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Sheehan JL, Jordan AA, Newman KL, Johnson LA, Eloubeidi D, Cohen-Mekelburg S, Berinstein JA, Tipirneni R, Higgins PDR. Are Depression and Anxiety Underdiagnosed in Socially Vulnerable Patients With Inflammatory Bowel Disease? Inflamm Bowel Dis 2024; 30:1696-1706. [PMID: 37878586 DOI: 10.1093/ibd/izad246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Depression and anxiety are highly prevalent among individuals with inflammatory bowel disease (IBD); however, little is understood about how social determinants of health (SDOH) may impact mental health diagnoses in this population. The social vulnerability index (SVI) is a publicly available tool that can be used to study SDOH in IBD patients. METHODS Home addresses from a retrospective cohort of IBD patients at a single center were used to geocode patients to their individual census tract and corresponding SVI. We used multivariable logistic regression to examine the relationship between SVI and comorbid mental health diagnoses in patients with IBD. Secondarily, data from standardized health questionnaires were then used to determine if patients were adequately screened for depression and anxiety. RESULTS In all, 9644 patients were included; 18% had a diagnosis of depression, 21% anxiety, and 32% had a composite of "any mental health diagnosis." Depression (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.02-1.56) but not anxiety (OR, 0.87; 95% CI, 0.71-1.06) nor "any mental health diagnosis" (OR, 1.09; 95% CI, 0.92-1.30) was associated with higher levels of social vulnerability. However, overall rates of screening for depression and anxiety were low (15% and 8%, respectively), with the lowest screening rates among the most socially vulnerable (depression 8.2%, anxiety 6.3%). CONCLUSIONS Disparities in the diagnoses of depression and anxiety for socially vulnerable patients with IBD exist. Awareness of these inequities is the first step toward developing interventions to improve mental health screening, eliminate barriers and bias, and promote referrals for appropriate mental health management.
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Affiliation(s)
- Jessica L Sheehan
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Ariel A Jordan
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Kira L Newman
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA
| | - Laura A Johnson
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA
| | - Dala Eloubeidi
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Shirley Cohen-Mekelburg
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, MI, USA
| | - Jeffrey A Berinstein
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Renuka Tipirneni
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - Peter D R Higgins
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, MI, USA
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Ma J, Liu W, Chai Y, Wang J, Kong G. Association of the intergenerational structure with the onset of depressive symptoms among middle-aged and older adults in China. Int J Soc Psychiatry 2024; 70:1083-1092. [PMID: 38847406 DOI: 10.1177/00207640241255587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
BACKGROUND Chinese family structure has undergone tremendous changes over the past few decades. Moreover, the association of the intergenerational structure with depression remains controversial. AIMS This study aimed to find out the association of the intergenerational structure and the onset of depressive symptoms among Chinese middle-aged and older adults. METHODS This study included 4,868 participants of the China Health and Retirement Longitudinal Study (CHARLS), who were enrolled in 2011 without depressive symptoms and followed up at least once later in 2013, 2015, 2018, and 2020. Taking the time-varying confounding effect into account, the time-dependent Cox regression models were used to estimate the association of the intergenerational structure and the onset of depressive symptoms. RESULTS Among the studied middle-aged and older adults, compared to one-generation households, higher hazard ratios (HR) of developing depressive symptoms were found in three-generation households in the study population (HR = 1.21, 95% CI [1.08, 1.36]). Further, for female participants, skipping-generation households (HR = 1.38, 95% CI [1.05, 1.83]) and three-generation lineal households (HR = 1.21, 95% CI [1.02, 1.43]) were found to be significantly associated with new-onset depressive symptoms compared to empty-nest couples. For male participants, living alone (HR = 1.65, 95% CI [1.30, 2.11]), living in standardized nuclear households (HR = 1.27, 95% CI [1.06, 1.54]), impaired nuclear households (HR = 1.80, 95% CI [1.18, 2.76]), or three-generation lineal households (HR = 1.34, 95% CI [1.12, 1.60]) were found to have a significant association with the onset of depressive symptoms. CONCLUSIONS This study found that males living alone, with unmarried children, or in three-generation lineal households, and females living with grandchildren were more likely to suffer from depressive symptoms. Therefore, special attention should be paid to people in these intergenerational structure subtypes.
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Affiliation(s)
- Jun Ma
- National Institute of Health Data Science, Peking University, Beijing, China
| | - Wenwen Liu
- National Institute of Health Data Science, Peking University, Beijing, China
| | - Yangfan Chai
- National Institute of Health Data Science, Peking University, Beijing, China
| | - Jiayu Wang
- National Institute of Health Data Science, Peking University, Beijing, China
| | - Guilan Kong
- National Institute of Health Data Science, Peking University, Beijing, China
- Advanced Institute of Information Technology, Peking University, Hangzhou, Zhejiang, China
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Ge H, Dong S, Su W, Guan W, Yu Q, Liu Y, Qi Y, Sun X, Zhang H, Ma G. Relationship between social participation and depressive symptoms in patients with multimorbidity: the chained mediating role of cognitive function and activities of daily living. BMC Public Health 2024; 24:1844. [PMID: 38987791 PMCID: PMC11234698 DOI: 10.1186/s12889-024-19157-7] [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: 03/25/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE The potential mechanisms linking social participation and depressive symptoms in Chinese individuals with multimorbidity are not yet fully understood. This study aims to explore how cognitive function and activities of daily living (ADLs) mediate the relationship between social participation and depressive symptoms in individuals with multimorbidity. METHODS We selected 3782 participants with multimorbidity from the 2018 China Health and Retirement Longitudinal Study. Data related to social participation, cognitive function, ADLs, and depressive symptoms were extracted. Regression and Bootstrap analyses were used to explore the sequential mediating effects of social participation, cognitive function, ADLs, and depressive symptoms. RESULTS (1) There was a significant correlation between social participation, cognitive function, activities of daily living, and depressive symptoms (p < 0.01). (2) Social participation directly affected depressive symptoms (β = -0.205, p < 0.05). (3) Cognitive function (β = -0.070, p < 0.01) and activities of daily living (β = -0.058, p < 0.01) played separate mediating roles in the effect of social participation on depressive symptoms. (4) Cognitive function and activities of daily living had a chain-mediated role in the relationship between social participation and depressive symptoms in patients with multimorbidity (β = -0.020, p < 0.01). CONCLUSION A chained mediating effect was found between cognitive function, ADLs, social participation, and depressive symptoms in patients with multimorbidity. Social participation was found to improve the cognitive function of patients with multimorbidity, which in turn enhanced their daily life activities and ultimately alleviated their depressive symptoms.
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Affiliation(s)
- Huaiju Ge
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Shihong Dong
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Wenyu Su
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Weimin Guan
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Qing Yu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Yan Liu
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong, China
| | - Yuantao Qi
- Shandong Cancer Research Institute (Shandong Tumor Hospital), Jinan, Shandong, China
| | - Xialing Sun
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Huiqing Zhang
- The First Affiliated Hospital of Shandong Second Medical University (Weifang People's Hospital), Weifang, Shandong, China.
| | - Guifeng Ma
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China.
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Polavarapu M, Barasa TN, Singh S, Orbain MM, Ibrahim S. An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study. Matern Child Health J 2024; 28:999-1009. [PMID: 38441865 PMCID: PMC11058605 DOI: 10.1007/s10995-024-03925-3] [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] [Accepted: 02/17/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Ohio ranks 43rd in the nation in infant mortality rates (IMR); with IMR among non-Hispanic black infants is three times higher than white infants. OBJECTIVE To identify the social factors determining the vulnerability of Ohio counties to IMR and visualize the spatial association between relative social vulnerability and IMR at county and census tract levels. METHODS The social vulnerability index (SVICDC) is a measure of the relative social vulnerability of a geographic unit. Five out of 15 social variables in the SVICDC were utilized to create a customized index for IMR (SVIIMR) in Ohio. The bivariate descriptive maps and spatial lag model were applied to visualize the quantitative relationship between SVIIMR and IMR, accounting for the spatial autocorrelation in the data. RESULTS Southeastern counties in Ohio displayed highest IMRs and highest overall SVIIMR; specifically, highest vulnerability to poverty, no high school diploma, and mobile housing. In contrast, extreme northwestern counties exhibited high IMRs but lower overall SVIIMR. Spatial regression showed five clusters where vulnerability to low per capita income in one county significantly impacted IMR (p = 0.001) in the neighboring counties within each cluster. At the census tract-level within Lucas county, the Toledo city area (compared to the remaining county) had higher overlap between high IMR and SVIIMR. CONCLUSION The application of SVI using geospatial techniques could identify priority areas, where social factors are increasing the vulnerability to infant mortality rates, for potential interventions that could reduce disparities through strategic and equitable policies.
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Affiliation(s)
- Mounika Polavarapu
- Department of Population Health, The University of Toledo, HH 1010, Mail Stop 119 2801 W. Bancroft St, Toledo, OH, 43606-3390, USA.
| | - Topista N Barasa
- Jack Ford Urban Affairs Center, The University of Toledo, Toledo, OH, 43606, USA
| | - Shipra Singh
- Department of Population Health, The University of Toledo, HH 1010, Mail Stop 119 2801 W. Bancroft St, Toledo, OH, 43606-3390, USA
| | | | - Safa Ibrahim
- Department of Population Health, The University of Toledo, HH 1010, Mail Stop 119 2801 W. Bancroft St, Toledo, OH, 43606-3390, USA
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Iriarte E, Larson ME, Behar-Zusman V. The Impact of COVID-19 Household Isolation on Conflict and Cohesion in One-, Two-, and Three-Generation Households With Older Adults. J Gerontol Nurs 2023; 49:47-56. [PMID: 36989472 DOI: 10.3928/00989134-20230310-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
The current cross-sectional study examined the effect of coronavirus disease 2019 (COVID-19) household isolation on household conflict and cohesion in one-, two-, and three-generation households with older adults (aged ≥65 years). Participants were 757 adults (aged ≥18 years) with at least one older adult in their household. Respondents were from 51 countries. Study variables were measured with the COVID-19 Household Environmental Scale. Non-parametric tests were used to assess differences between groups. Most participants (n = 437, 57.7%) lived in three-generation homes. Three-generation homes reported greater increases in conflict (p < 0.001) and cohesion (p < 0.001) during household isolation compared to oneand two-generation homes. Findings suggest that older adults living in multigenerational households experienced more cohesive and conflictive household environments as a function of the COVID-19 pandemic. Further research should explore how family or health care interventions could better support older adults and families as a unit of care to avoid adverse outcomes and boost resilience. [Journal of Gerontological Nursing, 49(4), 47-56.].
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Lench A, Perry M, Johnson RD, Fry R, Richardson G, Lyons RA, Akbari A, Edwards A, Collins B, Joseph-Williams N, Cooper A, Cottrell S. Household Composition and Inequalities in COVID-19 Vaccination in Wales, UK. Vaccines (Basel) 2023; 11:604. [PMID: 36992188 PMCID: PMC10055803 DOI: 10.3390/vaccines11030604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
The uptake of COVID-19 vaccination in Wales is high at a population level but many inequalities exist. Household composition may be an important factor in COVID-19 vaccination uptake due to the practical, social, and psychological implications associated with different living arrangements. In this study, the role of household composition in the uptake of COVID-19 vaccination in Wales was examined with the aim of identifying areas for intervention to address inequalities. Records within the Wales Immunisation System (WIS) COVID-19 vaccination register were linked to the Welsh Demographic Service Dataset (WDSD; a population register for Wales) held within the Secure Anonymised Information Linkage (SAIL) databank. Eight household types were defined based on household size, the presence or absence of children, and the presence of single or multiple generations. Uptake of the second dose of any COVID-19 vaccine was analysed using logistic regression. Gender, age group, health board, rural/urban residential classification, ethnic group, and deprivation quintile were included as covariates for multivariable regression. Compared to two-adult households, all other household types were associated with lower uptake. The most significantly reduced uptake was observed for large, multigenerational, adult group households (aOR 0.45, 95%CI 0.43-0.46). Comparing multivariable regression with and without incorporation of household composition as a variable produced significant differences in odds of vaccination for health board, age group, and ethnic group categories. These results indicate that household composition is an important factor for the uptake of COVID-19 vaccination and consideration of differences in household composition is necessary to mitigate vaccination inequalities.
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Affiliation(s)
- Alex Lench
- Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Malorie Perry
- Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Rhodri D. Johnson
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Richard Fry
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Gill Richardson
- Policy, Research and International Development, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK
| | - Ronan A. Lyons
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Ashley Akbari
- Population Data Science, Health Data Research UK, Swansea University Medical School, Swansea SA2 8PP, UK
| | - Adrian Edwards
- Wales COVID-19 Evidence Centre, PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, 8th floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | - Brendan Collins
- Health and Social Services Group, Finance Directorate, Welsh Government, Cardiff CF10 3NQ, UK
| | - Natalie Joseph-Williams
- Wales COVID-19 Evidence Centre, PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, 8th floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | - Alison Cooper
- Wales COVID-19 Evidence Centre, PRIME Centre Wales, Division of Population Medicine, School of Medicine, Cardiff University, 8th floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
| | - Simon Cottrell
- Vaccine Preventable Disease Programme and Communicable Disease Surveillance Centre, Public Health Wales, 2 Capital Quarter, Tyndall Street, Cardiff CF10 4BZ, UK
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Dong X, Ng N, Santosa A. Family structure and depressive symptoms among older adults in China: A marginal structural model analysis. J Affect Disord 2023; 324:364-369. [PMID: 36566935 DOI: 10.1016/j.jad.2022.12.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/26/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Mental well-being in the aging population is inevitably linked to families due to the reliance of older adults on family members. This study investigates the causal relationship between family structure and depressive symptoms among Chinese older adults in general and between gender and residential areas. METHODS We used China Health and Retirement Longitudinal Study (CHARLS) panel data, covering four data collection rounds over seven years. Family structure was classified into single-member, couple, nuclear family, and extended family. Taking into account time-varying confounding, we estimated the causal effects of family structure on depressive symptoms using marginal structural models. RESULTS Older people with cumulative exposure to single-member family type had an increased odds of depressive symptoms by an average of 33 % (95 % CI: 1.22-1.44) than their counterparts who lived in the couple family. Additionally, older people living in extended families also had 6 % higher odds of experiencing depressive symptoms (95 % CI: 1.00, 1.11). The longitudinal associations were consistent across gender groups and residential areas (p-value for interaction is 0.6638 for gender and 0.7043 for the residential area). LIMITATION The time-varying confounders (e.g., chronic health conditions) included in the analysis are based on self-reported data, which may be subject to measurement errors. CONCLUSION The risk of depressive symptoms is greater for older individuals living alone and in extended families. Screening for depression in the older population, particularly those living in "at-risk" households, is recommended.
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Affiliation(s)
- Xiaowei Dong
- School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Nawi Ng
- School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ailiana Santosa
- School of Public Health and Community Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Das Gupta D, Wong DWS. Age-Dependent Differences in Frequent Mental Distress (FMD) of US Older Adults Living in Multigenerational Families versus Living Alone. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3747. [PMID: 36834440 PMCID: PMC9964232 DOI: 10.3390/ijerph20043747] [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: 10/31/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Frequent mental distress (FMD) is prevalent among older Americans, but less is known about disparities in FMD of older adults living in multigenerational families versus living alone. We pooled cross-sectional data (unweighted, n = 126,144) from the Behavioral Risk Factor Surveillance System (BRFSS) between 2016 and 2020 and compared FMD (≥14 poor mental health days in the past 30 days = 1; 0 otherwise) of older adults (≥65 years) living in multigenerational families versus living alone in 36 states. After controlling for covariates, findings indicate 23% lower odds of FMD among older adults living in multigenerational households compared to counterparts living alone (adjusted odds ratio (AOR): 0.77; 95% confidence interval (CI): 0.60, 0.99). Findings also show that the reduction in the odds of FMD with each 5 year increase in age was larger among older adults living in multigenerational families by 18% (AOR: 0.56; 95% CI: 0.46, 0.70) compared to older adults living alone (AOR: 0.74; 95% CI: 0.71, 0.77), and this difference was significant at the 5% significance level. Multigenerational living may have a protective association with FMD among older adults. Further research is needed to identify multigenerational family and non-kin factors that translate into mental health advantages for older adults.
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Affiliation(s)
- Debasree Das Gupta
- Department of Kinesiology and Health Science, Emma Eccles Jones College of Education and Human Services, Utah State University, Logan, UT 84322, USA
| | - David W. S. Wong
- Department of Geography and Geoinformation Science, George Mason University, Fairfax, VA 22030, USA
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Wing K, Grint DJ, Mathur R, Gibbs HP, Hickman G, Nightingale E, Schultze A, Forbes H, Nafilyan V, Bhaskaran K, Williamson E, House T, Pellis L, Herrett E, Gautam N, Curtis HJ, Rentsch CT, Wong AYS, MacKenna B, Mehrkar A, Bacon S, Douglas IJ, Evans SJW, Tomlinson L, Goldacre B, Eggo RM. Association between household composition and severe COVID-19 outcomes in older people by ethnicity: an observational cohort study using the OpenSAFELY platform. Int J Epidemiol 2022; 51:1745-1760. [PMID: 35962974 PMCID: PMC9384728 DOI: 10.1093/ije/dyac158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Ethnic differences in the risk of severe COVID-19 may be linked to household composition. We quantified the association between household composition and risk of severe COVID-19 by ethnicity for older individuals. METHODS With the approval of NHS England, we analysed ethnic differences in the association between household composition and severe COVID-19 in people aged 67 or over in England. We defined households by number of age-based generations living together, and used multivariable Cox regression stratified by location and wave of the pandemic and accounted for age, sex, comorbidities, smoking, obesity, housing density and deprivation. We included 2 692 223 people over 67 years in Wave 1 (1 February 2020-31 August 2020) and 2 731 427 in Wave 2 (1 September 2020-31 January 2021). RESULTS Multigenerational living was associated with increased risk of severe COVID-19 for White and South Asian older people in both waves [e.g. Wave 2, 67+ living with three other generations vs 67+-year-olds only: White hazard ratio (HR) 1.61 95% CI 1.38-1.87, South Asian HR 1.76 95% CI 1.48-2.10], with a trend for increased risks of severe COVID-19 with increasing generations in Wave 2. There was also an increased risk of severe COVID-19 in Wave 1 associated with living alone for White (HR 1.35 95% CI 1.30-1.41), South Asian (HR 1.47 95% CI 1.18-1.84) and Other (HR 1.72 95% CI 0.99-2.97) ethnicities, an effect that persisted for White older people in Wave 2. CONCLUSIONS Both multigenerational living and living alone were associated with severe COVID-19 in older adults. Older South Asian people are over-represented within multigenerational households in England, especially in the most deprived settings, whereas a substantial proportion of White older people live alone. The number of generations in a household, number of occupants, ethnicity and deprivation status are important considerations in the continued roll-out of COVID-19 vaccination and targeting of interventions for future pandemics.
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Affiliation(s)
- Kevin Wing
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel J Grint
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Rohini Mathur
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Hamish P Gibbs
- Department of Geography, University College London, London, UK
| | - George Hickman
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Emily Nightingale
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Schultze
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Harriet Forbes
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Vahé Nafilyan
- Health Modelling Hub, Office of National Statistics, Newport, UK
| | - Krishnan Bhaskaran
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Williamson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Lorenzo Pellis
- Department of Mathematics, University of Manchester, Manchester, UK
| | - Emily Herrett
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Nileesa Gautam
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Aetion Inc, Boston, USA
| | - Helen J Curtis
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Christopher T Rentsch
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Angel Y S Wong
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Brian MacKenna
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Amir Mehrkar
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Seb Bacon
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Ian J Douglas
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Stephen J W Evans
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Laurie Tomlinson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Ben Goldacre
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
| | - Rosalind M Eggo
- The DataLab, University of Oxford Nuffield Department of Primary Care Health Sciences, Oxford, UK
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Correlates of influenza vaccination among underserved Latinx middle-aged and older adults: a cross-sectional survey. BMC Public Health 2022; 22:907. [PMID: 35524229 PMCID: PMC9077953 DOI: 10.1186/s12889-022-13121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 03/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx. Methods In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination. Results Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, thirty percent (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p-value=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p-value=0.008) or dissatisfaction with these experiences (p-value=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 – 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions. Conclusion The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.
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Cho LC, Yu CC, Kao CF. Social perception of young adults prolongs the lifespan of aged Drosophila. NPJ Aging Mech Dis 2021; 7:21. [PMID: 34471134 PMCID: PMC8410773 DOI: 10.1038/s41514-021-00073-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 07/01/2021] [Indexed: 12/02/2022] Open
Abstract
Lifespan is modulated at distinct levels by multiple factors, including genetic backgrounds, the environment, behavior traits, metabolic status, and more interestingly, sensory perceptions. However, the effects of social perception between individuals living in the same space remain less clear. Here, we used the Drosophila model to study the influences of social perception on the lifespan of aged fruit flies. We found the lifespan of aged Drosophila is markedly prolonged after being co-housed with young adults of the same gender. Moreover, the changes of lifespan were affected by several experimental contexts: (1) the ratios of aged and young adults co-housed, (2) the chronological ages of two populations, and (3) the integrity of sensory modalities. Together, we hypothesize the chemical/physical stimuli derived from the interacting young adults are capable of interfering with the physiology and behavior of aged flies, ultimately leading to the alteration of lifespan.
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Affiliation(s)
- Li-Chun Cho
- Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chih-Chieh Yu
- Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Institute of Molecular Medicine and Bioengineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chih-Fei Kao
- Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan. .,Center for Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
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Karim W, Courtin E, Muennig PA. Addressing the Social Determinants of Health in the Aftermath of COVID-19: Lessons From the 2008 Great Recession. Am J Public Health 2021; 111:1433-1435. [PMID: 34464203 PMCID: PMC8489602 DOI: 10.2105/ajph.2021.306359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Wasie Karim
- Wasie Karim and Peter A. Muennig are with the Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY. Emilie Courtin is with the Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Emilie Courtin
- Wasie Karim and Peter A. Muennig are with the Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY. Emilie Courtin is with the Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter A Muennig
- Wasie Karim and Peter A. Muennig are with the Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, NY. Emilie Courtin is with the Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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Bento JA, Santos JLF, Lebrão ML. Factors associated with the survival of elderly men in almost 15 years. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210021. [PMID: 34076089 DOI: 10.1590/1980-549720210021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/05/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To identify factors associated with a higher probability of survival for men aged 60 and over in the course of almost 15 years. METHODS Prospective cohort study, where time zero is the year 2000 and deaths (final event) were measured until November 2014. The independent variables were obtained from personal characteristics, childhood life, educational status, lifestyle, social support, work history, socioeconomic situation, and health condition. RESULTS At the end of the period, 25.8% of elderly men remained alive and the factors that stood out associated with a higher probability of survival were: performing 50% or more of the Basic and/or Instrumental Activities of Daily Living (95%CI 0.41 - 0.64), being the head of the family (95%CI 0.42 - 0.82), participating in the community (95%CI 0.52 - 0.88), working on their own (95%CI 0.54 - 0.88), and owning a home and goods (95%CI 0.56 - 0.92). CONCLUSION Characteristics related to a greater autonomy of the elderly men, even after almost 15 years, contributed to an increase in the probability of survival.
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Affiliation(s)
| | | | - Maria Lúcia Lebrão
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil
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Nafilyan V, Islam N, Ayoubkhani D, Gilles C, Katikireddi SV, Mathur R, Summerfield A, Tingay K, Asaria M, John A, Goldblatt P, Banerjee A, Glickman M, Khunti K. Ethnicity, household composition and COVID-19 mortality: a national linked data study. J R Soc Med 2021; 114:182-211. [PMID: 33759630 PMCID: PMC7994923 DOI: 10.1177/0141076821999973] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/15/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To estimate the proportion of ethnic inequalities explained by living in a multi-generational household. DESIGN Causal mediation analysis. SETTING Retrospective data from the 2011 Census linked to Hospital Episode Statistics (2017-2019) and death registration data (up to 30 November 2020). PARTICIPANTS Adults aged 65 years or over living in private households in England from 2 March 2020 until 30 November 2020 (n=10,078,568). MAIN OUTCOME MEASURES Hazard ratios were estimated for COVID-19 death for people living in a multi-generational household compared with people living with another older adult, adjusting for geographic factors, socioeconomic characteristics and pre-pandemic health. RESULTS Living in a multi-generational household was associated with an increased risk of COVID-19 death. After adjusting for confounding factors, the hazard ratios for living in a multi-generational household with dependent children were 1.17 (95% confidence interval [CI] 1.06-1.30) and 1.21 (95% CI 1.06-1.38) for elderly men and women. The hazard ratios for living in a multi-generational household without dependent children were 1.07 (95% CI 1.01-1.13) for elderly men and 1.17 (95% CI 1.07-1.25) for elderly women. Living in a multi-generational household explained about 11% of the elevated risk of COVID-19 death among elderly women from South Asian background, but very little for South Asian men or people in other ethnic minority groups. CONCLUSION Elderly adults living with younger people are at increased risk of COVID-19 mortality, and this is a contributing factor to the excess risk experienced by older South Asian women compared to White women. Relevant public health interventions should be directed at communities where such multi-generational households are highly prevalent.
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Affiliation(s)
- Vahé Nafilyan
- Office for National Statistics, Newport, UK
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Nazrul Islam
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | | | - Clare Gilles
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | | | - Rohini Mathur
- 6Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Miqdad Asaria
- LSE Health, London School of Economics and Political Sciences, London, UK
| | | | - Peter Goldblatt
- UCL Institute of Health Equity, University College London, London, UK
| | - Amitava Banerjee
- Institute of Health Informatics, University College London, London, UK
| | | | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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15
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Johnson RD, Griffiths LJ, Hollinghurst JP, Akbari A, Lee A, Thompson DA, Lyons RA, Fry R. Deriving household composition using population-scale electronic health record data-A reproducible methodology. PLoS One 2021; 16:e0248195. [PMID: 33780469 PMCID: PMC8007012 DOI: 10.1371/journal.pone.0248195] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/19/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Physical housing and household composition have an important role in the lives of individuals and drive health and social outcomes, and inequalities. Most methods to understand housing composition are based on survey or census data, and there is currently no reproducible methodology for creating population-level household composition measures using linked administrative data. METHODS Using existing, and more recent enhancements to the address-data linkage methods in the SAIL Databank using Residential Anonymised Linking Fields we linked individuals to properties using the anonymised Welsh Demographic Service data in the SAIL Databank. We defined households, household size, and household composition measures based on adult to child relationships, and age differences between residents to create relative age measures. RESULTS Two relative age-based algorithms were developed and returned similar results when applied to population and household-level data, describing household composition for 3.1 million individuals within 1.2 million households in Wales. Developed methods describe binary, and count level generational household composition measures. CONCLUSIONS Improved residential anonymised linkage field methods in SAIL have led to improved property-level data linkage, allowing the design and application of household composition measures that assign individuals to shared residences and allow the description of household composition across Wales. The reproducible methods create longitudinal, household-level composition measures at a population-level using linked administrative data. Such measures are important to help understand more detail about an individual's home and area environment and how that may affect the health and wellbeing of the individual, other residents, and potentially into the wider community.
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Affiliation(s)
- Rhodri D. Johnson
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Lucy J. Griffiths
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Joe P. Hollinghurst
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Alexandra Lee
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Daniel A. Thompson
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Ronan A. Lyons
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
| | - Richard Fry
- Population Data Science, Swansea University Medical School, Swansea, United Kingdom
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Bulut E, Brewster KL. Psychological distress in middle eastern immigrants to the United States: A challenge to the healthy migrant model? Soc Sci Med 2021; 274:113765. [PMID: 33639394 DOI: 10.1016/j.socscimed.2021.113765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/29/2020] [Accepted: 02/07/2021] [Indexed: 01/09/2023]
Abstract
RATIONALE AND OBJECTIVE Research has documented a robust mental health advantage among Asian and Latino immigrants to the United States relative to the native-born. The current investigation extended this line of research, asking whether Middle Eastern immigrants to the United States enjoy a similar mental health advantage. METHODS Drawing on pooled cross-sections from the 2007-2018 National Health Interview Surveys, we used OLS regression to examine psychological distress in Middle Eastern immigrants relative to both native-born Whites and immigrants from other global regions. We used statistical interactions to assess whether gender and period differences are contingent on region of birth. RESULTS Findings reveal that the average level of psychological distress is higher among Middle Eastern immigrants than among both U.S.-born Whites and immigrants from other regions. Despite changing circumstances of migration for Middle Easterners and implementation in the United States of anti-immigrant policies, we see no evidence that distress increased more among immigrants compared to native-born Whites. Results point to greater psychological distress among Middle Eastern women than their native-born White counterparts and women from other immigrant groups, as well as Middle Eastern men. In contrast, psychological distress levels for Middle Eastern and native-born White men were indistinguishable, suggesting that the Middle Eastern mental health disadvantage in the United States is borne solely by women. CONCLUSIONS Results show that the mental health advantage enjoyed by some immigrant groups does not extend to Middle Eastern women, contradicting the healthy migrant model and challenging the assumption of a uniform mental health advantage across immigrant groups.
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Affiliation(s)
- Elif Bulut
- Postdoctoral Fellow, Center for Demography & Population Health, Florida State University, USA.
| | - Karin L Brewster
- Professor of Sociology and Research Associate, Center for Demography & Population Health, Florida State University, USA.
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Souralová A, Kaymak Minaříková K, Žáková M. Being Daughter and Mother: Middle-aged Women in Three-generation Living. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2021. [DOI: 10.1080/15350770.2021.1883179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Fajardo-Bullón F, Pérez-Mayo J, Esnaola I, Anderson I, Knutagård M. Influence of Psychosocial Variables on the Health of People Living in Housing Exclusion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8983. [PMID: 33276637 PMCID: PMC7730692 DOI: 10.3390/ijerph17238983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/25/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
The aim of this study was to analyze the influence of some personal characteristics, health variables, and social support on the self-rated health of people in housing exclusion in Spain. For that purpose, we used the FOESSA Survey of Social Integration and Needs database, with a final sample of 1574 households. Being more educated and reporting a good life satisfaction stood out as the main factors preventing worse health status. Furthermore, results showed that being female, experiencing poverty-related food insecurity, not having health insurance, experiencing widowhood or partner bereavement, and having caring responsibilities for others or having a disabled person in the household are associated with increased reporting of regular or poor health. On the other hand, being young, having a diagnosed/long-term illness, and a big household size are preventive factors for good health. These results allowed identifying risk and prevention factors to inform interventions to improve the health of those living in housing exclusion. Promoting better education levels, social support, and overall life satisfaction could be important to improve health in this population. Developing social support policies for caring responsibilities and food insecurity must be a priority to improve the health of people living in housing exclusion.
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Affiliation(s)
- Fernando Fajardo-Bullón
- Department of Psychology, Faculty of Education and Psychology, University of Extremadura, Avenida de Elvas s/n, 06006 Badajoz, Spain
| | - Jesús Pérez-Mayo
- Department of Economics, University of Extremadura, 06006 Badajoz, Spain;
| | - Igor Esnaola
- Department of Development and Educational Psychology, Faculty of Education, University of the Basque Country, UPV/EHU, Avenida de Tolosa, 70, San Sebastián, 20018 Leioa, Spain
| | - Isobel Anderson
- Faculty of Social Sciences, University of Stirling, Stirling FK9 4LA, UK;
| | - Marcus Knutagård
- School of Social Work, Lund University, Box 23, 221 00 Lund, Sweden;
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19
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20
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Hu Y, Ruiz M, Bobak M, Martikainen P. Do multigenerational living arrangements influence depressive symptoms in mid-late life? Cross-national findings from China and England. J Affect Disord 2020; 277:584-591. [PMID: 32898819 DOI: 10.1016/j.jad.2020.07.142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND While living alone predicts depression in diverse ageing populations, the impact of multigenerational living is unclear. This study compared mid-late life depressive symptoms by living arrangements between societies with distinct kinship ties. METHODS Repeated data on depressive symptoms and living arrangements over 4 years from 16,229 Chinese (age≥45) and 10,403 English adults (age≥50) were analyzed using multilevel mixed-effects logistic regression. Elevated depressive symptoms were identified using the Center for Epidemiological Depression Scale criteria in each study. RESULTS Higher odds ratios (ORs) of elevated depressive symptoms were found in both Chinese and English adults aged<60 living with no partner but with children/grandchildren, compared to those living with a partner only. These ORs were greater for men (Chinese men: 3.09, 95% confidence interval: 2.00-4.78; English men: 3.44, 1.36-8.72) than for women (Chinese women: 1.77, 1.23-2.56; English women: 2.88, 1.41-3.67), after controlling for socioeconomic position, health behaviors, and health status. This male disadvantage was also observed for English, but not for Chinese, adults aged<60 living alone. For adults aged 60+, the increased odds among those living with no partner but with children/grandchildren and those living alone were smaller in both countries. LIMITATIONS Bias may exist because depressed participants are more likely to experience divorce or separation prior to baseline. CONCLUSIONS The relationship between living arrangements and depressive symptoms appears robust and consistent across social contexts, although the mechanisms differ. The protective role of partners in both China and England supports targeting those who do not live with partners to reduce depression.
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Affiliation(s)
- Yaoyue Hu
- School of Public Health and Management, Chongqing Medical University, 400016 Chongqing, P.R. China; Laboratory of Population Health, Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany.
| | - Milagros Ruiz
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Martin Bobak
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 7HB, UK
| | - Pekka Martikainen
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057 Rostock, Germany; Population Research Unit, Faculty of Social Sciences, University of Helsinki, Unioninkatu 35, FIN-00014 Helsinki, Finland; Department of Public Health Sciences, Stockholm University, SE-106 91 Stockholm, Sweden
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Ohrnberger J, Anselmi L, Fichera E, Sutton M. The effect of cash transfers on mental health: Opening the black box - A study from South Africa. Soc Sci Med 2020; 260:113181. [PMID: 32688162 PMCID: PMC7441310 DOI: 10.1016/j.socscimed.2020.113181] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/22/2020] [Accepted: 06/27/2020] [Indexed: 02/05/2023]
Abstract
There is a gap in the literature in understanding how cash transfer programmes affect mental health. We aim to fill this gap by conceptualising and estimating the mediation effects of an unconditional cash transfer programme on mental health. We use a sample of 4,535 adults living below the South African poverty line in four waves (2008-2014) of the South African National Income Dynamics Study. We use information on individual exposure to South Africa's largest unconditional cash transfer programme, the Child Support Grant. Mental health is measured by the 10-item version of the Centre for Epidemiological Depression Scale. We use the product of the coefficient method for the mediation analysis in combination with instrumental variable estimation. We find that physical health and lifestyle factors mediate the relationship of the unconditional cash transfer programme, each explaining about eight percent and 16% of the total positive effect. Our findings show that individuals living in poverty make investment decisions that are positive for their mental health, which has strong implications for policy makers.
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Affiliation(s)
- Julius Ohrnberger
- School of Public Health, MRC Centre for Global Infectious Disease Analysis, Imperial College London, United Kingdom.
| | - Laura Anselmi
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, United Kingdom
| | | | - Matt Sutton
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, United Kingdom
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Platt JM, Bates LM, Jager J, McLaughlin KA, Keyes KM. Changes in the depression gender gap from 1992 to 2014: Cohort effects and mediation by gendered social position. Soc Sci Med 2020; 258:113088. [PMID: 32540513 PMCID: PMC7377349 DOI: 10.1016/j.socscimed.2020.113088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
The depression gap (i.e., higher rates of depression among women than men) represents an important mental health disparity in the US. Differences in gendered social position (i.e., the roles, responsibilities, and opportunities available to women and men), which have been changing since the mid-20th Century may contribute to this gender gap. The present study examined the evidence for a changing depression gap across birth cohorts and tested the extent to which any changes over time were mediated by changes in relative social position between women and men. Data were from the National Longitudinal Surveys. The depression gap was defined as differences in mean CESD scores for women vs. men. The analytic sample included 13,666 respondents interviewed from 1992 to 2014. Hierarchical mixed models estimated the magnitude of the gender depression gap over time, its association with 10-year birth cohort (range: 1957-1994), and whether any variation was mediated by ratios among women relative to men of obtaining a college degree, being employed full-time, and the average number of hours spent doing housework per week, three indicators of gendered social position. There was a linear decrease in the depression gap by 0.18 points across birth cohort (95% CI = -0.26, -0.10). The results of the mediation analysis estimated that an increasing ratio of college degree attainment mediated 39% of the gender depression gap across cohorts (95% CI = 0.18, 0.78). There was no evidence of mediation due to changing employment or housework ratios. These findings partially support the hypothesis that the depression gap is changing over time and is meaningfully related to the social environment. Understanding the social causes of the depression gap can illuminate the fundamental processes through which depression disparities may be perpetuated or attenuated over time and may aid in the identification of strategies to reduce them.
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Affiliation(s)
- Jonathan M Platt
- Department of Epidemiology, Columbia University, New York, NY, USA.
| | - Lisa M Bates
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Justin Jager
- Department of Psychology Arizona State University, Tempe, AZ, USA
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Huffman C, Regules-García R, Vargas-Chanes D. Living arrangement dynamics of older adults in Mexico: Latent class analysis in an accelerated longitudinal design. DEMOGRAPHIC RESEARCH 2019; 41:1401-1436. [PMID: 32669948 PMCID: PMC7362683 DOI: 10.4054/demres.2019.41.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Because living arrangements have many implications for the well-being of older adults, knowledge regarding typical age-related developmental changes in living arrangements is of a major concern for public health policymakers, particularly in low- and middle-income countries dealing with growing aging populations. However, the much-needed empirical analysis of living arrangement dynamics is hindered by a lack of proper data. OBJECTIVE To exploit often-available short-term longitudinal data in the study of long-term phenomena, in this paper we accelerate the Mexican Health and Aging Study (MHAS) panel as a means to explore, over a broad age span, the household dynamics of Mexican older adults. METHODS Instead of working with a priori definitions of different household structures when analyzing transitions between them, we introduce a novel approach that estimates latent classes of developmental trends in the household composition of older people as they age. RESULTS We show how accelerated longitudinal designs, coupled with latent class analysis, can offer new insights into living arrangement dynamics. Our findings suggest that in Mexico the typical living arrangements at 50 years old serve as an important predictor of future living arrangements, and that typical living-arrangement trajectories are strongly gendered in Mexico. This new approach may prove to be indispensible when determining the social support needed by high-risk population groups and as a means to better anticipate the necessary financial resources to do so.
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Affiliation(s)
- Curtis Huffman
- Development Studies Program, National Autonomous University of Mexico (UNAMPUED)
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