Social inequality in the later life: cross-national comparison of quality of life.
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SUBMITTER: Motel-Klingebiel A
PROVIDER: S-EPMC5502678 | biostudies-other | 2004 Dec
REPOSITORIES: biostudies-other
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Project description:Social wellbeing is important to health, but maintaining social relations often becomes difficult in later life due to retirement, chronic disease, and the death of spouses and friends. Social media platforms, such as Facebook and Twitter, present accessible and low-cost communication technologies that have been demonstrated to enhance feelings of social connection and reduce loneliness in younger age groups. This exploratory study uses a four-week social media training workshop as an intervention in a randomised controlled study to examine whether similar social benefits might be realised for those at older ages, aged 65+ years. Social wellbeing measures of social capital, loneliness, social connectedness and social provisions were examined, revealing only small differences in social integration. As these findings seemingly contradict studies conducted with younger persons, the contexts of social media use in older adulthood are discussed, along with proposals for future research directions.
| S-EPMC10081153 | biostudies-literature
Project description:Background This study aimed to examine the association between exposure to the 1976 Great Tangshan Earthquake (GTE) in adolescence and later-life depressive symptoms and to investigate the potential mechanisms underlying this association. Methods Data were from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The 10-item short form of the Center for Epidemiologic Studies Depression scale (CESD-10) was chosen to measure depressive symptoms. We used the difference-in-difference (DID) method, binary logistic regression models, and multilevel logistic regression models to explore the association of earthquake exposure during adolescence with later-life depressive symptoms. Additionally, multilevel mediation analysis with structural equation modeling (MMSEM) was conducted to investigate potential mechanisms. Results We identified that adolescent exposure to earthquakes was related to a lower risk of depressive symptoms in later life (OR = 0.90, P = 0.019; OR = 0.48, P = 0.031; OR = 0.47, P = 0.034, respectively). However, this significant association was observed only in females (OR = 0.83, P = 0.028; OR = 0.46, P = 0.053; OR = 0.42, P = 0.037, respectively). Moreover, social activity participation played a mediating role in the association between exposure to earthquakes in adolescence and later-life depressive symptoms. Conclusions We observed a lower risk of depressive symptoms in later life in survivors of earthquake exposure during adolescence. Further, we found the mediating role of social participation in the association between earthquake exposure in adolescence and later-life depressive symptoms, which gives support for the posttraumatic growth (PTG) theory. Our findings imply that, in order to lower the risk of depression in later life following exposure to a natural disaster in adolescence, it is necessary to take into account the buffering effect of social participation. Highlights • Earthquake exposure in adolescence was related to lower later-life depression.• However, this significant association was found only in females, not in males.• Social participation mediates earthquake exposure's linkage with later depression.• The mediating role of social participation supports posttraumatic growth theory.
| S-EPMC10448222 | biostudies-literature
Project description:BACKGROUND:The aim of this study was to measure differences in quality-adjusted life expectancy (QALE) by income in Korea at the national and district levels. METHODS:Mortality rates and EuroQol-5D (EQ-5D) scores were obtained from the National Health Information Database of the National Health Insurance Service and the Korea Community Health Survey, respectively. QALE and differences in QALE among income quintiles were calculated using combined 2008-2014 data for 245 districts in Korea. Correlation analyses were conducted to investigate the associations of neighborhood characteristics with QALE and income gaps therein. RESULTS:QALE showed a graded pattern of inequality according to income, and increased over time for all levels of income and in both sexes, except for low-income quintiles among women, resulting in a widened inequality in QALE among women. In all 245 districts, pro-rich inequalities in QALE were found in both men and women. Districts with higher QALE and smaller income gaps in QALE were concentrated in metropolitan areas, while districts with lower QALE and larger income gaps in QALE were found in rural areas. QALE and differences in QALE by income showed relatively close correlations with socioeconomic characteristics, but relatively weak correlations with health behaviors, except for smoking and indicators related to medical resources. CONCLUSIONS:This study provides evidence of income-based inequalities in health measured by QALE in all subnational areas in Korea. Furthermore, QALE and differences in QALE by income were closely associated with neighborhood-level socioeconomic characteristics.
| S-EPMC7045490 | biostudies-literature
Project description:BackgroundSocioeconomic inequality in access to and use of health services and social care provided near the end of life, or end-of-life care (EOLC), is not well understood in many countries. We examined wealth inequality in EOLC-hospital, nursing home, and hospice use and receipt of formal and informal caregiving-in 22 countries in Europe, Asia (South Korea), and North America (United States, Mexico).MethodsWe used harmonized data from nationally representative studies of people aged 50 and older that collected information on healthcare utilisation and caregiving receipt in the time preceding death. We categorized countries according to their level of public long-term care (LTC) spending and examined EOLC prevalence across countries. We used logistic regression models to estimate wealth inequality in each type of EOLC.FindingsIn the USA the least wealthy had more hospital (OR 1.30, p = 0.008) and nursing home/care use (OR 1.88, p < 0.001). In South Korea the least wealthy had more nursing home/care use (OR 2.24, p = 0.003). The least wealthy in high LTC Europe had less hospice use (OR 0.56, p = 0.003). The least wealthy were also less likely to be hospitalized in European countries with low LTC spending (OR 0.81, p = 0.04), but more likely to receive informal caregiving (OR 1.25, p = 0.033). Formal care was more common among the least wealthy in high LTC Europe (OR 1.57, p = 0.002), the USA (OR 1.42, p < 0.001) and South Korea (OR 1.69, p = 0.028), but less common among the least wealthy in Mexico (OR 0.17, p < 0.001).InterpretationWealth inequality in EOLC exists across countries and reflects differences in the organization, financing, and delivery of care in different countries. The findings highlight the need to consider equity in current and future plans to improve EOLC access.FundingUnited States National Institute on Aging Grant R01AG030153.
| S-EPMC10030998 | biostudies-literature
Project description:OBJECTIVES:To investigate associations between level and changes in social isolation and in memory in older men and women. METHODS:The sample included 6,123 women and 5,110 men aged 50+ from the English Longitudinal Study of Aging (ELSA). Extended latent change score models from six measurement occasions every 2 years from 2002 were used to investigate associations between social isolation and memory. Models were adjusted for age, socioeconomic position, and health. RESULTS:Social isolation increased and memory decreased over time. Among men an initially high level of social isolation was associated with a somewhat greater decrease in memory. Among women a greater increase in social isolation predicted a greater decrease in memory and a larger change in social isolation was associated with further larger changes in isolation, although when social isolation reached a higher level it subsequently decreased. CONCLUSIONS:Results suggest that the association between social isolation and memory decline arises because social isolation is associated with increased memory decline rather than poor memory leading to increases in social isolation. Men with high levels of social isolation and women with accumulated social isolation over time are especially affected as these patterns of isolation were associated with more profound memory decline.
| S-EPMC6963696 | biostudies-literature
Project description:BACKGROUND:Single motherhood is associated with poorer health, but whether this association varies between countries is not known. We examine associations between single motherhood and poor later-life health in the USA, England and 13 European countries. METHODS:Data came from 25?125 women aged 50+ who participated in the US Health and Retirement Study, the English Longitudinal Study of Ageing and Survey of Health, Ageing and Retirement in Europe. We tested whether single motherhood at ages 16-49 was associated with increased risk of limitations with activities of daily living (ADL), instrumental ADL and fair/poor self-rated health in later life. RESULTS:33% of American mothers had experienced single motherhood before age 50, versus 22% in England, 38% in Scandinavia, 22% in Western Europe and 10% in Southern Europe. Single mothers had higher risk of poorer health and disability in later life than married mothers, but associations varied between countries. For example, risk ratios for ADL limitations were 1.51 (95% CI 1.29 to 1.98) in England, 1.50 (1.10 to 2.05) in Scandinavia and 1.27 (1.17 to 1.40) in the USA, versus 1.09 (0.80 to 1.47) in Western Europe, 1.13 (0.80 to 1.60) in Southern Europe and 0.93 (0.66 to 1.31) in Eastern Europe. Women who were single mothers before age 20, for 8+ years, or resulting from divorce or non-marital childbearing, were at particular risk. CONCLUSIONS:Single motherhood during early-adulthood or mid-adulthood is associated with poorer health in later life. Risks were greatest in England, the USA and Scandinavia. Selection and causation mechanisms might both explain between-country variation.
| S-EPMC4759498 | biostudies-literature
Project description:ObjectivesPrior research points to the importance of couple-level religious similarity for multiple dimensions of partnership quality and stability but few studies have investigated whether this association holds for older couples.MethodThe current article uses dyadic data from the National Social Life, Health, and Aging Project (NSHAP), a representative sample of 953 individuals age 62-91 plus their marital or cohabiting partners. We use modified actor-partner interdependence models.ResultsReligious service heterogamy predicted lower relationship happiness and satisfaction. Both associations were partially explained by the fact that religiously dissimilar partners report relatively little free time in joint activity. Further, religiously heterogamous couples had less frequent sex and engaged in less nonsexual touch than their more similar counterparts.ConclusionsTaken together, results attest to the ongoing importance of religious similarity-service attendance, in particular-for partnership quality in late life. Future research is needed to more fully examine which mechanisms account for these patterns.
| S-EPMC7357957 | biostudies-literature
Project description:In Bandung, Indonesia, urban expansion, rapid economic growth, and population increase present enormous challenges to the maintenance of a high quality of life (QOL) for its citizens. Moreover, income distribution in the city has become more unequal, thereby threatening social cohesion. Such situations led us to investigate the states and correlation of social cohesion and QOL in Bandung. In 2018, we conducted a questionnaire survey of social cohesion and QOL using 13 and 18 question items, respectively. We employed the Rasch model analysis to analyze the logit measures of 752 responses. The results revealed that the population of Bandung has high social cohesion and decent QOL. Our findings suggest that in Bandung QOL is significantly correlated with social cohesion, therefore strategies that seek to enhance social cohesion may be beneficial to improve the QOL.
| S-EPMC8513873 | biostudies-literature
Project description:BackgroundWith a growing population of cancer survivors in Denmark, the evaluation of health-related quality of life (HRQoL) has become increasingly important. We describe variations in HRQoL between educational groups in a national population of cancer survivors.MethodsWe conducted a cross-sectional questionnaire study among breast, prostate, lung, and colon cancer survivors diagnosed in 2010-2019 in Denmark. We used the EORTC QLQ-C30 to assess HRQoL including physical, role, emotional, cognitive, social functioning, and symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties). Information on educational level and clinical data were extracted from national registers and clinical databases. Levels of impaired functioning and severe symptoms were identified using newly established thresholds for clinical importance. Multivariate logistic regression was used to examine associations between education and HRQoL. All statistical tests were 2-sided.ResultsIn total, 27,857 (42%) participated in the study. Up to 72% and 75% of cancer survivors with short education (≤9 years) reported impaired functioning and severe symptoms, respectively. Cancer survivors with short compared to long education (>12 years) were more likely to report impaired functioning and severe symptoms, with for example significantly higher odds ratios (ORs) for impaired physical function (breast OR = 2.41, 99% CI = 2.01-2.89; prostate OR = 1.81, 99% CI = 1.48-2.21; lung OR = 2.97, 99% CI = 1.95-4.57; and colon cancer OR = 1.69, 99% CI = 1.28-2.24).ConclusionsCancer survivors with short education are at greater risk of impaired HRQoL than survivors with long education 2-12 years after diagnosis. This underscores the need for systematic screening and symptom management in cancer aftercare, in order to reach all cancer survivors, also cancer survivors with short education.
| S-EPMC10587985 | biostudies-literature
Project description:Older American adults are increasingly utilizing communication technologies, but research has seldom explored older adults' daily social media use and its interface with other "offline" social ties. To explore a complementary and/or compensatory function of social media in later life, this study employed data from the Daily Experiences and Well-Being Study (2016-2017) to examine associations between daily social media use, daily social encounters, social network structure, and daily mood. Community-dwelling older adults (N = 310; Mage = 73.96) reported on their overall social network structure (diversity in types of social ties and size of network), their daily social encounters in-person and by phone, social media use, and emotional well-being for 5 to 6 days. Multilevel models revealed that daily social media use was associated with daily mood in the context of daily social encounters and the size of the social network. Individuals reported less negative mood on days with more social media use and more in-person encounters. More daily social media use was associated with more positive mood for individuals with a relatively small social network but not for their counterparts with larger social networks. Findings suggest that social media is a distinct form of social resource in later life that may complement the emotional benefits of daily social encounters and compensate for the age-related reduction in social network size. Future research should consider how socially isolated older adults might use computer-mediated communication such as social media to foster a sense of social connection.
| S-EPMC10508904 | biostudies-literature