, 210096, PR China.
| | - Lan Feng
- National-Provincial Joint Engineering Research Center of Electromechanical Product Packaging, College of Civil Engineering, Nanjing Forestry University, Nanjing, 210037, PR China.
| | - Yi Qi
- School of Architecture and Urban Planning, Nanjing University, No. 22 Hankoulu Road, Nanjing, 210093, PR China.
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Joint trajectories of disability and related factors among older adults in China. Public Health 2021; 199:96-102. [PMID: 34583202 DOI: 10.1016/j.puhe.2021.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/07/2021] [Accepted: 08/23/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study aimed to identify disability trajectories and discover early disablement process factors associated with disability trajectories among older adults in China. STUDY DESIGN This is a prospective cohort study. METHODS Data were obtained from five waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2005 to 2018). The multitrajectory modelling approach was used to estimate the joint trajectories of activity of daily living (ADL) disability and instrumental activity of daily living (IADL) disability. A multinomial regression model was used to investigate how baseline disablement process factors among individuals aged 65-95 years are related to joint disability trajectory groups. RESULTS We identified three typical joint ADL and IADL disability trajectories. Demographic characters, social participation, community services, disease, impairment and functional limitations can all impact the disability trajectories among older adults. CONCLUSIONS The joint ADL and IADL disability trajectories of older adults are increasing, and the Chinese government should pay more attention to disability process elements to improve disability interventions among older adults.
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