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Li Y, Liu X. Effects of spatial accessibility of community health services on the activities of daily living among older adults in China: a propensity score matching study. Front Public Health 2024; 12:1335712. [PMID: 38932781 PMCID: PMC11199788 DOI: 10.3389/fpubh.2024.1335712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Background The Chinese government proposes to establish a hierarchical diagnosis and treatment system, and attaches great importance to community health services. Under the background of population aging and the increase of older adults with disability, this study aimed to analyze the effect of spatial accessibility of community health services on the activities of daily living (ADL) among older adults in China. Methods A research sample of 7,922 older adults from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018 was adopted. There were 2,806 participants in the treatment group and 5,116 participants in the control group. The propensity score matching method was adopted to match the treatment and control groups to calculate the values of average treatment effects on treated (ATT). Results The results of kernel density matching method showed that the factual ADL score of the treatment group was 10.912, the counterfactual ADL score of the control group was 10.694, and the ATT value was 0.218 (p < 0.01). The spatial accessibility of community health services could significantly improve the activities of daily living among older adults in China. Meanwhile, there was urban-rural heterogeneity in the impact of spatial accessibility of community health services on the activities of daily living of older adults in China. The effect value in urban samples (ATT = 0.371, p < 0.01) was higher than that in rural samples (ATT = 0.180, p < 0.01). Conclusion Spatial accessibility of community health services could improve the activities of daily living among older adults in China. The Chinese government should take actions to improve the distribution of community health service resources.
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Ma W, Shen Z. Impact of community care services on the health of older adults: evidence from China. Front Public Health 2023; 11:1160151. [PMID: 37143978 PMCID: PMC10151748 DOI: 10.3389/fpubh.2023.1160151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/22/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction The rapid growth in the population of older adults has put tremendous pressure on medical and social services in countries including China. Community care services are a feasible solution for promoting healthy aging in developing countries. This study investigated the association between community care services and the health of older adults in China. Method Using nationally representative survey data from China, consisting of four waves conducted in 2005, 2008, 2011, and 2014, a balanced panel dataset was constructed using a sample of 4,700 older adults (33.1% aged 80 years or older, 51.0% residing in rural areas, and 48.8% women). We employed linear regression models with time-fixed effects and instrumental variable approaches to estimate the effect of community care services on the health of older adults, as well as the differences in these effects across subgroups. Results The results showed that community care services lead to a significant improvement in both the objective and subjective health and wellbeing of older adults. Among the various service offerings, spiritual recreation services led to a significant increase in both objective and subjective health scores, while medical care services significantly improved wellbeing. This suggests a varied effect of subdivided service types. Further evidence suggests that spiritual recreation services have a significant health-enhancing effect on multiple groups of older adults, and the effect of medical care services is more effective for those living in rural areas, women, and those who are older than 80 years (all p < 0.05). Discussion Few studies have examined the impact of community care services on the health of older adults in developing countries. The findings present important implications for improving the health status of older adults and provide suggestions for establishing a socialized aged care system in China.
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Affiliation(s)
- Wenjing Ma
- School of Economics and Trade, Henan University of Animal Husbandry and Economy, Zhengzhou, China
| | - Zheng Shen
- School of Economics and Management, Zhejiang A&F University, Hangzhou, China
- *Correspondence: Zheng Shen
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Mesfin H, Cecchi F, Nillesen E, Tirivayi N. The effect of siblings' sex ratio on physical capital, human capital, and gendered time use among adolescents in Ethiopia. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101182. [PMID: 36126558 DOI: 10.1016/j.ehb.2022.101182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
We examine the role of siblings' sex ratio on adolescents' physical and human capital development, as well as gendered time allocation using data from the Young Lives project in Ethiopia. We use BMI-for-age and Weight-for-age to measure physical capital and grade attainment and scores in Mathematics and English tests as human capital indicators. Gendered time use is proxied by the hours per day the adolescent spends doing traditionally female-specific chores. Our identification strategy relies on the absence of sex-selective reproduction in our study area which implies that for a given number of siblings, their sex ratio should be exogenous. Our results show that having relatively more brothers than sisters increases both physical and human capital for adolescents, typically with a stronger effect for boys. Yet it also increases girls' time spent on traditionally female-specific tasks, especially in the rural areas. This points to a complex relationship between siblings' sex composition and long-term life outcomes for women.
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Affiliation(s)
- Hiwot Mesfin
- UNU-MERIT, Maastricht University, the Netherlands
| | - Francesco Cecchi
- Department of Development Economics, Wageningen University, the Netherlands.
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Gao T, Han S, Mo G, Sun Q, Zhang M, Liu H. A positive association between hunger in childhood and frailty in old age: Findings from the Chinese longitudinal healthy longevity survey. Front Med (Lausanne) 2022; 9:955834. [DOI: 10.3389/fmed.2022.955834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundChildhood hunger not only directly affects the physical and mental health of children and adolescents but also has a long-term negative effect on later health outcomes. In this cross-sectional study, we used a nationally representative Chinese sample to examine the relationship between hunger in childhood and frailty in older adults.Materials and methodsThe data were obtained from the 2018 Chinese Longitudinal Healthy Longevity Survey. The frailty index with 44 health deficits was used to identify frailty. Childhood hunger was measured by the question “Did you often go to bed hungry as a child?” Insurance status was categorized as New Rural Cooperative Medical Scheme (NRCMS), Urban Basic Medical Insurance Scheme (UBMIS), others, and no insurance. Multivariate logistic regression analysis was performed to estimate the adjusted relationship between childhood hunger and frailty.ResultsA total of 7,342 older people aged 65 years and older were analyzed in this study. Older people who experienced childhood hunger were more likely to have frailty than those who did not (OR = 1.13, 95% CI: 1.02–1.26), after adjustment for sociodemographic characteristics, family/social support, socioeconomic status, insurance status, and health behaviors. The association of childhood hunger with frailty was found in the 65–79 years group (OR = 1.21, 95% CI: 1.03–1.43), women (OR = 1.25, 95% CI: 1.08–1.45), individuals with rural residence (OR = 1.16, 95% CI: 1.03–1.31), agricultural work (OR = 1.16, 95% CI: 1.00–1.34), financial dependence (OR = 1.18, 95% CI: 1.02–1.37), and those participating in NRCMS (OR = 1.35, 95% CI: 1.16–1.56). Participants with hunger in childhood who were 80 years or older (OR = 0.80, 95% CI: 0.65–0.98) had lower odds of frailty. NRCMS (OR = 1.42, 95% CI: 1.02–1.98) showed increased odds of childhood hunger-related frailty.ConclusionExposure to hunger during childhood is linked to frailty among older adults, and age, financial support, and insurance status may mediate this relationship. Targeted interventions and policies to address frailty in older adults should be implemented.
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Zhang YS, Strauss JA, Hu P, Zhao Y, Crimmins EM. Links Between Mortality and Socioeconomic Characteristics, Disease Burden, and Biological and Physical Functioning in the Aging Chinese Population. J Gerontol B Psychol Sci Soc Sci 2021; 77:365-377. [PMID: 33837409 PMCID: PMC8824635 DOI: 10.1093/geronb/gbab059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Determinants of mortality may depend on the time and place where they are examined. China provides an important context in which to study the determinants of mortality at older ages because of its unique social, economic, and epidemiological circumstances. This study uses a nationally representative sample of persons in China to determine how socioeconomic characteristics, early-life conditions, biological and physical functioning, and disease burden predict 4-year mortality after age 60. METHODS We used data from the China Health and Retirement Longitudinal Study. We employed a series of Cox proportional hazard models based on exact survival time to predict 4-year all-cause mortality between the 2011 baseline interview and the 2015 interview. RESULTS We found that rural residence, poor physical functioning ability, uncontrolled hypertension, diabetes, cancer, a high level of systemic inflammation, and poor kidney functioning are strong predictors of mortality among older Chinese. DISCUSSION The results show that the objectively measured indicators of physical functioning and biomarkers are independent and strong predictors of mortality risk after accounting for several additional self-reported health measures, confirming the value of incorporating biological and performance measurements in population health surveys to help understand health changes and aging processes that lead to mortality. This study also highlights the importance of social and historical context in the study of old-age mortality.
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Affiliation(s)
- Yuan S Zhang
- Carolina Population Center, University of North Carolina, Chapel Hill, USA,Address correspondence to: Yuan S. Zhang, PhD, Carolina Population Center, University of North Carolina, 123 W Franklin St, Chapel Hill, NC 27516, USA. E-mail:
| | - John A Strauss
- Department of Economics, University of Southern California, Los Angeles, USA
| | - Peifeng Hu
- David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Yaohui Zhao
- National School of Development, Peking University, Beijing, China
| | - Eileen M Crimmins
- Davis School of Gerontology, University of Southern California, Los Angeles, USA
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Yang W, Wu B, Tan SY, Li B, Lou VWQ, Chen ZA, Chen X, Fletcher JR, Carrino L, Hu B, Zhang A, Hu M, Wang Y. Understanding Health and Social Challenges for Aging and Long-Term Care in China. Res Aging 2021; 43:127-135. [PMID: 32677535 PMCID: PMC7961665 DOI: 10.1177/0164027520938764] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The second King's College London Symposium on Ageing and Long-term Care in China was convened from 4 to 5th July 2019 at King's College London in London. The aim of the Symposium was to have a better understanding of health and social challenges for aging and long-term care in China. This symposium draws research insights from a wide range of disciplines, including economics, public policy, demography, gerontology, public health and sociology. A total of 20 participants from eight countries, seek to identify the key issues and research priorities in the area of aging and long-term care in China. The results published here are a synthesis of the top four research areas that represent the perspectives from some of the leading researchers in the field.
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Affiliation(s)
- Wei Yang
- Department of Global Health & Social Medicine, 4616King's College London, London, United Kingdom
| | - Bei Wu
- Rory Meyers College of Nursing, 5894New York University, New York, USA
| | - Si Ying Tan
- Lee Kuan Yew School of Public Policy, 37580National University of Singapore, Singapore
| | - Bingqin Li
- Social Policy Research Centre, 7800University of New South Wales, Sydney, Australia
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, Department of Social Work & Social Administration, The 25809University of Hong Kong, China
| | - Zhuo Adam Chen
- Department of Health Policy and Management, University of Georgia, Athens, GA, USA
- School of Economics, 56668University of Nottingham Ningbo China, Ningbo, Zhejiang, China
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
- Department of Economics, 5755Yale University, New Haven, CT, USA
| | - James Rupert Fletcher
- Department of Global Health & Social Medicine, 4616King's College London, London, United Kingdom
| | - Ludovico Carrino
- Department of Global Health & Social Medicine, 4616King's College London, London, United Kingdom
| | - Bo Hu
- Personal Social Services Research Unit, Department of Health Policy, 4905London School of Economics and Political Science, United Kingdom
| | - Anwen Zhang
- Adam Smith Business School, 3526University of Glasgow, United Kingdom
| | - Min Hu
- Department of Health Economics, School of Public Health, 12478Fudan University, Shanghai, China
| | - Yixiao Wang
- Department of Global Health & Social Medicine, 4616King's College London, London, United Kingdom
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Han K, Jia W, Wang S, Cao W, Song Y, Wang J, Liu M, Yang S, He Y. Synergistic Impact of Body Mass Index and Cognitive Function on All-Cause Mortality in Older Adults: A Nationwide Longitudinal Study. Front Endocrinol (Lausanne) 2021; 12:620261. [PMID: 34267724 PMCID: PMC8276260 DOI: 10.3389/fendo.2021.620261] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/07/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Body mass index (BMI) and cognitive function are independent predictors of mortality risk. However, little is known about the combined impact of BMI and cognitive function on the risk of all-cause mortality in older adults. In this study, we aimed to examine the associations between BMI, cognitive function, and all-cause mortality, including between-factor interactions, in the general population of older adults in China. METHODS We used the data between 2011 and 2018 from the Chinese Longitudinal Healthy Longevity Survey that included adults aged ≥65 years residing in the 23 provinces of China. The association between BMI and cognitive function on all-cause mortality was examined with the Cox proportional hazards regression model. RESULTS The study included 8,293 Chinese older adults. Low BMI (underweight) and cognitive impairment were associated with the highest risk of death after adjustments [hazard ratio (HR) = 2.18; 95% confidence interval (CI), 1.96-2.41]; this combined effect was more prominent among adults aged <100 years and women. In addition, there was an interaction effect of BMI and cognitive impairment on all-cause mortality (P <0.001). Concurrently, among older adults with normal cognition, the risk of mortality related to underweight was higher than among their cognitively impaired counterparts [55% (normal cognition) vs. 38% (cognitive impairment)]. CONCLUSIONS Low BMI (underweight) and cognitive impairment were independently and jointly associated with increased risk of all-cause mortality among Chinese older adults, and females showed a stronger effect in this association. The association between BMI and mortality was more pronounced in the participants with normal cognition than in their cognitively impaired counterparts.
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Affiliation(s)
- Ke Han
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wenzhe Cao
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang Song
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianwei Wang
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Medical School of Chinese PLA, Beijing, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yao He, ; Shanshan Yang,
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yao He, ; Shanshan Yang,
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Wang Z, Pang Y, Liu J, Wang J, Xie Z, Huang T. Association of healthy lifestyle with cognitive function among Chinese older adults. Eur J Clin Nutr 2020; 75:325-334. [PMID: 33116235 DOI: 10.1038/s41430-020-00785-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 07/27/2020] [Accepted: 10/13/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Dietary patterns and daily life habits have been reported to be associated with cognitive function in European populations. We aimed to examine the associations of dietary patterns and daily life habits with cognitive function among Chinese old people. SUBJECTS/METHODS We used 2011-2014 longitudinal data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) comprising 5716 participants with an average age of 82 years. Cognitive function was measured in 2014 based on the results of Mini-Mental Status Examination. Data on participants' dietary patterns and daily life habits were collected during baseline survey. Logistic regression models and general linear models were adopted to estimate the associations of dietary pattern and daily life habit with cognitive function. RESULTS Compared with participants in the lowest quartile of lifestyle score, those in the highest quartile had a lower risk of cognitive impairment after controlling for all covariates (OR = 0.52, 95% confidence interval (CI), 0.41-0.65, P < 0.001). Higher lifestyle score was associated with better cognitive function (β = 0.74, 95% CI, 0.55-0.93, P < 0.001). Participants with top quartile of dietary pattern had a lower risk of cognitive impairment (OR = 0.65, 95% CI, 0.51-0.81, P < 0.001). Similar trends were observed in daily life habit, showing that more exercises, moderate alcohol consumption, and non-smoking were associated with improved cognition status (OR = 0.64, 95% CI, 0.53-0.77, P < 0.001). CONCLUSIONS Our findings suggest that maintaining a healthy dietary pattern and carrying out outdoor exercises is associated with a lower risk of cognitive impairment among Chinese old people.
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Affiliation(s)
- Zhebin Wang
- Department of Global Health, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, 100191, Beijing, China
| | - Yuanjie Pang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, 100191, Beijing, China
| | - Jie Liu
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Beijing Technology & Business University, 100048, Beijing, China
| | - Jing Wang
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Beijing Technology & Business University, 100048, Beijing, China
| | - Zheng Xie
- Department of Global Health, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, 100191, Beijing, China.
| | - Tao Huang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, 100191, Beijing, China.
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Ying M, Wang S, Bai C, Li Y. Rural-urban differences in health outcomes, healthcare use, and expenditures among older adults under universal health insurance in China. PLoS One 2020; 15:e0240194. [PMID: 33044992 PMCID: PMC7549821 DOI: 10.1371/journal.pone.0240194] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/22/2020] [Indexed: 12/04/2022] Open
Abstract
Rural-urban inequalities in health status and access to care are a significant issue in China, especially among older adults. However, the rural-urban differences in health outcomes, healthcare use, and expenditures among insured elders following China's comprehensive healthcare reforms in 2009 remain unclear. Using the Chinese Longitudinal Healthy Longevity Surveys data containing a sample of 2,624 urban and 6,297 rural residents aged 65 and older, we performed multivariable regression analyses to determine rural-urban differences in physical and psychological functions, self-reported access to care, and healthcare expenditures, after adjusting for individual socio-demographic characteristics and health conditions. Nonparametric tests were used to evaluate the changes in rural-urban differences between 2011 and 2014. Compared to rural residents, urban residents were more dependent on activities of daily living (ADLs) and instrumental ADLs. Urban residents reported better adequate access to care, higher adjusted total expenditures for inpatient, outpatient, and total care, and higher adjusted out-of-pocket spending for outpatient and total care. However, rural residents had higher adjusted self-payment ratios for total care. Rural-urban differences in health outcomes, adequate access to care, and self-payment ratio significantly narrowed, but rural-urban differences in healthcare expenditures significantly increased from 2011 to 2014. Our findings revealed that although health and healthcare access improved for both rural and urban older adults in China between 2011 and 2014, rural-urban differences showed mixed trends. These findings provide empirical support for China's implementation of integrated rural and urban public health insurance systems, and further suggest that inequalities in healthcare resource distribution and economic development between rural and urban areas should be addressed to further reduce the rural-urban differences.
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Affiliation(s)
- Meiling Ying
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
| | - Sijiu Wang
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
| | - Chen Bai
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Yue Li
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
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‘Just another day’: the lived experience of being a hundred years old for ten New Zealanders. AGEING & SOCIETY 2019. [DOI: 10.1017/s0144686x19000072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractThe aim of this study was to gain an understanding of the experiences of extended longevity as perceived by centenarians. Centenarians (people over 100 years of age) are the fastest growing group of the ageing population in developed countries. Ten centenarians aged between 100 and 106 years, living in the Lower North Island of New Zealand, participated in the study. The biographical narrative interpretive method of inquiry guided data collection through face-to-face interviews, and thematic analysis was subsequently undertaken. Four themes were identified: (a) ‘becoming a centenarian: ‘Just another day’; (b) ‘growing up in a privileged environment’ that revealed four sub-themes: ‘having freedom and choice’, ‘being loved and nurtured’, ‘living healthy lifestyles’ and having ‘good education prospects’; (c) ‘unique opportunities in adult life’; and (d) ‘positive ageing and celebration of longevity’. The centenarians spoke nonchalantly about their experience of turning 100 and positive personalities were prominent features of the participants, who all expressed a sense of acceptance and satisfaction with life and contentment with living in the present, a feature throughout their lives that was ongoing and at an intergenerational level. This study has provided further insights into the existing literature on longevity and through the narratives of the centenarians has demonstrated the value of Erikson's psycho-social stages of development and Tornstam's theory of gerotranscendence when considering positive ageing.
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Wang F, Zhen Q, Li K, Wen X. Association of socioeconomic status and health-related behavior with elderly health in China. PLoS One 2018; 13:e0204237. [PMID: 30235282 PMCID: PMC6147496 DOI: 10.1371/journal.pone.0204237] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 09/05/2018] [Indexed: 11/19/2022] Open
Abstract
Previous health studies have focused on the correlation between socioeconomic status (SES) and health. We pooled data from the Chinese Longitudinal Healthy Longevity Survey (N = 9765) conducted in 2011, and examined the association of SES and health-related behavior with elderly health in China. The cumulative health disadvantage of the elderly caused by SES can be relieved by lifelong health-related behavior. In the same SES, the odds of self-rated health (SRH) as “good,” mini-mental state examination (MMSE) as “not impaired,” and activities of daily living (ADLs) as “not impaired” among the elderly who exercised regularly, were 46.9%, 28.6%, and 62.3% lower for the elderly who rarely exercised. The elderly who started doing regular exercise from 30 years old, achieved higher SRH, ADL, and MMSE scores to some extent. The health improvement advantage for the elderly who started doing regular exercises after 60 years old, was reduced. However, the odds of SRH as “good,” MMSE as “not impaired,” and ADLs as “not impaired” were still 3.4%, 12.5%, and 17.8%, respectively, higher than the respondents who never exercised. The health-related behaviors not only promote elderly health improvement, but its duration has also been found to be associated with the extent of health improvement.
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Affiliation(s)
| | - Qingkai Zhen
- China Institute of Sport Science, Beijing, China
| | - Kaigang Li
- Department of Exercise Science, College of Health and Human Science, Colorado State University, Fort Collins, Colorado, United States of America
| | - Xu Wen
- Department of Sport Science, College of Education, Zhejiang University, Hangzhou, China
- * E-mail:
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Santos JLF, Duarte YADO, Lebrão ML. Condições pregressas e saúde no estudo “Saúde, Bem-Estar e Envelhecimento” (SABE). REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21Suppl 02:e180011. [DOI: 10.1590/1980-549720180011.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/23/2015] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Introdução: Condições da infância podem influenciar peculiaridades individuais do desenvolvimento e assim afetar a saúde dos adultos. Objetivo: Avaliar associações entre condições pregressas e saúde, como informadas nas pesquisas SABE de 2000, de 2006 e de 2010. Métodos: Condições pregressas referem-se a situações anteriores aos 15 anos: a condição econômica, a fome, a avaliação da saúde, a presença de doenças e ter vivido em ambiente rural por mais de cinco anos. As variáveis de controle foram o sexo, a escolaridade e a renda. O desfecho é a autoavaliação da saúde nas categorias “Boa” e “Má”. A análise abrangeu pessoas entre 60 e 65anos. Resultados: A análise bivariada mostrou associações segundo a origem nas três coortes. Foram ainda significantes a condição econômica e ter passado fome, para os entrevistados em 2006. Na análise multivariada pela regressão de Poisson, o elemento de comparação foi a razão de prevalência. Origem rural foi a única entre as condições pregressas a apresentar significância no modelo inicial. As variáveis de controle- sexo, coorte, escolaridade - também apresentaram significância. No modelo final, foram consideradas as variáveis significantes no inicial e uma interação entre origem rural e número de doenças. Permaneceram significantes a coorte, o sexo, a escolaridade e o número de doenças quando o indivíduo teve origem rural. Estenúmero não foi associado ao desfecho se a origem fosse urbana. Conclusão: Há conexões entre as condições pregressas e a saúde do idoso, o que constitui em importante instrumento para a atenção à saúde, tanto para o indivíduo como para a comunidade.
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Wang J, Taylor AW, Zhang T, Appleton S, Shi Z. Association between Body Mass Index and All-Cause Mortality among Oldest Old Chinese. J Nutr Health Aging 2018; 22:262-268. [PMID: 29380854 DOI: 10.1007/s12603-017-0907-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To examine the association between BMI and all-cause mortality in the oldest old (≥80 years). DESIGN The study used a prospective cohort study design. SETTING Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998/99 and 2011. POPULATION 8026 participants aged 80 years and older were followed every two to three years. MEASUREMENTS Body weight and knee height were measured. Height was calculated based on knee height using a validated equation. Deaths were ascertained from family members during follow-up. RESULTS The mean BMI was 19.8 (SD 4.5) kg/m2. The prevalence of underweight, overweight and obese was 37.5%, 10.2% and 4.4%, respectively. There were 5962 deaths during 29503 person-years of follow-up. Compared with normal weight, underweight was associated with a higher mortality risk (HRs: 1.20 (95%CI 1.13-1.27) but overweight (HR 0.89 (95%CI 0.81-0.99)) were associated with a lower risk. Obesity had a HR 0.91 (95%CI 0.78-1.05) for mortality. CONCLUSION Among oldest old Chinese, underweight is associated with an increased risk of all-cause mortality but overweight is associated with a reduced risk. Interventions to reduce undernutrition should be given priority among the oldest old Chinese.
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Affiliation(s)
- J Wang
- Zumin Shi, Discipline of Medicine, University of Adelaide, Level 7, SAHMRI, North Terrace, Adelaide, Australia, 5005. Phone: +61 8 8313 1188; Fax: +61 8 8313 1228;
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14
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Baranowska-Rataj A, Barclay K, Kolk M. The effect of number of siblings on adult mortality: Evidence from Swedish registers for cohorts born between 1938 and 1972. Population Studies 2017; 71:43-63. [DOI: 10.1080/00324728.2016.1260755] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Kieron Barclay
- Stockholm University
- London School of Economics & Political Science
- Max Planck Institute for Demographic Research
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15
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Gu D, Yang F, Sautter J. Socioeconomic status as a moderator between frailty and mortality at old ages. BMC Geriatr 2016; 16:151. [PMID: 27506542 PMCID: PMC4979157 DOI: 10.1186/s12877-016-0322-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/26/2016] [Indexed: 12/28/2022] Open
Abstract
Background Despite the well-established power of frailty to predict mortality, and the known associations of socioeconomic status (SES) with mortality, it is largely unknown whether the linkage between frailty and mortality varies across different SES groups. This study aims to investigate whether SES moderates the association between frailty and mortality. Methods We relied on the 2008/2009 and 2011/2012 waves of the Chinese Longitudinal Healthy Longevity Survey, a nationwide sample of 13,731 adults aged 65 or older in China. Frailty was constructed using a cumulative index of 38 items (with 39 deficits) reflecting different dimensions of health; the index or the proportion of deficits ranges from 0 to 1, with greater scores indicating poorer health condition. SES was measured by a socioeconomic vulnerability index (SEVI) also from a similar cumulative approach consisting of 6 deficits; the proportion of deficits ranges from 0 to 1 with higher scores indicating lower SES. Eight Weibull hazard regression models were performed to examine how SES moderates the linkage between frailty and mortality. Results We found that a one percentage point increase in the frailty index was associated with an increased hazard ratio (HR) by 2.7 % (HR = 1.027, 95 % CI: 1.025–1.027); a one percentage point increase in SEVI score was associated with an increased hazard ratio by 0.6 % (HR = 1.006, 95 % CI: 1.004–1.008) controlling for demographics. When interactions between SEVI and frailty index were modeled, the increased mortality risk associated with frailty was weaker among people with lower SES than among people with higher SES (HR = 0.983, 95 % CI: 0.967–0.992). However, the moderating role of SES was diminished when interactions between SES and age and between frailty and age were modeled. With increasing age, the increased mortality risks associated with frailty and socioeconomic vulnerability weakened. Conclusions Frailty was a stronger predictor of mortality among individuals with higher SES than those with lower SES. The increased mortality risks associated with socioeconomic vulnerability and frailty weakened with age. Public health programs aimed at improving SES and promoting healthy longevity should start early in old age, or even earlier, and target poor and frail older adults for maximum impact.
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Affiliation(s)
- Danan Gu
- United Nations Population Division, Two UN Plaza, DC2-1910, New York, NY, 20012, USA.
| | - Fang Yang
- Department of Social Work, School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Jessica Sautter
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, USA
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16
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Khang YH, Kim HR. Socioeconomic Inequality in mortality using 12-year follow-up data from nationally representative surveys in South Korea. Int J Equity Health 2016; 15:51. [PMID: 27001045 PMCID: PMC4802872 DOI: 10.1186/s12939-016-0341-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 03/15/2016] [Indexed: 11/23/2022] Open
Abstract
Background Investigations into socioeconomic inequalities in mortality have rarely used long-term mortality follow-up data from nationally representative samples in Asian countries. A limited subset of indicators for socioeconomic position was employed in prior studies on socioeconomic inequalities in mortality. We examined socioeconomic inequalities in mortality using follow-up 12-year mortality data from nationally representative samples of South Koreans. Methods A total of 10,137 individuals who took part in the 1998 and 2001 Korea National Health and Nutrition Examination Surveys were linked to mortality data from Statistics Korea. Of those individuals, 1,219 (12.1 %) had died as of December 2012. Cox proportional hazard models were used to estimate the relative risks of mortality according to a wide range of socioeconomic position (SEP) indicators after taking into account primary sampling units, stratification, and sample weights. Results Our analysis showed strong evidence that individuals with disadvantaged SEP indicators had greater all-cause mortality risks than their counterparts. The magnitude of the association varied according to gender, age group, and specific SEP indicators. Cause-specific analyses using equivalized income quintiles showed that the magnitude of mortality inequalities tended to be greater for cardiovascular disease and external causes than for cancer. Conclusion Inequalities in mortality exist in every aspect of SEP indicators, both genders, and age groups, and four broad causes of deaths. The South Korean economic development, previously described as effective in both economic growth and relatively equitable income distribution, should be scrutinized regarding its impact on socioeconomic mortality inequalities. Policy measures to reduce inequalities in mortality should be implemented in South Korea. Electronic supplementary material The online version of this article (doi:10.1186/s12939-016-0341-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Young-Ho Khang
- Department of Health Policy and Management, Seoul National University College of Medicine, 103 Daehak-ro Jongno-gu, Seoul, 03080, South Korea. .,Institute of Health Policy and Management, Seoul National University Medical Research Center, Seoul, South Korea.
| | - Hye-Ryun Kim
- Korea Institute for Health and Social Affairs, Sejong, South Korea
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17
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Shi Z, Zhang T, Byles J, Martin S, Avery JC, Taylor AW. Food Habits, Lifestyle Factors and Mortality among Oldest Old Chinese: The Chinese Longitudinal Healthy Longevity Survey (CLHLS). Nutrients 2015; 7:7562-79. [PMID: 26371039 PMCID: PMC4586548 DOI: 10.3390/nu7095353] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/19/2015] [Accepted: 09/01/2015] [Indexed: 01/28/2023] Open
Abstract
There are few studies reporting the association between lifestyle and mortality among the oldest old in developing countries. We examined the association between food habits, lifestyle factors and all-cause mortality in the oldest old (≥80 years) using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). In 1998/99, 8959 participants aged 80 years and older took part in the baseline survey. Follow-up surveys were conducted every two to three years until 2011. Food habits were assessed using an in-person interview. Deaths were ascertained from family members during follow-up. Cox and Laplace regression were used to assess the association between food habits, lifestyle factors and mortality risk. There were 6626 deaths during 31,926 person-years of follow-up. Type of staple food (rice or wheat) was not associated with mortality. Daily fruit and vegetable intake was inversely associated with a higher mortality risk (hazard ratios (HRs): 0.85 (95% CI (confidence interval) 0.77–0.92), and 0.74 (0.66–0.83) for daily intake of fruit and vegetables, respectively). There was a positive association between intake of salt-preserved vegetables and mortality risk (consumers had about 10% increase of HR for mortality). Fruit and vegetable consumption were inversely, while intake of salt-preserved vegetables positively, associated with mortality risk among the oldest old. Undertaking physical activity is beneficial for the prevention of premature death.
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Affiliation(s)
- Zumin Shi
- School of Medicine, the University of Adelaide, Level 7 SAHMRI, North Terrace, Adelaide SA 5000, Australia.
| | - Tuohong Zhang
- School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China.
| | - Julie Byles
- Priority Research Centre for Gender, Health and Ageing, School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle NSW 2305, Australia.
| | - Sean Martin
- School of Medicine, the University of Adelaide, Level 7 SAHMRI, North Terrace, Adelaide SA 5000, Australia.
| | - Jodie C Avery
- School of Medicine, the University of Adelaide, Level 7 SAHMRI, North Terrace, Adelaide SA 5000, Australia.
| | - Anne W Taylor
- School of Medicine, the University of Adelaide, Level 7 SAHMRI, North Terrace, Adelaide SA 5000, Australia.
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18
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Zhang J, Li LW. Provincial Variation in Marketization and Successful Aging in China: A Multilevel Analysis. JOURNAL OF POPULATION AGEING 2015. [DOI: 10.1007/s12062-015-9119-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Saenz JL, Wong R. A life course approach to mortality in Mexico. SALUD PUBLICA DE MEXICO 2015; 57 Suppl 1:S46-53. [PMID: 26172234 DOI: 10.21149/spm.v57s1.7589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 07/16/2014] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Research on early life socioeconomic status (SES), education and mortality is less established in developing countries. This analysis aims to determine how SES and education are patterned across the life course and associated with adult mortality in Mexico. MATERIALS AND METHODS Data comes from 2001-2012 Mexican Health & Aging Study (Mexican adults age 50+, n= 11,222). Cox proportional hazard models predict mortality using baseline covariates. RESULTS In unadjusted analyses, similar mortality was seen across levels of early life SES. Lower early life SES was associated with better survival after accounting for education in the younger cohort. Lower education was only associated with mortality in the younger cohort. CONCLUSIONS Early life SES was associated with education but the relationship between education and mortality differed across cohorts in Mexico. Selective survival and differential returns to education may explain differences.
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Affiliation(s)
- Joseph L Saenz
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas, Estados Unidos de América
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas, Estados Unidos de América
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20
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Shen K, Zeng Y. Direct and indirect effects of childhood conditions on survival and health among male and female elderly in China. Soc Sci Med 2014; 119:207-14. [PMID: 25007734 DOI: 10.1016/j.socscimed.2014.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 06/05/2014] [Accepted: 07/02/2014] [Indexed: 01/06/2023]
Abstract
This paper investigates whether childhood conditions affect survival and health, both directly and indirectly through the mediating variable of adulthood socioeconomic status, among Chinese elderly. Using data from the 2008-2009 and 2011-2012 waves of the Chinese Longitudinal Healthy Longevity Survey, we apply structural equation models to estimate these effects. We find that favorable childhood conditions exert a negative direct impact on survival probability at senior ages, possibly resulting from mortality selection. Our results also support the pathways model, which indicates that advantageous childhood conditions improve socioeconomic status in adulthood and thus indirectly promote longevity and health at advanced ages. Combining the direct and indirect effects, the total effects of childhood advantages on survival and health are positive. We further demonstrate that direct and indirect effects of childhood conditions are stronger for women than they are for men. Our findings suggest that public policies that target childhood wellbeing may have far-reaching protective impacts on health among seniors.
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Affiliation(s)
- Ke Shen
- Institute of Population Research, School of Social Development and Public Policy, Fudan University, Shanghai, 200433, China.
| | - Yi Zeng
- Center for the Study of Aging and Human Development and Geriatric Division of Medical School, Duke University, Durham, NC 27710, USA; Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, 100871, China
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21
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Vathesatogkit P, Batty GD, Woodward M. Socioeconomic disadvantage and disease-specific mortality in Asia: systematic review with meta-analysis of population-based cohort studies. J Epidemiol Community Health 2014; 68:375-83. [DOI: 10.1136/jech-2013-203053] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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22
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Huang W, Lei X, Ridder G, Strauss J, Zhao Y. Health, Height, Height Shrinkage, and SES at Older Ages: Evidence from China. AMERICAN ECONOMIC JOURNAL. APPLIED ECONOMICS 2013; 5:86-121. [PMID: 26594311 PMCID: PMC4652843 DOI: 10.1257/app.5.2.86] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
In this paper, we build on the literature that examines associations between height and health outcomes of the elderly. We investigate the associations of height shrinkage at older ages with socioeconomic status, finding that height shrinkage for both men and women is negatively associated with better schooling, current urban residence, and household per capita expenditures. We then investigate the relationships between pre-shrinkage height, height shrinkage, and a rich set of health outcomes of older respondents, finding that height shrinkage is positively associated with poor health outcomes across a variety of outcomes, being especially strong for cognition outcomes.
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Affiliation(s)
- Wei Huang
- Department of Economics, Harvard University, Littauer Center, 1805 Cambridge St., Cambridge, MA 02138
| | - Xiaoyan Lei
- China Center for Economic Research, National School of Development, Peking University, Beijing 100871
| | - Geert Ridder
- Department of Economics, University of Southern California, 300 Kaprielian Hall, Los Angeles, CA 90089
| | - John Strauss
- Department of Economics, University of Southern California, 300 Kaprielian Hall, Los Angeles, CA 90089
| | - Yaohui Zhao
- China Center for Economic Research, National School of Development, Peking University, Beijing 100871, China
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23
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McEniry M. Early-life conditions and older adult health in low- and middle-income countries: a review. J Dev Orig Health Dis 2013; 4:10-29. [PMID: 23316272 PMCID: PMC3540412 DOI: 10.1017/s2040174412000499] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Population aging and subsequent projected large increases in chronic conditions will be important health concerns in low- and middle-income countries. Although evidence is accumulating, little is known regarding the impact of poor early-life conditions on older adult (50 years and older) health in these settings. A systematic review of 1141 empirical studies was conducted to identify population-based and community studies in low- and middle-income countries, which examined associations between early-life conditions and older adult health. The resulting review of 20 studies revealed strong associations between (1) in utero/early infancy exposures (independent of other early life and adult conditions) and adult heart disease and diabetes; (2) poor nutrition during childhood and difficulties in adult cognition and diabetes; (3) specific childhood illnesses such as rheumatic fever and malaria and adult heart disease and mortality; (4) poor childhood health and adult functionality/disability and chronic diseases; (5) poor childhood socioeconomic status (SES) and adult mortality, functionality/disability and cognition; and (6) parental survival during childhood and adult functionality/disability and cognition. In several instances, associations remained strong even after controlling for adult SES and lifestyle. Although exact mechanisms cannot be identified, these studies reinforce to some extent the importance of early-life environment on health at older ages. Given the paucity of cohort data from the developing world to examine hypotheses of early-life conditions and older adult health, population-based studies are relevant in providing a broad perspective on the origins of adult health.
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Affiliation(s)
- M. McEniry
- Institute for Social Research, ICPSR, Population Studies Center, University of Michigan, Ann Arbor, USA
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24
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Gu D, Sautter J, Huang C, Zeng Y. Health inputs and cumulative health deficits among the older Chinese. Soc Sci Med 2011; 72:806-14. [PMID: 21306808 DOI: 10.1016/j.socscimed.2010.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 09/16/2010] [Accepted: 12/21/2010] [Indexed: 11/18/2022]
Abstract
Using a health economics framework, we examined how both individual level investments at different life stages and current community-level environmental factors affect individual health stock and flows at old ages. We used a nationwide dataset from the 2002 and 2005 waves of the Chinese Longitudinal Healthy Longevity Survey, which included more than 15,000 adults aged 65 and older from 22 provinces in mainland China. We measured health stock with a cumulative health deficit index, a measure developed in geriatrics and gerontology that reflects deficits, illnesses, and functional impairment in numerous domains of health. The cumulative health deficit index has not been used in health economics before, but is a significant contribution because it captures the health stock concept very well and overcomes the problems of inconsistency resulting from the use of different measures of health stock in research. Our results show that several proxy measures for individual health investments in both childhood (nutritional status and parental survival status) and adulthood (family financial condition and access to healthcare) yielded positive returns to health stock measured by the cumulative health deficit index. Investments in social connections and healthy behaviors (religious involvement, alcohol use, and exercise) also produced positive returns in health stock. Current community-level factors such as air quality and labor force participation rate were significantly associated with levels of health deficits in old age as well. Yet, most of these individual investment and community environment variables did not significantly affect short-term health flows (improvement or deterioration in health status over three years). Our findings have important implications for developing preventive health programs in the context of population aging by focusing on policy-relevant predictors and a comprehensive indicator of health status in later life.
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Affiliation(s)
- Danan Gu
- United Nations Population Division, 2 Untied Nations Plaza, DC2-1910, New York, NY 10017, USA.
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25
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Huang C, Soldo BJ, Elo IT. Do early-life conditions predict functional health status in adulthood? The case of Mexico. Soc Sci Med 2011; 72:100-7. [PMID: 21074924 PMCID: PMC3020092 DOI: 10.1016/j.socscimed.2010.09.040] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 08/01/2010] [Accepted: 09/07/2010] [Indexed: 11/16/2022]
Abstract
Relatively few researchers have investigated early antecedents of adult functional limitations in developing countries. In this study, we assessed associations between childhood conditions and adult lower-body functional limitations (LBFL) as well as the potential mediating role of adult socioeconomic status, smoking, body mass index, and chronic diseases or symptoms. Based on data from the Mexican Health and Aging Study (MHAS) of individuals born prior to 1951 and contacted in 2001 and 2003, we found that childhood nutritional deprivation, serious health problems, and family background predict adult LBFL in Mexico. Adjustment for the potential mediators in adulthood attenuates these associations only to a modest degree.
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Affiliation(s)
- Cheng Huang
- Emory University, Rollins School of Public Health, 1518 Clifton RD NE, Rm 738, Atlanta, GA 30322, USA.
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Margolis R. Childhood Morbidity and Health in Early Adulthood: Life course linkages in a high morbidity context. ADVANCES IN LIFE COURSE RESEARCH 2010; 15:132-146. [PMID: 21516232 PMCID: PMC3079227 DOI: 10.1016/j.alcr.2010.10.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This paper examines whether morbidity in early and later childhood is associated with health later in life. I investigate the relationship between five types of childhood morbidity and risk factors for cardiovascular disease among Guatemalan adults who experienced high levels of morbidity in childhood. The analysis is based on the Human Capital Study (2002-2004), a recent follow-up of the INCAP Longitudinal Study conducted between 1969 and 1977. I find that most types of childhood morbidity are associated with poorer adult health, independent of family background, adult socioeconomic status, and health behaviors. Higher levels of infections in childhood were associated with a low level of high density lipoprotein (HDL), and higher level of triglycerides, plasma glucose, waist circumference, and obesity (but not hypertension). These results are consistent with the literature that finds that childhood morbidity is associated with increased morbidity and mortality at older ages. However, diarrheal disease in later childhood was associated with lower levels of some risk factors, as measured by triglycerides and plasma glucose, suggesting that exposure to bacteria after infancy may be beneficial for some measures of adult health.
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Hermalin AI, Ofstedal MB, Sun C, Liu IW. Nativity Differentials in Older Age Mortality in Taiwan: Do They Exist and Why? REN KOU XUE KAN / KUO LI TAI-WAN TA HSUEH 2009; 39:1-58. [PMID: 21887404 PMCID: PMC3163851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Comparisons of migrants versus native populations have become increasingly important as a means of gaining insight into the factors affecting health and mortality levels and the relationship between them. Taiwan underwent a unique migration in 1949-50, as more than a million people, mostly young men, arrived from Mainland China following the Communist civil war victory. The Mainlanders were distinct from the original settlers in several ways: they represented different provinces in China, were better educated, and had distinct occupational profiles. Since 1950, Taiwan has experienced a rapid demographic transition and notable economic development, resulting in mortality decline. In this paper, we generate age- and cause-specific death rates circa 1990 by education and nativity to evaluate the relative importance of each factor. We also use longitudinal survey data to help interpret the differentials in terms of selection, risk factors, and other dynamics of health and mortality.
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Affiliation(s)
- Albert I Hermalin
- Research Professor Emeritus, Population Studies Center, University of Michigan
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