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Birkenmaier J, Jung E, McMillin S, Qian Z. Are credit scores and financial well-being associated with physical health? SOCIAL WORK IN HEALTH CARE 2023; 62:162-178. [PMID: 37120849 DOI: 10.1080/00981389.2023.2207614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/03/2022] [Accepted: 04/21/2023] [Indexed: 05/30/2023]
Abstract
Consumer credit score has been used as an indicator of financial strain that could potentially impact health. Subjective financial well-being, or one's feelings about one's expectations, preferences, and satisfaction with their financial situation, is related to financial strain. This study examined whether subjective financial well-being mediates the association between credit score and self-reported physical health in a national representative sample. Using structural equation modeling (SEM), we test whether a mediating association exists between self-rated credit score and self-rated physical health. Results suggest that, after controlling for sociodemographic variables, those who reported higher credit scores have better health (β = 0.175, p < .001) and higher financial well-being (β = 0.469, p < .001), and those who reported higher financial well-being have better health (β = 0.265, p < .001). The mediation effect of financial well-being on the association between credit and physical health is also positive and statistically significant (β = 0.299, p < .001). Thus, subjective feelings about one's financial situation would enhance the observed positive association between credit and health. Practice and policy implications are included.
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Affiliation(s)
- Julie Birkenmaier
- School of Social Work, Saint Louis University, St Louis, Missouri, USA
| | - Euijin Jung
- Refugee Behavioral Health Postdoctoral Fellow, Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, Massachusetts, USA
| | - Stephen McMillin
- School of Social Work, Saint Louis University, St Louis, Missouri, USA
| | - Zhengmin Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
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2
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Loibl C, Bruine de Bruin W, Summers B, McNair S, Verhallen P. Which financial stressors are linked to food insecurity among older adults in the United Kingdom, Germany, and the Netherlands? An exploratory study. Food Secur 2021. [DOI: 10.1007/s12571-021-01206-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Moeini S, Watzlaf V, Zhou L, Abernathy RP. Development of a Weighted Well-Being Assessment Mobile App for Trauma Affected Communities: A Usability Study. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2020; 18:1o. [PMID: 33633525 PMCID: PMC7883351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A well-being mobile app was built and tested by performing a usability study in a trauma affected community (TAC). Seven usability tasks were given to social workers during Phase 1. Phase 2 of the usability study was a re-test of the same tasks with the same social workers after refinements were applied. The results showed that most users preferred darker foreground colors, lighter background colors, larger fonts, and larger sized UI components. Statistically significant improvements were found after changes were implemented to the app and included time for page navigation (Z = -2.366, p = 0.018), logout (Z = -1.997, p = 0.046), and item selection in a page (Z = -2.371, p = 0.018). UI positioning and size changes proved to be a significant determinant of user satisfaction based on the positive feedback received from the computer systems usability questionnaire (CSUQ). (User1: p = .000, User 2 withdrew; User3: p = .010, User4: p = .000, User5: p = .001, User6: p = .006, User7: p = .025). HIM professionals assisted in the design, development, and administration of the usability study. This is another area in which HIM professionals are needed when assessing health and wellness in communities affected by trauma.
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Affiliation(s)
- Steve Moeini
- business intelligence engineer with over 15 years experience building analytics solutions in the healthcare sector. His background includes relational modeling and analytical design
| | - Valerie Watzlaf
- vice chair of education and associate professor within the Department of Health Information Management in the School of Health and Rehabilitation Sciences (SHRS) at the University of Pittsburgh. She also holds a secondary appointment in the Graduate School of Public Health
| | - Leming Zhou
- an associate professor and the program director for the Master of Science in Health Informatics program within the Department of Health Information Management. He also holds secondary appointments in the Department of Bioengineering in the School of Engineering and McGowan Institute for Regenerative Medicine
| | - Rev Paul Abernathy
- CEO of Neighborhood Resilience Project (NRP) located in Pittsburgh, PA. Rev. Paul has worked with the research team mentioned above in building various NRP projects related to TACs
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Widding-Havneraas T, Pedersen SH. The role of welfare regimes in the relationship between childhood economic stress and adult health: a multilevel study of 20 European countries. SSM Popul Health 2020; 12:100674. [PMID: 33083511 PMCID: PMC7552090 DOI: 10.1016/j.ssmph.2020.100674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/22/2020] [Accepted: 09/26/2020] [Indexed: 11/18/2022] Open
Abstract
Childhood economic conditions are important for adult health, and welfare regimes may modify this relationship by altering exposure to social determinants of health. We examine the association between childhood economic stress (CES) and self-rated health (SRH) and cancer (any type), and how welfare regimes may influence these associations. We used data from European Social Survey round 7. Our study is based on 30 024 individuals between 25 to 75 years from 20 European countries grouped into five welfare regimes (Scandinavian, Anglo-Saxon, Bismarckian, Southern and Eastern). Multilevel models were used to assess the association between CES and SRH/cancer, and interactions between CES and welfare regimes. CES increased the risk of poor SRH (RR 1.41, 95% CI 1.29–1.54) and cancer (RR 1.19, 95% CI 1.02–1.37). Controlling for adult socioeconomic status slightly reduced risk for poor SRH, but not cancer. CES increased the probability of poor SRH in the Southern and Eastern regime, and the probability of cancer in the Anglo-Saxon regime, relative to the Scandinavian regime. Childhood economic stress increases the risk of poor self-rated health and cancer. More comprehensive welfare states mitigate these associations, which emphasizes the impact of welfare policies on long-term health outcomes of childhood economic conditions. The association between childhood economic stress and adult self-rated health and cancer was examined. The interaction of childhood economic stress and welfare regimes was tested on a large data set with 20 European countries. The article draws on welfare regime and life course theory. Childhood economic stress increased risk of poor self-rated health and cancer in adulthood. Welfare regimes affected the association between childhood economic stress and adult poor self-rated health and cancer.
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Affiliation(s)
- Tarjei Widding-Havneraas
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Norway
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Samuel LJ, Szanton SL, Wolff JL, Ornstein KA, Parker LJ, Gitlin LN. Socioeconomic disparities in six-year incident dementia in a nationally representative cohort of U.S. older adults: an examination of financial resources. BMC Geriatr 2020; 20:156. [PMID: 32370792 PMCID: PMC7201761 DOI: 10.1186/s12877-020-01553-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 04/12/2020] [Indexed: 11/18/2022] Open
Abstract
Background Less educational training is consistently associated with incident dementia among older adults, but associations between income and financial strain with incident dementia have not been well tested in national samples. This is an important gap because, like education, financial resources are potentially modifiable by policy change and strengthening the social safety net. This study tested whether financial resources (income and financial strain) predict six-year incident dementia independent of education and occupation. Methods The National Health and Aging Trends Study is a prospective cohort study that recruited a nationally representative sample of U.S. Medicare beneficiaries aged ≥65 years. Incident dementia (2013 to 2018) was classified based on diagnosis, cognitive test scores or proxy-reported changes among participants dementia-free in 2012 (n = 3785). Baseline socioeconomic measures included income to poverty ratio (analyzed separately for those < 500% vs. ≥500% poverty threshold), financial strain, education and history of professional occupation. Discrete time survival analysis applied survey weights to account for study design and nonresponse. Coefficients were standardized to compare the strength of associations across the four socioeconomic measures. Results Adjusting for socioeconomic measures, demographic characteristics, home ownership, retirement, chronic conditions, smoking, BMI and depressive symptoms, higher income (hazard OR = 0.84, 95% CI: 0.74, 0.95 among those < 500% poverty) and higher education (hOR = 0.73, 95% CI: 0.65, 0.83) were associated with lower odds, and financial strain with higher odds (hOR = 1.20, 95% CI: 1.09, 1.31), of incident dementia. Conclusion Low income and greater financial strain predict incident dementia among older adults and associations are comparable to those of low education among U.S. older adults. Interventions to mitigate financial strain through improving access to economic opportunity and strengthening safety net programs and improving access to them in low income groups may complement other ongoing efforts to prevent dementia.
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Affiliation(s)
- Laura J Samuel
- Johns Hopkins University School of Nursing, 525 North Wolfe St., Rm 426, Baltimore, MD, 21205, USA.
| | - Sarah L Szanton
- Johns Hopkins University School of Nursing, 525 North Wolfe St., Rm 426, Baltimore, MD, 21205, USA.,Johns Hopkins Bloomberg School of Public Health Department of Health Policy and Management, Baltimore, USA
| | - Jennifer L Wolff
- Johns Hopkins Bloomberg School of Public Health Department of Health Policy and Management, Baltimore, USA
| | - Katherine A Ornstein
- Icahn School of Medicine at Mount Sinai, Department of Geriatrics and Palliative Medicine and Institute for Translational Epidemiology, New York, USA
| | - Lauren J Parker
- Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior and Society, New York, USA
| | - Laura N Gitlin
- Johns Hopkins University School of Nursing, 525 North Wolfe St., Rm 426, Baltimore, MD, 21205, USA.,Drexel University College of Nursing and Health Professions, Philadelphia, USA
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6
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Sieber S, Cheval B, Orsholits D, Van der Linden BW, Guessous I, Gabriel R, Kliegel M, Aartsen MJ, Boisgontier MP, Courvoisier D, Burton-Jeangros C, Cullati S. Welfare regimes modify the association of disadvantaged adult-life socioeconomic circumstances with self-rated health in old age. Int J Epidemiol 2020; 48:1352-1366. [PMID: 30608584 DOI: 10.1093/ije/dyy283] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Welfare regimes in Europe modify individuals' socioeconomic trajectories over their life-course, and, ultimately, the link between socioeconomic circumstances (SECs) and health. This paper aimed to assess whether the associations between life-course SECs (early-life, young adult-life, middle-age and old-age) and risk of poor self-rated health (SRH) trajectories in old age are modified by welfare regimes (Scandinavian [SC], Bismarckian [BM], Southern European [SE], Eastern European [EE]). METHODS We used data from the longitudinal SHARE survey. Early-life SECs consisted of four indicators of living conditions at age 10. Young adult-life, middle-age, and old-age SECs indicators were education, main occupation and satisfaction with household income, respectively. The association of life-course SECs with poor SRH trajectories was analysed by confounder-adjusted multilevel logistic regression models stratified by welfare regime. We included 24 011 participants (3626 in SC, 10 256 in BM, 6891 in SE, 3238 in EE) aged 50 to 96 years from 13 European countries. RESULTS The risk of poor SRH increased gradually with early-life SECs from most advantaged to most disadvantaged. The addition of adult-life SECs differentially attenuated the association of early-life SECs and SRH at older age across regimes: education attenuated the association only in SC and SE regimes and occupation only in SC and BM regimes; satisfaction with household income attenuated the association across regimes. CONCLUSIONS Early-life SECs have a long-lasting effect on SRH in all welfare regimes. Adult-life SECs attenuated this influence differently across welfare regimes.
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Affiliation(s)
- Stefan Sieber
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland
| | - Boris Cheval
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland
| | - Dan Orsholits
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland
| | - Bernadette W Van der Linden
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Idris Guessous
- Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Rainer Gabriel
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.,ZHAW School of Social Work, Institute of Diversity and Social Integration, Zurich, Switzerland
| | - Matthias Kliegel
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.,Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Marja J Aartsen
- NOVA - Norwegian Social Research, Centre for Welfare and Labour Research, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Matthieu P Boisgontier
- Brain Behaviour Laboratory, University of British Columbia, Vancouver, British Columbia, Canada.,Movement Control & Neuroplasticity Research Group, Department of Kinesiology, KU Leuven, Leuven, Belgium
| | - Delphine Courvoisier
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.,Unit of Population Epidemiology, Department of Community Medicine, Primary Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Claudine Burton-Jeangros
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- Swiss NCCR "LIVES - Overcoming Vulnerability: Life Course Perspectives", University of Geneva, Geneva, Switzerland.,Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
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7
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Richardson S, Carr E, Netuveli G, Sacker A. Country-level welfare-state measures and change in wellbeing following work exit in early old age: evidence from 16 European countries. Int J Epidemiol 2020; 48:389-401. [PMID: 30277529 PMCID: PMC6469302 DOI: 10.1093/ije/dyy205] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2018] [Indexed: 11/23/2022] Open
Abstract
Background Although the effects of individual-level factors on wellbeing change following work exit have been identified, the role of welfare-state variables at the country level has yet to be investigated. Methods Data on 8037 respondents aged 50 years and over in 16 European countries were drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA). We employed multilevel models to assess determinants of change in wellbeing following work exit, using CASP-12 change scores. After adjusting for institutionally defined route and timing of work exit, in addition to other individual-level variables, we tested country-level variables including welfare-state regime and measures of disaggregated welfare spending to determine their associations with wellbeing change and the proportion of between-country variance explained. Results Individuals whose exit from paid work was involuntary or diverged from the typical retirement age experienced declines in wellbeing. Country effects accounted for 7% of overall variance in wellbeing change. Individuals residing in countries with a Mediterranean welfare regime experienced more negative changes in wellbeing, with a difference of –2.15 (–3.23, –1.06) CASP-12 points compared with those in Bismarckian welfare states. Welfare regime explained 62% of between-country variance. National per-capita expenditure on non-healthcare in-kind benefits (services) was associated with more positive wellbeing outcomes. Conclusions National expenditure on in-kind benefits, particularly non-healthcare services, is associated with more favourable wellbeing change outcomes following work exit in early old age. Welfare-state effects explain the majority of between-country differences in change in wellbeing.
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Affiliation(s)
- Sol Richardson
- Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK
| | - Ewan Carr
- Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gopalakrishnan Netuveli
- Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK.,Institute for Health and Human Development, University of East London, London, UK
| | - Amanda Sacker
- Research Department of Epidemiology and Public Health, International Centre for Life Course Studies in Society and Health, University College London, London, UK
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8
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Shahidi FV, Muntaner C, Shankardass K, Quiñonez C, Siddiqi A. The effect of welfare reform on the health of the unemployed: evidence from a natural experiment in Germany. J Epidemiol Community Health 2020; 74:211-218. [PMID: 31915239 DOI: 10.1136/jech-2019-213151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/18/2019] [Accepted: 12/21/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Over the past several decades, governments have enacted far-reaching reforms aimed at reducing the generosity and coverage of welfare benefits. Prior literature suggests that these policy measures may have deleterious effects on the health of populations. In this study, we evaluate the impact of one of the largest welfare reforms in recent history-the 2005 Hartz IV reform in Germany-with a focus on estimating its effect on the health of the unemployed. METHODS We employed a quasi-experimental difference-in-differences (DID) design using population-based data from the German Socio-Economic Panel Study, covering the period between 1994 and 2016. We applied DID linear probability modelling to examine the association between the Hartz IV reform and poor self-rated health, adjusting for a range of demographic and socioeconomic confounders. RESULTS The Hartz IV reform was associated with a 3.6 (95% CI 0.9 to 6.2) percentage point increase in the prevalence of poor self-rated health among unemployed persons affected by the reform relative to similar but unaffected controls. This negative association appeared immediately following the implementation of the reform and has persisted over time. CONCLUSION Governments in numerous European and North American jurisdictions have introduced measures to further diminish the generosity and coverage of welfare benefits. In line with growing concerns over the potential consequences of austerity and associated policy measures, our findings suggest that these reform efforts pose a threat to the health of socioeconomically disadvantaged populations.
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Affiliation(s)
- Faraz V Shahidi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada .,Institute for Work and Health, Toronto, Ontario, Canada
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ketan Shankardass
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, Wilfrid Laurier University, Waterloo, Ontario, Canada.,Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Carlos Quiñonez
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
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Income Trajectories and Subjective Well-Being: Linking Administrative Records and Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234779. [PMID: 31795266 PMCID: PMC6926602 DOI: 10.3390/ijerph16234779] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 11/16/2019] [Accepted: 11/25/2019] [Indexed: 01/07/2023]
Abstract
An association between income and life satisfaction has been well documented, however, little is known of how income trajectories affect different facets of subjective well-being (SWB). The aim of this study was to examine how several aspects of income dynamics are related to life satisfaction and affect balance. Longitudinal information on income from administrative records covering 13 years (1999-2011) is linked to cross-sectional data on SWB collected in 2011/12 from the nationally representative Study on Mental Health at Work (S-MGA; n = 3364). Parameters from subject-specific regression analyses of income over time were used as indicators of income development in regressions over all participants, conducted separately for men and women. Associations between income and life satisfaction were stronger and more consistent than associations between income and affect balance. Major findings were that longer-term income change was more strongly related to SWB than current deviation from expected income. Higher stability in income development was associated with higher SWB. A higher share of income from benefits predicted lower life satisfaction and a more negative affect balance. Our results show the importance of examining income trajectories and taking into account source of income to gain a more differentiated view on the income-SWB association.
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Bambra C, Smith KE, Pearce J. Scaling up: The politics of health and place. Soc Sci Med 2019; 232:36-42. [PMID: 31054402 DOI: 10.1016/j.socscimed.2019.04.036] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 04/05/2019] [Accepted: 04/24/2019] [Indexed: 12/01/2022]
Abstract
Research into the role of place in shaping inequalities in health has focused largely on examining individual and/or localised drivers, often using a context-composition framing. Whilst this body of work has advanced considerably our understanding of the effects of local environments on health, and re-established an awareness of the importance of place for health, it has done so at the expense of marginalising and minimising the influences of macro political and economic structures on both place and health. In this paper, we argue that: (i) we need to scale up our analysis, moving beyond merely analysing local horizontal drivers to take wider, vertical structural factors into account; and (ii) if we are serious about reducing place-based health inequalities, such analysis needs be overtly linked to appropriate policy levers. Drawing on three case studies (the US mortality disadvantage, Scotland's excess mortality, and regional health divides in England and Germany) we outline the theoretical and empirical value of taking a more political economy approach to understanding geographical inequalities in health. We conclude by outlining the implications for future research and for efforts to influence policy from 'scaling up' geographical research into health inequalities.
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Affiliation(s)
- Clare Bambra
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, UK.
| | - Katherine E Smith
- Global Health Policy Unit, Department of Social Policy, Edinburgh University, UK
| | - Jamie Pearce
- Centre for Research on Environment Society and Health (CRESH), School of Geosciences, Edinburgh University, UK
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11
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Can physical activity compensate for low socioeconomic status with regard to poor self-rated health and low quality-of-life? Health Qual Life Outcomes 2019; 17:33. [PMID: 30736815 PMCID: PMC6368755 DOI: 10.1186/s12955-019-1102-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 01/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Both high socioeconomic status (SES) and high physical activity (PA) are associated with better self-rated health (SRH) and higher quality-of-life (QoL). Aim To investigate whether high levels of PA may compensate for the association between low SES and subjective health outcomes in terms of poorer SRH and lower QoL. Method Data from a cross-sectional, population-based study (n = 5326) was utilized. Multiple logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between indicators of SES (economic situation and educational level), SRH and QoL, as well as between the combination of SES and PA in relation to SRH and QoL. Result Participants with high PA and economic problems had approximately the same OR for good SRH as those with low PA and without economic problems (OR 1.75 [95% CI 1.20–2.54] and 1.81 [1.25–2.63] respectively). Participants with high PA and low education had higher odds for good SRH (OR 3.34 [2.96–5.34] compared to those with low PA and high education (OR 1.46 [0.89–2.39]).Those with high PA and economic problems had an OR of 2.09 [1.42–3.08], for high QoL, while the corresponding OR for those with low PA and without economic problems was 4.38 [2.89–6.63]. Conclusion Physically active people with low SES, had the same or even better odds to report good SRH compared to those with low PA and high SES. For QoL the result was not as consistent. The findings highlight the potential for promotion of PA to reduce SES-based inequalities in SRH. Electronic supplementary material The online version of this article (10.1186/s12955-019-1102-4) contains supplementary material, which is available to authorized users.
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12
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Ward M, McGarrigle CA, Kenny RA. More than health: quality of life trajectories among older adults—findings from The Irish Longitudinal Study of Ageing (TILDA). Qual Life Res 2018; 28:429-439. [DOI: 10.1007/s11136-018-1997-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2018] [Indexed: 11/28/2022]
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13
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Ribeiro AI, Krainski ET, Carvalho MS, Launoy G, Pornet C, de Pina MDF. Does community deprivation determine longevity after the age of 75? A cross-national analysis. Int J Public Health 2018; 63:469-479. [PMID: 29480326 DOI: 10.1007/s00038-018-1081-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 01/27/2018] [Accepted: 02/10/2018] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Analyze the association between socioeconomic deprivation and old-age survival in Europe, and investigate whether it varies by country and gender. METHODS Our study incorporated five countries (Portugal, Spain, France, Italy, and England). A 10-year survival rate expressing the proportion of population aged 75-84 years who reached 85-94 years old was calculated at area-level for 2001-11. To estimate associations, we used Bayesian spatial models and a transnational measure of deprivation. Attributable/prevention fractions were calculated. RESULTS Overall, there was a significant association between deprivation and survival in both genders. In England that association was stronger, following a dose-response relation. Although lesser in magnitude, significant associations were observed in Spain and Italy, whereas in France and Portugal these were even weaker. The elimination of socioeconomic differences between areas would increase survival by 7.1%, and even a small reduction in socioeconomic differences would lead to a 1.6% increase. CONCLUSIONS Socioeconomic deprivation was associated with survival among older adults at ecological-level, although with varying magnitude across countries. Reasons for such cross-country differences should be sought. Our results emphasize the importance of reducing socioeconomic differences between areas.
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Affiliation(s)
- Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600, Porto, Portugal. .,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal. .,INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
| | - Elias Teixeira Krainski
- The Norwegian University for Science and Technology, Trondheim, Norway.,Departamento de Estatística, Universidade Federal do Paraná, Curitiba, Brazil
| | - Marilia Sá Carvalho
- PROCC-Programa de Computação Científica, Fundação Oswaldo Cruz, Rio De Janeiro, Brazil
| | - Guy Launoy
- U1086 INSERM-University of Caen Normandy (FRANCE), CHU Caen, Caen, France
| | - Carole Pornet
- Public Health Department, Regional Health Agency of Normandy, Caen, France
| | - Maria de Fátima de Pina
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal.,ICICT/FIOCRUZ, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde/Fundação Oswaldo Cruz, Rio De Janeiro, Brazil.,CARTO, FEN/UERJ, Departamento de Engenharia Cartográfica, Faculdade de Engenharia da, Universidade do Estado do Rio de Janeiro, Rio De Janeiro, Brazil
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Buttrick NR, Heintzelman SJ, Oishi S. Inequality and well-being. Curr Opin Psychol 2017; 18:15-20. [DOI: 10.1016/j.copsyc.2017.07.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 06/06/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022]
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Niedzwiedz CL, Katikireddi SV, Reeves A, McKee M, Stuckler D. Economic insecurity during the Great Recession and metabolic, inflammatory and liver function biomarkers: analysis of the UK Household Longitudinal Study. J Epidemiol Community Health 2017; 71:1005-1013. [PMID: 28855264 PMCID: PMC5754862 DOI: 10.1136/jech-2017-209105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/12/2017] [Accepted: 06/14/2017] [Indexed: 12/11/2022]
Abstract
Background Economic insecurity correlates with adverse health outcomes, but the biological pathways involved are not well understood. We examine how changes in economic insecurity relate to metabolic, inflammatory and liver function biomarkers. Methods Blood analyte data were taken from 6520 individuals (aged 25–59 years) participating in Understanding Society. Economic insecurity was measured using an indicator of subjective financial strain and by asking participants whether they had missed any bill, council tax, rent or mortgage payments in the past year. We investigated longitudinal changes in economic insecurity (remained secure, increase in economic insecurity, decrease in economic insecurity, remained insecure) and the accumulation of economic insecurity. Linear regression models were calculated for nine (logged) biomarker outcomes related to metabolic, inflammatory, liver and kidney function (as falsification tests), adjusting for potential confounders. Results Compared with those who remained economically stable, people who experienced consistent economic insecurity (using both measures) had worsened levels of high-density lipoprotein (HDL)-cholesterol, triglycerides, C reactive protein (CRP), fibrinogen and glycated haemoglobin. Increased economic insecurity was associated with adverse levels of HDL-cholesterol (0.955, 95% CI 0.929 to 0.982), triglycerides (1.077, 95% CI 1.018 to 1.139) and CRP (1.114, 95% CI 1.012 to 1.227), using the measure of financial strain. Results for the other measure were generally consistent, apart from the higher levels of gamma-glutamyl transferase observed among those experiencing persistent insecurity (1.200, 95% CI 1.110 to 1.297). Conclusion Economic insecurity is associated with adverse metabolic and inflammatory biomarkers (particularly HDL-cholesterol, triglycerides and CRP), heightening risk for a range of health conditions.
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Affiliation(s)
| | | | - Aaron Reeves
- International Inequalities Institute, London School of Economics and Political Science, London, UK
| | - Martin McKee
- Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - David Stuckler
- Department of Policy Analysis and Public Management, University of Bocconi, Milan, Italy
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Zhou L, Watzlaf V, Abernathy P, Abdelhak M. A Health Information System for Scalable and Comprehensive Assessment of Well-Being: A Multidisciplinary Team Solution. PERSPECTIVES IN HEALTH INFORMATION MANAGEMENT 2017; 14:1d. [PMID: 28855857 PMCID: PMC5559692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
To improve the health and well-being of the medically underserved in a free clinic in Pittsburgh, Pennsylvania, a multidisciplinary team representing several health information management and information technology (IT) professionals, including faculty, students, researchers, and clinicians, created a novel IT system called imHealthy. The imHealthy system includes four critical components: a multidomain well-being questionnaire, a mobile app for data collection and tracking, a customization of an open-source electronic health record (EHR), and a data integration and well-being evaluation program leading to recommendations for personalized interventions to caregivers serving the medically underserved. This multidisciplinary team has worked closely on this project and finished critical components of the imHealthy system. Evaluations of these components will be conducted, and factors facilitating the design and adoption of the imHealthy system will be presented. The results from this research can serve as a model for free clinics with similar needs that identified by the research team in Cleveland, Indianapolis, Minnesota, Motor City, Orange County, San Diego, and St. Louis.
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Affiliation(s)
- Leming Zhou
- Department of Health Information Management at the University of Pittsburgh in Pittsburgh, PA
| | - Valerie Watzlaf
- Department of Health Information Management at the University of Pittsburgh in Pittsburgh, PA
| | | | - Mervat Abdelhak
- Department of Health Information Management at the University of Pittsburgh in Pittsburgh, PA
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Sahrakorpi N, Koivusalo SB, Eriksson JG, Kautiainen H, Stach-Lempinen B, Roine RP. Perceived Financial Satisfaction, Health Related Quality of Life and depressive Symptoms in Early Pregnancy. Matern Child Health J 2017; 21:1493-1499. [DOI: 10.1007/s10995-017-2271-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Niedzwiedz CL, Richardson EA, Tunstall H, Shortt NK, Mitchell RJ, Pearce JR. The relationship between wealth and loneliness among older people across Europe: Is social participation protective? Prev Med 2016; 91:24-31. [PMID: 27471027 DOI: 10.1016/j.ypmed.2016.07.016] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/09/2016] [Accepted: 07/23/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE 1. Examine the relationship between household wealth, social participation and loneliness among older people across Europe. 2. Investigate whether relationships vary by type of social participation (charity/volunteer work, sports/social clubs, educational/training course, and political/community organisations) and gender. 3. Examine whether social participation moderates the association between wealth and loneliness. METHODS Data (N=29,795) were taken from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), which was collected during 2013 from 14 European countries. Loneliness was measured using the short version of the Revised-University of California, Los Angeles (R-UCLA) Loneliness Scale. We used multilevel logistic models stratified by gender to examine the relationships between variables, with individuals nested within countries. RESULTS The risk of loneliness was highest in the least wealthy groups and lowest in the wealthiest groups. Frequent social participation was associated with a lower risk of loneliness and moderated the association between household wealth and loneliness, particularly among men. Compared to the wealthiest men who often took part in formal social activities, the least wealthy men who did not participate had greater risk of loneliness (OR=1.91, 95% CI: 1.44 to 2.51). This increased risk was not observed among the least wealthy men who reported frequent participation in formal social activities (OR=1.12, 95% CI: 0.76 to 1.67). CONCLUSION Participation in external social activities may help to reduce loneliness among older adults and potentially acts as a buffer against the adverse effects of socioeconomic disadvantage.
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Affiliation(s)
- Claire L Niedzwiedz
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, Scotland EH8 9XP, UK.
| | - Elizabeth A Richardson
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, Scotland EH8 9XP, UK.
| | - Helena Tunstall
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, Scotland EH8 9XP, UK.
| | - Niamh K Shortt
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, Scotland EH8 9XP, UK.
| | - Richard J Mitchell
- Centre for Research on Environment, Society and Health (CRESH), University of Glasgow, Glasgow, Scotland G12 8RZ, UK.
| | - Jamie R Pearce
- Centre for Research on Environment, Society and Health (CRESH), University of Edinburgh, Edinburgh, Scotland EH8 9XP, UK.
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Niedzwiedz CL, Mitchell RJ, Shortt NK, Pearce JR. Social protection spending and inequalities in depressive symptoms across Europe. Soc Psychiatry Psychiatr Epidemiol 2016; 51:1005-14. [PMID: 27138947 PMCID: PMC4947487 DOI: 10.1007/s00127-016-1223-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/16/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Common mental disorders are an increasing global public health concern. The least advantaged in society experience a greater burden of mental illness, but inequalities in mental health vary by social, political, and economic contexts. This study investigates whether spending on different types of social protection alters the extent of social inequality in depressive symptoms. METHODS Data were obtained from the 2006 and 2012 cross-sectional waves of the European Social Survey, which included 48,397 individuals from 18 European countries. Depressive symptoms were measured using the Centre for Epidemiologic Studies-Depression Scale (CES-D 8). Statistical interactions between country-level social protection spending and individuals' education level, employment and family status were explored using multilevel regression models. RESULTS Higher spending on active labour market programmes was related to narrower inequality in depressive symptoms by education level. Compared to men with high education, the marginal effect of having low education was 1.67 (95 % CI, 1.46-1.87) among men in countries with lower spending and 0.85 (95 % CI, 0.66-1.03) in higher spending countries. Single parents exhibited fewer depressive symptoms, as spending on family policies increased. Little evidence was found for an overall association between spending on unemployment benefits and employment-related inequalities in depressive symptoms, but in 2012, unemployment spending appeared beneficial to mental health among the unemployed. CONCLUSIONS Greater investment in social protection may act to reduce inequalities in depressive symptoms. Reductions in spending levels or increased conditionality may adversely affect the mental health of disadvantaged social groups.
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Affiliation(s)
- Claire L. Niedzwiedz
- />Centre for Research on Environment, Society and Health, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP Scotland, UK
| | - Richard J. Mitchell
- />Centre for Research on Environment, Society and Health, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ Scotland, UK
| | - Niamh K. Shortt
- />Centre for Research on Environment, Society and Health, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP Scotland, UK
| | - Jamie R. Pearce
- />Centre for Research on Environment, Society and Health, University of Edinburgh, Drummond Street, Edinburgh, EH8 9XP Scotland, UK
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