Key elements composing self-rated health in older adults: a comparative study of 11 European countries.
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ABSTRACT:
SUBMITTER: Verropoulou G
PROVIDER: S-EPMC5547370 | biostudies-other | 2009 Sep
REPOSITORIES: biostudies-other
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Project description:BACKGROUND: The global financial crisis of 2008 is likely to have repercussions on public health in Europe, not least through escalating mass unemployment, fiscal austerity measures and inadequate social protection systems. The purpose of this study is to analyse the role of unemployment insurance for deteriorating self-rated health in the working age population at the onset of the fiscal crisis in Europe. METHODS: Multilevel logistic conditional change models linking institutional-level data on coverage and income replacement in unemployment insurance to individual-level panel data on self-rated health in 23 European countries at two repeated occasions, 2006 and 2009. RESULTS: Unemployment insurance significantly reduces transitions into self-rated ill-health and, particularly, programme coverage is important in this respect. Unemployment insurance is also of relevance for the socioeconomic gradients of health at individual level, where programme coverage significantly reduces health risks attached to educational attainment. CONCLUSIONS: Unemployment insurance mitigated adverse health effects both at individual and country-level during the financial crisis. Due to the centrality of programme coverage, reforms to unemployment insurance should focus on extending the number of insured people in the labour force.
| S-EPMC4112438 | biostudies-literature
Project description:Self-rated health (SRH) may have different implications in various social and cultural settings. However, few studies are available concerning SRH among older persons across countries. The aim of this study was to analyse whether there are cross-national differences in the association between status characteristics, several diseases common among older persons, activities of daily living (ADL), and SRH. The study base was the Comparison of Longitudinal European Studies on Aging (CLESA), which includes data from six population-based studies on aging conducted in Finland, Israel, Italy, The Netherlands, Spain and Sweden. The study population comprised 5,629 persons, with participants from all countries except Italy. Logistic regression analyses were used to assess the relationship between status characteristics, health conditions, ADL and SRH. To examine whether the association among status characteristics, health conditions, ADL and outcome differed across the CLESA countries, interaction terms defined as "variable*country" were considered separately for each variable. Regression analyses revealed that sex, education, lifetime occupation, heart disease and respiratory disease were differently distributed across countries. Among homogeneous factors, marital status (OR=1.21), hypertension (OR=1.41), stroke (OR=1.67), diabetes (OR=2.15), cancer (OR=1.47), musculoskeletal diseases (OR=2.44), and ADL (OR=2.72) turned out to be significantly associated with fair or poor SRH. The results indicate that there are differences in self-ratings of health across countries. These differences cannot be explained entirely by status characteristics, self-reported diseases or functional ability. However, an important finding was that in all countries most of the indicators of medical and functional health were homogeneously associated with SRH.
| S-EPMC5547684 | biostudies-other
Project description:Both self-rated health (SRH) and inflammation are implicated in chronic diseases and premature mortality. Better SRH is associated with lower proinflammatory cytokines, but there is little evidence about whether this relationship is more stable or dynamic.To study the between- and within-person associations between SRH and IL-6.Older adults (N=131; Mage=75 years) rated their health and provided blood samples for analysis of IL-6 at separate occasions every 6 months over a period up to 5 years. Age, sex, BMI, neuroticism, and statin use were examined as covariates in multilevel models.In bivariate models, better SRH, lower BMI, younger age, and female sex correlated with lower IL-6. In multilevel models, stable SRH (between-person differences; p<.001) but not dynamic SRH (within-person changes; p=.93) correlated with IL-6. The stable relationship persisted with demographic and health covariates in the model.Better stable SRH but not dynamic SRH was robustly associated with lower IL-6 among older adults, lending support to previous cross-sectional findings on the relation between inflammatory markers and SRH. The findings suggest that trait-like mechanisms, rather than changes over a time scale of 6-month waves, govern this association. To further investigate the mechanisms behind the SRH-IL-6 association, studies with different measurement frequencies, higher within-person variability, and experimental approaches are warranted.
| S-EPMC4828288 | biostudies-literature
Project description:In this study we investigate the impact of individual, parental and social factors on young adults’ job-finding intentions across countries and overall. We test our hypotheses by conducting binary logistic regressions on the basis of an original dataset that comprises responses from more than 5200 young adults and their parents from 11 European countries. Our findings show that individual factors are most decisive in shaping the job-finding intentions of young adults. Most importantly, being enrolled in education does not prevent young adults from lowering their aspirations with respect to anticipated earnings or finding more sophisticated jobs. Social factors, in terms of being socially involved or having more friends in employment, lead to stronger mobility intentions as well as to stronger intentions to improve skills or develop new ones. At the country level, and compared to Italian participants, who go through a longer school-to-work transition, participants from Northern or Central European countries, as well as from the United Kingdom, show weaker mobility intentions. In many of these countries, young adults are also more willing than their Italian counterparts to lower income aspirations, while being less inclined to lower their aspirations in terms of finding more sophisticated jobs. In a last step, we reflect on education as a means of improving professional aspirations and the need to offer adequate on-the-ground services to help young people through the school-to-work transition, especially in Southern European countries. Supplementary Information The online version contains supplementary material available at 10.1007/s11205-022-02941-6.
| S-EPMC9261251 | biostudies-literature
Project description:The objectives of this quantitative study were to (1) ascertain to what extent older adults aged 50 and above feel and desire to be younger than their age, and classify themselves as young versus old; (2) compare these patterns with those found among other cross-cultural populations; and (3) assess the extent to which self-rated health and life satisfaction predict age identities. This study was carried out on a sample of 500 dwellers of the Senegalese capital aged 50 and older. This sample was constructed using the quota method to strive for representativeness. Most of the respondents wanted to be younger than their chronological age (51.8 %), but only 27.8 % felt younger than they were. Moreover, 80 % of the sample claimed to be old. Self-rated health predicted felt age and the feeling of being old. Furthermore, the less-satisfied Dakar residents were with their life, the younger they wanted to be. We first discuss our results in a comparative perspective focused on how orientations toward individualism and collectivism could be related to age identity, and on demographic characteristics of the Senegalese population-where life expectancy is 59.3 years old. We then analyze the relevance of age identity dimensions as indicators of successful aging in Dakar.
| S-EPMC5547411 | biostudies-other
Project description:BackgroundAs more individuals survive sepsis, there is an urgent need to understand its effects on patient-reported outcomes.Research questionWhat is the effect of sepsis on self-rated health, and what role, if any, does functional disability play in mediating this effect?Study design and methodsWe conducted a survey- and administrative claims-based retrospective cohort study using the US Health and Retirement Study, a nationally representative cohort-based survey of older adults in the United States, from 2000 through 2016. We matched Medicare beneficiaries hospitalized with sepsis in 2000 to 2008 to nonhospitalized individuals. Self-rated health and functional disability were tracked biannually for 8 years. Differences in self-rated health between the cohorts were measured using mixed models with and without controlling for changes in functional disability.ResultsSeven hundred fifty-eight individuals with sepsis were matched 1:1 to 758 nonhospitalized individuals, all aged 65 years and older. Among survivors, sepsis was associated with worse self-rated health in years 2 and 4 (adjusted absolute difference in self-rated health on a 5-point scale in year 2: -0.24 [95% CI, -0.38 to -0.10] and year 4: -0.17 [95% CI, -0.33 to -0.02]) but not in years 6 or 8. After accounting for changes in functional status, the association between sepsis and self-rated health was still present but reduced in year 2 (adjusted absolute difference in self-rated health, -0.18 [95% CI, -0.31 to -0.05]) and was not present in years 4, 6, or 8.InterpretationSelf-rated health worsened initially after sepsis but returned to the level of that of nonhospitalized control subjects by year 6. Mitigating sepsis-related functional disability may play a key role in improving self-rated health after sepsis.
| S-EPMC7674979 | biostudies-literature
Project description:ObjectivesThis article examines patterns of self-rated physical and mental health by sexual orientation among middle-aged and older adults in Canada, a rapidly growing subpopulation shown to be at risk of poor health.MethodWe use the Canadian Community Health Survey (CCHS 2015-2016) to estimate logit models predicting fair/poor self-rated physical and mental health by sexual orientation among middle-aged and older adults, stratifying by sex and age group.ResultsWe find no differences in physical health for gay men and lesbian women compared with their heterosexual counterparts. However, middle-aged gay men are disadvantaged in terms of mental health, but not women. Bisexual women are disadvantaged in terms of physical health, and for mental health in some model specifications. Respondents who did not know their sexual orientation have poorer health across some measures of health and age groups.DiscussionOur findings add to the paucity of research on older sexual minorities in Canada. They highlight the importance of separating out sexual minority groups because bisexual women have distinct health profiles. In addition, this is the first study to examine the health of respondents who "do not know" their sexual orientation, and future research should distinguish between different explanations for their poor health.
| S-EPMC7489081 | biostudies-literature
Project description:This study sought to identify the principal factors that predict forgone health care due to cost among European and Israeli older adults. The analysis applied the Andersen-Newman model of health service utilization to data from the first wave of the Survey of Health, Ageing and Retirement in Europe (n = 28,849). Relinquished health care was regressed on the predisposing characteristics, need factors and economic access attributes of the respondents, in general, and in each of 12 countries, in particular. The results showed that forgone health care due to cost occurs among a substantial minority of older adults. Moreover, relinquished care is associated with younger old age, greater health needs and perceived economic inadequacy. Although statistically significant in certain cases, country of residence does not constitute a robust predictor of health care relinquishment. Social policy should address the antecedents of forgone health care in order to more effectively meet the health needs of the older population.
| S-EPMC3535497 | biostudies-other
Project description:BACKGROUND:Multimorbidity is associated with greater likelihood of disability, health-related quality of life, and mortality, greater than the risk attributable to individual diseases. The objective of this study is to examine the association between unique multimorbidity combinations and prospective disability and poor self-rated health (SRH) in older adults in Europe. METHODS:We conducted a prospective analysis using data from the Survey of Health, Ageing and Retirement in Europe in 2013 and 2015. We used hierarchical models to compare respondents with multiple chronic conditions to healthy respondents and respondents reporting only one chronic condition and made within-group comparisons to examine the marginal contribution of specific chronic condition combinations. RESULTS:Less than 20% of the study population reported having zero chronic conditions, while 50% reported having at least two chronic conditions. We identified 380 unique disease combinations among people who reported having at least two chronic conditions. Over 35% of multimorbidity could be attributed to five specific multimorbidity combinations, and over 50% to ten specific combinations. Overall, multimorbidity combinations that included high depressive symptoms were associated with increased odds of reporting poor SRH, and increased rates of ADL-IADL disability. CONCLUSIONS:Multimorbidity groups that include high depressive symptoms may be more disabling than combinations that include only somatic conditions. These findings argue for a continued integration of both mental and somatic chronic conditions in the conceptualization of multimorbidity, with important implications for clinical practice and healthcare delivery.
| S-EPMC6661084 | biostudies-other
Project description:BackgroundSeveral new antidiabetic medicines (GLP-1 receptor agonists, DPP-4 inhibitors, and SGLT-2 inhibitors) have been approved by the European Medicines Agency since 2006. The aim of this study was to evaluate the uptake of new antidiabetic medicines in European countries over a 10-year period.MethodsThe study used IQVIA quarterly value and volume sales data January 2006-December 2016. The market uptake of new antidiabetic medicines together with intensity of prescribing policy for all antidiabetic medicines were estimated for Austria, Croatia, France, Germany, Hungary, Italy, Poland, Slovenia, Spain, Sweden, and the United Kingdom. The following measures were determined: number of available new active substances, median time to first continuous use, volume market share, and annual therapy cost.ResultsAll countries had at least one new antidiabetic medicine in continuous use and an increase in intensity of prescribing policy for all antidiabetic medicines was observed. A tenfold difference in median time to first continuous use (3-30 months) was found. The annual therapy cost in 2016 of new antidiabetic medicines ranged from EUR 363 to EUR 769. Among new antidiabetic medicines, the market share of DPP-4 inhibitors was the highest. Countries with a higher volume market share of incretin-based medicines (Spain, France, Austria, and Germany) in 2011 had a lower increase in intensity of prescribing policy. This kind of correlation was not found in the case of SGLT-2 inhibitors.ConclusionsThis study found important differences and variability in the uptake of new antidiabetic medicines in the included countries.
| S-EPMC8235847 | biostudies-literature