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Inomata S, Lu Y, Matsuyama S, Murakami Y, Tsuji I. Association between education and disability-free life expectancy among Japanese older people: The Ohsaki Cohort 2006 study. Arch Gerontol Geriatr 2024; 125:105466. [PMID: 38749086 DOI: 10.1016/j.archger.2024.105466] [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: 01/22/2024] [Revised: 04/28/2024] [Accepted: 04/29/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Higher education level is associated with longer disability-free life expectancy (DFLE). However, evidence is scarce regarding factors that can contribute to eliminating inequality in DFLE according to education level. This study aimed to clarify the association between education and DFLE and estimate whether DFLE in people with lower education may increase to the same level as that in people with higher education through social participation. METHODS We analyzed data from 13,849 Japanese people aged 65 years and older who participated in a 13-year prospective study. At baseline, we collected information on education levels (low, middle, or high) and social participation. DFLE was defined as the average duration people expect to live without disability. To calculate DFLE for each education level group, the multistate life table method was employed using a Markov model. RESULTS At the age of 65 years, DFLE (95 % confidence interval [CI]) in women with low education was 21.3 years (20.8-21.8) without social participation and 24.3 (23.8-24.9) with social participation. In the middle education group, DFLE was 22.1 (21.6-22.6) without social participation and 25.0 (24.6-25.5) with social participation. In the high education group, DFLE was 22.1 (21.5-22.8) without social participation and 25.5 (25.0-26.0) with social participation. Similar results were found for men. CONCLUSIONS DFLE in people with low or middle education with social participation was almost the same as that in those with high education with social participation, suggesting the possibility that disparities in DFLE by education level could be offset by promoting social participation in older adults.
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Affiliation(s)
- Shiori Inomata
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukai Lu
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sanae Matsuyama
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshitaka Murakami
- Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Ichiro Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, School of Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Keim-Klärner S, Adebahr P, Brandt S, Gamper M, Klärner A, Knabe A, Kupfer A, Müller B, Reis O, Vonneilich N, Ganser MA, de Bruyn C, von der Lippe H. Social inequality, social networks, and health: a scoping review of research on health inequalities from a social network perspective. Int J Equity Health 2023; 22:74. [PMID: 37098617 PMCID: PMC10131340 DOI: 10.1186/s12939-023-01876-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 03/28/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND This review summarises the present state of research on health inequalities using a social network perspective, and it explores the available studies examining the interrelations of social inequality, social networks, and health. METHODS Using the strategy of a scoping review, as outlined by Arksey and O'Malley (Int J Sci Res Methodol 8:19-32, 2005), our team performed two searches across eight scientific, bibliographic databases including papers published until October 2021. Studies meeting pre-defined eligibility criteria were selected. The data were charted in a table, and then collated, summarised, and reported in this paper. RESULTS Our search provided a total of 15,237 initial hits. After deduplication (n = 6,168 studies) and the removal of hits that did not meet our baseline criteria (n = 8,767 studies), the remaining 302 full text articles were examined. This resulted in 25 articles being included in the present review, many of which focused on moderating or mediating network effects. Such effects were found in the majority of these studies, but not in all. Social networks were found to buffer the harsher effects of poverty on health, while specific network characteristics were shown to intensify or attenuate the health effects of social inequalities. CONCLUSIONS Our review showed that the variables used for measuring health and social networks differed considerably across the selected studies. Thus, our attempt to establish a consensus of opinion across the included studies was not successful. Nevertheless, the usefulness of social network analysis in researching health inequalities and the employment of health-promoting interventions focusing on social relations was generally acknowledged in the studies. We close by suggesting ways to advance the research methodology, and argue for a greater orientation on theoretical models. We also call for the increased use of structural measures; the inclusion of measures on negative ties and interactions; and the use of more complex study designs, such as mixed-methods and longitudinal studies.
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Affiliation(s)
| | - Philip Adebahr
- Institute of Sociology, University of Technology Chemnitz, Chemnitz, Germany
| | - Stefan Brandt
- Landesfrauenrat Mecklenburg-Vorpommern e.V., Rostock, Germany
| | - Markus Gamper
- Institut für vergleichende Bildungsforschung und Sozialwissenschaften, University of Cologne, Cologne, Germany
| | - Andreas Klärner
- Thünen Institute of Rural Studies, Bundesallee 64, Brunswick, Germany
| | - André Knabe
- Rostocker Institut für Sozialforschung und gesellschaftliche Praxis e.V., Rostock, Germany
| | - Annett Kupfer
- Institute of Social Pedagogy, Social Work and Welfare Studies, Technische Universität Dresden, Dresden, Germany
| | - Britta Müller
- Institute of Medical Psychology and Medical Sociology, Rostock University Medical Center, Rostock, Germany
| | - Olaf Reis
- Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Rostock University Medical Center, Rostock, Germany
| | - Nico Vonneilich
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Aliverdi F, Bayat Jozani Z, Ghavidel N, Qorbani M, Mohammadian Khonsari N, Mohamadi F, Mohraz M, Mahmoodi Z. Relationships among COVID-19 phobia, health anxiety, and social relations in women living with HIV in Iran: A path analysis. PLoS One 2022; 17:e0275455. [PMID: 36194595 PMCID: PMC9531807 DOI: 10.1371/journal.pone.0275455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/17/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. Materials and methods This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. Results Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (β = -0.14) showed the greatest negative relationship, and health anxiety (β = 0.11) had the strongest positive relationship on the direct path. On the indirect path, fear of COVID-19 (β = 0.049) displayed the greatest positive relationship. The level of education (β = 0.29) was the only variable showing a significant positive relationship with social relations on both direct and indirect paths. Conclusion Our result showed that increased fear and health anxiety related to a higher social relations score in WLHIV. Hence, due to their vulnerability, these people require more support and education to adhere to health protocols in future pandemics and similar situations.
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Affiliation(s)
- Fatemeh Aliverdi
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Zahra Bayat Jozani
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Ghavidel
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail: (MQ); (ZM)
| | | | - Farima Mohamadi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
- * E-mail: (MQ); (ZM)
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4
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Kim JW. Different roles of social participation in socioeconomic disparities in depressive symptoms of Koreans across age groups. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01556-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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5
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Muhammad T, Kumar P, Srivastava S. How socioeconomic status, social capital and functional independence are associated with subjective wellbeing among older Indian adults? A structural equation modeling analysis. BMC Public Health 2022; 22:1836. [PMID: 36180950 PMCID: PMC9523926 DOI: 10.1186/s12889-022-14215-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Subjective well-being (SWB) is of particular interest among gerontologists and health researchers with important implications for interventions especially in poor-resource settings. This study aimed to explore the possible pathways from socioeconomic status (SES), functional independence and social capital towards SWB among older adults in India. Methods Cross-sectional data from the “Building a Knowledge Base on Population Aging in India” (BKPAI) survey with a total sample of 9231 older adults aged 60 years and above were used. The outcome variable was low SWB (LSWB). The study used univariate and bivariate analysis for reporting the initial results. Further, the study employed the structural equation modeling (SEM) technique using maximum likelihood estimation (MLE) procedure to estimate the covariance matrix. Results Overall, about 27% of older adults reported LSWB. Reporting LSWB was more prevalent among older adults who had no income (30.8%) and those who had income but not sufficient to fulfil their basic needs (39.4%, p < 0.001). The prevalence of reporting LSWB was significantly higher among older adults who had no asset ownership (36.5%, p < 0.001) than those who had asset ownership. The path from the SEM shows that LSWB and SES are negatively related to each other. Moreover, LSWB had significant negative relationship with independence (β = -0.032, p < 0.001) and social capital (β = -0.020; p < 0.001). In addition, results found a positive relationship between SES and independence (β = 0.019; p < 0.001), SES and social capital (β = 0.016; p < 0.001), and independence and social capital (β = 0.033; p < 0.001). Conclusions The findings highlight that higher SES, good physical functioning as well as favorable social capital are interdependent factors of late-life wellbeing and a multidimensional approach in policymaking can ensure a successful and active ageing among older Indian adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14215-4.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088
| | - Pradeep Kumar
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088
| | - Shobhit Srivastava
- International Institute for Population Sciences, Mumbai, Maharashtra, India, 400088.
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Yu C, Zhang X, Gao J. Multi-Dimensional Comparison of the Impact Mechanism of the Self-Rated Health Status of Urban and Rural Residents in Chinese Social Environments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10625. [PMID: 36078341 PMCID: PMC9518462 DOI: 10.3390/ijerph191710625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Self-rated health status (SRHS) reflects individuals' social environment, and the difference between urban and rural areas in China further highlights the impact of social environment on health. This paper aimed to systematically analyze and compare the impact mechanism of the SRHS of urban and rural residents from multiple dimensions, i.e., time, space, and scale. Drawing on data from the Chinese General Social Survey (CGSS) and China Statistical Yearbook, we used spatial, cross, and HLM analyses. Results indicate that: (1) From 2010 to 2017, the overall SRHS level of Chinese residents gradually declined; the gradient pattern of east, middle, and west became more marked, and the health level in rural areas generally fell behind that of urban areas. (2) The focus of SRHS moved toward mental health, and people's perceptions of the social environment gradually became a key factor affecting health. (3) In the long term, the gradient allocation of medical service resources could narrow the gap between urban and rural areas to comprehensively improve regional health levels.
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Affiliation(s)
- Chao Yu
- School of Geographic Sciences, Xinyang Normal University, Xinyang 464000, China
- The Center of Targeted Poverty Alleviation and Rural Revitalization, Xinyang Normal University, Xinyang 464000, China
| | - Xinyi Zhang
- School of Geographic Sciences, Xinyang Normal University, Xinyang 464000, China
- The Center of Targeted Poverty Alleviation and Rural Revitalization, Xinyang Normal University, Xinyang 464000, China
| | - Junbo Gao
- The Center of Targeted Poverty Alleviation and Rural Revitalization, Xinyang Normal University, Xinyang 464000, China
- School of Tourism, Xinyang Normal University, Xinyang 464000, China
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7
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Adhikari N, Uddin S. Health Inequalities in Older Norwegians and the Mediating Role of Social Networks. Int J Aging Hum Dev 2022:914150221112281. [PMID: 35837689 DOI: 10.1177/00914150221112281] [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: 11/16/2022]
Abstract
This study aims to contribute to understanding how social networks serve as an intervening pathway leading to socioeconomic health inequality among older adults in Norway. Longitudinal survey data from the second and the third waves of the Norwegian Life Course, Ageing, and Generation Study were used in this paper. Hayes PROCESS was used to estimate the mediating effect of the contact frequency and the support potential of friends on the impact of social-economic position (SEP) at wave 2 on health outcomes at wave 3. The total indirect effect of the income on physical health observed was 0.04. The total indirect effect of the highest level of education attained on physical health observed was 0.12. The result showed a social-economic gradient in health among older adults in Norway where the social network is a crucial pathway via which SEP influences peoples' health.
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Affiliation(s)
- Nabaraj Adhikari
- International Social Welfare and Health Policy Scholar, 418298Oslo Metropolitan University, Oslo, Norway.,Master of Public Health, The Royal Tropical Institute (KIT), Amsterdam, the Netherlands
| | - Shahad Uddin
- International Social Welfare and Health Policy Scholar, 418298Oslo Metropolitan University, Oslo, Norway
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8
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Zhao B, Kong F, Shin DE, Nam EW. Gender Disparity and the Association Between Socioeconomic Status, Mental Health, and the Need for Long-Term Services and Support Among the Older Koreans. Front Public Health 2022; 10:888011. [PMID: 35719606 PMCID: PMC9203953 DOI: 10.3389/fpubh.2022.888011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/06/2022] [Indexed: 12/05/2022] Open
Abstract
Background Population aging-the inevitable increase in the percentage of older adults-is occurring all around the world as the fertility rate declines and life expectancy rises. This study examined the relationship between socioeconomic status (SES), mental health, and the need for long-term services and support (LTSS) among Korean older adults. It also aimed to provide evidence-based information for South Korea's long-term support services and programs. Methods This study used the data on older adults aged over 60 years from the 2018 Korean Longitudinal Study of Aging (KLoSA). Ultimately, 5,527 older adults were included in the database (42.6% men, 57.4% women). To clarify the association between SES, mental health, and the need for LTSS among older Korean men and women, chi-squared test, t-test, and structural equation modeling (SEM) were performed. Results The SEM analysis showed that a significant, negative association was observed between SES and the need for LTSS among these older adults-the higher SES groups would generally have less need for LTSS. Mental health had a strong, negative impact on the need for LTSS-better mental health status of the older individuals would indicate a lower need for LTSS, and the effect was stronger among older men. Meanwhile, the positive relationship between SES and mental health was verified-the higher the SES of these older adults the better their mental health. Conclusions Gender- and social class-sensitive impacts of mental health on the need for LTSS were observed in this study. These findings could provide an evidence-based reference for interventions targeting different genders and social classes in Korea's long-term care system, such as the enhancement of social welfare and mental health status of the older adults.
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Affiliation(s)
- Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, Wonju, South Korea
- Yonsei Global Health Center, Yonsei University, Wonju, South Korea
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Health Commission (NHC) Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Dong Eun Shin
- Yonsei Global Health Center, Yonsei University, Wonju, South Korea
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, Wonju, South Korea
- Yonsei Global Health Center, Yonsei University, Wonju, South Korea
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9
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Socio-economic and technological aspects of mental health of older persons: the role of strong and weak ties in Ghana. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x21001859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Research indicates that social capital can influence the extent to which socio-economic status (SES) and information and communications technology (ICT) affect mental health. This study uses empirical data to examine the veracity of this claim by examining the effect of SES and ICT use on the mental health of older persons in Ghana, as well as the moderating role of bonding (i.e. strong ties) and bridging (i.e. weak ties) social capital in these associations. Data were drawn from 409 older persons from four regions in Ghana as part of a broader cross-sectional survey. Ordinal logistic regression analyses showed that SES and ICT use had positive associations with mental health after adjusting for other socio-demographic factors. Bridging social capital modified the association between SES and mental health positively. Bonding social capital also moderated the relations between ICT use on mental health positively. We argue that the prevalent nature of resources embedded in strong ties and the diversity of support that emerge from weak ties account for the difference in their influence observed in this study. Thus, while advances in socio-economic and technological conditions can enhance older persons’ mental health, equal attention must be paid to the characteristics of their strong and weak ties as they possess the resources to make socio-technological policies even more meaningful.
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Guo X, Li J, Su F, Chen X, Cheng Y, Xue B. Has the Sudden Health Emergency Impacted Public Awareness? Survey-Based Evidence from China. Behav Sci (Basel) 2022; 12:bs12020021. [PMID: 35200273 PMCID: PMC8869217 DOI: 10.3390/bs12020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/20/2022] Open
Abstract
Public environmental cognition is an important basis for optimizing environmental management and reducing tensions between humans and land. Although the level of environmental cognition is a gradual process under normal conditions, it often changes qualitatively because of major public emergencies. During the 2019 new coronavirus epidemic (COVID-19), the most significant public health event in recent years, 24,188 national samples were obtained based on a network survey. The comprehensive evaluation method was used to assess the impact of major public events on public environmental cognition and the characteristics of spatial and temporal distribution. The findings are as follows. (1) During the epidemic period, sudden public health emergencies effectively promoted the national residents’ environmental awareness, whether urban residents or rural; most respondents generally agreed with the concept of “respect nature and cherish life”. (2) The environmental cognition of national residents was higher in the northwest and lower in the northeast of China, which is suitable for economic and social development and humanistic tradition. (3) There was a clear positive correlation between environmental awareness and education level. (4) During the epidemic, nervousness of respondents had a negative effect on environmental cognition. This study provides scientific support and a basis for decision making for the government to carry out environmental management optimization and improve the ecological and environmental cognition of the public, as well as devise effective intervention mechanisms with different time and space dimensions for similar future public health emergencies.
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Affiliation(s)
- Xiaojia Guo
- College of Geographical Science, Shanxi Normal University, Taiyuan 030031, China;
| | - Jingzhong Li
- College of Urban Planning and Architecture, Xuchang University, Xuchang 461000, China;
| | - Fang Su
- School of Economics and Management, Shaanxi University of Science & Technology, Xi’an 710021, China;
| | - Xingpeng Chen
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China
- Correspondence:
| | - Yeqing Cheng
- College of Geography and Environmental Sciences, Hainan Normal University, Haikou 571158, China;
| | - Bing Xue
- Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang 110016, China;
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11
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Gazzaz AZ, Carpiano RM, Aleksejuniene J. Socioeconomic status, social support, and oral health-risk behaviors in Canadian adolescents. J Public Health Dent 2021; 81:316-326. [PMID: 34590718 DOI: 10.1111/jphd.12478] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/17/2021] [Accepted: 09/17/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We tested hypotheses regarding how adolescent oral health-related behaviors are associated with socioeconomic status (SES) and family and peer social support, including the extent to which such associations differ for boys and girls. METHODS We analyzed data from the 2013/2014 Canadian Health Behavior in School-aged Children Study for 20,357 adolescents ages 12-18 years. Family Affluence Scale was used to assess SES. Family and peer social support were assessed using the Multidimensional Scale of Perceived Social Support. We estimated average marginal effects from multivariable binary logistic regression models for three oral health-risk behaviors outcomes: infrequent toothbrushing, high sugar-sweetened beverage (SSB) intake, and high sweets consumption across both genders. RESULTS Adolescents from low SES households had lower probability of parental and peer support, and were significantly more likely to report infrequent toothbrushing and high SSB consumption, both before and after controlling for both types of support. Lower family support was associated with higher probability of engaging in infrequent toothbrushing and high SSB intake, while lower peer support was associated with higher probability of engaging in infrequent toothbrushing and lower likelihood of engaging in high SSB consumption. The associations of family support with oral health-related behaviors were somewhat stronger for boys than girls. CONCLUSIONS Low SES and low family support were associated with a higher likelihood of oral health-risk behaviors (infrequent toothbrushing and SSB consumption). Regardless of adolescents' gender, parental support exerted a protective role, but peer support had countervailing risk and protective roles on oral health-related behaviors.
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Affiliation(s)
- Arwa Z Gazzaz
- Department of Oral Health Science, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Richard M Carpiano
- School of Public Policy, University of California, Riverside, California, USA.,Department of Sociology, University of California, Riverside, California, USA
| | - Jolanta Aleksejuniene
- Department of Oral Health Science, Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
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12
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Dougall I, Weick M, Vasiljevic M. Social class and wellbeing among staff and students in higher education settings: Mapping the problem and exploring underlying mechanisms. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1111/jasp.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Isla Dougall
- Department of Psychology Durham University Durham UK
| | - Mario Weick
- Department of Psychology Durham University Durham UK
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13
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Hu X, Wang T, Huang D, Wang Y, Li Q. Impact of social class on health: The mediating role of health self-management. PLoS One 2021; 16:e0254692. [PMID: 34270623 PMCID: PMC8284807 DOI: 10.1371/journal.pone.0254692] [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: 10/25/2020] [Accepted: 07/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background Studies have explored the relationship between social class and health for decades. However, the underlying mechanism between the two remains not fully understood. This study aimed to explore whether health self-management had a mediating role between social class and health under the framework of Socio-cultural Self Model. Methods 663 adults, randomly sampled from six communities in Southwest China, completed the survey for this study. Social class was assessed using individuals’ income, education, occupation. Health self-management was assessed through evaluation of the health self-management behavior, health self-management cognition, health self-management environment. Physical health and mental health were measured by the Chinese version of Short-Form (36-item) Health Survey, which contains Physical Functioning, Role-Physical, Role-Emotional, Vitality, Mental Health, Social Function, Bodily Pain and General Health. Pearson’s correlation was used to examine the associations between major variables. Mediation analyses were performed to explore the mediating role of health self-management. Results Social class positively predicted self-rated health. The lower the social class, the lower the self-reported physical and mental health. Health self-management partially mediated the relationship between social class and self-rated health. That is, the health self-management ability of the lower class, such as access to healthy and nutritious food and evaluate their own health status, is worse than that of the higher class, which leads to physical and mental health inequality between the high and the low classes. Conclusion Health self-management mediated the relationship between social class and health. Promoting health self-management abilities are conducive to improving both physical and mental health.
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Affiliation(s)
- Xiaoyong Hu
- Faculty of Psychology, Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, People's Republic of China
| | - Tiantian Wang
- Faculty of Psychology, Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, People's Republic of China
| | - Duan Huang
- School of Health, Wuhan Sports University, Wuhan, People's Republic of China
| | - Yanli Wang
- Faculty of Psychology, Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, People's Republic of China
| | - Qiong Li
- School of Health, Wuhan Sports University, Wuhan, People's Republic of China
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14
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Karos K, McParland JL, Bunzli S, Devan H, Hirsh A, Kapos FP, Keogh E, Moore D, Tracy LM, Ashton-James CE. The social threats of COVID-19 for people with chronic pain. Pain 2020; 161:2229-2235. [PMID: 32694381 PMCID: PMC7382418 DOI: 10.1097/j.pain.0000000000002004] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Kai Karos
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Group on Experimental Health Psychology, Department for Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Joanna L McParland
- Department of Psychology, Glasgow Caledonian University, Glasgow, Scotland
| | - Samantha Bunzli
- Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Australia
| | - Hemakumar Devan
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Adam Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, IN, United States
| | - Flavia P Kapos
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Edmund Keogh
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - David Moore
- Department of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Lincoln M Tracy
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Claire E Ashton-James
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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15
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Vonneilich N, Lüdecke D, von dem Knesebeck O. Educational inequalities in self-rated health and social relationships - analyses based on the European Social Survey 2002-2016. Soc Sci Med 2019; 267:112379. [PMID: 31300251 DOI: 10.1016/j.socscimed.2019.112379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 02/19/2019] [Accepted: 06/20/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND While there is evidence for educational health inequalities in Europe, studies on time trends and on the explanatory contribution of social relations are less consistent. It has been shown that the use of welfare state typologies can be helpful to examine health inequalities in a comparative perspective. Against this background, analyses are focused on three research questions: (1) How did educational inequalities in self-rated health (SRH) develop between 2002 and 2016 in different European countries? (2) In how far can structural and functional aspects of social relations help to explain these inequalities? (3) Do these explanatory contributions vary between different types of welfare states? METHODS Data stem from the European Social Survey. Data from 20 countries across 8 waves (2002-2016) was included in the sample (allocated to 5 types of welfare states). Structural aspects of social relations were measured by living with a partner, frequency of social contacts and social participation. Availability of emotional support was used as functional dimension. Educational level was assessed based on the International Standard Classification of Education. SRH was measured in all waves on a five-point scale by one question: "How is your health in general? Would you say it is very good, good, fair, bad or very bad?" RESULTS Across all countries, educational inequalities were increasing between 2002 and 2016. Explanatory contribution of emotional support, living with a partner, and social contacts was small (5% or less across the eight waves). Social participation explained 11% of the educational inequalities in SRH in the European countries. There were small variations in the explanatory contribution of social participation between welfare states. CONCLUSIONS Promoting social participation, especially of people with low education is a possible intervention to reduce inequalities in SRH in Europe.
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Affiliation(s)
- Nico Vonneilich
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
| | - Daniel Lüdecke
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
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16
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Fang M, Mirutse G, Guo L, Ma X. Role of socioeconomic status and housing conditions in geriatric depression in rural China: a cross-sectional study. BMJ Open 2019; 9:e024046. [PMID: 31110082 PMCID: PMC6530296 DOI: 10.1136/bmjopen-2018-024046] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The primary aim of this study was to describe the socioeconomic status (SES), housing conditions and depression of the elderly in rural China, as well as to examine the associations between depression and SES and housing conditions using the China Health and Retirement Longitudinal Study (CHARLS). DESIGN This is a cross-sectional study. SETTING A nationally representative sample of elderly in rural China. PARTICIPANTS A total of 4585 elderly adults in 2015 in rural China. OUTCOME MEASURES Prevalence and risk factors of depression among rural elderly. RESULTS Among the participants in this study, approximately 46.15% (2116/4585) reported depressive symptoms (10-item Center for Epidemiologic Studies Depression Scale [CESD-10] score >10) in rural China. The results revealed significant associations between higher scores on CESD-10 (indicating more symptoms of depression) and lowest personal annual income (OR=1.63, 95% CI 1.290 to 2.060), polluting cooking fuel (OR=1.16, 95% CI 1.018 to 1.321), toilet without seat (OR=1.273, 95% CI 1.056 to 1.535), as well as having no bath facility (OR=1.172, 95% CI 1.025 to 1.341) after adjustment for confounders. CONCLUSION Elderly in rural China experienced severe depressive symptoms. Lowest personal annual income, polluting cooking fuel, toilet without seat and having no bath facility were significantly associated with more depressive symptoms. Caution needs to be taken in generalising the findings of this study to the rest of the population in China since its highly selected sample.
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Affiliation(s)
- Mingwang Fang
- West China School of Public Health, Sichuan University, Chengdu, China
| | | | - Ling Guo
- Department of Health Management, Chongqing Nursing Vocational College, Chongqing, China
| | - Xiao Ma
- West China School of Public Health, Sichuan University, Chengdu, China
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17
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Fang M, Chen J, Guo L, Ma X. Gender Differences in Geriatric Depressive Symptoms in Rural China: The Role of Physical Housing Environments and Living Arrangements. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050774. [PMID: 30836602 PMCID: PMC6427662 DOI: 10.3390/ijerph16050774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 02/14/2019] [Accepted: 02/20/2019] [Indexed: 11/25/2022]
Abstract
Physical housing environment and living arrangements are significant determinants of health, particularly in developing countries, although results are mixed. We conducted this study to examine the gender differences in geriatric depressive symptoms in rural China, and further explored the influence of housing environments and living arrangements on depressive symptoms. The data used for this study were from the third wave of the nationally representative China Health and Retirement Longitudinal Study (CHARLS) survey in 2015; a total of 2056 females and 2529 males were included in this study. According to the analysis findings, 46.15% of the respondents had depressive symptoms based on the CES-D, with a statistically significant gender difference of 54.32% in females and 39.50% in males. Logistic Regression findings identified that with regard to the items of physical housing environments, toilets without seats (OR = 1.349) and the unavailability of bathing facilities (OR = 1.469) were statistically associated with depressive symptoms among male participants, whereas for female participants the use of polluting fuels (OR = 1.248) and living arrangements (i.e., living with children, OR = 1.430) was statistically associated with depressive symptoms. Statistically significant gender differences were found for having shower or bath facilities and our findings underscored that physical housing environments and living arrangements were associated with depressive symptoms for both genders. Moreover, the study revealed that a slight gender difference exists in terms of geriatric depression in rural China. Females are more likely to become depressed than their male counterparts with the same characteristics.
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Affiliation(s)
- Mingwang Fang
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Jinfeng Chen
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
| | - Ling Guo
- Department of Health management, Chongqing Nursing Vocational College, Chongqing 402763, China.
| | - Xiao Ma
- Department of Health-Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.
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18
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[Socioeconomic differences in health and need for care among the elderly]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:238-246. [PMID: 30783686 DOI: 10.1007/s00103-019-02917-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In view of the continuing increase in life expectancy, the question arises as to the state of health in which these years of gained life can be spent. The research findings on social differences in health and life expectancy suggest that this question has to be answered differently for different population groups. Even after the age of 65, persons with a low socioeconomic status are more likely to be affected by chronic illnesses and complaints, functional limitations of everyday activities, as well as impairments of well-being and health-related quality of life. With a significant proportion of people with low socioeconomic status still dying prematurely, the increase in lifetime that is observed for all population groups could increase the social gap in health in later life. This implies the challenge of giving special attention to the needs of socially disadvantaged groups in policies and programs aiming to improve the health of older people and preventing the need for care.
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19
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Torres JL, da Silva SLA, Lustosa LP. The role of education on the association between disability and depressive symptoms among community-dwelling older adults: Evidence from Frailty in Brazilian Older People (Fibra) study. Arch Gerontol Geriatr 2019; 80:120-124. [DOI: 10.1016/j.archger.2018.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 10/26/2018] [Accepted: 11/08/2018] [Indexed: 10/27/2022]
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20
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Oshio T. Widening disparities in health between educational levels and their determinants in later life: evidence from a nine-year cohort study. BMC Public Health 2018; 18:278. [PMID: 29471834 PMCID: PMC5824535 DOI: 10.1186/s12889-018-5181-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 02/19/2018] [Indexed: 11/13/2022] Open
Abstract
Background Education has attracted more attention as a key determinant of health in later life. In this study, the hypothesis that widened educational disparities in health can be observed in later life was investigated, and the factors that mediated the association between education and changes in health were also assessed. Methods Using the 9-year (10-wave) longitudinal data of 20,024 individuals (9320 men and 10,704 women) aged 50–59 years at baseline, collected from a nationwide population survey in Japan (2005–2014), the changes in self-rated health, functional limitations, and psychological distress between educational levels were compared. Mediation analysis was further conducted to assess the factors that mediated the association between education and changes in health, with reference to six types of potential mediators (household spending, social participation, leisure-time physical activity, smoking, problem drinking, and regular health check-ups). The analyses were conducted separately for men and women. Results All three health variables rapidly deteriorated among lower-educated men and women. For men, the six potential mediators mediated 55.2%, 64.3%, and 47.3% of the associations between educational levels and changes in self-rated health, functional limitations, and psychological distress, respectively. The proportions for women were 42.0%, 49.5%, and 58.8%, respectively. Social participation was the primary mediator, followed by physical activity, regular health check-ups, and smoking. In general, no substantial or consistent differences were observed between men and women. Conclusions The results suggested that policy measures that encourage social participation and promote healthy behaviors can improve educational disparities in health in later life.
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Affiliation(s)
- Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8603, Japan.
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21
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McGarrigle CA, Timonen V, Layte R. Choice and Constraint in the Negotiation of the Grandparent Role: A Mixed-Methods Study. Gerontol Geriatr Med 2018; 4:2333721417750944. [PMID: 29372176 PMCID: PMC5774728 DOI: 10.1177/2333721417750944] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 10/13/2017] [Accepted: 11/30/2017] [Indexed: 12/04/2022] Open
Abstract
Few studies have examined how the allocation and consequences of grandchild care vary across different socioeconomic groups. We analyze qualitative data alongside data from The Irish Longitudinal Study on Ageing (TILDA), in a convergent mixed-methods approach. Regression models examined characteristics associated with grandchild care, and the relationship between grandchild care and depressive symptoms and well-being. Qualitative data shed light on processes and choices that explain patterns of grandchild care provision. Tertiary-educated grandparents provided less intensive grandchild care compared with primary educated. Qualitative data indicated that this pattern stems from early boundary-drawing among higher educated grandparents while lower socioeconomic groups were constrained and less able to say no. Intensive grandchild care was associated with more depressive symptoms and lower well-being and was moderated by participation in social activities and level of education attainment. The effect of grandchild care on well-being of grandparents depends on whether it is provided by choice or obligation.
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Affiliation(s)
| | - Virpi Timonen
- Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - Richard Layte
- Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
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22
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Lamu AN, Olsen JA. Yes, health is important, but as much for its importance via social life: The direct and indirect effects of health on subjective well-being in chronically ill individuals. HEALTH ECONOMICS 2018; 27:209-222. [PMID: 28660631 DOI: 10.1002/hec.3536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 03/03/2017] [Accepted: 05/15/2017] [Indexed: 05/05/2023]
Abstract
There is an increasing evidence that health-related quality of life, income, and social relationships are important to our subjective well-being (SWB). Little is known, however, about the specific indirect pathways that link health to SWB via social relationships and income. On the basis of a unique data set of 7 disease groups from 6 OECD-countries (N = 6,173), we investigate the direct and indirect effects of health on SWB by using structural equation modeling. Three alternative measures of health are used: For generic instruments (EQ-5D-5L; SF-6D), the total indirect effect was stronger (0.226; 0.249) than its direct effect (0.157; 0.205). For the visual analogue scale, the direct effect was stronger (0.322) than its total indirect effect (0.179). Most of the indirect effect of improved health on SWB transmitted through social relationships. The effect via income was small. Nevertheless, the presence of unmeasured confounders may bias the estimates. An important lesson for researchers is to include meaningful items on social relationships when measuring the benefits from improved health. An important lesson for policy makers is that social isolation appears to be more detrimental to overall well-being than ill health. Hence, the Health and Care Services should facilitate social arenas for people with chronic conditions.
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Affiliation(s)
- Admassu N Lamu
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Jan Abel Olsen
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Centre for Health Economics, Monash University, Clayton, Australia
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23
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Festin K, Thomas K, Ekberg J, Kristenson M. Choice of measure matters: A study of the relationship between socioeconomic status and psychosocial resources in a middle-aged normal population. PLoS One 2017; 12:e0178929. [PMID: 28832585 PMCID: PMC5568385 DOI: 10.1371/journal.pone.0178929] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 05/22/2017] [Indexed: 12/30/2022] Open
Abstract
Psychosocial resources may serve as an important link to explain socioeconomic differences in health. Earlier studies have demonstrated that education, income and occupational status cannot be used interchangeably as indicators of a hypothetical latent social dimension. In the same manner, it is important to disentangle the effect of measuring different constructs of psychosocial resources. The aim of this study was therefore to analyse if associations between socioeconomic status (SES) and psychosocial resources differ depending on the measures used. A cross-sectional population-based study of a random sample (n = 1007) of middle-aged individuals (45-69 years old, 50% women) in Sweden was performed using questionnaire and register data. SES was measured as education, occupation, household income and self-rated economy. Psychosocial resources were measured as social integration, social support, mastery, self-esteem, sense of coherence (SOC) and trust. Logistic regression models were applied to analyse the relationships controlling for the effects of possible confounders. The measures of SES were low or moderately correlated to each other as were the measures of psychosocial resources. After controlling for age, sex, country of birth and employment status, household income and self-rated economy were associated with all six psychosocial resources; occupation was associated with three (social integration, self-esteem and trust) and education with two (social integration and self-esteem). Social integration and self-esteem showed a significant and graded relationship with all SES measures; trust was associated with all SES measures except education, whereas SOC and mastery were only associated with household income and self-rated economy. After controlling for other SES measures, no associations with psychosocial resources remained for education or occupation. In conclusion, associations between SES and psychosocial resources did differ depending on the measures used. The findings illustrate the importance of the choice of measure when investigating SES as well as psychosocial resources.
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Affiliation(s)
- Karin Festin
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
- * E-mail:
| | - Kristin Thomas
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
| | - Joakim Ekberg
- Unit for Health Analysis, Centre for Healthcare Development, Region Östergötland, Linköping, Sweden
| | - Margareta Kristenson
- Division of Community Medicine, Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
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Aartsen M, Veenstra M, Hansen T. Social pathways to health: On the mediating role of the social network in the relation between socio-economic position and health. SSM Popul Health 2017; 3:419-426. [PMID: 29349235 PMCID: PMC5769056 DOI: 10.1016/j.ssmph.2017.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 05/03/2017] [Accepted: 05/05/2017] [Indexed: 10/30/2022] Open
Abstract
Good health is one of the key qualities of life, but opportunities to be and remain healthy are unequally distributed across socio-economic groups. The beneficial health effects of the social network are well known. However, research on the social network as potential mediator in the pathway from socio-economic position (SEP) to health is scarce, while there are good reasons to expect a socio-economical patterning of networks. We aim to contribute to our understanding of socio-economic inequalities in health by examining the mediating role of structural and functional characteristics of the social network in the SEP-health relationship. Data were from the second wave of the Norwegian study on the life course, aging and generation study (NorLAG) and comprised 4534 men and 4690 women aged between 40 and 81. We applied multiple mediation models to evaluate the relative importance of each network characteristic, and multiple group analysis to examine differences between middle-aged and older men and women. Our results indicated a clear socio-economical patterning of the social network for men and women. People with higher SEP had social networks that better protect against loneliness, which in turn lead to better health outcomes. The explained variance in health in older people by the social network and SEP was only half of the explained variance observed in middle-aged people, suggesting that other factors than SEP were more important for health when people age. We conclude that it is the function of the network, rather than the structure, that counts for health.
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Abstract
This study investigated the relationship between childhood misfortune and 10-year change in health and whether this relationship was mediated by the quality of social relations. We used data from the Midlife in the United States (MIDUS) national longitudinal study, 1995-1996 (Time 1) and 2005-2006 (Time 2). Childhood misfortune was measured at Time 1 using indicators of financial strain, family structure, and abuse. Self-rated physical and mental health indicators were obtained at both occasions. The measure of quality of social relations was based on items relative to social support and social strain from spouse, friends, and family at Time 1. Mediational models showed that a higher level of childhood misfortune was associated with low-quality family relations which in turn tend to account for change in mental health. These findings suggest that childhood misfortune is associated with the quality of social relations, which in turn explain individual changes in mental health in adulthood.
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Affiliation(s)
- Jiyoung Lyu
- 1 Hallym University Institute of Aging, Chuncheon, Korea
| | - Stefan Agrigoroaei
- 2 Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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26
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Torres JL, Lima-Costa MF, Marmot M, de Oliveira C. Wealth and Disability in Later Life: The English Longitudinal Study of Ageing (ELSA). PLoS One 2016; 11:e0166825. [PMID: 27875579 PMCID: PMC5119775 DOI: 10.1371/journal.pone.0166825] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 11/05/2016] [Indexed: 11/25/2022] Open
Abstract
We examined wealth inequalities in disability, taking into account the effect of both depression and social support among older English adults using data from 5,506 community-dwelling people aged 50 years and over from the English Longitudinal Study of Ageing (ELSA). Disability was measured as self-reported limitations in the Basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Depressive symptomatology was measured using the 8-item Center for Epidemiological Studies-Depression (CES-D) scale. Social support was assessed by marital status and frequency of contact with friends, relatives or children. Multinomial logistic regression models were used to assess the role of social support and depressive symptoms on disability by total household wealth, which is a measure of accumulated assets over the course of life. Our findings showed that the poorest men with disability were more likely to live without a partner and have no weekly contact with children, family or friends compared to the wealthiest. Among women with disability, the poorest were more likely to report loneliness and have no partner while the wealthiest and the intermediate groups were more likely to be living with a partner. There was a strong inverse dose-response association between wealth and depressive symptoms among all participants with disability. This study shows a clear wealth gradient in disability among older English adults, especially for those with elevated depressive symptoms.
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Affiliation(s)
- Juliana Lustosa Torres
- Programa de Pós-graduação em Saúde Pública, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Fernanda Lima-Costa
- Rene Rachou Research Center, the Oswaldo Cruz Foundation in the State of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Michael Marmot
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Cesar de Oliveira
- Research Department of Epidemiology and Public Health, University College London, London, United Kingdom
- * E-mail:
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27
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Read S, Grundy E, Foverskov E. Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review. Aging Ment Health 2016; 20:529-42. [PMID: 25806655 PMCID: PMC4784497 DOI: 10.1080/13607863.2015.1023766] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe. METHOD Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and International Bibliography of the Social Sciences (IBSS). We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population-based samples of older people in Europe and published 1995-2013. RESULTS A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health-related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances. CONCLUSION The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors.
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Affiliation(s)
- Sanna Read
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom,Corresponding author.
| | - Emily Grundy
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
| | - Else Foverskov
- Department of Social Policy, London School of Economics and Political Science, London, United Kingdom
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Ruiz JM, Hamann HA, Mehl MR, O’Connor MF. The Hispanic health paradox: From epidemiological phenomenon to contribution opportunities for psychological science. GROUP PROCESSES & INTERGROUP RELATIONS 2016. [DOI: 10.1177/1368430216638540] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Similar to non-Hispanic Blacks, Hispanics/Latinos experience a range of psychosocial and physical health challenges, including high rates of poverty, neighborhood segregation, discrimination, poor healthcare access, and high rates of obesity, diabetes, and undiagnosed and late-stage diagnosed diseases. Despite such risks, Hispanics generally experience better physical health and lower mortality than non-Hispanic Whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. With the basic phenomenon increasingly well-established, attention now turns to the sources of such resilience. The current aims are to briefly examine the epidemiological paradox and highlight potential sociocultural resilience factors that may contribute to the paradoxical effects. We conclude with presentation of a framework for modeling sociocultural resilience and discuss future directions for psychological contributions.
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Longitudinal trajectory patterns of social support: correlates and associated mental health in an Australian national cohort of young women. Qual Life Res 2015; 24:2075-86. [DOI: 10.1007/s11136-015-0946-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 10/23/2022]
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30
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Rennert W, Porras Blanco R, Muniz G. The effects of smokeless cookstoves on peak expiratory flow rates in rural Honduras. J Public Health (Oxf) 2014; 37:455-60. [DOI: 10.1093/pubmed/fdu087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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31
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Zajacova A, Dowd J. Happiness and health among U.S. working adults: is the association explained by socio-economic status? Public Health 2014; 128:849-51. [DOI: 10.1016/j.puhe.2014.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 05/14/2014] [Accepted: 06/11/2014] [Indexed: 10/24/2022]
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Longitudinal analysis of relationships between social support and general health in an Australian population cohort of young women. Qual Life Res 2014; 24:485-92. [PMID: 25099200 DOI: 10.1007/s11136-014-0774-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The influence of social support on health and quality of life has been well documented. There is less evidence on whether health status affects social support, and little is known about longitudinal relationships between social support and health in early adulthood. This study investigates these associations using both concurrent and time-lagged measures at 5 time-points over 12 years during early adulthood. METHODS A population-based cohort of 9,758 young women from the Australian Longitudinal Study on Women's Health was used. Women were aged 22-27 in 2000 and 35-39 in 2012. The General Health subscale of the SF-36 and the MOS Social Support Survey 6-item Scale were used, with scores standardised to a range of 0-100. Longitudinal tobit models were used, because both social support and general health data were left skewed, with marked ceiling effects. All models were adjusted for status of the outcome of interest at the immediately previous survey. RESULTS With both concurrent and time-lagged measures, there was a statistically significant difference in mean general health scores across social support quintiles after adjusting for demographic and behavioural covariates: lower general health was associated with lower social support. In reverse, social support mean scores were also significantly different across general health quintiles in both concurrent and time-lagged fully adjusted models. CONCLUSION Social support is significantly associated with both current and subsequent general health in early adulthood. The significance of the reverse associations indicates that the two mutually influence each other. This study highlights the importance of social support as a health-related quality of life issue.
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Etman A, Kamphuis CBM, van der Cammen TJM, Burdorf A, van Lenthe FJ. Do lifestyle, health and social participation mediate educational inequalities in frailty worsening? Eur J Public Health 2014; 25:345-50. [PMID: 25061232 DOI: 10.1093/eurpub/cku093] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lower educated older persons are at increased risk of becoming frail as compared with higher educated older persons. To reduce educational inequalities in the development of frailty, we investigated whether lifestyle, health and social participation mediate this relationship. METHODS Longitudinal data of 14 082 European community-dwelling persons aged 55 years and older participating in the Survey on Health, Ageing, and Retirement in Europe (SHARE) in 2004 and 2006, were used. Associations of lifestyle (smoking behaviour and alcohol consumption), health (depression, memory function, chronic diseases) and social participation, with educational level and frailty worsening were investigated using regression models. In multinomial logistic regression analysis, mediators were added to models in which educational level was associated with worsening in frailty over 2 years follow-up. RESULTS In all countries, frailty worsening was more prevalent among lower as compared with higher educated persons, although odds ratios were only statistically significant in five of the 11 countries included [ORs varying from 1.40 (95% CI: 1.06-1.84) to 1.61 (95% CI: 1.21-2.14)]. Except for smoking behaviour and memory function, the factors under study all showed associations with educational level and frailty worsening that met the conditions for mediation. After inclusion of the four relevant mediators, attenuation of odds ratios varied between 4.9 and 31.5%. CONCLUSION While lifestyle, health and social participation were associated with frailty worsening over 2 years among European community-dwelling older persons, only small to moderate parts of educational inequalities in frailty worsening were explained by these factors.
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Affiliation(s)
- Astrid Etman
- 1 Department of Public Health, Erasmus University MC, Rotterdam, The Netherlands
| | - Carlijn B M Kamphuis
- 1 Department of Public Health, Erasmus University MC, Rotterdam, The Netherlands
| | - Tischa J M van der Cammen
- 2 Department of Internal Medicine, Section of Geriatric Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands 3 Department of Medicine, Brighton and Sussex Medical School, Brighton, UK 4 Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Alex Burdorf
- 1 Department of Public Health, Erasmus University MC, Rotterdam, The Netherlands
| | - Frank J van Lenthe
- 1 Department of Public Health, Erasmus University MC, Rotterdam, The Netherlands
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Socioeconomic status, cognitive-emotional factors, and health status following myocardial infarction: testing the Reserve Capacity Model. J Behav Med 2014; 38:110-21. [PMID: 25022863 DOI: 10.1007/s10865-014-9583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 06/19/2014] [Indexed: 01/24/2023]
Abstract
Health disparities by socioeconomic status (SES) exist for many outcomes, including patients' subjective health status after myocardial infarction (MI). The Reserve Capacity Model (RCM), a theoretical means to understand such disparities, was tested to examine the possible mediating effects of cognitive-emotional factors on the association between SES and health status. Data from 2,348 post-MI patients in PREMIER were used. Indicators of SES were collected during hospitalization via personal interviews, while participants completed measures of stress and reserves at 1 month, depressive symptoms at 6 months, and health status at 1 year through telephone interviews. Structural equation model results provide partial support for the RCM, as cognitive-emotional factors partially mediated the association between SES and mental health status. For physical health status, results supported direct rather than indirect effects of SES. Findings suggest psychosocial interventions with patients of low SES will have their greatest effects on appraisals of psychological health status.
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Tamayo T, Claessen H, Rückert IM, Maier W, Schunk M, Meisinger C, Mielck A, Holle R, Thorand B, Narres M, Moebus S, Mahabadi AA, Pundt N, Krone B, Slomiany U, Erbel R, Jöckel KH, Rathmann W, Icks A. Treatment pattern of type 2 diabetes differs in two German regions and with patients' socioeconomic position. PLoS One 2014; 9:e99773. [PMID: 24915157 PMCID: PMC4051778 DOI: 10.1371/journal.pone.0099773] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/19/2014] [Indexed: 11/19/2022] Open
Abstract
Background Diabetes treatment may differ by region and patients' socioeconomic position. This may be particularly true for newer drugs. However, data are highly limited. Methods We examined pooled individual data of two population-based German studies, KORA F4 (Cooperative Health Research in the Region of Augsburg, south), and the HNR (Heinz Nixdorf Recall study, west) both carried out 2006 to 2008. To ascertain the association between region and educational level with anti-hyperglycemic medication we fitted poisson regression models with robust error variance for any and newer anti-hyperglycemic medication, adjusting for age, sex, diabetes duration, BMI, cardiovascular disease, lifestyle, and insurance status. Results The examined sample comprised 662 participants with self-reported type 2 diabetes (KORA F4: 83 women, 111 men; HNR: 183 women, 285 men). The probability to receive any anti-hyperglycemic drug as well as to be treated with newer anti-hyperglycemic drugs such as insulin analogues, thiazolidinediones, or glinides was significantly increased in southern compared to western Germany (prevalence ratio (PR); 95% CI: 1.12; 1.02–1.22, 1.52;1.10–2.11 respectively). Individuals with lower educational level tended to receive anti-hyperglycemic drugs more likely than their better educated counterparts (PR; 95% CI univariable: 1.10; 0.99–1.22; fully adjusted: 1.10; 0.98–1.23). In contrast, lower education was associated with a lower estimated probability to receive newer drugs among those with any anti-hyperglycemic drugs (PR low vs. high education: 0.66; 0.48–0.91; fully adjusted: 0.68; 0.47–0.996). Conclusions We found regional and individual social disparities in overall and newer anti-hyperglycemic medication which were not explained by other confounders. Further research is needed.
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Affiliation(s)
- Teresa Tamayo
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Heiner Claessen
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Ina-Maria Rückert
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Werner Maier
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Michaela Schunk
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Christine Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Andreas Mielck
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Rolf Holle
- Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, Neuherberg, Germany
| | - Barbara Thorand
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Maria Narres
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Amir-Abbas Mahabadi
- Department of Cardiology, West-German Heart Center, University of Duisburg-Essen, Essen, Germany
| | - Noreen Pundt
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Bastian Krone
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Uta Slomiany
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- Department of Cardiology, West-German Heart Center, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital of Essen, University Duisburg-Essen, Essen, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Andrea Icks
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- Department of Public Health, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
- * E-mail:
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Individual-level socioeconomic status and community-level inequality as determinants of stigma towards persons living with HIV who inject drugs in Thai Nguyen, Vietnam. J Int AIDS Soc 2013; 16:18637. [PMID: 24242257 PMCID: PMC3833190 DOI: 10.7448/ias.16.3.18637] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 08/22/2013] [Accepted: 08/29/2013] [Indexed: 11/08/2022] Open
Abstract
Introduction HIV infection may be affected by multiple complex socioeconomic status (SES) factors, especially individual socioeconomic disadvantage and community-level inequality. At the same time, stigma towards HIV and marginalized groups has exacerbated persistent concentrated epidemics among key populations, such as persons who inject drugs (PWID) in Vietnam. Stigma researchers argue that stigma fundamentally depends on the existence of economic power differences in a community. In rapidly growing economies like Vietnam, the increasing gap in income and education levels, as well as an individual's absolute income and education, may create social conditions that facilitate stigma related to injecting drug use and HIV. Methods A cross-sectional baseline survey assessing different types of stigma and key socioeconomic characteristics was administered to 1674 PWID and 1349 community members living in physical proximity throughout the 32 communes in Thai Nguyen province, Vietnam. We created four stigma scales, including HIV-related and drug-related stigma reported by both PWID and community members. We then used ecologic Spearman's correlation, ordinary least-squares regression and multi-level generalized estimating equations to examine community-level inequality associations, individual-level SES associations and multi-level SES associations with different types of stigma, respectively. Results There was little urban–rural difference in stigma among communes. Higher income inequality was marginally associated with drug-related stigma reported by community members (p=0.087), and higher education inequality was significantly associated with higher HIV-related stigma reported by both PWID and community members (p<0.05). For individuals, higher education was significantly associated with lower stigma (HIV and drug related) reported by both PWID and community members. Part-time employed PWID reported more experiences and perceptions of drug-related stigma, while conversely unemployed community members reported enacting lower drug-related stigma. Multi-level analysis revealed that the relationship between education inequality and HIV-related stigma is superseded by the effect of individual-level education. Conclusions The results of the study confirm that socioeconomic factors at both the individual level and community level affect different types of stigma in different ways. Attention should be paid to these differences when planning structural or educational interventions to reduce stigma, and additional research should investigate the mechanisms with which SES and inequality affect social relationships and, in turn, stigma.
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