Neighborhood Disorder, Social Ties, and Preventive Healthcare Utilization among Urban-Dwelling Older Adults

Sustaining the momentum for adult vaccination post-COVID-19 to leverage the global uptake of life-course immunisation: A scoping review and call to action

OBJECTIVES

The COVID-19 pandemic changed the adult vaccination landscape, possibly permanently. This review attempts to quantitate the magnitude of those changes.

METHODS

PubMed was searched for studies on adult / life-course vaccination between 1 January 2020 until 8 November 2022.

RESULTS

Twenty-one articles were identified and observations summarised as positive developments/impediments to life-course immunisation, and areas needing policy and structural reform. Unprecedented funding, international co-operation and technical advances led to COVID-19 vaccines authorised in record time. Investments in infrastructure and an expanded healthcare workforce streamlined vaccine delivery to adults. Constant media coverage and targeted messaging have improved health literacy. Conversely, the speed of vaccine development was perceived as a safety risk, and an 'infodemic' of misinformation propagated through social media negatively influenced vaccine uptake. Vaccine access and affordability remains inequitable among older adults and minority groups.

CONCLUSIONS

The COVID pandemic led to an opportunity to permanently change policies, attitudes, and systems for vaccine delivery to adults to establish a global life-course approach to immunisation. This is a call for action to sustain the momentum triggered by the COVID-19 pandemic. Addressing inequalities, improving health literacy and optimally using social media are critical to sustain adult vaccinations in post-COVID-19 era.

Perceived Neighborhood Racial Composition and Depressive Symptoms Among Black Americans Across Adulthood: Evaluating the Role of Psychosocial Risks and Resources

Objectives: To evaluate the relationships between perceived neighborhood racial composition (PNRC), psychosocial risks and resources, and depressive symptoms among young (ages 22-35), middle-aged (ages 36-49), and older (ages 50+) Black Americans. Methods: Full sample and age-stratified linear regression models estimated the PNRC-depressive symptoms association and the extent to which it persisted after accounting for psychosocial risks (i.e., neighborhood disorder, other social stressors) and resources (i.e., mastery, social support, racial identity) among 627 Black Americans in the Nashville Stress and Health Study. Results: Living in racially integrated and predominately White neighborhoods was associated with elevated depressive symptoms. While psychosocial risks and resources explained a substantial portion of these associations, patterns varied across age groups. Discussion: PNRC impacts depressive symptoms among Black Americans by shaping psychosocial risks and resources. Findings underscore interconnections between contextual and psychosocial factors, as well as the distinct mental health significance of these processes across stages of adulthood.

Trust, Interaction with Neighbors, and Vaccination during the COVID-19 Pandemic: A Cross-Sectional Analysis of Chinese Data

The COVID-19 pandemic significantly impacted public health and quality of life, leading to government recommendations for vaccination. Using cross-sectional data from a nationwide population-based survey conducted in China (N = 6860), this study aimed to examine the associations between individual vaccine uptake and general trust in others, trust in government, and interaction with neighbors. We conducted a multilevel logistic regression analysis to examine the relevance of these factors at the individual and community levels. Among young adults, higher levels of general trust at both levels were positively associated with vaccination, with odds ratios (OR) of 1.35 (95% confidence interval [CI]: 1.07, 1.70) and 1.58 (95% CI: 1.14, 2.18), respectively. We also found a positive association between vaccination and community-level interaction with neighbors, with ORs of 1.55 (95% CI: 1.11, 2.17). In contrast, among older individuals, vaccination was positively associated only with individual-level interaction with neighbors, with an OR of 1.55 (95% CI: 1.15, 2.08). The results indicated that vaccine uptake was associated with an individual's views of society and the social environment of the community, with substantial variations between the young and the old. Our findings emphasize the significance of public health measures to strengthen neighborhood interactions among older adults.

Trajectories of Preventive Health Care Utilization Among Older Koreans: The Role of Social Relationships

Background

Receiving timely health screening is associated with important public health benefits among older adults. By focusing on the role of social relationships, the present study was aimed at examining longitudinal trajectories of health screening use among older adults in Korea, whose universal health care system provides free-of-charge health screening.

Methods

A nationally representative sample of 3,575 individuals aged 65 or older from wave one of the Korean Longitudinal Study of Aging (2006) was followed for 10 years (up to Wave 6, 2016). Mixed-effect logit models were used to investigate how an older adult’s social relationship characteristics (i.e., household composition, financial support from family, social group participation, and the frequency of contact with friends or relatives) were associated with their trajectories of participation in the national health screening program.

Results

Despite the low financial burden, only 49.7% of older adults in Korea reported receiving the recommended health screening at the baseline. Although the probability of receiving recommended health screening increased over the 10-year study period, the trajectories were significantly different by an older adult’s social relationship characteristics. All four social relationship characteristics were significantly associated with receiving health screening. However, those with more frequent social contacts and those who participated in social groups showed steeper increases in the probability of receiving health screening (i.e., significant interaction with time).

Conclusions

This study highlights the importance of social relationships and intervention approaches that accommodate socially isolated older adults to facilitate their timely receipt of recommended preventive care.

Mothers with justice-involved sons: Socioeconomic impacts of COVID-19 by neighborhood disorder in the United States

Women, particularly mothers, have faced disparate socioeconomic consequences throughout the COVID-19 pandemic. Research has yet to examine whether the consequences of the pandemic vary based on the level of neighborhood disorder, which is associated with various health conditions, including COVID-19 complications. The present study utilizes data from a diverse sample of 221 women with justice-involved sons interviewed during the early months of the COVID-19 pandemic. Negative binominal and logistic regression analyses were conducted to examine whether perceived neighborhood social disorder is related to socioeconomic impacts of the COVID-19 pandemic, and whether the relation varies for mothers with and without children in their home during the pandemic. The results suggest that greater perceived neighborhood social disorder was associated with increased in COVID-19-related socioeconomic consequences. Neighborhood social disorder affected socioeconomic impacts above and beyond the effects of having a child living in the home. Additionally, Latinas experienced greater socioeconomic impacts than women of other races and ethnicities. The results indicate a key relationship between the neighborhood conditions a woman lives in and the extent of the socioeconomic consequences they faced during the early months of the COVID-19 pandemic. Future directions and direct implications of the study findings are discussed.

Severity of Dementia Is Associated with Increased Periodontal Inflamed Surface Area: Home Visit Survey of People with Cognitive Decline Living in the Community

No studies have measured the periodontal inflamed surface area in people with dementia, although periodontal disease is a major health issue in this group. This study aimed to determine the relationship between dementia severity and periodontal inflamed surface area. An interdisciplinary team, including a dentist and psychiatrist, conducted an in-home survey of older people living in the community. This cross-sectional study was designed as part of a larger cohort study. The interdisciplinary team visited 198 individuals with cognitive decline. We surveyed the clinical dementia rating, periodontal inflamed surface area, number of teeth, and other health issues. We used multiple linear regression analysis to assess the 75 people who were able to take part in all the visits. Number of teeth (Beta = 0.479, p < 0.001), clinical dementia rating (Beta = 0.258, p = 0.013), and age (Beta = 0.250, p = 0.017) were independently associated with periodontal inflamed surface area after adjusting for biological sex, depression, diabetes, collagen disease, visual disorder, and osteoporosis medication. To make communities more dementia-friendly, we must protect older people with dementia from developing poor oral health, which may require home visits for dental assessment.