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Pang M, Wang J, Tian T, Zhao J, Jiang X, Li H, Kong F. The mediating effect of social support on the association between socioeconomic status and self-reported oral health status among the migrant elderly following children in Weifang, China: a cross-sectional study. BMC Oral Health 2022; 22:619. [PMID: 36529752 PMCID: PMC9760054 DOI: 10.1186/s12903-022-02649-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Driven by population aging and the rapid urbanization in China, many migrant elderly following children (MEFC) moved to big cities to care for their grandchildren. The purpose of this study is to clarify the mediating effect of social support on the relationship between socioeconomic status (SES) and self-reported oral health status among the MEFC in Weifang, China. METHODS Multistage cluster random sampling was used to select the participants and finally 613 MEFC were included in the survey. The Social Support Rating Scale (SSRS) and the Chinese version of the Geriatric Oral Health Assessment Index (GOHAI) scale were used for data collection. Descriptive analysis, Rao-Scott test, t-test and structural equation modeling (SEM) were conducted in this study. RESULTS Mean score of GOHAI of the MEFC was 54.95 ± 6.47. The SES of MEFC exerted positive direct effect both on social support (standardized coefficient = 0.15) and self-reported oral health status (standardized coefficient = 0.22); social support exerted positive direct effect on self-reported oral health status (standardized coefficient = 0.17). Social support partially mediated the association between SES and self-reported oral health status [95% confidence interval (CI) 0.003-0.064, P < 0.05], and the mediating effect of social support accounted for 12.0% of the total effect. CONCLUSIONS Higher GOHAI score of MEFC indicated their better self-reported oral health status. MEFCs' SES could exert positive effect both on social support and self-reported oral health status, while the mediating effect of social support between SES and self-reported oral health status of MEFC was established.
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Affiliation(s)
- Mingli Pang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Jieru Wang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Tingting Tian
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Jinfeng Zhao
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Xiaoxu Jiang
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Hexian Li
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
| | - Fanlei Kong
- grid.27255.370000 0004 1761 1174Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China ,grid.27255.370000 0004 1761 1174NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012 China
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Zhou Z, Zhang W, Fang Y. Early-life exposure to Chinese famine and stroke risk in mid- to late life: the mediating roles of cognitive function and depression. BMC Geriatr 2022; 22:294. [PMID: 35392831 PMCID: PMC8988351 DOI: 10.1186/s12877-022-02990-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Limited research has examined the role that famine exposure plays in adulthood stroke risk. We aim to explore the causal implications of early exposure to the Great Chinese Famine on stroke risk and determine whether these associations were mediated by cognitive function, and depression. METHODS We sampled 12,681 individuals aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) and divided them into fetally exposed, childhood-exposed, adolescence/adulthood-exposed and unexposed groups. Stroke was defined by self- or proxy-reported physician diagnosis. Based on a counterfactual framework, marginal structural models were used to estimate the natural direct effect and the natural indirect effects through cognitive function and depression for causal inference. RESULTS We found that early-life exposure to Chinese famine was directly related to increased stroke risk in mid- to late life. Cognitive function and depression accounted for a greater part of the effect for childhood famine exposure, mediating 36.35% (95%CI: 14.19, 96.19%) of the overall association between famine exposure and incident stroke, than for the fetal, adolescence/adulthood famine exposure groups. However, the natural indirect effect through depression was not significant in the fetally exposed group. The results were robust in the sensitivity analysis of model specification and unobserved confounding. CONCLUSIONS Our findings are consistent with the latency, pathway, and accumulation models, supporting the life-course theory. Early stages of life exposed to the Chinese Famine were associated with higher risk of stroke in mid- to late life. Enhanced cognitive and depression interventions may reduce stroke risk in middle-aged and older Chinese adults who exposure to famine in early life.
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Affiliation(s)
- Zi Zhou
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Affairs and School of Public Health, Xiamen University, Xiamen, 361102, Fujian, China
| | - Wei Zhang
- Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, Fujian, China
| | - Ya Fang
- Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, Fujian, China.
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Ge M, Zhu D, Lee H. WITHDRAWN: Health risk assessment of rural older population. Work 2021:WOR205350. [PMID: 34275921 DOI: 10.3233/wor-205350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Ahead of Print article withdrawn by publisher.
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Affiliation(s)
- Minshu Ge
- The school of Finace, RenMin University of China, Beijing, China
| | - Dan Zhu
- Shanghai National Accounting Institute, Shanghai, China
| | - Hallie Lee
- Economic management Department, DePauw University, Greencastle, USA
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Zhao S, Long M, Diao Y, Ma H, Liu M, Feng Z, Wang Y. Culture-related grief beliefs and social support influence depressive symptoms of Shidu parents in rural China. Eur J Psychotraumatol 2021; 12:1945748. [PMID: 34367525 PMCID: PMC8312613 DOI: 10.1080/20008198.2021.1945748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Parents who have lost their only child are known as Shidu parents in China. Losing an only child is an enormous tragedy for parents that can trigger severe depressive symptoms. Few studies have explored the influence of cultural beliefs and social support on depressive symptoms. OBJECTIVE This study aimed to explore the relationship between culture-related grief beliefs, social support and depressive symptoms among Shidu parents in rural China. METHOD This cross-sectional study was conducted in Sujiatun district of Shenyang, China. Data were collected from November 2019 to February 2020 from 228 rural Shidu parents. Questionnaires consisted of the Center for Epidemiologic Studies Depression Scales (CES-D), the Culture-related Grief Beliefs of Shidu Parents Questionnaire (CBSQ), the Social Support Rating Scale (SSRS), and demographic and bereavement-related information. Hierarchical multiple linear regression analysis was conducted to examine the associations among culture-related grief beliefs, social support and depressive symptoms. RESULTS Of the 228 Shidu parents, 87.0% reported depressive symptoms (CES-D ≥ 16). The mean age of the participants was 62.91 years, ranging from 50 to 86. Regression analysis indicated that parents' younger age, lower education level and debts were prominent risk factors for depressive symptoms. Perceived stigma (a subscale of CBSQ) was positively associated with depressive symptoms. Social support was negatively associated with depressive symptoms. CONCLUSIONS Given the high prevalence of depressive symptoms in rural Shidu parents, there is a critical need to reduce perceived stigma and increase social support to alleviate depressive symptoms among Shidu parents in rural China.
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Affiliation(s)
- Shuang Zhao
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Meijun Long
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Yucong Diao
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Hongfei Ma
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Minghui Liu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Ziyi Feng
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
| | - Yang Wang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, Liaoning, P.R. China
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Xu X, Wen J, Zhou N, Shi G, Tang R, Wang J, Skritskaya NA. Grief and Posttraumatic Growth Among Chinese Bereaved Parents Who Lost Their Only Child: The Moderating Role of Interpersonal Loss. Front Psychol 2020; 11:558313. [PMID: 33162907 PMCID: PMC7581902 DOI: 10.3389/fpsyg.2020.558313] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: Losing the only child is considered as the most severe kind of bereavement. It can trigger intense grief symptoms along with loss of psychosocial resources, but meanwhile, it can also lead to posttraumatic growth (PTG). The current study aimed to examine (a) whether a curvilinear relationship exists between grief and PTG and (b) the moderating role of resources-loss among Chinese bereaved parents who lost their only child (shidu parents). Methods: One hundred and ninety-nine shidu parents from five provinces completed the assessment packet covering prolonged grief symptoms and PTG, as well as resource loss. Hierarchical regression analyses were computed to examine the curvilinear relationship and the moderating effect of interpersonal loss and socio-economic loss. Results: There was no significant curvilinear relationship between grief and PTG in shidu parents. Under the high levels of interpersonal loss, shidu parents' PTG scores decreased as the severity of grief increased. However, the socio-economic loss did not show a significant moderating effect. Conclusion: The results of the current study did not show a significant curvilinear relationship between grief and PTG in shidu parents. High levels of grief coupled with high levels of interpersonal loss may interfere with their ability to achieve PTG. Therefore, evaluating degrees of interpersonal loss seems to be an important part of the treatment process when working with shidu parents. To facilitate their adaptation from a positive perspective, helping them maintain existing or develop new interpersonal relationships may be helpful.
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Affiliation(s)
- Xin Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jun Wen
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Ningning Zhou
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Guangyuan Shi
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Renzhihui Tang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Natalia A Skritskaya
- Center for Complicated Grief, Columbia School of Social Work, New York, NY, United States
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Zhao X, Hu H, Zhou Y, Bai Y. What are the long-term effects of child loss on parental health? Social integration as mediator. Compr Psychiatry 2020; 100:152182. [PMID: 32430143 DOI: 10.1016/j.comppsych.2020.152182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Some bereaved parents experience a decreasing trajectory of grief, while others fail to adapt over the long term and persistently suffer from negative health consequences. This study investigates the mediating role of social integration in the relationship between losing an only child and parental health in a family-oriented society. METHOD A sample of 1828 bereaved parents and 4739 non-bereaved parents was drawn from a 10-city survey in China. Regression methods were used to examine the impact of child loss on parental health, and Sobel test was applied to examine the mediating role of social integration. RESULTS Bereaved parents who lost their only child have worse self-rated health and more negative affect than the non-bereaved parents, which lasted for years after the death of the only child. The Sobel test shows that 24.8% of the total effects on self-rated health and 6.7% of the total effects on negative affect can be explained via decreased social integration. The gender of parents and child as well as fertility intentions are important sources of heterogeneity in the Chinese culture. LIMITATION The results based on cross-sectional data may only reveal correlation rather than causality. The data was retrieved from self-reported questionnaires and there is a lack of objective measures of parental health. Moreover, the detailed mechanisms behind how child loss resulted in less social integration should be further explored. CONCLUSIONS Significant disparities in health outcomes and social integration were found for bereaved parents relative to the non-bereaved parents. Future work is needed to assess the health of bereaved parents, identify the vulnerable and disadvantaged groups, and design inclusive intervention programs.
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Affiliation(s)
- Xintong Zhao
- School of Labor and Human Resources, Renmin University of China, No. 59, Zhongguancun Street, Haidian District, Beijing 100872, PR China.
| | - Hongwei Hu
- School of Public Administration and Policy, Renmin University of China, No. 59, Zhongguancun Street, Haidian District, Beijing 100872, PR China.
| | - Yi Zhou
- Guanghua School of Management and Center for Social Research, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing 100871, PR China.
| | - Yang Bai
- Guanghua School of Management, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing 100871, PR China.
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