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Ribeiro TD, Carvalho H, Gouveia ÉR, Nascimento M, Peralta M, Marques A. Frailty and Health-Related Quality of Life Among European Older Adults: The Moderating Effect of Human Development Index. J Aging Soc Policy 2024:1-14. [PMID: 39190824 DOI: 10.1080/08959420.2024.2384179] [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: 10/16/2023] [Accepted: 03/21/2024] [Indexed: 08/29/2024]
Abstract
The Human Development Index (HDI) is a proxy for the social and economic level of countries, which is related to the health and well-being of older adults. This study aimed to examine the moderating effect of the HDI on the relationship between frailty and health-related quality of life among European older adults. Participants were 23,972 older adults (53.2% female, M = 74.2 years old, SD = 6.75 years old) from 24 European countries, joining wave 8 (2020) of the Survey of Health, Aging, and Retirement in Europe (SHARE). Multilevel modeling was used to analyze nested data. Significant differences in health-related quality of life among the several European Union countries were observed (intraclass correlation coefficient [ICC] = 0.18, LRT (1) = 5568.07, p < .001). The HDI has been shown to moderate the relationship between frailty and health-related quality of life among older adults, buffering the impact of frailty on the health-related quality of life. Since healthy aging is a priority for the European Union, policies mitigating the impact of HDI on the relationship between frailty and health-related quality of life should be implemented.
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Affiliation(s)
- Tiago D Ribeiro
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Helena Carvalho
- Iscte - Instituto Universitário de Lisboa, Centro de Investigação e Estudos de Sociologia (CIES-IUL), Lisboa, Portugal
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, Funchal, Portugal
- LARSYS, Interactive Technologies Institute, Funchal, Portugal
| | - Marcelo Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Petrolina, Brazil
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Univerisdade de Lisboa, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Univerisdade de Lisboa, Lisbon, Portugal
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Rezaei M, Forouzan K, Eini-Zinab H, Omidvar N, Jafaripour S, Rezazadeh A. Dietary diversity and its association with changes in anthropometric indices of community-dwelling older adults in Tehran, Iran: a longitudinal study (2017-2021). BMC Public Health 2024; 24:2253. [PMID: 39164719 PMCID: PMC11334311 DOI: 10.1186/s12889-024-19635-y] [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: 05/19/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Dietary diversity refers to the consumption of a variety of foods or food groups over a given reference period, which is crucial for improving nutrition and overall health. This longitudinal study aimed to investigate the association between dietary diversity and anthropometric indices in community-dwelling older adults living in Tehran in 2017 and 2021. METHODS The current study was conducted on 368 older adults [204 (55.4%) women and 164 (44.6%) men] over 60 years of age living in Tehran, who were selected by a systematic cluster sampling method at two-time points, 2017 and 2021. Anthropometric measures (weight, height, hip circumference, and waist circumference) were assessed with standard methods. The participants' dietary intake was assessed by completing two non-consecutive 24-hour recalls, and dietary diversity score (DDS) was calculated based on Kant's method. Statistical analysis was performed using R software by the mixed effect model method. RESULTS The mean DDS of the participants in 2017 (5.07 ± 1.20) was higher than that in 2021 (4.94 ± 1.09) (p < 0.05). DDS and dairy diversity score decreased significantly over time. After adjusting for confounders, there was an inverse relationship between the DDS and Body Mass Index (BMI) (B = -0.22; SE = 0.09), but the interaction effect of year × DDS (B = 0.19; SE = 0.10) was not significant (p = 0.06). However, there was a positive relationship between the DDS and A Body Shape Index (ABSI) (B = 0.00; p = 0.022), after adjusting for confounders, this relationship was no longer significant. Additionally, the interaction effect of year and DDS on the ABSI was not significant. CONCLUSION The dietary intake and dietary diversity of older adult residents of Tehran declined dramatically with age, and a higher DDS was associated with improved anthropometric indices. DDS had an inverse relationship with general obesity in the studied participants, and the passage of time did not affect this relationship. The DDS can be used as a predictive index and is a powerful tool for investigating changes in nutritional status in longitudinal studies of old age. However, longer-duration studies are needed to obtain more conclusive results.
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Affiliation(s)
- Mahshid Rezaei
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimia Forouzan
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Jafaripour
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hosseinpour-Niazi S, Niknam M, Amiri P, Mirmiran P, Ainy E, Izadi N, Gaeini Z, Azizi F. The association between ultra-processed food consumption and health-related quality of life differs across lifestyle and socioeconomic strata. BMC Public Health 2024; 24:1955. [PMID: 39039502 PMCID: PMC11265477 DOI: 10.1186/s12889-024-19351-7] [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: 03/26/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND In this prospective study, we aimed to examine the association between ultra-processed foods and health-related quality of life (HRQoL) and to evaluate the effect of lifestyle and socioeconomic factors on this association. METHODS This study included 1766 adults (aged 18 to 78, 54.3% women), who took part in the Tehran Lipid and Glucose study. The Short-Form 12-Item Health Survey version 2 was used to determine HRQoL, which includes the physical component summary (PCS) and mental component summary (MCS) scores. Ultra-processed food consumption was assessed using a validated semi-quantitative food frequency questionnaire. Lifestyle (physical activity and smoking status) and socioeconomic factors (education level and employment status) were also determined. General linear models (GLM) were applied to estimate the mean (95% confidence interval) for MCS and PCS scores across the ultra-processed foods tertiles. Additionally, the effect of lifestyle and socioeconomic factors on the relationship between ultra-processed foods and HRQoL was examined using GLM. RESULTS The median consumption of ultra-processed foods was 11.9% (IQR: 8.2 to 16.8) of total energy intake. There was a significant inverse association between ultra-processed foods consumption and PCS, but not MCS, after adjustment for confounding factors. Significant interactions were observed between ultra-processed food consumption, sex, and occupation on PCS score (all P values < 0.001). The interaction test tended to be significant for smoking status, education levels, and physical activity levels. As ultra-processed food consumption increased, the PCS score significantly decreased in women (P = 0.043), low physical active subjects (P = 0.014), smokers (P = 0.015), and lower-educated individuals (P = 0.022). Non-employed individuals with higher ultra-processed food intake showed a decline in their PCS and MCS scores. While there was no significant difference in MCS score among different strata of lifestyle and socioeconomic status across tertiles of ultra-processed foods. CONCLUSIONS Higher intake of ultra-processed foods was associated with poorer physical health, particularly among women, those with unhealthy lifestyles, and low socioeconomic conditions.
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Affiliation(s)
- Somayeh Hosseinpour-Niazi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Mahdieh Niknam
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran.
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elaheh Ainy
- Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Izadi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, No. 24, A'rabi St., Yeman Av., Velenjak, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yogeswaran V, Kim Y, Franco RL, Lucas AR, Sutton AL, LaRose JG, Kenyon J, D’Agostino RB, Sheppard VB, Reding K, Hundley WG, Cheng RK. Association of poverty-income ratio with cardiovascular disease and mortality in cancer survivors in the United States. PLoS One 2024; 19:e0300154. [PMID: 38968306 PMCID: PMC11226125 DOI: 10.1371/journal.pone.0300154] [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: 09/07/2023] [Accepted: 02/22/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Lower income is associated with high incident cardiovascular disease (CVD) and mortality. CVD is an important cause of morbidity and mortality in cancer survivors. However, there is limited research on the association between income, CVD, and mortality in this population. METHODS This study utilized nationally representative data from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional survey evaluating the health and nutritional status of the US population. Our study included NHANES participants aged ≥20 years from 2003-2014, who self-reported a history of cancer. We evaluated the association between income level, prevalence of CVD, and all-cause mortality. All-cause mortality data was obtained through public use mortality files. Income level was assessed by poverty-income ratio (PIR) that was calculated by dividing family (or individual) income by poverty guideline. We used multivariable-adjusted Cox proportional hazard models through a backward elimination method to evaluate associations between PIR, CVD, and all-cause mortality in cancer survivors. RESULTS This cohort included 2,464 cancer survivors with a mean age of 62 (42% male) years. Compared with individuals with a higher PIR tertiles, those in the lowest PIR tertile had a higher rate of pre-existing CVD and post-acquired CVD. In participants with post-acquired CVD, the lowest PIR tertile had over two-fold increased risk mortality (Hazard Ratio (HR) = 2.17; 95% CI: 1.27-3.71) when compared to the highest PIR tertile. Additionally, we found that PIR was as strong a predictor of mortality in cancer survivors as CVD. In patients with no CVD, the lowest PIR tertile continued to have almost a two-fold increased risk of mortality (HR = 1.72; 95% CI: 1.69-4.35) when compared to a reference of the highest PIR tertile. CONCLUSIONS In this large national study of cancer survivors, low PIR is associated with a higher prevalence of CVD. Low PIR is also associated with an increased risk of mortality in cancer survivors, showing a comparable impact to that of pre-existing and post-acquired CVD. Urgent public health resources are needed to further study and improve screening and access to care in this high-risk population.
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Affiliation(s)
- Vidhushei Yogeswaran
- Division of Cardiology, University of Washington Medical Center, Seattle, WA, United States of America
| | - Youngdeok Kim
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, United States of America
| | - R. Lee Franco
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Alexander R. Lucas
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Arnethea L. Sutton
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jessica G. LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jonathan Kenyon
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Ralph B. D’Agostino
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, United States of America
| | - Vanessa B. Sheppard
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Kerryn Reding
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, United States of America
| | - W. Gregory Hundley
- Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Richard K. Cheng
- Division of Cardiology, University of Washington Medical Center, Seattle, WA, United States of America
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Nicoll I, Lockwood G, Strohschein FJ, Fitch L, Longo CJ, Newton L, Fitch MI. Relationship between income and concerns about physical changes and help-seeking by older adult cancer survivors: a secondary analysis. BMC Geriatr 2023; 23:184. [PMID: 36991354 PMCID: PMC10061760 DOI: 10.1186/s12877-023-03887-1] [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: 03/16/2022] [Accepted: 03/13/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE Globally, the number of older adults surviving cancer is anticipated to grow rapidly over the next decades. Cancer and its treatment can leave survivors with a myriad of challenges including physical changes which impact independence and quality of life. This project explored the relationship of income level with concerns and help-seeking for physical changes following treatment in older Canadian survivors of cancer. METHODS A Canada-wide survey of community-dwelling survivors of cancer explored their experiences with survivorship care one to three years following completion of treatment. A secondary trend analysis examined the relationship of income with older adults' level of concern and help-seeking experiences regarding physical consequences they attributed to their cancer treatment. RESULTS In total, 7,975 people aged 65 years and older who survived cancer responded to the survey, of whom 5,891 (73.9%) indicated annual household income. Prostate (31.3%), colorectal (22.7%) and breast (21.8%) cancer accounted for the majority of respondents. Of those who reported household income data, over 90% wrote about the impact of physical changes following treatment, their concerns about the changes, and whether they sought help for their concerns. The most frequently identified physical challenge was fatigue (63.7%). Older survivors with low annual household incomes of less than $CA25,000 reported the highest levels of concern about multiple physical symptoms. 25% or more of the survey respondents across all income levels reported difficulty finding assistance for their concerns about the physical challenges, especially in their local communities. CONCLUSION Older survivors of cancer can experience a range of physical changes, amenable to intervention by physical therapy, yet experience challenges obtaining relevant help. Those with low income are more severely affected, even within a universal healthcare system. Financial assessment and tailored follow-up are recommended.
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Affiliation(s)
| | | | | | - Lauren Fitch
- Physiotherapist, Riverview, New Brunswick, Canada
| | - Christopher J Longo
- Health Policy and Management, DeGroote School of Business, McMaster University, Hamilton, ON, Canada
| | - Lorelei Newton
- School of Nursing, University of Victoria, Victoria, BC, Canada
| | - Margaret I Fitch
- Bloomberg Faculty of Nursing, University of Toronto, 207 Chisholm Ave, M4C 4V9, Toronto, ON, Canada.
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Physical activity and body mass index were interactively related to health-related quality of life among older adults. Arch Gerontol Geriatr 2023; 104:104833. [PMID: 36240587 DOI: 10.1016/j.archger.2022.104833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE The purpose of this study was to examine how meeting physical activity (PA) guidelines (i.e., moderate-to-vigorous aerobic activity, muscle strengthening activity) and weight status were interactively related to health-related quality of life (HRQoL) among older adults. METHODS A cross-sectional analysis was conducted using data from 87,495 older adults aged 65+ years who participated in the U.S. 2019 Behavioral Risk Factor Surveillance System. PA, weight status, and HRQoL were assessed by validated questionnaires via phone interviews. Binomial logistic regression models were used to examine the interactive effects of meeting PA guidelines and weight status on the odds of having poor HRQoL after controlling for key confounders. RESULTS Compared to participants meeting both PA guidelines and with normal weight, both underweight and obese older adults had significantly higher odds of having poor general health (OR= 1.55-6.16) regardless of meeting PA guideline status, and those meeting muscle strengthening activities only or meeting neither PA guideline reported higher odds of poor physical health (OR= 1.83-6.22) regardless of weight status. Similarly, those meeting neither PA guideline had significantly higher odds of having poor mental health (OR= 1.69-2.78) regardless of weight status, and those meeting muscle strengthening activities only or meeting neither PA guideline reported higher odds of having frequent activity limitation days (OR= 2.18-7.05). CONCLUSIONS The positive associations between moderate-to-vigorous aerobic PA and HRQoL indicate the need to promote aerobic PA in older adults. Both sex and weight status should be considered when designing PA interventions to improve HRQoL among older adults.
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Block C, König HH, Hajek A. Oral health and quality of life: findings from the Survey of Health, Ageing and Retirement in Europe. BMC Oral Health 2022; 22:606. [PMID: 36517821 PMCID: PMC9753255 DOI: 10.1186/s12903-022-02599-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of this study was to clarify the link between oral health and quality of life among older adults in Europe. METHODS Cross-sectional data from wave 5 (n = 59,048 observations) were used from the representative Survey of Health, Ageing and Retirement in Europe. Oral health was quantified by three questions: presence of all natural teeth (yes; no); among individuals with missing natural teeth, the number of missing teeth and the extent of replaced natural teeth were quantified. Quality of life was quantified using the widely used CASP-12. Multiple linear regressions were used to determine the association between oral health and quality of life, adjusting for various potential confounders. RESULTS Multiple linear regressions showed that higher quality of life was associated with (1) the presence of all natural teeth and among individuals with missing natural teeth, with (2) a lower number of missing natural teeth and (3) completely replaced natural teeth. Additionally, quality of life was positively associated with younger age, being female, being married or in a partnership, higher income, higher educational level, not currently smoking, a lower number of functional impairments, better self-rated health, a lower number of depressive symptoms and a lower number of chronic diseases. CONCLUSION Study findings showed an association between oral health and quality of life among older adults in Europe. Thus, the importance of good oral health for successful ageing was stressed. Future research is required to clarify the underlying mechanisms. Moreover, longitudinal studies are required to confirm our current findings.
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Affiliation(s)
- Celina Block
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
| | - Hans-Helmut König
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
| | - André Hajek
- grid.9026.d0000 0001 2287 2617Department of Health Economics and Health Services Research, University of Hamburg, Hamburg Center for Health Economics, Hamburg, Germany
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Zajacova A, Lee J, Grol-Prokopczyk H. The Geography of Pain in the United States and Canada. THE JOURNAL OF PAIN 2022; 23:2155-2166. [PMID: 36057388 PMCID: PMC9927593 DOI: 10.1016/j.jpain.2022.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 01/04/2023]
Abstract
Pain epidemiologists have, thus far, devoted scant attention to geospatial analyses of pain. Both cross-national and, especially, subnational variation in pain have been understudied, even though geographic comparisons could shed light on social factors that increase or mitigate pain. This study presents the first comparative analysis of pain in the U.S. and Canada, comparing the countries in aggregate, while also analyzing variation across states and provinces. Analyses are based on cross-sectional data collected in 2020 from U.S. and Canadian adults 18 years and older (N = 4,113). The focal pain measure is a product of pain frequency and pain interference. We use decomposition and regression analyses to link socioeconomic characteristics and pain, and inverse-distance weighting spatial interpolation to map pain levels. We find significantly and substantially higher pain in the U.S. than in Canada. The difference is partly linked to Americans' worse economic conditions. Additionally, we find significant pain variability within the U.S. and Canada. U.S. states in the Deep South, Appalachia, and parts of the West stand out as pain 'hotspots' with particularly high pain levels. Overall, our findings identify areas with a high need for pain prevention and management; they also urge further scholarship on geographic factors as important covariates in population pain. PERSPECTIVE: This study documents the high pain burden in the U.S. versus Canada, and points to states in the Deep South, Appalachia, and parts of the West as having particularly high pain burden. The findings identify geographic areas with a high need for pain prevention and management.
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Affiliation(s)
| | - Jinhyung Lee
- Geography, University of Western Ontario, Ontario
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Ran X, Huang T, Chen G. Subjective Socioeconomic Status, Class Mobility and Health Disparities of Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13955. [PMID: 36360833 PMCID: PMC9654853 DOI: 10.3390/ijerph192113955] [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: 09/19/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study is threefold: (1) investigate the impact of subjective socioeconomic status on the health of older people with a further exploration of its extent, (2) explore the relationship between diverse class mobility trajectories and health disparities among older people, and (3) examine the health disparities among older people with different subjective socioeconomic statuses in groups of various class mobility. The data for this study came from the Chinese General Social Survey (CGSS) of 2017, and regression and moderation models are used. The results indicate that for each level of increase in the subjective socioeconomic status of older people, the health score significantly increased by 0.159. The health status of older people who experienced upward class mobility is significantly better than those who did not; therefore, different class mobility trajectories also shape health disparities. The moderation role of class mobility on the impact of subjective socioeconomic status on the health of older people is also confirmed. The results provide further support for the subjective socioeconomic status having a significant impact on the health of older people with different class mobility trajectories. An upward class mobility trajectory somewhat diminishes this influence. Therefore, policy interventions should be provided to enhance the subjective socioeconomic status of older people and increase their opportunities for upward class mobility.
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Affiliation(s)
| | | | - Gong Chen
- Institute of Population Research, Peking University, Beijing 100871, China
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Zajacova A, Siddiqi A. A comparison of health and socioeconomic gradients in health between the United States and Canada. Soc Sci Med 2022; 306:115099. [PMID: 35779499 PMCID: PMC9383268 DOI: 10.1016/j.socscimed.2022.115099] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 10/18/2022]
Abstract
Data from the early 2000s indicated worse overall health and larger socioeconomic (SES) health inequalities in the U.S. than in Canada. Yet, sociopolitical contexts, health levels, and SES-health inequalities have changed in both countries during the intervening two decades. Drawing on new data, we update the comparison of health levels and SES-health gradients between the two countries. Analyses, focused on self-rated health, are based on two complementary sets of data sources: Resilience and Recovery (RR) data, a harmonized U.S.-Canada survey of social conditions collected in 2020 (N = 3743); and a pair of leading nationally representative health data sources from each country: the National Health Interview Surveys (NHIS, N = 104,027) and the Canadian Community Health Survey (CCHS, N = 97,605), both collected in 2017-2018. Health levels and disparities, net of demographic and socioeconomic covariates, were estimated using modified Poisson models for relative comparisons; descriptives and predicted levels of fair/poor health show the comparisons from absolute perspective. Both data sources show that U.S. adults continue to have significantly worse health than Canadians; the disadvantage may be due to SES differences between the two populations. However, the two data sources yield conflicting findings on SES-health inequalities: the RR data indicate no difference between the two countries in socioeconomic health gradients, while the NHIS/CCHS data show a significantly steeper gradient in the U.S. than in Canada for both education and income. Canadian adults continue to report better health than their U.S. peers, but it is unclear whether health inequalities remain smaller as well. We discuss potential reasons for the conflicting findings and call for a large new cross-national data collection, which will enable scholars and policymakers to better understand health and wellbeing in the U.S. and Canadian contexts.
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Affiliation(s)
- Anna Zajacova
- 5330 Social Science Centre, University of Western Ontario, London, ON, N6A 5C2, Canada.
| | - Arjumand Siddiqi
- University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
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11
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García-Mayor J, Gouveia ÉR, Marques A, De la Cruz-Sánchez E, Moreno-Llamas A, França C, Gouveia BR, Ihle A. Exploring the Role of Physical Activity in Mediating the Association between Educational Level and Health-Related Quality of Life in an Adult Lifespan Sample from Madeira Island. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137608. [PMID: 35805268 PMCID: PMC9265542 DOI: 10.3390/ijerph19137608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/18/2022] [Accepted: 06/19/2022] [Indexed: 11/17/2022]
Abstract
Background: People more socioeconomically vulnerable tend to have a poorer health-related quality of life (HRQoL). Studies are trying to analyse the factors that may condition this relationship, including physical activity (PA), which may influence the relationship between socioeconomic status (SES) and HRQoL. This study aimed to analyse the relationship between SES and HRQoL through specific domains of PA. Methods: A total of 381 adults (≥18 years) from the Autonomous Region of Madeira completed the measurements. Mediation analyses using bootstrapping methods adjusted for confounding variables were performed to relate SES and HRQoL; the latter was evaluated using the physical component score (PCS) of the SF-12, the mental component score (MCS) of the SF-12, and the total score in the SF-12 questionnaire (SF-12 score), through physical activity. Results: Educational level was positively related to PCS and SF-12 score. Leisure-time PA (not including sports PA) and PA at work, as single mediating variables, did not mediate the relationship between SES and HRQoL. The total PA suppressed the socioeconomic gradient of HRQoL by 8–10%, 39–46%, and 15–16%, respectively, for the PCS, MCS, and the SF-12 score; sports PA mediated the relationship by 13–16%, 50%, and 15–21%, respectively. Conclusions: The results suggest that sports PA contributes to reducing the socioeconomic gradient of HRQoL.
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Affiliation(s)
- Jesús García-Mayor
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain; (J.G.-M.); (E.D.l.C.-S.); (A.M.-L.)
| | - Élvio Rúbio Gouveia
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal;
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Correspondence: ; Tel.: +351-291-705-313 (ext. 5313)
| | - Adilson Marques
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics, University of Lisbon, 1499-002 Lisbon, Portugal;
- Instituto de Saúde Ambiental (ISAMB), University of Lisbon, 1649-020 Lisbon, Portugal
| | - Ernesto De la Cruz-Sánchez
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain; (J.G.-M.); (E.D.l.C.-S.); (A.M.-L.)
| | - Antonio Moreno-Llamas
- Public Health and Epidemiology Research Group, San Javier Campus, University of Murcia, 30720 San Javier, Spain; (J.G.-M.); (E.D.l.C.-S.); (A.M.-L.)
| | - Cíntia França
- Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal;
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
| | - Bruna R. Gouveia
- LARSYS, Interactive Technologies Institute, 9020-105 Funchal, Portugal;
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Regional Directorate of Health, Secretary of Health of the Autonomous Region of Madeira, 9004-515 Funchal, Portugal
- Saint Joseph of Cluny Higher School of Nursing, 9050-535 Funchal, Portugal
| | - Andreas Ihle
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland;
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Shin DS, Jeong BY. Older Female Farmers and Modeling of Occupational Hazards, Wellbeing, and Sleep-Related Problems on Musculoskeletal Pains. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127274. [PMID: 35742520 PMCID: PMC9223070 DOI: 10.3390/ijerph19127274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 11/25/2022]
Abstract
Musculoskeletal pains seem to be the most prevalent among occupational diseases in older female farmers. This study analyzes the relationships between exposure to ergonomic or environmental hazards, sleep-related problems, wellbeing, and musculoskeletal pains in older female farmers. In this study, older farmer means a farmer aged ≥60, and 2005 older female farmers were selected. A structural equation model (SEM) was used to investigate the relationships. In the results of SEM, musculoskeletal pains were more affected by the level of wellbeing (standardized path coefficient = −0.149) than the level of sleep-related problems (standardized path coefficient = 0.131) or the exposure level of ergonomic hazards (standardized path coefficient = 0.086). Among the ergonomic risk factors felt by elderly female farmers, the influence level of “awkward posture” (0.735), “repetitive motion” (0.718), or “standing posture” (0.693) was greater than that of “manual material handling” (0.661). “Vibration” (0.786) and “noise” (0.683) were influential variables of environmental hazards. In addition, “upper limb pain” (0.796) and “lower limb pain” (0.751) variables were more influential variables of musculoskeletal pains than the “backache” (0.472) variable. This study shows that strategies to improve wellbeing or sleep problems are important to alleviate or prevent musculoskeletal pains among older female farmers.
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Affiliation(s)
- Dong Seok Shin
- Korea National Industrial Convergence Center, Korea Institute of Industrial Technology, Ansan 15588, Korea;
| | - Byung Yong Jeong
- Department of Industrial and Management Engineering, Hansung University, Seoul 02876, Korea
- Correspondence:
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Jeong BY. Comparisons of working conditions and health-related problems between older male and female crop farmers. Work 2022; 72:1025-1033. [PMID: 35634825 DOI: 10.3233/wor-210138] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Although the number of farmers in Korea is declining, the proportion of older farmers aged ≥60 increases. OBJECTIVE This study aims to analyze gender differences in working conditions, exposure to risk factors, and health problems of older crop farmers aged ≥60. METHODS This study used data from the 5th Korean Working Conditions Survey (KWCS) data of 818 male and 985 female crop farmers aged ≥60 years. RESULTS This study showed that older female farmers had higher ratios of living alone (45.0% vs. 13.4%, p < 0.001), lower education levels (80.7% vs. 53.4%, p < 0.001), and lower average incomes (1.565 vs. 2.036 million KRW, p < 0.001) than that of males. Among subjective scores on the exposure of risk factors, only females' repetitive motion (4.923) and awkward posture (4.415) scores were higher than that of males' repetitive motion (4.601) (p < 0.001) and awkward posture (4.159) scores (p = 0.001). However, female's health problem rates on upper limb pain (68.3%), lower extremity pain (67.6%), backache (48.4%), overall fatigue (44.8%), and headache and eyestrain (25.0%) were higher than that of male's complaint rates on upper limb pain (48.5%) (p < 0.001), lower extremity pain (53.3%) (p < 0.001), backache (35.0%) (p < 0.001), overall fatigue (39.5%) (p = 0.024), and headache and eyestrain (19.4%) (p = 0.005). The rate of depression symptoms in females (54.6%), with a high proportion of single-person households, was higher than that of males (46.9%) (p = 0.001). CONCLUSIONS The musculoskeletal pains and depression symptoms of older female farmers are prevalent, and efforts and support are required to improve working conditions.
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Affiliation(s)
- Byung Yong Jeong
- Department of Industrial and Management Engineering, Hansung University, Seoul, Republic of Korea E-mail: ; ORCiD: https://orcid.org/0000-0001-6837-1324
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DePaul VG, Parniak S, Nguyen P, Hand C, Letts L, McGrath C, Richardson J, Rudman D, Bayoumi I, Cooper H, Tranmer J, Donnelly C. Identification and engagement of naturally occurring retirement communities to support healthy aging in Canada: A set of methods for replication. BMC Geriatr 2022; 22:355. [PMID: 35459126 PMCID: PMC9028895 DOI: 10.1186/s12877-022-03045-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/08/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Naturally occurring retirement communities (NORCs), unplanned communities with a high proportion of older adult residents, offer a model to support older adults to age well in place. The aim of this paper is to provide a comprehensive description of the methods used to identify and engage NORCs appropriate for the development of supportive service programming in Canada. METHODS Three steps were used to identify and select NORCs in which to develop supportive service programming including: 1) identification of potential NORCs using Canadian Census Dissemination Areas, the Ontario Marginalization Index and Google Maps, 2) engagement of property owner/manager to determine the availability of common space for communal programming and willingness of the owner to support programming and, 3) engagement of older adult residents within the NORC to co-design programming. RESULTS Four cities in the south-east, south-central, and south-west of Ontario, Canada were identified to develop NORCs with supportive service programming. Using the methods described, six NORCs were identified, landlords and older adult residents were engaged, and programs initiated between April 2018 and March 2019. The sites included two private high-rise apartments, a city-owned low-rise subsidized apartment complex, two multi-building private high-rise complexes and a mobile home community. An average of 35 (min 20, max 78) older adult members were engaged in an average of 20.5 unique activity sessions at each site per month. On average, social (54%) and physical activities (30%) were more common than nutritional (10%) and knowledge-sharing (8%). CONCLUSIONS The increased prevalence of unplanned, geographically-bound NORCs creates an opportunity for governments, social and health service providers and policy makers to support healthy aging in their communities. Our experience with the creation of six new NORCs with supportive service programming provides a tested set of methods that can be applied in other communities.
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Affiliation(s)
- Vincent G DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
- Health Services and Policy Research Institute, Queen's University, Kingston, Canada.
| | - Simone Parniak
- Health Services and Policy Research Institute, Queen's University, Kingston, Canada
| | - Paul Nguyen
- Institute of Clinical Evaluative Sciences, Queen's University, Kingston, Canada
| | - Carri Hand
- School of Occupational Therapy, Western University, London, Canada
| | - Lori Letts
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Colleen McGrath
- School of Occupational Therapy, Western University, London, Canada
| | - Julie Richardson
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | - Debbie Rudman
- School of Occupational Therapy, Western University, London, Canada
| | - Imaan Bayoumi
- Department of Family Medicine, Queen's University, Kingston, Canada
| | - Helen Cooper
- Oasis Senior Supportive Living Inc, Kingston, Canada
| | - Joan Tranmer
- Health Services and Policy Research Institute, Queen's University, Kingston, Canada
- Institute of Clinical Evaluative Sciences, Queen's University, Kingston, Canada
- School of Nursing, Queen's University, Kingston, Canada
| | - Catherine Donnelly
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
- Health Services and Policy Research Institute, Queen's University, Kingston, Canada
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Hayajneh AA, Rababa M. The Association of Frailty with Poverty in Older Adults: A Systematic Review. Dement Geriatr Cogn Disord 2022; 50:407-413. [PMID: 34929708 DOI: 10.1159/000520486] [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: 09/15/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Suffering from both frailty and poverty may have significant negative consequences on older adults' lives. This study aimed to conduct a systematic review to investigate the relationship between frailty and low income among older adults. METHODS This systematic review was guided by the PRISMA guidelines and was aimed at exploring the frailty in older adults with low income and evaluating the robustness of the synthesis. Cross-sectional and longitudinal studies published in English between 2008 and 2020 were identified using search terms entered into the following databases: CINAHL, Medline, Google Scholar, and PubMed. RESULTS Nine articles met the inclusion criteria. This review revealed a positive relationship between frailty and poverty. Such a relationship could be explained through 3 dimensions of the relationship between frailty and poverty among older adults identified based on the findings of the reviewed studies. DISCUSSION/CONCLUSION The social life, environmental conditions, and financial issues were positively correlated and coexisted with both frailty and poverty. Frailty should be treated on a holistic basis, considering financial issues. Among these financial issues is poverty, which disrupts older adults' social activities, hinders them from building successful social relationships, and reduces their quality of life.
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Affiliation(s)
- Audai A Hayajneh
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Rababa
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Determining the association of perceived health status among united states older adults with self-reported pain. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2021.100051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Chen S, Malete L, Ling J. An examination of physical activity guidelines and health-related quality of life among U.S. older adults. Prev Med 2022; 156:106986. [PMID: 35150753 DOI: 10.1016/j.ypmed.2022.106986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/30/2021] [Accepted: 02/06/2022] [Indexed: 01/02/2023]
Abstract
Physical activity can help improve the poor health-related quality of life in older adult population. Although the Physical Activity Guidelines for Americans recommend both aerobic and muscle strengthening activities for adults, previous studies predominantly focused on aerobic activity with limited research on muscle strengthening activities. The purpose of this cross-sectional study was to examine the relationships between meeting physical activity guidelines (i.e., aerobic activity, muscle strengthening activity) and health-related quality of life in the older adult population. Data of 87,495 older adults aged ≥65 years from the U.S. 2019 Behavioral Risk Factor Surveillance System were analyzed. Phone interviews and validated questionnaires were used to assess aerobic activity, muscle strengthening activity, and health-related quality of life. Binomial logistic regression was used to examine the relationships between meeting physical activity guidelines and health-related quality of life while adjusting for key covariates (i.e., age, sex, race, education, marital status, employment status, income, body mass index, smoking, drinking, and comorbidities). Participants meeting both or aerobic activity guideline only had significantly lower odds of reporting all components of health-related quality of life (i.e., general health, mental health, physical health, activity limitation) than those who met neither guideline (OR = 0.37-0.58) and those who met muscle strengthening activity guideline only (OR = 0.34 - 0.74). Given the stronger positive association between aerobic activity and health-related quality of life than that between muscle strengthening activity and health-related quality of life, future research should focus on promoting aerobic activity to increase health-related quality of life among older people.
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Affiliation(s)
- Sisi Chen
- Michigan State University, East Lansing, MI 48824, USA.
| | | | - Jiying Ling
- Michigan State University, East Lansing, MI 48824, USA
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Malicka B, Skośkiewicz-Malinowska K, Kaczmarek U. The impact of socioeconomic status, general health and oral health on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health among Polish older adults. BMC Geriatr 2022; 22:2. [PMID: 34979959 PMCID: PMC8722217 DOI: 10.1186/s12877-021-02716-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 12/13/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The study aims to evaluate the impact of socioeconomic status, general health and oral health parameters on Health-Related Quality of Life (HRQoL), Oral Health-Related Quality of Life (OHRQoL) and mental health in elderly urban residents of South-Western Poland. METHODS The 500 residents of Wroclaw, aged 65 and older provided demographic and personal information as well as their medical history. A patient's oral condition were determined based on the clinical oral examination.Quality of Life was assessed using Euro-Quality of Life (EQ-5D), Oral Health Impact Profile-14 (OHIP-14) and Patient Health Questionnaire (PHQ-9).The association between exposure (socioeconomic status, general health and oral health) and outcome (HRQoL, OHRQoL and mental health variables) were analyzed with the use of four models: P - Poisson model, NB-Negative Binomial model, ZIP - Zero Inflated Poisson model, ZINB - Zero Inflated Negative Binomial model. RESULTS The best model turned out to be the ZINB model, in which a negative binomial distribution in the count equation is assumed. In this model, only 13 independent variables had a significant effect on HRQoL, OHRQoL, and mental health. HRQoL assessed with the EQ-5D is significantly influenced by: living conditions 0.133 (95% CI: 0.001, 0.267, p = 0.049), income -0.348 (95%CI: -0.466, -0.230, p < 0.001), diabetes mellitus 0.437 (95%CI: 0.250, 0.624, p < 0.001), myocardial infarction 0.454 (95% CI: 0.151, 0.757, p = 0.003), stroke 0.543 (95%CI: 0.094, 0.992, p = 0.018) and renal disease 0.466 (95% CI: 0.206, 0.726, p < 0.001). Factors negatively affecting OHRQOL are: the need for oral treatment 0.278 (95%CI: 0.104, 0.452, p = 0.002), the number of missing teeth 0.053 (95%CI: 0.039, 0.067, p < 0.001) and gender 0.271 (95%CI: 0.015, 0.527, p = 0.038) and age -0.025 (95%CI: -0.042, -0.008, p = 0.003). An important factor influencing the level of depression assessed by the PHQ-9 questionnaire may be the material condition -0.225 (95%CI: -0.349, -0.101, p < 0.001). It should be emphasized that living with other people may be a factor that significantly increases the probability of avoiding the occurrence of depression symptoms. CONCLUSION The study concerning elderly residents of the macroregion in Poland found the impact of socioeconomic, general health and oral health parameters on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health. Research on the quality of life of the elderly at the local level allowed to assess the factors linked to quality of life of older adults.
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Affiliation(s)
- Barbara Malicka
- Department of Conservative Dentistry With Endodontics, Wroclaw Medical University, Wrocław, Poland.
| | | | - Urszula Kaczmarek
- Department of Conservative Dentistry With Endodontics, Wroclaw Medical University, Wrocław, Poland
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Mehdipanah R, Martin J, Eisenberg AK, Schulz AJ, Morgenstern LB, Langa KM. Housing status, mortgage debt and financial burden as barriers to health among older adults in the U.S. HOUSING AND SOCIETY 2022; 49:58-72. [PMID: 35280971 PMCID: PMC8916742 DOI: 10.1080/08882746.2021.1881373] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We examine relations between housing status, mortgage, financial burden, and healthy aging among older U.S. adults. We combine cross-sectional data from 2012 to 2014 Health and Retirement Study cohorts. Using regression models, we examined associations between owners and renters, mortgage and non-mortgage holders, financial strain, and difficulty paying bills, and poor self-rated health (SRH), heart condition (HC) and hospitalization (past two years). We find that compared to owners, renters had greater likelihood of poor SRH and hospitalization. Regardless of tenure, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Mortgage holders had lower likelihood of poor SRH. Accounting for mortgage status, financial strain was associated with greater likelihood of poor SRH, HC and hospitalization, while difficulty paying bills was associated with poor SRH and HC. Associations between tenure or mortgage status and health were not modified by either financial burden factors. We conclude that there need to be more robust and inclusive programs that assist older populations with housing could improve self-rated health, with particular attention to renters, mortgage holders and those experiencing financial burden.
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Affiliation(s)
- Roshanak Mehdipanah
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Jaclyn Martin
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Alexa K. Eisenberg
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Amy J. Schulz
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Lewis B. Morgenstern
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Kenneth M. Langa
- Division of General Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, United States,Veterans Affairs Center for Clinical Management Research, Ann Arbor, MI, United States,Institute for Social Research, University of Michigan, Ann Arbor, MI, United States,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
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Older Male Construction Workers and Sustainability: Work-Related Risk Factors and Health Problems. SUSTAINABILITY 2021. [DOI: 10.3390/su132313179] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study aims to analyze the characteristics of working conditions, exposure to risk factors, and health-related problems of older male construction workers. In this study, 1519 male construction workers were the subjects of study, and the working conditions, exposure to occupational risk factors, and physical health-related problems were compared among workers under 50 years, in their 50s, and 60 or over. Older male construction workers have lower educational backgrounds and lower average salaries. The degree of exposure to risk factors was higher in workers aged 60 or over than other age groups, such as high temperature, awkward posture, manual material handling, standing posture, repetitive motion, fumes/dust, vapor, skin contact, and tobacco smoke. In addition, the complaint rate of hearing problems, overall fatigue, backache, upper limb pain, or lower limb pain was higher in older workers. In particular, the complaint rate of musculoskeletal pain was 56.6%, overall fatigue was 40.3%, and the rate of depression symptoms was 41.9%. This study shows a high prevalence of musculoskeletal disorders, overall fatigue, and depression symptoms of male elderly construction workers, suggesting that comprehensive support is needed to improve not only the working conditions of workers but also psychological health problems.
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Buchcik J, Borutta J, Nickel S, von dem Knesebeck O, Westenhöfer J. Health-related quality of life among migrants and natives in Hamburg, Germany: An observational study. J Migr Health 2021; 3:100045. [PMID: 34405190 PMCID: PMC8352133 DOI: 10.1016/j.jmh.2021.100045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/03/2020] [Accepted: 04/10/2021] [Indexed: 10/27/2022] Open
Abstract
Purpose The aim of this observational study was firstly, to assess the Health-related Quality of Life (HrQoL) among migrants and German natives in Hamburg, Germany, using the SF-12 mental and physical summary scores and secondly, to evaluate the contribution of selected sociodemographic and socioeconomic variables to explain the variance in mental and physical HrQoL separately for migrants and natives. Methods Face-to-face interviews were conducted with n=809 participants between May 2018 and July 2019 in six randomly selected statistical districts of Hamburg grouped into four levels of socioeconomic status (SES). The SF-12 questionnaire was used to measure the HrQoL. Socioeconomic (school education, income) and sociodemographic (age, gender, marital status, children) data was recorded, too. Results Migrants and natives scored higher in mental (migrants: M=45.77, SD=7.66; natives: M=47.60, SD=6.14) than in physical HrQoL (migrants: M=42.55, SD=5.55; natives: M=42.03, SD=4.71). Natives had a significantly higher (p<0.001) SF-12 mental summary score than migrants. There was a positive association between education and mental HrQoL (β=0.248, p=2.308) in the migrant but not in the native group. Due to limitations of the study the results of the impact of migration on the HrQoL require interpretation. Conclusion Differences between migrants and German natives in HrQoL were partially confirmed. Future research should differentiate more strongly between migration contexts as well as other determinants of health (e.g. early life, social support, unemployment) and their policy implications according to the WHO.
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Affiliation(s)
- Johanna Buchcik
- University of Applied Sciences (HAW Hamburg), Faculty of Life Sciences, Department of Health Sciences; Ulmenliet 20, 21033 Hamburg, Germany
| | - Jana Borutta
- University of Applied Sciences (HAW Hamburg), Faculty of Life Sciences, Department of Health Sciences; Ulmenliet 20, 21033 Hamburg, Germany
| | - Stefan Nickel
- University Medical Center Hamburg-Eppendorf (UKE), Center for Psychosocial Medicine, Institute of Medical Sociology; Martinistraße 52, 20246 Hamburg, Germany
| | - Olaf von dem Knesebeck
- University Medical Center Hamburg-Eppendorf (UKE), Center for Psychosocial Medicine, Institute of Medical Sociology; Martinistraße 52, 20246 Hamburg, Germany
| | - Joachim Westenhöfer
- University of Applied Sciences (HAW Hamburg), Faculty of Life Sciences, Department of Health Sciences; Ulmenliet 20, 21033 Hamburg, Germany
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22
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Schmidt T, Christiansen LB, Schipperijn J, Cerin E. Social network characteristics as correlates and moderators of older adults' quality of life-the SHARE study. Eur J Public Health 2021; 31:541-547. [PMID: 33547475 DOI: 10.1093/eurpub/ckab001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The quality of life (QoL) of older adults is a key aspect of healthy ageing, and older adults' socioeconomic status (SES), the neighbourhood they live in and their social networks (SN) are known to impact QoL. However, little is known about the interaction between these concepts. The aim was to examine how SN, SES and neighbourhood type are associated with QoL in older adults. METHODS : Wave 4 (year 2011) and wave 6 (year 2015) data from the longitudinal Survey of Health, Ageing and Retirement in Europe were used for the analysis. Multilevel regression models estimated the associations including 34 792 participants from wave 4 and 67 334 participants from wave 6 from 16 countries (mean age = 66.45 years). The outcome variable was QoL, independent variables were SES (education and making end meet) and neighbourhood type (housing type and housing area), and SN variables (satisfaction and size) were the moderators. RESULTS : SES and SN variables were positively associated with QoL. Living in a house or duplex was positively associated with QoL compared with living in a farmhouse. SN moderated the association between education and QoL. The effect of area type on QoL was moderated by SN size. SN satisfaction was an independent correlate of QoL. CONCLUSION : Older adults' satisfaction with their SN may be more important than having a large SN. Low SES older adults may be more prone to having weak SN. Maintaining and creating supportive SN may attenuate the negative effects of low SES or less favourable neighbourhood characteristics.
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Affiliation(s)
- Tanja Schmidt
- Research Unit for Active Living, Department of Sports Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars B Christiansen
- Research Unit for Active Living, Department of Sports Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jasper Schipperijn
- Research Unit for Active Living, Department of Sports Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia.,School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
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Agarwal G, Pirrie M, Gao A, Angeles R, Marzanek F. Subjective social isolation or loneliness in older adults residing in social housing in Ontario: a cross-sectional study. CMAJ Open 2021; 9:E915-E925. [PMID: 34584006 PMCID: PMC8486468 DOI: 10.9778/cmajo.20200205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Older adults face greater risk of social isolation, but the extent of social isolation among low-income older adults living in social housing is unknown. This study aims to explore the rate of, and risk factors contributing to, subjective social isolation or loneliness among older adults in social housing. METHODS We conducted a cross-sectional study of data collected from a community program held in the common rooms of 55 social housing buildings in 14 communities across Ontario, Canada, from May 2018 to April 2019. Participants were program attendees aged 55 years and older who resided in the buildings. Program implementers assessed social isolation using the 3-Item Loneliness Scale from the University of California, Los Angeles and risk factors using common primary care screening tools. We extracted data for this study from the program database. We compared the rate of social isolation to Canadian Community Health Survey data using a 1-sample χ2 test, and evaluated associations between risk factors and social isolation using univariate and multivariate logistic regressions. RESULTS We included 806 residents in 30 buildings for older adults and 25 mixed-tenant buildings. Based on the 3-Item UCLA Loneliness Scale, 161 (20.0%) of the 806 participants were socially isolated. For those aged 65 and older, the rate of social isolation was nearly twice that observed in the same age group of the general population (36.1% v. 19.6%; p < 0.001). Risk factors were age (65-84 yr v. 55-64 yr adjusted odds ratio [OR] 1.99, 95% confidence interval [CI] 1.01-3.93), alcohol consumption (adjusted OR 2.45, 95% CI 1.09-5.54), anxiety or depression (adjusted OR 6.05, 95% CI 3.65-10.03) and income insecurity (adjusted OR 2.10, 95% CI 1.24-3.53). Protective factors were having at least 1 chronic cardiometabolic disease (adjusted OR 0.44, 95% CI 0.24-0.80), being physically active (adjusted OR 0.47, 95% CI 0.30-0.73) and having good to excellent general health (adjusted OR 0.60, 95% CI 0.39-0.90). INTERPRETATION The high rate of social isolation in low-income older adults living in social housing compared with the general population is concerning. Structural barriers could prevent engagement in social activities or maintenance of social support, especially for older adults with income insecurity and anxiety or depression; interventions are needed to reduce subjective social isolation in this population.
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Affiliation(s)
- Gina Agarwal
- Departments of Family Medicine (Agarwal, Pirrie, Angeles, Marzanek), and Health Research Methods, Evidence, and Impact (Agarwal), and Faculty of Health Sciences (Gao), McMaster University, Hamilton, Ont.
| | - Melissa Pirrie
- Departments of Family Medicine (Agarwal, Pirrie, Angeles, Marzanek), and Health Research Methods, Evidence, and Impact (Agarwal), and Faculty of Health Sciences (Gao), McMaster University, Hamilton, Ont
| | - Angela Gao
- Departments of Family Medicine (Agarwal, Pirrie, Angeles, Marzanek), and Health Research Methods, Evidence, and Impact (Agarwal), and Faculty of Health Sciences (Gao), McMaster University, Hamilton, Ont
| | - Ricardo Angeles
- Departments of Family Medicine (Agarwal, Pirrie, Angeles, Marzanek), and Health Research Methods, Evidence, and Impact (Agarwal), and Faculty of Health Sciences (Gao), McMaster University, Hamilton, Ont
| | - Francine Marzanek
- Departments of Family Medicine (Agarwal, Pirrie, Angeles, Marzanek), and Health Research Methods, Evidence, and Impact (Agarwal), and Faculty of Health Sciences (Gao), McMaster University, Hamilton, Ont
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Trends in health-related quality of life of female breast cancer survivors using the Medical Expenditure Panel Survey (MEPS), 2008-2016. Qual Life Res 2021; 30:3547-3558. [PMID: 34052940 DOI: 10.1007/s11136-021-02895-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE In recent years, breast cancer detection and treatment have advanced. As a result, increased attention to breast cancer survivorship should have improved their health-related quality of life (HRQoL). Our aim was to examine the trends in the HRQoL of female breast cancer survivors between 2008 and 2016, to determine whether or not the increased focus on survivorship has translated into improved HRQoL. Furthermore, stratified analyses were conducted by race/ethnicity and age group and these were compared to a similar group of women without a breast cancer history. METHODS Repeated cross-sectional analyses using the Medical Expenditure Panel Survey between 2008 and 2016 were conducted. Pooled ordinary least squares (OLS) regression was used to examine the trends in physical component scores (PCS-12) and mental component scores (MCS-12) among breast cancer survivors and a similar population of women without a breast cancer history. Analyses stratified by race/ethnicity and age group were also conducted. RESULTS Among breast cancer survivors, after adjusting for confounders, there was no change in PCS-12 scores over time, but the MCS-12 scores increased by 0.27 points (95% CI 0.09-0.45). Those without a history of breast cancer had mean PCS-12 scores that were 0.13 points greater each year (95% CI 0.02-0.24) while their mean MCS-12 scores were 0.10 (95% CI 0.00-0.21) points greater each year. After stratifying by race/ethnicity, Hispanic breast cancer survivors had a small increase in PCS-12 (β: 0.65; 95% CI 0.01-1.29), and MCS-12 scores (β: 0.70; 95% CI 0.06-1.33) over time. Similar small effects were found when stratified by age group, both among breast cancer survivors and those without a history of breast cancer. The younger age group (< 50 years) reported poorer MCS-12 than the older population (age 50 years and above). CONCLUSION Our study generated findings showing the trends in the HRQoL of breast cancer survivors and compared these to a similar population of women without a history of breast cancer. This paper highlights the importance of focusing on the mental health of young breast cancer survivors to improve their prospects at a good quality of life post-breast cancer diagnosis and treatment.
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Zhang C, Cai Y, Xue Y, Zheng X, Yang X, Lu J, Hou L, Li M. Exploring the influencing factors of quality of life among the empty nesters in Shanxi, China: a structural equation model. Health Qual Life Outcomes 2021; 19:156. [PMID: 34049560 PMCID: PMC8161619 DOI: 10.1186/s12955-021-01793-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 05/20/2021] [Indexed: 02/07/2023] Open
Abstract
Background As China’s aging trend intensifies and the proportion of empty nests increases, the health-related quality of life of the elderly is the focus of social attention. Previous studies focused on the quality of life of the elderly, rather than empty nesters, and lacked the discussion of the mechanism of influencing factors. Thus, this study aimed to explore the influencing factors of the quality of life (QOL) and interaction mechanisms among empty nesters in Shanxi Province, China, so as to provide practical reference for improving the QOL of empty nesters. Methods A total of 4901 empty nesters in Shanxi Province, China, were selected using multi-stage random cluster sampling method in this cross-sectional study. The quality of life was assessed with the Short Form 36 Health Survey (SF-36). Multiple linear regression analysis (stepwise) was performed to examine the factor associated with QOL. Structural equation model (SEM) approach was conducted to test the direct and indirect association between QOL influencing factors with QOL. Results The average QOL score of empty nesters was 63.34 (SD = 17.23). The multiple linear regression revealed that gender, age, education, monthly income, drinking status, exercise frequency, physical examination frequency, attention to daily nutritional health, relationship with a spouse and relationship with children were significant predictors of the empty nester’s QOL (P < 0.05) (R2 = 0.128). SEM showed that behavioral lifestyle had a direct effect on QOL (β = 0.446, P < 0.001). Socio-economic status had an indirect effect (β = 0.288, P < 0.001) on QOL through behavioral lifestyle. The family relationship had an indirect effect (β = 0.115, P < 0.001) on QOL. Conclusion Behavioral lifestyle was the strongest influencing factor in the quality of life among empty nesters, followed by socio-economic status and family relationships. Thus, maintaining a healthy behavioral lifestyle was important to improve the QOL of the empty nesters. Our findings provide a concrete and strong reference for the formulation of targeted intervention strategies.
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Affiliation(s)
- Chichen Zhang
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, Guangdong, China. .,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,School of Management, Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Yuan Cai
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, Guangdong, China.,School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao Zheng
- School of Health Management, Southern Medical University, No. 1023, South Shatai Road, Guangzhou, 510515, Guangdong, China.,School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaozhao Yang
- School of Sociology and Anthropology Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jiao Lu
- School of Management, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Lihong Hou
- The Second Affiliated Hospital, Shaanxi University of Chinese Medicine, Xi'an, Shaanxi, China
| | - Mimi Li
- Jincheng People's Hospital, Jincheng, Shanxi, China
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Eum M, Kim H. Relationship between Active Aging and Quality of Life in Middle-Aged and Older Koreans: Analysis of the 2013-2018 KNHANES. Healthcare (Basel) 2021; 9:240. [PMID: 33672386 PMCID: PMC7926408 DOI: 10.3390/healthcare9020240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 11/16/2022] Open
Abstract
With the increase in the aging population worldwide, social interest in having a vibrant and valuable old age has been increasing with changes in the perspectives on old age. This study aimed to determine the relationship between active aging and health-related quality of life (HRQOL) in middle-aged and older Korean using national data. The subjects were 14,117 adults aged ≥55 years. HRQOL was evaluated using the EuroQol-5 Dimension (EQ-5D) questionnaire, and active aging was defined based on the health factors, participation factors, and security factors. The average EQ-5D score was 91.04 ± 0.143. Hierarchical multiple regression analysis sequentially inputting the health, participation, and security factors showed that health factors had the strongest influence on HRQOL (F = 216.656, p < 0.001). In the final model, which included all variables, activity limit (B = -10.477, p < 0.001) and subjective health status (B = -7.282, p < 0.001) were closely related to the HRQOL. In addition, economic activity, income level, home ownership, private health insurance, and unmet healthcare needs were associated with HRQOL. The R2 of the model was 38.2%. To improve the HRQOL of middle-aged and older people, it is necessary to consider active aging factors. Furthermore, follow-up studies using various indicators reflecting active aging should be conducted.
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Affiliation(s)
- MiJung Eum
- Department of Nursing Science, Kyungbuk College, 77 Daehak-ro, Yeongju-si 36133, Gyeongbuk, Korea;
| | - HyungSeon Kim
- Department of Nursing, Bucheon University, 56 Sosa-ro, Bucheon-si 14774, Gyeonggi-do, Korea
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Influence of the health status and other contributing factors on quality of life of the older people. VOJNOSANIT PREGL 2021. [DOI: 10.2298/vsp210217033v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction/Aim: Aim of the study was to investigate influence of the health
status as well as other contributing factors on perceived quality of life of
the older people in Belgrade. Methods: The survey was conducted in October
2019 on a representative sample of 764 people aged between 65 and 79 years
(X = 72.68 ? 7.11), (39.9% male and 60.1% female) living in Belgrade. The
research used a questionnaire developed on the basis of the World Health
Organization methodology for age friendly cities, aimed to explore 11 areas
important for the elderly. Results: Factor of physical accessibility of
community is highly significant [?2 (df = 3, n = 764) = 238.905; p < 0.001]
and explained 39.4% of variance of perceived quality of life, while
socio-economic factors show the same amount of variance, 35.0% [?2 (df = 3,
n = 764) = 207.571; p < 0.001]. Social environment explains 24.6% of
variance of perceived quality of life [?2 (df = 4, n = 764) = 140.242; p <
0.001]. Health status has greatest explanatory power regarding perceived
quality of life and explain as much as 46.7% of variance [?2 (df = 8, n =
764) = 292.083; p < 0.001]. When unique impact of health status on quality
of life is analyzed, when other variables are controlled, health status
explains 21.6% of variance in addition to variance explained by physical
accessibility, socio-economic status and social environment. Conclusion:
Although health status has the greatest impact on perceived quality of life
of older people, interventions on other life important domains such as
physical accessibility, socio-economic status and social environment could
have positive impact on perceived quality of life where health status alone
could not be improved.
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Kim HY, Nho JH, Kim JY, Kim SR. Validity and reliability of the Korean version of the world health organization quality of life instrument-older adults module. Geriatr Nurs 2020; 42:548-554. [PMID: 33143853 DOI: 10.1016/j.gerinurse.2020.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022]
Abstract
The World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) is a scale that measures quality of life (QoL) based on the characteristics of older adults. This study aimed to evaluate the reliability and validity of the Korean version of the WHOQOL-OLD. It was administered to 273 older adults by convenience sampling in Jeonbuk, South Korea. The six-factor model was validated by confirmatory factor analysis (χ2=462.52 [p<.001], normed χ2=1.95, comparative fit index=0.94, Tucker-Lewis index=0.92, standardized root mean residual=0.06, root mean square error of approximation=0.059). Concurrent validity was demonstrated with the WHOQOL-BREF (r = 00.708), SF-12 (r = 0.508) and the Depression, Anxiety and Stress Scale (r=-0.499). In addition, the Korean version of the WHOQOL-OLD was evaluated for known group validity. Cronbach's alpha coefficient for the total scale was 0.897. The Korean version of the WHOQOL-OLD showed acceptable validity and reliability for measuring QoL in older Korean adults.
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Affiliation(s)
- Hye Young Kim
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Republic of Korea.
| | - Ju-Hee Nho
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Republic of Korea.
| | - Ji Young Kim
- College of Nursing, Jeonbuk Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Jeollabuk-do 54896, Republic of Korea.
| | - Sung Reul Kim
- College of Nursing, Korea University, 145 Anam-ro, Seongbuk-Gu, Seoul 02841, Republic of Korea.
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Olsen JA, Lindberg MH, Lamu AN. Health and wellbeing in Norway: Population norms and the social gradient. Soc Sci Med 2020; 259:113155. [PMID: 32650252 DOI: 10.1016/j.socscimed.2020.113155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/07/2023]
Abstract
Measures of health-related quality of life are important in health technology assessments, and useful when analysing health inequalities across population sub-groups. This paper provides population norms on health and wellbeing in Norway based on two waves of a comprehensive health survey: Wave 6 of The Tromsø Study conducted in 2007/08 (N = 12,981) and Wave 7 conducted in 2015/16 (N = 21,083). By use of these data, the paper aims to provide new insight on how different measures of health and wellbeing, and different indicators for socio-economic position, will affect the magnitude of a reported social gradient in health. We apply validated multi-item instruments for measuring health and subjective well-being; the health state utility instrument EQ-5D, and the satisfaction with life scale, as well as a direct valuation of health on a visual analogue scale. We apply three indicators for socio-economic position; education, occupation and household income, each measured along four levels. After descriptive statistics, regression analyses are performed separately for men and women, adjusted for age, to explain the magnitude of the social gradient along each socio-economic indicator. The social gradient in health showed a consistent positive trend, along all three socio-economic indicators; it was strongest with income, and weakest with education. When health had been valued directly on a visual analogue scale, the gradient was steeper than when valued indirectly via the EQ-5D descriptive system. The social gradient in subjective well-being also showed consistent positive trends, except with education as the socio-economic indicator. We have shown that the magnitude of the social gradient critically depends on which socio-economic indicator is used, and whether health is being measured indirectly via the EQ-5D descriptive system or directly on a visual analogue scale. The strongest gradient in subjective well-being was observed with income as the socio-economic indicator.
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Affiliation(s)
- Jan Abel Olsen
- Department of Community Medicine, UiT, The Arctic University of Norway, 9037, Tromsø, Norway; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway; Centre for Health Economics, Monash University, Melbourne, Australia.
| | - Marie Hella Lindberg
- Department of Community Medicine, UiT, The Arctic University of Norway, 9037, Tromsø, Norway
| | - Admassu Nadew Lamu
- Department of Community Medicine, UiT, The Arctic University of Norway, 9037, Tromsø, Norway; Department of Global Public Health and Primary Care, University of Bergen, Norway
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McMaughan DJ, Oloruntoba O, Smith ML. Socioeconomic Status and Access to Healthcare: Interrelated Drivers for Healthy Aging. Front Public Health 2020; 8:231. [PMID: 32626678 PMCID: PMC7314918 DOI: 10.3389/fpubh.2020.00231] [Citation(s) in RCA: 246] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/15/2020] [Indexed: 01/30/2023] Open
Abstract
The rapid growth of the global aging population has raised attention to the health and healthcare needs of older adults. The purpose of this mini-review is to: (1) elucidate the complex factors affecting the relationship between chronological age, socio-economic status (SES), access to care, and healthy aging using a SES-focused framework; (2) present examples of interventions from across the globe; and (3) offer recommendations for research-guided action to remediate the trend of older age being associated with lower SES, lack of access to care, and poorer health outcomes. Evidence supports a relationship between SES and healthcare access as well as healthcare access and health outcomes for older adults. Because financial resources are proportional to health status, efforts are needed to support older adults and the burdened healthcare system with financial resources. This can be most effective with grassroots approaches and interventions to improve SES among older adults and through data-driven policy and systems change.
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Affiliation(s)
- Darcy Jones McMaughan
- Department of Health Education and Promotion, School of Community Health Sciences, Counseling, and Counseling Psychology, Oklahoma State University, Stillwater, OK, United States
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
| | - Oluyomi Oloruntoba
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX, United States
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States
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JieAnNaMu, Xu X, You H, Gu H, Gu J, Li X, Cui N, Kou Y. Inequalities in health-related quality of life and the contribution from socioeconomic status: evidence from Tibet, China. BMC Public Health 2020; 20:630. [PMID: 32375713 PMCID: PMC7203898 DOI: 10.1186/s12889-020-08790-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 04/27/2020] [Indexed: 12/29/2022] Open
Abstract
Background This study aimed to understand the association between socioeconomic status (SES) and Health Related Quality of Life (HRQoL) and the contribution of SES to health inequality among Tibetans of agricultural and pastoral areas (APA) in Tibet, China. Methods The data were from Health Survey of Tibetans in APA conducted in 2014. A total of 816 respondents were enrolled for the analysis Multiple linear regression was employed to examine the relationship between SES and HRQoL. Concentration index (CI) was used to measure the degree of health inequality and a Wagstaff-type CI decomposition method was applied to measure the contribution of SES to inequality. Results SES had significant association with HRQoL among the Tibetans in APA. The high SES group was more likely to have a higher Eq-5d index (0.77 vs. 0.67, P < 0.001) and VAS (72.94 vs. 62.41, P < 0.001) than the low SES group. The Concentration index of the Eq-5d index and VAS for total sample was 0.022 and 0.026 respectively, indicating a slight pro-rich inequality among this population. The decomposition analyses showed the SES is the main contributor to health inequality and contributed 45.50 and 41.39% to inequality for the Eq-5d index and VAS, respectively. Conclusion The results showed SES is positively associated with HRQoL among Tibetans in APA. There was a slight pro-rich inequality in the health of the participants and most health inequality was attributable to SES. This study is helpful in gaining an insight into the HRQoL, health inequality and the relationship between SES and health inequality among Tibetans of APA in China.
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Affiliation(s)
- JieAnNaMu
- Center for Health Policy and Management Studies, Nanjing University, Nanjing, China
| | - Xinpeng Xu
- Center for Health Policy and Management Studies, Nanjing University, Nanjing, China
| | - Hua You
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China.
| | - Hai Gu
- Center for Health Policy and Management Studies, Nanjing University, Nanjing, China.
| | - Jinghong Gu
- Nanjing Foreign Language School, Nanjing, China
| | - Xiaolu Li
- Department of Otolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Nan Cui
- Center for Health Policy and Management Studies, Nanjing University, Nanjing, China
| | - Yun Kou
- Center for Health Policy and Management Studies, Nanjing University, Nanjing, China
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de Lira C, Taveira H, Rufo-Tavares W, Santos D, Celini P, Oliveira L, Andrade M, Nikolaidis P, Rosemann T, Knechtle B, Vancini R. Does Health Professional Counseling Impact the Quality-of-Life Levels of Older Adults Enrolled in Physical Activity Programs? MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E146. [PMID: 32218371 PMCID: PMC7231264 DOI: 10.3390/medicina56040146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/13/2020] [Accepted: 03/20/2020] [Indexed: 11/16/2022]
Abstract
Background and objectives: There are studies showing that exercise counseled by health professionals can improve physical fitness. However, less is known about the effects of exercise counseling on quality of life. The aim of this study was to investigate health-related quality of life of older adults who received or did not receive physical exercise counseling by sport and exercise professionals or physicians. Materials and Methods: This was a cross-sectional study that investigated quality of life of older adults who did or did not receive exercise counseling from health professionals. Older adults who were physically active took part in this study: 45 participants performed exercise advised by sport and exercise professionals (SEPCG), 19 participants performed exercise advised by physicians (PCG), and 26 participants performed exercise without counseling (NCG). Participants answered the SF-36 to estimate quality of life. Results: Analysis revealed that responses on all SF-36 subscales were higher in those participants who received counseling by sport and exercise professionals (Functioning capacity, β = -26.283, p < 0.001 and β = -26.482, p < 0.001, Role limitations due to physical problems, β = -43.372, p < 0.001 and β = -45.177, p < 0.001, Pain, β = -17.634, p < 0.001 and β = -16.015, p < 0.001, General health perceptions, β = -38.008, p < 0.001 and β = -32.529, p < 0.001, Vitality, β = -18.573, p < 0.001 and β = -16.406, p = 0.001, Social functioning, β = -37.963, p < 0.001 and β = -29.224, p < 0.001, Role limitations due to emotional problems, β = -52.246, p < 0.001 and β = -40.173, p < 0.001, Mental health, β = -17.381, p < 0.001 and β = -12.121, p < 0.001, PCG and NCG respectively). Conclusions: The results showed that those older adults who were counseled by sport and exercise professionals presented better quality of life, possibly because these professionals counseled exercise based on current guidelines for exercise prescription.
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Affiliation(s)
- Claudio de Lira
- Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia 74690-900, Brazil
| | - Henrique Taveira
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (H.T.); (W.R.-T.); (P.C.); (L.O.); (R.V.)
| | - Weverton Rufo-Tavares
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (H.T.); (W.R.-T.); (P.C.); (L.O.); (R.V.)
| | - Douglas Santos
- Colegiado de Educação Física, Universidade do Estado da Bahia, Teixeira de Freitas 45992-255, Brazil;
| | - Paulo Celini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (H.T.); (W.R.-T.); (P.C.); (L.O.); (R.V.)
| | - Lucas Oliveira
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (H.T.); (W.R.-T.); (P.C.); (L.O.); (R.V.)
| | - Marilia Andrade
- Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo 04023-900, Brazil;
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland;
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, 9001 St. Gallen, Switzerland;
| | - Rodrigo Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória 29075-910, Brazil; (H.T.); (W.R.-T.); (P.C.); (L.O.); (R.V.)
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Yang M, Rosenberg MW, Li J. Spatial Variability of Health Inequalities of Older People in China and Related Health Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051739. [PMID: 32155968 PMCID: PMC7084825 DOI: 10.3390/ijerph17051739] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/27/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
China is facing serious population aging issues because of many unintended consequences of the economic reforms that began in the 1980s and with social policies such as the “one child” policy. Understanding the spatial distribution of the health status of older people has attracted more and more attention in many countries, including China. By employing descriptive analysis, this study uses data from the Chinese Population Censusand Statistical Year Bookto explore the health inequalities of older people at the national level. Based on the Getis-Ord Gi*, this study finds that the uneven spatial distribution of socio-economic status results in health inequalities for older people at the national level. The geographic distribution of life expectancy was correlated with a number of important demographic, socio-economic, and environmental variables. For further research, investigations should be conducted among individuals at micro-geographic scales.
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Affiliation(s)
- Mengqi Yang
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China;
| | - Mark W. Rosenberg
- Department of Geography and Urban Planning, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Jie Li
- School of Geographical Sciences, Guangzhou University, Guangzhou 510006, China;
- College of Resources and Environmental Science, Ningxia University, Yinchuan 750021, China
- Correspondence:
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The Associations of Income, Education and Income Inequality and Subjective Well-Being among Elderly in Hong Kong-A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041271. [PMID: 32079186 PMCID: PMC7068358 DOI: 10.3390/ijerph17041271] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/12/2020] [Accepted: 02/13/2020] [Indexed: 12/02/2022]
Abstract
Background: Higher income and education and lower income inequality in a neighbourhood have been shown to be related to better mental health outcome in developed countries. However, it is not clear whether these factors would affect the subjective well-being of the elderly, especially in a setting with recent rapid economic development. Methods: This study was conducted in 80 community centres with a total of 7552 community-dwelling elderly (mean age 75.9 years (SD = 7.79), 79% female) in Hong Kong. Income at individual level was measured as perceived disposable income. Education level was also collected. At district level, income was measured by district median household income and education was measured as the proportion of the population with no formal schooling. Income inequality was quantified using Gini coefficients. Low subjective well-being was defined as any one or a combination of the following: not satisfied with life, no meaning of life and being unhappy (Likert scale ≤ 2). Multilevel logistic regression was used to assess the association of income, education and income inequality and low subjective well-being. Results: We found that 15.3% (95% confidence interval (CI): 14.5 to 16.1) of the elderly have low subjective well-being. Compared with elderly who reported a very adequate disposable income, those who reported a very inadequate disposable income are at increased risk of low subjective well-being (OR=5.08, 95%CI: 2.44 to 10.59). Compared with elderly with tertiary education, those with no formal schooling were at higher risk (OR=1.60, 95%CI 1.22 to 2.09). Income inequality was not related to subjective well-being. Conclusions: Elderly with inadequate disposable income and lower education level are more likely to suffer from low subjective well-being. At the neighbourhood level, income inequality was not related to subjective well-being. However, the relationships between neighbourhood income and education level and individuals’ subjective well-being are not clear.
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Chiu SYR, Yang Z. Influence of family income and medical insurance coverage on health-related quality of life and optimism in cancer patients at a Hong Kong private hospital: A cross-sectional study. Psychooncology 2019; 28:1971-1977. [PMID: 31293022 DOI: 10.1002/pon.5175] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/07/2019] [Accepted: 07/06/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Health-related quality of life (HRQL) and optimism are important health domains that express the physical, emotional, and psychological well-being of cancer patients. Previous studies have explored income and medical insurance coverage as predictors of their well-being with the aim to better understand their financial needs. The primary objective of this study was to examine the associations in the private health sector in Hong Kong. METHODS The study was conducted cross-sectionally with a structured questionnaire in traditional Chinese. HRQL was assessed with the RAND 12-item Health Survey, and optimism was assessed with the Life Orientation Test. The two primary predictors were family income and medical insurance coverage. The associations were tested using logistic regression, controlling for other sociodemographic and clinical covariates. RESULTS A total of 428 questionnaires were used in the regression model. After adjusting for other covariates, no significant association was observed with family income as the predictor. Medical insurance coverage was a significant and positive predictor of optimism with odds ratio of 2.30 and 95% confidence interval of 1.30 to 4.05 for the group with the most coverage with little to no coverage as the reference group. CONCLUSIONS The significant association between medical insurance coverage and optimism might be an indication that the medical cost was a financial burden to many cancer patients in Hong Kong. In addition to their medical needs, cancer support organization and health care practitioners must be able to recognize and assist with the financial needs of the cancer patients.
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Affiliation(s)
- Sai Yiu Richard Chiu
- Radiation and Oncology Centre, Hong Kong Baptist Hospital, Kowloon Tong, Hong Kong
| | - Zuyao Yang
- Division of Epidemiology, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
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Guhl E, Althouse A, Sharbaugh M, Pusateri AM, Paasche-Orlow M, Magnani JW. Association of income and health-related quality of life in atrial fibrillation. Open Heart 2019; 6:e000974. [PMID: 31168380 PMCID: PMC6519582 DOI: 10.1136/openhrt-2018-000974] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 03/02/2019] [Accepted: 03/18/2019] [Indexed: 01/21/2023] Open
Abstract
Objective Health-related quality of life (HRQoL) is a patient-centred benchmark promoted by clinical guidelines in atrial fibrillation (AF). Income is associated with health outcomes, but how income effects HRQoL in AF has limited investigation. Methods We enrolled a convenience cohort with AF receiving care at a regional healthcare system and assessed demographics, medical history, AF treatment, income, education and health literacy. We defined income as a categorical variable (<$20 000; $20 000-$49 999; $50 000-$99 999; >$100 000). We used two complementary HRQoL measures: (1) the atrial fibrillation effect on quality of life (AFEQT), measuring composite and domain scores (daily activity, symptoms, treatment concerns, treatment satisfaction; range 0-100); (2) the 12-item Short Form Survey (SF-12), measuring general HRQoL with physical and mental health domains (range 0-100). We related income to HRQoL and adjusted for relevant covariates. Results In 295 individuals with AF (age 71±10, 40% women), we observed significant differences in HRQoL by income. Higher mean composite AFEQT scores were observed for higher income groups: participants with income <$20 000 had the lowest HRQoL (n=35, 68.2±21.4), and those with income >$100 000 had the highest HRQoL (n=64, 81.9±17.0; p=0.04). We also observed a significant difference by income in the AFEQT daily activity domain (p=0.02). Lower income was also associated with lower HRQoL in the mental health composite score of the SF-12 (59.7±21.5, income <$20 000 vs 79.3±16.3, income >$100 000; p<0.01). Conclusion We determined that income was associated with HRQoL in a cohort with prevalent AF. Given the marked differences, we consider income as essential for understanding patient-centred outcomes in AF.
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Affiliation(s)
- Emily Guhl
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Andrew Althouse
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Michael Sharbaugh
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | | | - Michael Paasche-Orlow
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jared W Magnani
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Agarwal G, Angeles R, Pirrie M, McLeod B, Marzanek F, Parascandalo J, Thabane L. Reducing 9-1-1 Emergency Medical Service Calls By Implementing A Community Paramedicine Program For Vulnerable Older Adults In Public Housing In Canada: A Multi-Site Cluster Randomized Controlled Trial. PREHOSP EMERG CARE 2019; 23:718-729. [PMID: 30624150 DOI: 10.1080/10903127.2019.1566421] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Older adults account for 38-48% of emergency medical service (EMS) calls, have more chronic diseases, and those with low income have lower quality of life. Mobile integrated health and community paramedicine may help address these health inequalities and reduce EMS calls. This study examines the effectiveness of the Community Paramedicine at Clinic (CP@clinic) program in decreasing EMS calls and improving health outcomes in low-income older adults. Methods: This was an open-label, pragmatic, cluster-randomized controlled trial conducted within subsidized public housing buildings for older adults in 5 paramedic services across Ontario, Canada. A total of 30 apartment buildings were eligible (>50 units, >60% of units occupied by older adults, unique postal code, available match for pairing). Paired buildings were randomly allocated to intervention (CP@clinic for one year) or control (usual care) via computer-generated randomization. The CP@clinic intervention is a community-based, paramedic-led, health promotion and disease prevention program held weekly in building common rooms. CP@clinic includes risk assessment with validated tools, decision support, health promotion, referrals to resources, and reports back to family doctors. All residents could participate, but only older adults (55 years and older) were included in analyses. The primary outcome was building-level EMS calls from paramedic service databases. Secondary outcomes were individual-level changes in chronic disease risk factors and quality-adjusted-life-years (QALYs). Data were analyzed using Generalized Estimating Equations to account for clustering by sites. Results: Intention-to-treat analysis showed no significant difference in EMS calls (mean difference = -0.37/100 apartment units/month, 95%CI: -0.98 to 0.24). Sensitivity analysis excluding data from 2 building pairs with eligibility changes after intervention initiation revealed a significant difference in EMS calls in favor of the intervention buildings (mean difference = -0.90/100 apartment units/month, 95%CI: -1.54 to -0.26). At the individual level, there was a significant QALY increase (mean difference = 0.06, 95%CI: 0.02 to 0.10) and blood pressure decrease (systolic mean change = 3.65 mmHg, 95%CI: 2.37 to 4.94; diastolic mean change = 2.03 mmHg, 95%CI: 1.00 to 3.06). Conclusions: CP@clinic showed a significant decrease in EMS calls, decrease in BP, and improvement in QALYs among older adults in subsidizing public housing, suggesting this simple program should be replicated in other communities with public housing. Trial Registration: Clinicaltrials.gov, Registration no. NCT02152891.
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You X, Zhang Y, Zeng J, Wang C, Sun H, Ma Q, Ma Y, Xu Y. Disparity of the Chinese elderly's health-related quality of life between urban and rural areas: a mediation analysis. BMJ Open 2019; 9:e024080. [PMID: 30782725 PMCID: PMC6352780 DOI: 10.1136/bmjopen-2018-024080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 11/04/2018] [Accepted: 12/18/2018] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study aimed to examine the urban-rural disparity in health-related quality of life (HRQoL) of the Chinese elderly and to explore the mediating roles of socioeconomic status (SES) and frequency of contact with children in the relationship between urban/rural areas and HRQoL. METHODS This cross-sectional study used data from China Health and Retirement Longitudinal Study for 2015-2016, involving 12 369 Chinese aged 45 years and over. HRQoL of respondents was measured by three-level EuroQol five dimensions (EQ-5D-3L). SES, based on principal components analysis, was combined by the individual possessions of durable consumer goods and houses. Frequency of contact with children was derived from the responses to whether they live with children and how often they contact with them. Mediation analyses were performed to examine the mediating effects of SES and frequency of contact in the relationship between urban/rural areas and HRQoL. RESULTS Urban respondents had higher scores of HRQoL than rural respondents (p<0.05). As SES and frequency of contact with children increased, the scores of HRQoL of the elderly went up as well. Mediation analyses proved the possible mediating effects of SES and frequency of contact in the relationship between urban/rural areas and HRQoL (0.0713 and 0.0064). The indirect effects induced by SES and frequency of contact were 65.45% and 5.90%, respectively. CONCLUSIONS There was a significant difference in HRQoL between urban and rural middle-aged and elderly participants, which was partially mediated by urban-rural disparities in SES and frequency of contact with children. Higher SES and frequency of contact with children contributed to higher health status in the Chinese elderly.
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Affiliation(s)
- Xinyi You
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Yali Zhang
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Jinfeng Zeng
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Congju Wang
- Department of Chronic Disease Management, Centers for Disease Control and Prevention of Suzhou High-tech Zone, Suzhou, China
| | - Hongpeng Sun
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Qinghua Ma
- Department of Chronic Disease Management, The 3rd People’s Hospital of Xiangcheng District, Suzhou, China
| | - Yana Ma
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
| | - Yong Xu
- Department of Child Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, China
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Hosseinpour M, Esmaeilpour Aghdam M, Piri M, Maleki F. Determinants of Health-Related Quality of Life in Rural Elderly People of the West of Iran: A Population-Based, Cross-Sectional Study. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2019. [DOI: 10.15171/ijer.2019.01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background and aims: World’s older population is growing, and attention is being directed to the improvement of their health-related quality of life (HRQoL). This article was conducted to investigate the HRQoL and associated factors in rural elderly residents in west of Iran. Methods: By using the multistage sampling method, 346 elders from rural areas of Shahindezh were enrolled in this population-based, cross-sectional study conducted in 2014. To assess the HRQoL of the elderly people, the Leiden-Padua (LEIPAD) questionnaire was used. The economic status was classified into 3 categories (good, moderate, and low) using the principal component analysis. Descriptive statistics, independent t test, ANOVA, and Spearman correlation coefficient were used to analyze data. Multivariate linear regression was performed to determine predictive factors. Results: The mean values and confidence intervals of total core scale and total moderator scale were 38.6 (36.7-40.6) and 31.2 (29.6-32.6), respectively. Univariate analysis showed age, marital status, economic status, occupation, income source, and ethnicity were associated with HRQoL (P<0.05). Multivariate analysis showed the married, the illiterate, widows/widowers and the divorced, people with low economic status, and the self-employed had low HRQoL with respect to total scale and total core scale models (P<0.05). Conclusion: HRQoL varies according to socioeconomic factors. Its determinants should be addressed in social and health policies designed to improve the health of older people, especially the most vulnerable groups.
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Affiliation(s)
- Marjan Hosseinpour
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Mohammad Esmaeilpour Aghdam
- Department of E-learning in Medical Sciences, Virtual School, Tehran University of Medical Sciences, Tehran, Iran
| | - Masumeh Piri
- Department of Health Education & Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Maleki
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Sidani MA, Reed BC, Steinbauer J. Geriatric Care Issues. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rezaei S, Hajizadeh M, Salimi Y, Moradi G, Nouri B. What Explains Socioeconomic Inequality in Health-related Quality of Life in Iran? A Blinder-Oaxaca Decomposition. J Prev Med Public Health 2018; 51:219-226. [PMID: 30286593 PMCID: PMC6182272 DOI: 10.3961/jpmph.18.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/09/2018] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES This study aimed to explain the health-related quality of life (HRQoL) gap between the poorest and the wealthiest quintiles in the capitals of Kermanshah and Kurdistan Provinces (Kermanshah and Sanandaj), in western Iran. METHODS This was a cross-sectional study conducted among 1772 adults. Data on socio-demographic characteristics, socioeconomic status (SES), lifestyle factors, body mass index, and HRQoL of participants were collected using a self-administered questionnaire. The slope and relative indices of inequality (SII and RII, respectively) were employed to examine socioeconomic inequality in poor HRQoL. Blinder-Oaxaca (BO) decomposition was used to quantify the contribution of explanatory variables to the gap in the prevalence of poor HRQoL between the wealthiest and the poorest groups. RESULTS The overall crude and age-adjusted prevalence of poor HRQoL among adults was 32.0 and 41.8%, respectively. The SII and RII indicated that poor HRQoL was mainly concentrated among individuals with lower SES. The absolute difference (%) in the prevalence of poor HRQoL between the highest and lowest SES groups was 28.4. The BO results indicated that 49.9% of the difference was explained by different distributions of age, smoking behavior, physical inactivity, chronic health conditions, and obesity between the highest and lowest SES groups, while the remaining half of the gap was explained by the response effect. CONCLUSIONS We observed a pro-rich distribution of poor HRQoL among adults in the capitals of Kermanshah and Kurdistan Provinces. Policies and strategies aimed at preventing and reducing smoking, physical inactivity, chronic health conditions, and obesity among the poor may reduce the gap in poor HRQoL between the highest and lowest SES groups in Iran.
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Affiliation(s)
- Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Hajizadeh
- School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - Yahya Salimi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ghobad Moradi
- Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Bijan Nouri
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Agarwal G, Angeles R, Pirrie M, McLeod B, Marzanek F, Parascandalo J, Thabane L. Evaluation of a community paramedicine health promotion and lifestyle risk assessment program for older adults who live in social housing: a cluster randomized trial. CMAJ 2018; 190:E638-E647. [PMID: 29807936 PMCID: PMC5973885 DOI: 10.1503/cmaj.170740] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Low-income older adults who live in subsidized housing have higher mortality and morbidity. We aimed to determine if a community paramedicine program - in which paramedics provide health care services outside of the traditional emergency response - reduced the number of ambulance calls to subsidized housing for older adults. METHODS We conducted an open-label pragmatic cluster-randomized controlled trial (RCT) with parallel intervention and control groups in subsidized apartment buildings for older adults. We selected 6 buildings using predefined criteria, which we then randomly assigned to intervention (Community Paramedicine at Clinic [CP@clinic] for 1 yr) or control (usual health care) using computer-generated paired randomization. CP@clinic is a paramedic-led, community-based health promotion program to prevent diabetes, cardiovascular disease and falls for residents 55 years of age and older. The primary outcome was building-level mean monthly ambulance calls. Secondary outcomes were individual-level changes in blood pressure, health behaviours and risk of diabetes assessed using the Canadian Diabetes Risk Questionnaire. We analyzed the data using generalized estimating equations and hierarchical linear modelling. RESULTS The 3 intervention and 3 control buildings had 455 and 637 residents, respectively. Mean monthly ambulance calls in the intervention buildings (3.11 [standard deviation (SD) 1.30] calls per 100 units/mo) was significantly lower (-0.88, 95% confidence interval [CI] -0.45 to -1.30) than in control buildings (3.99 [SD 1.17] calls per 100 units/mo), when adjusted for baseline calls and building pairs. Survey participation was 28.4% (n = 129) and 20.3% (n = 129) in the intervention and control buildings, respectively. Residents living in the intervention buildings showed significant improvement compared with those living in control buildings in quality-adjusted life years (QALYs) (mean difference 0.09, 95% CI 0.01 to 0.17) and ability to perform usual activities (odds ratio 2.6, 95% CI 1.2 to 5.8). Those who received the intervention had a significant decrease in systolic (mean change 5.0, 95% CI 1.0 to 9.0) and diastolic (mean change 4.8, 95% CI 1.9 to 7.6) blood pressure. INTERPRETATION A paramedic-led, community-based health promotion program (CP@clinic) significantly lowered the number of ambulance calls, improved QALYs and ability to perform usual activities, and lowered systolic blood pressure among older adults living in subsidized housing. Trial registration: Clinicaltrials.gov, no. NCT02152891.
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Affiliation(s)
- Gina Agarwal
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont.
| | - Ricardo Angeles
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont
| | - Melissa Pirrie
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont
| | - Brent McLeod
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont
| | - Francine Marzanek
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont
| | - Jenna Parascandalo
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont
| | - Lehana Thabane
- Department of Family Medicine (Agarwal, Angeles, Pirrie, Marzanek, Parascandalo), and Department of Health Research Methods, Evidence, and Impact (Agarwal), McMaster University; Hamilton Paramedic Services (McLeod); Biostatistics Unit (Thabane), St. Joseph's Healthcare Research Institute, Hamilton, Ont
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Strout K, Jemison J, O'Brien L, Wihry D, Waterman T. GROW: Green Organic Vegetable Gardens to Promote Older Adult Wellness: a Feasibility Study. J Community Health Nurs 2018; 34:115-125. [PMID: 28767290 DOI: 10.1080/07370016.2017.1340554] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Protecting older adult's cognitive health is a public health priority. Wellness behaviors within 6 domains have demonstrated effectiveness in protecting older adult's cognitive abilities. Interventions targeted to low-income older adults are needed because these populations experience greater social and physical health disparities compared to adults in higher socioeconomic statuses. This study examined the feasibility of engaging independent, community-dwelling older adults living in low-income senior housing in cultivating raised-bed gardens and reviewed the improvements in cognition and nutrition. Ten participants received ergonomic garden tools, seeds, waist-height garden beds, and weekly garden education. Participants planted vegetables of their choosing and tended to their garden beds for 17 weeks. Cognition and nutrition outcomes were measured before and after the intervention. Adults successfully engaged in the intervention throughout the duration and experienced improvement in cognitive and nutrition outcomes.
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Affiliation(s)
- Kelley Strout
- a Assistant Professor, School of Nursing , University of Maine , Orono , Maine
| | - John Jemison
- b Extension Professor, Cooperative Extension , University of Maine , Orono , Maine
| | - Liam O'Brien
- c Associate Professor, Mathematics and Statistics , Colby College , Waterville , Maine
| | - David Wihry
- d Project Manager, University of Maine Center on Aging , Bangor , Maine
| | - Timothy Waterman
- e Nursing Student , School of Nursing, University of Maine , Orono , Maine
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Agarwal G, Habing K, Pirrie M, Angeles R, Marzanek F, Parascandalo J. Assessing health literacy among older adults living in subsidized housing: a cross-sectional study. Canadian Journal of Public Health 2018; 109:401-409. [PMID: 29981094 DOI: 10.17269/s41997-018-0048-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 11/25/2017] [Indexed: 01/23/2023]
Abstract
OBJECTIVES This study aimed to assess functional health literacy levels among older adults living in subsidized housing in Hamilton, Ontario, and to assess the relationships between health literacy and other important health indicators, such as education level, age, ethnicity, body mass index (BMI), and self-reported health status. METHODS Older adults (n = 237) living in subsidized housing buildings in Hamilton, ON, were assessed using the NVS-UK as a measure of functional health literacy in addition to a health indicator questionnaire through structured interview. Health literacy levels were analyzed using descriptive statistics and logistic regression to determine relationships between health literacy levels and other health indicators. RESULTS Participants' mean age was 73 years, 67% were female, 70% were not educated beyond high school, and 91% were white. Over 82% of participants had below adequate health literacy levels using the NVS-UK. Multivariable logistic regression revealed significant relationships between functional health literacy and BMI, education level, and pain and discomfort levels. No significant relationships were found between health literacy level and age group, anxiety and depression levels, CANRISK (Diabetes risk) score, gender, marital status, mobility issues, self-care issues, self-reported health status, or performance of usual activities. CONCLUSIONS As the population of older adults continues to grow, the appropriate resources must be available to both improve and support the health literacy level of the population. Future health research should gather information on the health literacy levels of target populations to ensure more equitable health service. This research provides a significant opportunity to better understand populations with health literacy barriers.
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Affiliation(s)
- Gina Agarwal
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada. .,Department of Health, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
| | - Kendra Habing
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Melissa Pirrie
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Ric Angeles
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Francine Marzanek
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
| | - Jenna Parascandalo
- Department of Family Medicine, McMaster University, 100 Main St. W, DBHSC, Hamilton, ON, L8P 1H6, Canada
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45
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Weisman A, Lovblom LE, Keenan HA, Tinsley LJ, D'Eon S, Boulet G, Farooqi MA, Lovshin JA, Orszag A, Lytvyn Y, Brent MH, Paul N, Bril V, Cherney DZ, Perkins BA. Diabetes Care Disparities in Long-standing Type 1 Diabetes in Canada and the U.S.: A Cross-sectional Comparison. Diabetes Care 2018; 41:88-95. [PMID: 29118059 PMCID: PMC5741151 DOI: 10.2337/dc17-1074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 10/05/2017] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess national differences in diabetes care and quality of life (QOL) between individuals with long-standing type 1 diabetes (≥50 years) in Canada and the U.S. RESEARCH DESIGN AND METHODS Cross-sectional data from identical surveys administered in the Canadian Study of Longevity in Diabetes and the Joslin Medalist Study, collected in 2013-2016 and 2005-2011, respectively, were compared. Laboratory values and ophthalmic examination were completed by clinical care physicians for Canadians and the Joslin Clinic for Americans. Univariate comparisons and multivariable regression for HbA1c, QOL, insulin pump use, and coronary artery disease (CAD) were performed. Nephropathy, CAD, and peripheral arterial disease (PAD) were self-reported; neuropathy was defined by a Michigan Neuropathy Screening Instrument (Questionnaire component) score ≥3, and proliferative retinopathy was documented from ophthalmic examination. QOL was self-reported on an ordinal scale. RESULTS Three hundred sixty-one Canadians and 668 Americans had similar ages (mean 65.78 years [SD 8.67] vs. 66.38 years [7.66], P = 0.27) and durations of diabetes (median 53.00 years [interquartile range 51.00, 58.00] vs. 53.00 years [51.00, 57.00], P = 0.51). Canadians had higher HbA1c (mean 7.53% [SD 1.03] [59 mmol/mol] vs. 7.22% [0.98] [55 mmol/mol], P < 0.0001), lower QOL (36.9% vs. 48.7% with "excellent" QOL, P = 0.0002), and less CAD (29.7% vs. 41.2%, P = 0.0003) and insulin pump use (43.3% vs. 55.6%, P = 0.0002). Other complication rates were similar. Residual differences for Canadians compared with Americans remained after adjustment for age, sex, CAD, PAD, education, and relevant a priori selected variables: 0.28% higher HbA1c (P = 0.0004); and odds ratios of 0.68 (95% CI 0.51, 0.90), 0.46 (0.31, 0.68), and 0.71 (0.52, 0.96) for higher QOL, CAD, and insulin pump use, respectively. CONCLUSIONS Although Canadians and Americans have similar rates of complications other than CAD, further research is required to understand why Canadians have higher HbA1c levels, lower QOL, and less insulin pump use.
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Affiliation(s)
- Alanna Weisman
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.,Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Leif E Lovblom
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | | | | | - Genevieve Boulet
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Mohammed A Farooqi
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Julie A Lovshin
- Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Andrej Orszag
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Yuliya Lytvyn
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael H Brent
- Department of Ophthalmology & Vision Sciences and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Narinder Paul
- Division of Cardiothoracic Imaging, Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada
| | - Vera Bril
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - David Z Cherney
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Bruce A Perkins
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada .,Division of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Bonaccio M, Di Castelnuovo A, Costanzo S, Persichillo M, De Curtis A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. Health-related quality of life and risk of composite coronary heart disease and cerebrovascular events in the Moli-sani study cohort. Eur J Prev Cardiol 2017; 25:287-297. [PMID: 29243510 DOI: 10.1177/2047487317748452] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background To assess the association between health-related quality of life (HRQL) and a composite outcome including incident coronary heart disease (CHD) and cerebrovascular events in a large general population-based cohort. Design Prospective analysis on 17,102 men and women (mean age 53 ± 11) free from cardiovascular disease at time of enrolment in the Moli-sani cohort (2005-2010). Methods HRQL was assessed by the 36-Item Short Form Health Survey. Hazard ratios with 95% confidence intervals (95% CIs) were calculated using multivariable Cox-proportional hazard models. Results At the end of follow-up (median 4.2 years), 237 new events occurred (coronary heart disease n = 197, cerebrovascular disease n = 42). In a multivariable model adjusted for socioeconomic factors, chronic disease and health-related behaviours, both mental and physical HRQL were inversely associated with the risk of the composite outcome (hazard ratio = 0.57; 0.39-0.84 and hazard ratio = 0.62; 0.40-0.94, respectively; highest vs. lowest quartile). Further adjustment for C-reactive protein marginally modified the association with physical HRQL (hazard ratio = 0.67; 0.43-1.02). Similar findings were obtained when only CHD events were analysed (hazard ratio = 0.63; 0.41-0.96 for highest versus lowest mental HRQL) although results with physical HRQL were no longer significant (hazard ratio = 0.65; 0.40-1.04 for highest versus lowest quartile). Associations with incident cerebrovascular disease showed a trend toward protection (hazard ratio = 0.50; 0.22-1.17 and hazard ratio = 0.51; 0.22-1.23 for highest versus lowest tertile of mental and physical HRQL, respectively). Conclusions HRQL is an independent predictor of composite CHD/cerebrovascular outcomes in an adult population. The magnitude of the association was not affected either by socioeconomic factors, health conditions or health-related behaviours. Improvement of quality of life may be a major factor in targeting appropriate prevention strategies for cardiovascular health.
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Affiliation(s)
- Marialaura Bonaccio
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Augusto Di Castelnuovo
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Simona Costanzo
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Mariarosaria Persichillo
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Amalia De Curtis
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Chiara Cerletti
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Maria Benedetta Donati
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Giovanni de Gaetano
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy
| | - Licia Iacoviello
- 1 Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli, Italy.,2 Department of Medicine and Surgery, Research Centre in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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47
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How Medicine Has Changed the End of Life for Patients With Cardiovascular Disease. J Am Coll Cardiol 2017; 70:1276-1289. [DOI: 10.1016/j.jacc.2017.07.735] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/20/2022]
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48
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The significance of frailty in the relationship between socioeconomic status and health-related quality of life in the Korean community-dwelling elderly population: mediation analysis with bootstrapping. Qual Life Res 2017; 26:3323-3330. [DOI: 10.1007/s11136-017-1672-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
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49
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Bahramnezhad F, Chalik R, Bastani F, Taherpour M, Navab E. The social network among the elderly and its relationship with quality of life. Electron Physician 2017; 9:4306-4311. [PMID: 28713500 PMCID: PMC5498693 DOI: 10.19082/4306] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 12/24/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Attention to the needs of the elderly is a social necessity, and it seems that evaluating the social network and quality of life of the elderly can be useful in a better understanding of their needs. This study was performed to determine the relationship between the social network and the quality of life of the elderly in the city of Bojnoord in Iran. METHODS In this cross-sectional study, 201 elderly people aged 60 years or more were selected by continuous and consecutive sampling method in Bojnoord, Iran in 2014. Data were collected using demographic questionnaire, Lubben social network scale and LEIPAD elderly quality of life questionnaire. Data were analyzed by SPSS 16 and using descriptive statistics and independent-samples t-test, ANOVA and Pearson product-moment coefficient. RESULTS The results showed that 30.3% of elderly people studied, were subjected to a high risk of isolation. The highest mean in social network dimensions was in the family (19.68%), friends (12.01%) and the neighbors (9.90%), respectively. The mean score for quality of life of the elderly was as moderate to high (63.90±13.73), and among the quality of life dimensions, the highest mean was related to the self-care dimension (15.59%), and the lowest mean was related to the sexual functioning dimension (1.53%). The findings suggested a positive and significant relationship between social network and quality of life in the elderly who were studied (p<0.000, r=0.468). CONCLUSION This study was a step toward understanding the social network status and quality of life of the elderly. It is necessary to say that health care professionals, especially nurses, display a significant role in the community to help people in this regard.
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Affiliation(s)
- Fatemeh Bahramnezhad
- Ph.D. of Nursing, Assistant Professor, Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Raheleh Chalik
- M.Sc., Department of Geriatric Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Bastani
- Ph.D. of Nursing, Associate Professor, Department of Geriatric Nursing, Faculty of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Taherpour
- M.Sc. in biostatistics, Faculty of Biostatistics, North Khorasan University of Medical Sciences, Bojnoord, Iran
| | - Elham Navab
- Ph.D. of Nursing, Assistant Professor, Head of Department of Geriatric and Critical Care Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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50
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Sidani MA, Reed BC, Steinbauer J. Geriatric Care Issues: An American and an International Perspective. Prim Care 2017; 44:e15-e36. [PMID: 28164825 DOI: 10.1016/j.pop.2016.09.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As the global population ages, there is an opportunity to benefit from the increased longevity of a healthy older adult population. Healthy older individuals often contribute financially to younger generations by offering financial assistance, paying more in taxes than benefits received, and providing unpaid childcare and voluntary work. Governments must address the challenges of income insecurity, access to health care, social isolation, and neglect that currently face elderly adults in many countries. A reduction in disparities in these areas can lead to better health outcomes and allow societies to benefit from longer, healthier lives of their citizens.
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Affiliation(s)
- Mohamad A Sidani
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Brian C Reed
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey Steinbauer
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
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