Background: To analyse time trends in self-rated health in older people by gender and age and examine disability in the time trends of self-rated health. Methods: The data used come from the Spanish National Health Surveys conducted in 2001, 2003, 2006 and 2011–12. Samples of adults aged 16 yr and older were selected. Multivariate logistic regression was used to assess the association between age, gender, socio-economic status, marital status, disability and self-rated health across period study. Results: Women exhibited lower (higher) prevalence of good self-rated health (disability) compared to men. The multivariate analysis for time trends found that good self-rated health increased from 2001 to 2012. Overall, variables associated with a lower likelihood of good self-rated health were: being married or living with a partner, lower educational level, and disability. Conclusion: Trends of good self-rated health differ by gender according to socio-demographic factors and the prevalence of disability. PMID:27141490
Shetterly, S M; Baxter, J; Mason, L D; Hamman, R F
OBJECTIVES: This study investigated whether objective health indicators explained lower self-rated health among Hispanics compared with non-Hispanic Whites. It also considered socioeconomic and cultural explanations. METHODS: Health ratings of 429 Hispanics and 583 non-Hispanic Whites aged 20 through 74 were analyzed with logistic regression. RESULTS: Illness indicators were found to be strongly correlated with self-rated health in both ethnic groups, but after such markers were controlled for, Hispanics remained 3.6 times more likely to report fair or poor health (95% confidence interval = 2.4, 5.3). Adjustment for socioeconomic factors accounted for a portion of Hispanics' lower health rating, but the strongest explanatory factor was acculturation. CONCLUSIONS: Because of cultural and economic influences on definitions of health, ethnic differences in self-assessed health may not accurately reflected patterns resulting from objective health measurements. PMID:9003141
Meireles, Adriana Lúcia; Xavier, César Coelho; de Souza Andrade, Amanda Cristina; Proietti, Fernando Augusto; Caiaffa, Waleska Teixeira
Health status is often analyzed in population surveys. Self-rated health (SRH) is a single-item summary measure of the perception of one's health. In Brazil, studies on the SRH of adolescents remain scarce, especially those aiming to understand the domains that compose this construct. Therefore, the aim of this study is to determine the prevalence of poor SRH and its associated factors among 11- to 13-year-olds and 14- to 17-year-olds living in a large urban center in Brazil. This cross-sectional study was conducted using a household survey across Belo Horizonte that included 1,042 adolescents. Stratified logistic regression models were used for each age group to assess the associations between worse SRH and the following variables: socio-demographic, social and family support, lifestyles, psychological health, and anthropometry. Approximately 11% (95% CIs = 8.7-13.6) of the studied adolescents rated their health as poor, and SHR decreased with age among males and females. This trend was more pronounced among girls (from 6.9% among 11- to 13-year-old girls to 16.9% among 14- to 17-year-old girls) than boys (from 8.3% among 11- to 13-year-old boys to 11% among 14- to 17-year-old boys). Worse SRH was associated with family support (as assessed by the absence of parent-adolescent conversations; odds ratio [OR] = 3.5 among 11- to 13-year-olds), family structure (OR = 2.8 among 14- to 17-year-olds), and argument reporting (OR = 8.2 among 14- to 17-year-olds). Among older adolescents, the consumption of fruit fewer than five times per week (OR = 2.4), life dissatisfaction (OR = 2.8), underweight status (OR = 6.7), and overweight status (OR = 2.7) were associated with poor SRH. As adolescents age, their universe expands from their relationship with their parents to include more complex issues, such as their lifestyles and life satisfaction. Therefore, these results suggest the importance of evaluating SRH across adolescent age groups and demonstrate the influence of the
Meireles, Adriana Lúcia; Xavier, César Coelho; de Souza Andrade, Amanda Cristina; Proietti, Fernando Augusto; Caiaffa, Waleska Teixeira
Health status is often analyzed in population surveys. Self-rated health (SRH) is a single-item summary measure of the perception of one’s health. In Brazil, studies on the SRH of adolescents remain scarce, especially those aiming to understand the domains that compose this construct. Therefore, the aim of this study is to determine the prevalence of poor SRH and its associated factors among 11- to 13-year-olds and 14- to 17-year-olds living in a large urban center in Brazil. This cross-sectional study was conducted using a household survey across Belo Horizonte that included 1,042 adolescents. Stratified logistic regression models were used for each age group to assess the associations between worse SRH and the following variables: socio-demographic, social and family support, lifestyles, psychological health, and anthropometry. Approximately 11% (95% CIs = 8.7–13.6) of the studied adolescents rated their health as poor, and SHR decreased with age among males and females. This trend was more pronounced among girls (from 6.9% among 11- to 13-year-old girls to 16.9% among 14- to 17-year-old girls) than boys (from 8.3% among 11- to 13-year-old boys to 11% among 14- to 17-year-old boys). Worse SRH was associated with family support (as assessed by the absence of parent-adolescent conversations; odds ratio [OR] = 3.5 among 11- to 13-year-olds), family structure (OR = 2.8 among 14- to 17-year-olds), and argument reporting (OR = 8.2 among 14- to 17-year-olds). Among older adolescents, the consumption of fruit fewer than five times per week (OR = 2.4), life dissatisfaction (OR = 2.8), underweight status (OR = 6.7), and overweight status (OR = 2.7) were associated with poor SRH. As adolescents age, their universe expands from their relationship with their parents to include more complex issues, such as their lifestyles and life satisfaction. Therefore, these results suggest the importance of evaluating SRH across adolescent age groups and demonstrate the influence of
Little is known about how different lifestyle factors mediate the relationship between socioeconomic status (SES) and health among middle-aged and older adults in Korea. Using data from the Korean Longitudinal Study of Aging, this study examined the direct effects of SES on self-rated health and how lifestyle factors mediate the relationships between SES and self-rated health. This study further tested whether the effects of SES and lifestyle factors differ as people age. The findings indicate that higher levels of income and education as well as not being in poverty predicted better self-rated health. Meanwhile, engaging in regular exercise and being underweight significantly mediated the relationship between education and self-rated health as well as between poverty and self-rated health. Finally, poverty and regular exercise had a greater impact on self-rated health in old age than in middle age. Implications for enhancing antipoverty policies and exercise programs are discussed.
Ability to predict and prevent incipient functional decline in older adults may help prolong independence. Cognition is related to everyday function and easily administered, sensitive cognitive tests may help identify at-risk individuals. Factors like depressive symptoms and self-rated health are also associated with functional ability and may be as important as cognition. The purpose of this study was to investigate the relationship between concurrent longitudinal changes in cognition, depression, self-rated health and everyday function in a well-defined cohort of healthy 85 year olds that were followed-up at the age of 90 in the Elderly in Linköping Screening Assessment 85 study. Regression analyses were used to determine if cognitive decline as assessed by global (the Mini-Mental State Examination) and domain specific (the Cognitive Assessment Battery, CAB) cognitive tests predicted functional decline in the context of changes in depressive symptoms and self-rated health. Results showed deterioration in most variables and as many as 83% of these community-dwelling elders experienced functional difficulties at the age of 90. Slowing-down of processing speed as assessed by the Symbol Digits Modality Test (included in the CAB) accounted for 14% of the variance in functional decline. Worsening self-rated health accounted for an additional 6%, but no other variables reached significance. These results are discussed with an eye to possible preventive interventions that may prolong independence for the steadily growing number of normally aging old-old citizens. PMID:27551749
Roth, David L; Skarupski, Kimberly A; Crews, Deidra C; Howard, Virginia J; Locher, Julie L
The predictive effects of age and self-rated health (SRH) on all-cause mortality are known to differ across race and ethnic groups. African American adults have higher mortality rates than Whites at younger ages, but this mortality disparity diminishes with advancing age and may "crossover" at about 75-80 years of age, when African Americans may show lower mortality rates. This pattern of findings reflects a lower overall association between age and mortality for African Americans than for Whites, and health-related mechanisms are typically cited as the reason for this age-based crossover mortality effect. However, a lower association between poor SRH and mortality has also been found for African Americans than for Whites, and it is not known if the reduced age and SRH associations with mortality for African Americans reflect independent or overlapping mechanisms. This study examined these two mortality predictors simultaneously in a large epidemiological study of 12,181 African Americans and 17,436 Whites. Participants were 45 or more years of age when they enrolled in the national REasons for Geographic and Racial Differences in Stroke (REGARDS) study between 2003 and 2007. Consistent with previous studies, African Americans had poorer SRH than Whites even after adjusting for demographic and health history covariates. Survival analysis models indicated statistically significant and independent race*age, race*SRH, and age*SRH interaction effects on all-cause mortality over an average 9-year follow-up period. Advanced age and poorer SRH were both weaker mortality risk factors for African Americans than for Whites. These two effects were distinct and presumably tapped different causal mechanisms. This calls into question the health-related explanation for the age-based mortality crossover effect and suggests that other mechanisms, including behavioral, social, and cultural factors, should be considered in efforts to better understand the age-based mortality
Mosing, Miriam A; Zietsch, Brendan P; Shekar, Sri N; Wright, Margaret J; Martin, Nicholas G
Optimism has been shown to be important in maintaining wellbeing into old age, but little is known about the sources of variation in optimism and its links to mental and somatic health. Optimism, mental, and self-rated health were measured in 3,053 twin individuals (501 MZF, 153 MZM, 274 DZF, 77 DZM, and 242 DZ opposite-sex twin pairs and 561 single twins) over 50 years using the life orientation test, the General Health Questionnaire and a single-item question for self-rated health. Additive genetic factors explained 36, 34, and 46% of the variation in optimism, mental, and self-rated health, respectively, with the remainder being due to non-shared environmental influences. Genetic influences accounted for most of the covariance between the variables (14-20% of the genetic variance) indicating that in older adults genes predisposing to high optimism also predispose to good mental health and self-rated health.
This thesis is centered on self-rated health (SRH) as an outcome measure, as a predictor, and as a marker. The thesis uses primary data from the WHO Study on global AGEing and adult health (SAGE) implemented in India in 2007. The structural equation modeling approach is employed to understand the pathways through which the social environment, disability, disease, and sociodemographic characteristics influence SRH among older adults aged 50 years and above. Cox proportional hazard model is used to explore the role of SRH as a predictor for mortality and the role of disability in modifying this effect. The hierarchical ordered probit modeling approach, which combines information from anchoring vignettes with SRH, was used to address the long overlooked methodological concern of interpersonal incomparability. Finally, multilevel model-based small area estimation techniques were used to demonstrate the use of large national surveys and census information to derive precise SRH prevalence estimates at the district and sub-district level. The thesis advocates the use of such a simple measure to identify vulnerable communities for targeted health interventions, to plan and prioritize resource allocation, and to evaluate health interventions in resource-scarce settings. The thesis provides the basis and impetus to generate and integrate similar and harmonized adult health and aging data platforms within demographic surveillance systems in different regions of India and elsewhere.
Burr, Hermann; Pohrt, Anne; Rugulies, Reiner; Holtermann, Andreas; Hasselhorn, Hans Martin
Objective Due to the growing proportion of older employees in the work force in several countries, the importance of age in the association between work and health is becoming increasingly relevant. Few studies have investigated whether age modifies the association of physical work demands with health. We hypothesized that the association of demanding body postures with deteriorated self-rated health (SRH) is stronger among older employees than among younger employees. Method We analyzed three 5-year cohorts in the Danish Work Environment Cohort Study comprising 8318 observations from 5204 employees (follow-up participation rate 83%) with good baseline SRH. Physical work demands were assessed as demanding body postures. Age was divided into tertiles; young (18-32 years), middle-aged (33-43 years) and old (44-59 among men and 44-54 years among women). Poor SRH ("fairly good", "poor", and "very poor") was measured with a single item. Log binomial regressions were stratified by gender. Effect modification (ie, interaction) was defined as deviation from additivity and examined by calculating the relative excess risk due to interaction (RERI). The reference group was employees aged 18-32 years with low physical exposure. Results When predicting deterioration of SRH, an interaction between demanding body postures and age was found among men [RERI: 0.75, 95% confidence interval (95% CI) 0.16-1.34, regarding the age group 44-59 years] and among women (RERI: 0.84, 95% CI 0.19-1.34, for the age group 33-43 years; and 1.17, 95% CI 0.42-1.93, for the age group 44-54 years). Conclusion The study findings suggest that demanding body postures have a stronger impact on health among older compared to younger employees.
Little is known about how different lifestyle factors mediate the relationship between socioeconomic status (SES) and health among middle-aged and older adults in Korea. Using data from the Korean Longitudinal Study of Aging, this study examined the direct effects of SES on self-rated health and how lifestyle factors mediate the relationships…
Whitley, Elise; Popham, Frank; Benzeval, Michaela
Purpose of the Study: With increasing longevity in industrialized populations, there is growing interest in what defines “successful aging” (SA). Various SA measures have been proposed but no consensus has been reached and many have been criticized for not representing the views and priorities of older people. We consider whether the Rowe–Kahn SA model captures older individual’s perceptions of their own health and aging. Methods: Using two cohorts of 886 and 483 men and women from the West of Scotland Twenty-07 Study, aged around 57 and 76, respectively, we explored associations between Rowe–Kahn SA dimensions (absence of disease/disability; good physical/cognitive functioning; good interpersonal/productive social engagement) and four aspects of self-rated health and satisfaction (current general health; health for age; satisfaction with health; satisfaction with life). Results: Respondents’ self-rated health and satisfaction was generally good but few had all six Rowe–Kahn dimensions positive, the conventional definition of SA. All individual positive SA dimensions were associated with better self-rated health and satisfaction. This was consistent across age, gender, manual/nonmanual occupations, and personality. The prevalence of good self-rated health and satisfaction increased with increasing numbers of positive SA dimensions. Implications: The Rowe–Kahn model provides a functional definition of SA. Future work on ageing should include all Rowe–Kahn dimensions and consider SA as a continuum. PMID:26970606
Belanger, Emmanuelle; Zunzunegui, Maria–Victoria; Phillips, Susan; Ylli, Alban; Guralnik, Jack
Objective The aim of this study was to explore the validity of self-rated health across different populations of older adults, when compared to the Short Physical Performance Battery. Design Cross-sectional analysis of the International Mobility in Aging Study. Setting Five locations: Saint-Hyacinthe and Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). Participants Older adults between 65 and 74 years old (n = 1,995). Methods The Short Physical Performance Battery (SPPB) was used to measure physical performance. Self-rated health was assessed with one single five-point question. Linear trends between SPPB scores and self-rated health were tested separately for men and women at each of the five international study sites. Poor physical performance (independent variable) (SPPB less than 8) was used in logistic regression models of self-rated health (dependent variable), adjusting for potential covariates. All analyses were stratified by gender and site of origin. Results A significant linear association was found between the mean scores of the Short Physical Performance Battery and ordinal categories of self-rated health across research sites and gender groups. After extensive control for objective physical and mental health indicators and socio-demographic variables, these graded associations became non-significant in some research sites. Conclusion These findings further confirm the validity of SRH as a measure of overall health status in older adults. PMID:27089219
Borim, Flávia Silva Arbex; Neri, Anita Liberalesso; Francisco, Priscila Maria Stolses Bergamo; Barros, Marilisa Berti de Azevedo
OBJECTIVE To analyze the association between negative self-rated health and indicators of health, wellbeing and sociodemographic variables in older adults. METHODS Cross-sectional study that used data from a population-based health survey with a probability cluster sample that was carried out in Campinas, SP, Southeastern Brazil,, in 2008 and 2009. The participants were older adults (≥ 60 years) and the dependent variable was self-rated health, categorized as: excellent, very good, good, bad and very bad. The adjusted prevalence ratios were estimated by means of Poisson multiple regression. RESULTS The highest prevalences of bad/very bad self-rated health were observed in the individuals who never attended school, in those with lower level of schooling, with monthly per capita family income lower than one minimum salary. Individuals who scored five or more in the physical health indicator also had bad self-rated health, as well as those who scored five or more in the Self-Reporting Questionnaire 20 and those who did not refer feeling happiness all the time. CONCLUSIONS The independent effects of material life conditions, physical and mental health and subjective wellbeing, observed in self-rated health, suggest that older adults can benefit by health policies supported by a global and integrative view of old age. PMID:25372161
Background This paper has two objectives. Firstly, it provides an overview of the social network module, data collection procedures, and measurement of ego-centric and complete-network properties in the Korean Social Life, Health, and Aging Project (KSHAP). Secondly, it directly compares the KSHAP structure and results to the ego-centric network structure and results of the National Social Life, Health, and Aging Project (NSHAP), which conducted in-home interviews with 3,005 persons 57 to 85 years of age in the United States. Methods The structure of the complete social network of 814 KSHAP respondents living in Township K was measured and examined at two levels of networks. Ego-centric network properties include network size, composition, volume of contact with network members, density, and bridging potential. Complete-network properties are degree centrality, closeness centrality, betweenness centrality, and brokerage role. Results We found that KSHAP respondents with a smaller number of social network members were more likely to be older and tended to have poorer self-rated health. Compared to the NSHAP, the KSHAP respondents maintained a smaller network size with a greater network density among their members and lower bridging potential. Further analysis of the complete network properties of KSHAP respondents revealed that more brokerage roles inside the same neighborhood (Ri) were significantly associated with better self-rated health. Socially isolated respondents identified by network components had the worst self-rated health. Conclusions The findings demonstrate the importance of social network analysis for the study of older adults’ health status in Korea. The study also highlights the importance of complete-network data and its ability to reveal mechanisms beyond ego-centric network data. PMID:25217892
Sørensen, Mette Rosenlund; Matthiessen, Jeppe; Holm, Lotte; Knudsen, Vibeke Kildegaard; Andersen, Elisabeth Wreford; Tetens, Inge
The aim of this study was to analyse concordance between Danish adults' recorded diet quality and their own assessment of the healthiness and to examine socio-demographic, health and behavioural characteristics associated with an optimistic or pessimistic self-assessment. Data were derived from The Danish National Survey of Diet and Physical Activity 2011-2013 and included a random sample of 3014 adults (18-75 y). Diet quality was evaluated on the basis of seven-day pre-coded food diaries and categorised 'unhealthy', 'somewhat healthy' and 'healthy'. Self-assessment of the healthiness of own diets was registered via personal interviews and categorised healthy enough 'to a high degree', 'to some degree' or 'not at all/only partly'. Highly and somewhat optimistic self-assessment, respectively, were defined as assessing own diets as healthy enough to a high degree or to some degree while having unhealthy diets. Highly and somewhat pessimistic self-assessment, respectively, were defined as assessing own diets as not healthy enough or healthy enough to some degree while having healthy diets. Multiple logistic regression models were used to examine characteristics associated with optimistic and pessimistic self-assessments, respectively. Among individuals with unhealthy diets, 13% were highly optimistic and 42% somewhat optimistic about the healthiness of their diets. Among individuals with healthy diets, 14% were highly pessimistic and 51% somewhat pessimistic about the healthiness of their diets. Highly optimistic self-assessment was associated with increasing age, excellent self-rated health, normal weight and a moderate activity level. Highly pessimistic self-assessment was associated with decreasing age, good self-rated health and being obese. The findings indicate that people seem to use personal health characteristics as important references when assessing the healthiness of their diets.
OBJECTIVES—As self rated health and mortality represent different dimensions of public health and as risk behaviours have been closely related to mortality, we wanted to examine whether (poor) self rated health on the one hand and risk behaviours on the other can be attributed to different causes. METHODS—The Taganrog household survey (1998) was conducted in the form of face to face interviews and included 1009 people and their families. To estimate health differences and differences in risk behaviours between groups, logistic regressions were performed. RESULTS—In Taganrog between 1993/94 and 1998, changes in self rated health seem to have been much more dramatic than changes in smoking and different in direction from changes in heavy alcohol consumption. Moreover, self rated "poor" health was especially common among those whose economic situation was worse in 1998 than 10 years before. However, having a poorer economy during the period 1988-1998, does not seem to have affected drinking or smoking habits significantly. CONCLUSIONS—Self rated health seems to be closely related to three indicators of economic circumstances. Risk behaviours are probably important for the poor state of public health in Russia, but may be less sensitive to the economic aspects of the transition than is self rated health. Keywords: self rated health; risk behaviours PMID:11604437
Schnittker, Jason; Bacak, Valerio
Using the 1980 to 2002 General Social Survey, a repeated cross-sectional study that has been linked to the National Death Index through 2008, this study examines the changing relationship between self-rated health and mortality. Research has established that self-rated health has exceptional predictive validity with respect to mortality, but this validity may be deteriorating in light of the rapid medicalization of seemingly superficial conditions and increasingly high expectations for good health. Yet the current study shows the validity of self-rated health is increasing over time. Individuals are apparently better at assessing their health in 2002 than they were in 1980 and, for this reason, the relationship between self-rated health and mortality is considerably stronger across all levels of self-rated health. Several potential mechanisms for this increase are explored. More schooling and more cognitive ability increase the predictive validity of self-rated health, but neither of these influences explains the growing association between self-rated health and mortality. The association is also invariant to changing causes of death, including a decline in accidental deaths, which are, by definition, unanticipated by the individual. Using data from the final two waves of data, we find suggestive evidence that exposure to more health information is the driving force, but we also show that the source of information is very important. For example, the relationship between self-rated health and mortality is smaller among those who use the internet to find health information than among those who do not.
Hamid, Tengku Aizan; Momtaz, Yadollah Abolfathi; Abdul Rashid, Sharifah Norazizan Syed
Several studies have found that older women report lower self-rated health than men. However, it is not clear why older women are more likely to report poor self-rated health than older men. Data for this study came from a national cross-sectional survey, Mental Health and Quality of Life of Older Malaysians (MHQoLOM). Included in the survey were…
Svedberg, Pia; Bardage, Carola; Sandin, Sven; Pedersen, Nancy L
The aim of this study was to investigate what psychosocial predictors, life-style factors and health behaviors in early adulthood are of importance for self-ratings of health after the age of 45. Like-sexed adult twins born 1926-1950 (n = 16,080) from the Swedish Twin Registry that participated in a questionnaire in 1973 and in a telephone interview conducted between 1998 and 2002 were included. Exposure data was collected in 1973 and information on self-rated health and covariates was collected at the second contact 25 years later. Logistic regression using Generalized Estimating Equations was used to evaluate the associations. Conditional logistic regression was used to control for familial and genetic effects in the sample. Pain, lack of exercise, smoking, obesity, unemployment, perceived stress and personality are associated with future poor self-rated health, after controlling for age, sex, illness, education and socio-economic status. Familial and genetic effects influence the associations between recurrent headache, exercise, obesity, and poor self-rated health. Overall, these findings provide support for long-term effects of health behavior and psychosocial risk factors on poor self-ratings of health, beyond the influence of obvious health consequences such as disorders or illnesses. Genetic and familial factors are of importance only for some of these associations.
Kelleher, C C; Tay, J; Gabhainn, S Nic
In this analysis we employed the International Health Behaviour Among School Aged Children (HBSC) 1998 data, comprising 8326 Irish children and 115,327 children in the International dataset, to examine influences on self reported health among young people. Factors were similar for both boys and girls and between countries. Daily smokers, those reporting intoxication at least once, those taking infrequent exercise and those reporting difficulty in making friends were all predictive of poor self-rated health in adjusted odds ratio models. Disposable means, as measured by the Family Affluence Score was also a significant predictor of self-rated health but not as influential as reported lifestyle. In a multi-level between country comparison of 15 OECD countries, individual health behaviours explained much, but not all of the variability in poor self reported health (0.26, SE 0.08), and of various ecological level indicators considered in the final model only % voting and % males with minimum 2nd level of male education in the population were influential factors, with between-country variations still not fully explained (0.10, SE 0.03).
Sonkusare, S; Adinegara; Hebbar, S
The purpose of this study was to study the determinants of self rated health in the low-risk pregnant women of Melaka Tengah in Malaysia. A total of 387 subjects were analysed. The role of mental health, psychosocial stressors, support from husband, coping skills, socio-economic status and pregnancy characteristics in determining self- rated health were studied. Health items were taken from the Duke Health Profile. Bad obstetric history, poor mental health, stress from the family were found to be significantly associated with poor self - rated health whereas good support from the husband was related to good self - rated health.
Reyes Fernández, Benjamín; Rosero-Bixby, Luis; Koivumaa-Honkanen, Heli
Objective: The study examined the relationship of self-rated health and self-rated economic situation with depressed mood, and life satisfaction as mediator of this relationship among older adults in Costa Rica. Method: A longitudinal study was conducted with a subsample (N = 1,618) from the Costa Rican Longevity and Healthy Aging Study (CRELES). Self-rated health, self-rated economic situation, depressed mood, and life satisfaction were measured at baseline, and depressed mood was reassessed 18 months later. Putative mechanisms for changes in depressed mood were examined by means of conditional process analysis. Results: Self-rated health was negatively associated to depressed mood. This effect took place via life satisfaction. An interaction showed that better economic situation compensated the effect of a low self-rated health on life satisfaction. Discussion: This study suggests that subjective variables such as self-rated health, economic situation, and life satisfaction should be considered when addressing the onset of depressed mood. PMID:26092651
Blakely, T A; Kennedy, B P; Kawachi, I
OBJECTIVES: This study tested the hypothesis that disparities in political participation across socioeconomic status affect health. Specifically, the association of voting inequality at the state level with individual self-rated health was examined. METHODS: A multilevel study of 279,066 respondents to the Current Population Survey (CPS) was conducted. State-level inequality in voting turnout by socioeconomic status (family income and educational attainment) was derived from November CPS data for 1990, 1992, 1994, and 1996. RESULTS: Individuals living in the states with the highest voting inequality had an odds ratio of fair/poor self-rated health of 1.43 (95% confidence interval [CI] = 1.22, 1.68) compared with individuals living in the states with the lowest voting inequality. This odds ratio decreased to 1.34 (95% CI = 1.14, 1.56) when state income inequality was added and to 1.27 (95% CI = 1.10, 1.45) when state median income was included. The deleterious effect of low individual household income on self-rated health was most pronounced among states with the greatest voting and income inequality. CONCLUSIONS: Socioeconomic inequality in political participation (as measured by voter turnout) is associated with poor self-rated health, independently of both income inequality and state median household income. PMID:11189832
Proulx, Christine M; Snyder-Rivas, Linley A
Although research has explored the association between marital quality and physical health in marriage, existing research fails to consider possible bidirectional associations between changes in individuals' marital quality and self-rated health. To address this gap, this study used latent change models to assess whether adults' marital happiness and problems over a 20-year period predicted subsequent changes in self-rated health, as well as whether self-rated health over the same time period was associated with changes in marital happiness and problems. The sample included 707 continuously married adults who participated in all six waves of the Marital Instability Over the Life Course panel study. Participants averaged 35 years in age at the first wave and were continuously married to the same spouse over the 20-year period. Latent differential models in AMOS 19 showed that unidirectional coupling existed for marital happiness and self-rated health only, such that higher levels of marital happiness predicted subsequent elevations in self-rated health over time. No evidence was found for bidirectional coupling between marital problems and self-rated health. Possible explanations for these patterns of results are discussed, including important directions for future researchers.
Bath, Peter A.
Purpose: The aims of this study were to examine differences between older men and women: (a) in the ability of self-rated health to predict mortality, (b) in the effect of different follow-up periods on the self-rated health mortality relationship, and (c) in the relative importance of self-rated health and self-rated change in health in…
Objectives The aim of the study is to expand knowledge about predictors of the self-rated health and mental health in fifty-year-old women. The study exploring links between self-rated mental/health and optimism, self-esteem, acceptance of the changes in physical look and some sociodemographic factors. Methods Participants in this study were 209 women aged 50 to 59. A single-items measures of self-rated health and mental health were used. Self-esteem was measured through the Rosenberg Self-Esteem Scale; optimism through the OPEB questionnaire; acceptance of the changes in physical look was rated by respondents on a seven-point scale. Participants were also asked about weight loss attempts, the amount of leisure time, and going on vacation during the last year. Results Predictors of the self-rated mental health in women in the age range of 50 to 59 were: acceptance of the changes in physical look, self-esteem and optimism. Predictors of the self-rated health were: optimism and acceptance of the changes in physical look. Conclusion Optimism and acceptance of the changes in physical look seem to be important factors that may impact subjective health both physical and mental of women in their 50s. The role of the leisure time and vacation in instilling the subjective health requires further investigation. PMID:26793678
Takahashi, Yusuke; Roberts, Brent W; Hoshino, Takahiro
The pathways between parenting behaviours, personality and physical health have all been separately studied. Prior research has paid little attention to the indirect effects of personality in the path between parenting behaviours and better health. The purpose of this study was to explore the mediational effects of conscientiousness on the relationships between parental socialisation of responsibility and self-rated health, and to examine potential age differences in this mediational pathway. In total, 736 female and 749 male members across Japan participated in this study. They were divided into three groups by age category: younger-, middle-aged and older-aged. Conscientiousness and health were concurrently rated, while parental socialisation of responsibility was retrospectively assessed. Our analyses revealed that parental socialisation of responsibility is positively associated with conscientiousness and self-rated health, that conscientiousness is positively associated with self-rated health, and that conscientiousness fully mediated the effect of parental socialisation of responsibility on self-rated health. The mediational links were consistent across younger, middle-aged and older-aged cohorts. Our findings suggest that greater parental socialisation of responsibility relates to higher conscientiousness, and consequently healthier adults. These findings imply that parental behaviours could be a plausible target for intervention to foster the development of conscientiousness and better health.
Aida, Jun; Kondo, Katsunori; Kondo, Naoki; Watt, Richard G; Sheiham, Aubrey; Tsakos, Georgios
The erosion of social capital in more unequal societies is one mechanism for the association between income inequality and health. However, there are relatively few multi-level studies on the relation between income inequality, social capital and health outcomes. Existing studies have not used different types of health outcomes, such as dental status, a life-course measure of dental disease reflecting physical function in older adults, and self-rated health, which reflects current health status. The objective of this study was to assess whether individual and community social capital attenuated the associations between income inequality and two disparate health outcomes, self-rated health and dental status in Japan. Self-administered questionnaires were mailed to subjects in an ongoing Japanese prospective cohort study, the Aichi Gerontological Evaluation Study Project in 2003. Responses in Aichi, Japan, obtained from 5715 subjects and 3451 were included in the final analysis. The Gini coefficient was used as a measure of income inequality. Trust and volunteering were used as cognitive and structural individual-level social capital measures. Rates of subjects reporting mistrust and non-volunteering in each local district were used as cognitive and structural community-level social capital variables respectively. The covariates were sex, age, marital status, education, individual- and community-level equivalent income and smoking status. Dichotomized responses of self-rated health and number of remaining teeth were used as outcomes in multi-level logistic regression models. Income inequality was significantly associated with poor dental status and marginally significantly associated with poor self-rated health. Community-level structural social capital attenuated the covariate-adjusted odds ratio of income inequality for self-rated health by 16% whereas the association between income inequality and dental status was not substantially changed by any social capital
Detollenaere, Jens; Baert, Stijn; Willems, Sara
We study whether migrant health in Europe is associated with the cultural distance between their host country and country of origin. To this end, we run multilevel regression models on data merging self-rated health and social background of ≥3800 migrants from the European Social Survey with an index of cultural distance based on country differences in values, norms and attitudes measured in the World Values Survey. We find that higher levels of cultural distance are associated with worse migrant health. This association is comparable in size with the negative association between health and female (compared with male) gender but less important than the association between health and education level. In addition, this association is less significant among second-generation than first-generation migrants.
Miranda, Patricia Y; Reyes, Adriana; Hudson, Darrell; Yao, Nengliang; Bleser, William K; Amy Snipes, S; BeLue, Rhonda
Citizenship facilitates home ownership, which promotes access to additional resources and structures social context, factors that improve the health of individuals and communities. The objective of this study was to examine whether citizenship moderated the association between homeownership and self-rated health. We used multivariate logistic regression models and propensity score matching techniques to examine this association using pooled years 2000-2010 of the Medical Expenditure Panel Survey data linked with the National Health Interview Survey to examine U.S. adults aged 18 and older (N=170,429). Rates of fair/poor health among homeowners vs. non-homeowners were comparable for foreign-born non-citizens. However, native- and foreign-born citizen non-homeowners showed significantly higher rates of reporting fair/poor health, with native-born citizens having the highest rates of poor health. While homeownership is protective for self-rated health, not meeting the "American Dream" of home ownership may be embodied more in the health of native-born citizens as "failure" and translate into poorer self-rated health. However, the economic privileges of homeownership and its association with better self-rated health are limited to citizens. Non-citizens may be disadvantaged despite socioeconomic position, particularly wealth as considered by homeownership, placing citizenship at the forefront as the most proximate and important burden besides socioeconomic status that needs further investigation as a fundamental health determinant.
Perera, Bilesha; Østbye, Truls; Jayawardana, Chandramali
The prevalence of different neighborhood environmental stressors and associations between the stressors and self-rated health are described in a representative sample of 2,077 individuals, aged 18-85 years, in southern Sri Lanka. Mosquito menace (69.4%), stray dog problems (26.8%), nuisance from neighbors (20.3%), and nuisance from drug users (18.7%) were found to be the most prevalent environmental stressors. None of the stressors investigated were associated with self-rated physical health, but nuisance from neighbors, nuisance from drug users, shortage of water and having poor water/sewage drainage system were associated with self-rated mental health among the respondents.
Gu, Danan; Zhu, Haiyan; Brown, Tyson; Hoenig, Helen; Zeng, Yi
Objective To investigate factors associated with tourism experiences, and the association between tourism experiences and subsequent self-rated health. Method Multilevel logistic regression models and four waves of panel data from a large nationally representative survey of older adults in China were employed. Results Those who had a tourism experience tended to be younger, men, urban residents, have a higher socioeconomic status (SES), and frequently participate in leisure activities and exercise. However, controlling for SES, women were more likely than men to have a tourism experience. Notably, tourism was negatively associated with poor self-rated health and the association was robust to adjustments for a wide range of confounders. Discussion The net beneficial impact of tourism on self-rated health may operate through several mechanisms such as improvements in tourists’ cognitive functioning, healthy lifestyles, self-esteen, family and social relations, and psychological and spirtual well-being. Tourism participation is an effective way to promote healthy aging. PMID:26486781
Johnson, Nan E.
Purpose: I examine whether less favorable self-rated health raises the risk of outmigration more for young-old adults (aged 53-63 at the start of the 10-year longitudinal study in 1994) in nonmetro than metro counties and increases the odds that both groups of outmigrants will choose metro over nonmetro destinations. Finally, I examine whether…
Wu, Zhijun; Jian, Weiyan; Chan, Kit Yee
Background China’s rapidly changing economic landscape has led to widening social inequalities. Occupational status in terms of occupational type and prestige may reflect these socio-structural shifts of social position and be more predictive of self-rated health status than income and education, which may only reflect more gradual acquisitions of social status over time. The goals of this study were to understand the role of occupational status in predicting self-rated health, which is well known to be associated with long-term mortality, as well as compare the occupational status to the other major socioeconomic indicators of income and education. Methods Data from the 2010 baseline surveys of the China Family Panel Studies, which utilized multi-stage probability sampling with implicit stratification was used. Logistic regression was used to examine the relationship of various socioeconomic indicators (i.e. occupational status, income, and education) with self-rated health as the primary outcome of interest. A series of models considered the associations of occupational category or occupational prestige with self-rated health. Results The final sample consisted of 14,367 employed adults aged 18–60, which was nationally representative of working adults in China. We found that occupation was not a major predictor of self-rated health in China when age, ethnicity, location, marital status, physical and mental health status were controlled for, with the exception of women working in lower grade management and professional jobs (OR = 1.82, 95% CI: 1.03–3.22). In comparison, income followed by education exhibited greater association with self-rated health. The highest income group had the least probability to report poor health (In men: OR = 0.30, 95% CI: 0.21–0.43. In women: OR = 0.44, 95% CI: 0.26–0.73). People educated with junior high school had better self-rated health than those with primary and below education level (In men: OR = 0.62, 95% CI: 0.50–0
Nguyen, Muoi T.; Chan, Winnie Y.; Keeler, Courtney
Abstract Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data. This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6). Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ2 tests and a 2-part model (logistics regression and generalized linear model regression for the first and second stages, respectively). Although predictive of any health expenditure, SRMH alone was not highly predictive of the dollar value of that health expenditure conditional on any spending. By comparison, the K6 measure was significantly and positively associated with the probability of any health expenditure as well as the dollar value of that spending. Taken together, both the K6 and SRMH measures suggest a positive relationship between poor mental health and the probability of any health expenditure and total expenditure conditional on any spending, even when adjusting for other confounding factors such as race/ethnicity, sex, age, educational attainment, insurance status, and some regional characteristics. Our results suggest that psychological distress and SRMH may represent potential pathways linking poor mental health to increased health care expenditure. Further research exploring the nuances of these relationships may aid researchers, practitioners, and policy makers in addressing issues of inflated health care expenditure in populations at risk for poor mental health. PMID:26334899
Bombak, Andrea E.; Bruce, Sharon G.
Objectives Self-rated health (SRH) is a commonly used measure in surveys to assess general health status or health-related quality of life. Differences have been detected in how different ethnic groups and nationalities interpret the SRH measure and assess their health. This review summarizes the research conducted on SRH within and between ethnic groups, with a focus on indigenous groups. Study design and methods A search of published academic literature on SRH and ethnicity, including a comprehensive review of all relevant indigenous research, was conducted using PubMed and summarized. Results A wide variety of research on SRH within ethnic groups has been undertaken. SRH typically serves as an outcome measure. Minority respondents generally rated their health worse than the dominant population. Numerous culturally-specific determinants of SRH have been identified. Cross-national and cross-ethnicity comparisons of the associations of SRH have been conducted to assess the validity of SRH. While SRH is a valid measure within a variety of ethnicities, differences in how SRH is assessed by ethnicities have been detected. Research in indigenous groups remains generally under-represented in the SRH literature. Conclusions These results suggest that different ethnic groups and nationalities vary in SRH evaluations, interpretation of the SRH measure, and referents employed in rating health. To effectively assess and redress health disparities and establish culturally-relevant and effective health interventions, a greater understanding of SRH is required, particularly among indigenous groups, in which little research has been conducted. PMID:22663937
Kim, Seung-Sup; Williams, David R.
Background There is mounting evidence that discriminatory experiences can harm health. However, previous research has mainly focused on the health effects of racial discrimination in U.S. or European countries although there is pervasive discrimination by gender, age, education and other factors in Asian countries. Methods We analyzed the data from the 7th wave of Korean Labor and Income Panel Study to investigate the association between perceived discriminatory experience and poor self-rated health in South Korea. Perceived discriminatory experiences were measured in eight situations through a modified Experience of Discrimination questionnaire. In each of eight situations, the lifetime prevalence of perceived discriminatory experience was compared between men and women and the main causes of those experiences were identified separately by gender. After adjusting for potential confounders, we examined the association between perceived discriminatory experience and poor self-rated health in each of eight social situations and also checked the association using the number of situations of perceived discriminatory experiences. Results For both men and women, education level and age were the main sources of work-related perceived discriminatory experiences. Gender was one of the main causes among women across eight situations and more than 90% of women reported their gender as a main cause of discriminatory experience in getting higher education and at home. Discriminatory experiences in four situations were positively associated with poor self-rated health. The odds ratio for poor self-rated health for those exposed to one, two, three or four or more social situations of perceived discrimination were respectively 1.06 (95% CI : 0.87–1.29), 1.15 (95% CI : 0.96–1.55), 1.59 (95% CI : 1.19–2.14), and 1.78 (95% CI :1.26–2.51). Conclusion There is consistent association between perceived discriminatory experience and poor self-rated health across eight social
Adverse economic shocks exert an influence on health perceptions, but little is known about the effect of sudden positive changes in a person's financial situation on self-rated health, particularly among low income people. This paper explores the association between an increase in the amount of non-contribution pensions, public cash transfers given to Costa Rican elderly of low socio-economic status (SES) and changes in self-rated health over time. The analysis is based on data from CRELES, the "Costa Rican Study on Longevity and Healthy Aging", which is based on a probabilistic sample of people born in 1945 or earlier, and living in Costa Rica by 2002. The fieldwork for the first and second waves of CRELES was conducted from 2004 to 2006, and from 2006 to 2008, respectively. The Costa Rican Government raised the amount of the non-contribution pension for the poor 100% before July 2007, and an additional 100% after that date. Due to the CRELES fieldwork schedule, the data have a natural quasi-experimental design, given that approximately half of CRELES respondents were interviewed before July 2007, independently of their status in receiving the public cash transfers. Using random effects ordered probit regression models, we find that people who experienced such increase report a greater improvement in self-rated health between waves than those who experienced a smaller increase and than the rest of the interviewees. Results suggest that increases in income may lead to a greater improvement in self-rated health.
Khawaja, Marwan; Mowafi, Mona
Aims Our study extends research on the social determinants of health by exploring the association between a new, potentially very significant dimension, cultural capital by type and self-rated health among low-income women living in outer Beirut, Lebanon. Methods Self-rated general health was assessed using household data from a cross-sectional survey of 1869 women, conducted in 2003. Three types of cultural capital were included: watching cultural TV programs, producing art (e.g., drawing, theatre performance) and consuming art or literature (e.g., attending exhibits, reading literary books). Associations between self-rated health status and types of cultural capital were assessed using odds ratios from binary logistic regression models. Results With the exception of art production, lack of cultural capital increased the odds of self-perceived poor health status adjusting for socio-demographics and other risk factors. The adjusted odds ratios were 1.86 (95% CI: 1.07 to 3.22) for watching cultural TV programs and 1.52 (95% CI: 1.12 to 2.06) for consuming art. As expected, health risk factors, age, social support and community of residence were also associated with health status. Conclusions Two types of cultural capital were strong predictors of self perceived health status among women living in poor urban communities, regardless of social capital, income and other relevant risk factors. PMID:17852992
Tsoh, Janice Y; Sentell, Tetine; Gildengorin, Ginny; Le, Gem M; Chan, Elaine; Fung, Lei-Chun; Pasick, Rena J; Stewart, Susan; Wong, Ching; Woo, Kent; Burke, Adam; Wang, Jun; McPhee, Stephen J; Nguyen, Tung T
Older Chinese immigrants are a growing population in the United States who experience multiple healthcare communication barriers such as limited English proficiency and low health literacy. Each of these obstacles has been associated with poor health outcomes but less is known about their effects in combination. This study examined the association between healthcare communication barriers and self-rated health among older Chinese immigrants. Cross-sectional survey data were obtained from 705 Chinese American immigrants ages 50-75 living in San Francisco, California. Communication barriers examined included spoken English proficiency, medical interpreter needs, and health literacy in written health information. The study sample (81 % females, mean age = 62) included 67 % who spoke English poorly or not at all, 34 % who reported needing a medical interpreter, and 37 % who reported "often" or "always" needing assistance to read health information. Two-thirds reported poor self-rated health; many reported having access to racial-concordant (74 %) and language-concordant (86 %) healthcare services. Both poor spoken English proficiency and low health literacy were associated with poor self-rated health, independent of other significant correlates (unemployment, chronic health conditions, and having a primary doctor who was ethnic Chinese). Results revealed that spoken English proficiency and print health literacy are independent communication barriers that are directly associated with health status among elderly Chinese American immigrants. Access to racial- or language-concordant health care services did not appear to resolve these barriers. These findings underscore the importance of addressing both spoken and written healthcare communication needs among older Chinese American immigrants.
Khalaila, R N Rabia
Socioeconomic inequalities in health are well documented. Recently, researchers have shown interest in exploring the mechanisms by which measures of SES operate through it to impact SRH, such as material, psychosocial and behavioral factors. To examine the relationships between SES indicators and self-rated health (SRH); and to determine whether health behaviors and obesity mediate the association between SES indicators and SRH. A secondary analysis of data previously collected through the third survey of socioeconomic and health status of the Arab population in Israel, in which the SRH of 878 Arab-Israelis age 50 or older were analyzed using logistic regression. The results showed that higher education level and current employment in old age are associated with better SRH. However, neither subjective economic status nor family income was associated with SRH. Greater physical activity was found to be related to good\\very good SRH, while obesity was associated with less than good SRH. Finally, health behaviors (physical activity) and obesity were revealed as mediators between SES indicators (education and employment status) and SRH. The results highlight the importance of high education level and employment status in old age to reduce health inequalities. The findings also show that the relationship between SES and SRH can operate through behavioral mechanisms (i.e., physical activity) and their consequences (i.e., obesity), that can, however, be changed in old age.
Brown, Dustin C; Hummer, Robert A; Hayward, Mark D
Education's benefits for individuals' health are well documented, but it is unclear whether health benefits also accrue from the education of others in important social relationships. We assess the extent to which individuals' own education combines with their spouse's education to influence self-rated health among married persons ages 25 and older in the United States (N = 337,846) with pooled data from the 1997-2010 National Health Interview Survey. Results from age and gender-specific models revealed that own education and spouse's education each share an inverse association with fair/poor self-rated health among married men and women. Controlling for spousal education substantially attenuated the association between individuals' own education and fair/poor self-rated health and the reduction in this association was greater for married women than married men. The results also suggest that husbands' education is more important for wives' self-rated health than vice versa. Spousal education particularly was important for married women ages 45-64. Overall, the results imply that individuals' own education and spousal education combine to influence self-rated health within marriage. The results highlight the importance of shared resources in marriage for producing health.
Segerstrom, Suzanne C.
Objective Self-rated health (SRH) predicts mortality above and beyond objective health risks and as such comprises an important aspect of health. Established contributors to self-rated health include affect, age, and disease, but neither their dynamic nor their synergistic contributions to SRH have been comprehensively tested. Methods The present study employed older adults (N = 150; M age = 75 years) and a longitudinal design with 6-month waves over up to 5 years. Positive and negative affect (PA, NA), chronic disease, and SRH were assessed at each wave. Results In multilevel models with single predictors, older age, more chronic disease, and higher NA predicted worse SRH, whereas higher PA predicted better SRH. Affect predicted SRH both between and within people. In multilevel models with interactions between affect and age or disease, individual differences in NA predicted worse SRH primarily in older people. Within people, changes in NA were associated with changes in SRH, but more so in younger than in older people. Within people, changes in PA were associated with changes in SRH, but only when health was better than usual. Conclusions There were both dynamic and synergistic relationships between affect and SRH that could only emerge in a multilevel, multivariable design. In the case of NA, between-person, trait NA had the opposite relationship to SRH and age compared with within-person, state NA. Which component of this relationship predicts mortality is an important question for future research. PMID:23914813
Rhee, Min-Kyoung; Mor Barak, Michàlle E; Gallo, William T
This study examined mechanisms of the effect of involuntary retirement on self-rated health and mental health among adults aged 50 or older. Using two waves of the Health and Retirement Study (2006 and 2010), we selected a sample of 1,195 individuals working for pay at baseline who responded to a lifestyle questionnaire in both waves. Regression-based path analyses were conducted to test the mediating effects of financial control, positive and negative family relationships, and social integration on the relationship between involuntary retirement and self-rated health and mental health. Results of mediation analyses indicated that transition to involuntary retirement was directly negatively associated with subsequent self-rated health and indirectly negatively associated with mental health via perception of less financial control. Voluntary retirement was indirectly positively associated with both self-rated and mental health via perception of more financial control. No significant direct or indirect effects of retirement were found when retirement was measured with an aggregate measure without specifying its voluntariness. Findings emphasize the importance of specifying the voluntariness of retirement and recognizing the heterogeneity in the mechanisms of involuntary and voluntary retirement.
Meadows, Sarah O.
The association between marital status and health among men has been well documented, but few studies track health trajectories following family structure transitions among unmarried fathers. Using the Fragile Families and Child Wellbeing Study this article examines trajectories of paternal mental health and self-rated health, focusing on…
Furuya, Yoko; Kondo, Naoki; Yamagata, Zentaro; Hashimoto, Hideki
Health literacy (HL) is a key determinant of health in a contemporary society characterized by abundant information. Previous studies have suggested that basic or functional HL is positively associated with health, whereas evidences on the association between health and communicative/critical HL are scarce. Furthermore, confounding by socioeconomic status on HL-health association has been poorly tested. Using cross-sectional data from a nationally representative community-based survey in Japan, we investigated whether communicative/critical HL is associated with self-rated health independent of socioeconomic status. A total of 1237 subjects participated in this study; the response rate was 62%. To measure communicative/critical HL, we used three questions assessing the respondents' ability to select, to communicate to others and to evaluate specific health-related information. Potential confounders included demographic factors, household income, employment status, and educational attainment. A multivariate model revealed that good self-reported health was significantly associated with younger age [odds ratio (OR), 0.99; 95% confidence interval (CI), 0.97-0.99], employment (OR, 2.89; 95% CI, 1.06-7.88) and higher communicative/critical HL scores (OR 2.75; 95%CI, 1.93-3.90). Respondents with lower education were likely to have poorer communicative/critical HL. These results imply that to close the health gap, policy interventions should focus on the promotion of HL among deprived sociodemographic groups.
Damián, Javier; Pastor-Barriuso, Roberto; Valderrama-Gama, Emiliana
Background Although self-rated health has been extensively studied in community older people, its determinants have seldom been investigated in institutional settings. We carried out a cross-sectional study to describe the physical, mental, and social factors associated with self-rated health in nursing homes and other geriatric facilities. Methods A representative sample of 800 subjects 65 years of age and older living in 19 public and 30 private institutions of Madrid was randomly selected through stratified cluster sampling. Residents, caregivers, physicians, and nurses were interviewed by trained geriatricians using standardized instruments to assess self-rated health, chronic illnesses, functional capacity, cognitive status, depressive symptoms, vision and hearing problems, and social support. Results Of the 669 interviewed residents (response rate 84%), 55% rated their health as good or very good. There was no association with sex or age. Residents in private facilities and those who completed primary education had significantly better health perception. The adjusted odds ratio (95% confidence interval) for worse health perception was 1.18 (1.07–1.28) for each additional chronic condition, 2.37 (1.38–4.06) when comparing residents with moderate dependency to those functionally independent, and 10.45 (5.84–18.68) when comparing residents with moderate/severe depressive symptoms to those without symptoms. Visual problems were also associated with worse health perception. Similar results were obtained in subgroup analyses, except for inconsistencies in cognitively impaired individuals. Conclusion Chronic conditions, functional status, depressive symptoms and socioeconomic factors were the main determinants of perceived health among Spanish institutionalized elderly persons. Doubts remain about the proper assessment of subjective health in residents with altered cognition. PMID:18304308
Relationship of Self-Rated Health to Stroke Incidence and Mortality in Older Individuals with and without a History of Stroke: A Longitudinal Study of the MRC Cognitive Function and Ageing (CFAS) Population
Mavaddat, Nahal; van der Linde, Rianne; Parker, Richard; Savva, George; Kinmonth, Ann Louise; Brayne, Carol; Mant, Jonathan
Introduction Poor self-rated health (SRH) has been associated with increased risk of death and poor health outcomes even after adjusting for confounders. However its’ relationship with disease-specific mortality and morbidity has been less studied. SRH may also be particularly predictive of health outcomes in those with pre-existing conditions. We studied whether SRH predicts new stroke in older people who have never had a stroke, or a recurrence in those with a prior history of stroke. Methods MRC CFAS I is a multicentre cohort study of a population representative sample of people in their 65th year and older. A comprehensive interview at baseline included questions about presence of stroke, self-rated health and functional disability. Follow-up at 2 years included self-report of stroke and stroke death obtained from death certificates. Multiple logistical regression determined odds of stroke at 2 years adjusting for confounders including disability and health behaviours. Survival analysis was performed until June 2014 with follow-up for up to 13 years. Results 11,957 participants were included, of whom 11,181 (93.8%) had no history of stroke and 776 (6.2%) one or more previous strokes. Fewer with no history of stroke reported poor SRH than those with stroke (5 versus 21%). In those with no history of stroke, poor self-rated health predicted stroke incidence (OR 1.5 (1.1–1.9)), but not stroke mortality (OR 1.2 (0.8–1.9)) at 2 years nor for up to 13 years (OR 1.2(0.9–1.7)). In those with a history of stroke, self-rated health did not predict stroke incidence (OR 0.9(0.6–1.4)), stroke mortality (OR 1.1(0.5–2.5)), or survival (OR 1.1(0.6–2.1)). Conclusions Poor self-rated health predicts risk of stroke at 2 years but not stroke mortality among the older population without a previous history of stroke. SRH may be helpful in predicting who may be at risk of developing a stroke in the near future. PMID:26928666
Wu, Chi-Fang; Wang, Ming-Sheng; Eamon, Mary Keegan
Using a national sample of single mothers from the 2007 and 2009 waves of the Panel Study of Income Dynamics, this study examined the effects of multiple employment statuses on the selfrated health of single mothers during the recent economic recession. Unlike other studies, the current study minimized selection bias by controlling for prior self-rated health, in addition to other predisposing factors, enabling factors, and need factors. We found that underemployment, but not unemployment, is associated with lower levels of self-rated health of single mothers. Results further indicate that the 25-39 age range (compared to the 18-24 age range), lower family income, prior lower self-rated health, more chronic diseases, and binge drinking place single mothers at an increased risk of lower levels of self-rated health. In contrast, strength-building physical activity is significantly associated with higher levels of self-rated health. Implications for health care policy and social work practice are drawn from the results.
Background Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults. Methods This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed. Results In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health. Conclusion Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students. PMID:24195632
Eriksson, Malin; Ng, Nawi
Until recently, most studies on social capital and health have been cross-sectional making it difficult to draw causal conclusions. This longitudinal study used data from 33,621 individuals (15,822 men and 17,799 women) from the Västerbotten Intervention Program, to analyse how changes in access to individual social capital influence self-rated health (SRH) over time. Two forms of structural social capital, i.e. informal socializing and social participation, were measured. Age, sex, education, marital status, smoking, snuff, physical activity, alcohol consumption, high blood pressure, and body mass index were analysed as potential confounders. The association between changes in access to structural social capital and SRH in the follow-up was adjusted for SRH at baseline, as well as for changes in the socio-demographic and health-risk variables over time. The results support that changes in access to structural social capital over time impact on SRH. Remaining with no/low level of informal socializing over time increased the odds ratio for poor SRH for both men and women (OR of 1.45; 95%CI = 1.22-1.73 among men and OR of 1.56; 95%CI = 1.33-1.84 among women). Remaining with no/low levels of social participation was also detrimental to SRH in men and women (OR 1.14; 95%CI = 1.03-1.26 among men and OR 1.18; 95%CI = 1.08-1.29 among women). A decrease in informal socializing over time was associated with poor SRH for women and men (OR of 1.35; 95%CI = 1.16-1.58 among men and OR of 1.57; 95%CI = 1.36-1.82 among women). A loss of social participation had a negative effect on SRH among men and women (OR of 1.16; 95%CI = 1.03-1.30 among men and OR of 1.15; 95%CI = 1.04-1.27 among women). Gaining access to social participation was harmful for SRH for women (OR 1.17; 95%CI = 1.05-1.31). Structural social capital has complex and gendered effects on SRH and interventions aiming to use social capital for health promotion purposes require an awareness of its gendered nature.
Waller, Göran; Hamberg, Katarina; Forssén, Annika
Background In epidemiological research, self-rated health is an independent predictor of mortality, cardiovascular diseases, and other critical outcomes. It is recommended for clinical use, but research is lacking. Aim To investigate what happens in consultations when the question ‘How would you assess your general health compared with others your own age?’ is posed. Design and setting Authentic consultations with GPs at health centres in Sweden. Method Thirty-three planned visits concerning diabetes, pain, or undiagnosed symptoms were voice-recorded. Dialogue regarding self-rated health was transcribed verbatim and analysed using a systematic text condensation method. Speaking time of patients and doctors was measured and the doctors’ assessment of the value of the question was documented in a short questionnaire. Results Two overarching themes are used to describe patients’ responses to the question. First, there was an immediate reaction, often expressing strong emotions, setting the tone of the dialogue and influencing the continued conversation. This was followed by reflection regarding their functional ability, management of illnesses and risks, and/or situation in life. The GPs maintained an attitude of active listening. They sometimes reported a slight increase in consultation time or feeling disturbed by the question, but mostly judged it as valuable, shedding additional light on the patients’ situation and making it easier to discuss difficulties and resources. The patients’ speaking time increased noticeably during this part of the consultation. Conclusion Asking patients to comparatively self-rate their health is an effective tool in general practice. PMID:26324500
Kochergin, Clavdia Nicolaevna; Proietti, Fernando Augusto; César, Cibele Comini
This study aimed to analyze the prevalence of negative self-rated health and associated factors in the quilombola community (descendants of escaped slaves) in Vitória da Conquista, Bahia State, Brazil. A household survey was conducted with 797 adults in 2011. Data on self-rated health, socioeconomic and demographic characteristics, lifestyle, social support, health status, and access to health services were obtained through questionnaires. Multivariate logistic regression analysis was performed, adjusted for sex and age. Prevalence of negative self-rated health was 12.5%. After statistical modeling, the following variables remained associated with self-rated health: skin color, schooling, adequate consumption of fruits and vegetables, chronic illness, physical limitations, and at least one medical visit in the previous 12 months. Self-rated health was associated with socioeconomic/demographic dimensions, lifestyle, social support, and health status.
Link, Bruce G.; Susser, Ezra S.; Factor-Litvak, Pam; March, Dana; Kezios, Katrina L.; Lovasi, Gina S.; Rundle, Andrew G.; Suglia, Shakira F.; Fader, Kim M.; Andrews, Howard F.; Johnson, Eileen; Cirillo, Piera M.; Cohn, Barbara A.
Extensive evidence leads us to expect that health disparities by race and socioeconomic status found in one generation might be reproduced in the next. To the extent that this occurs it is important to assess life course processes responsible for the reproduction. Prospective evidence concerning such life course processes is hard to come by as it requires long-term follow-up of individuals from childhood through adult life. We present data from the Child Health and Development Disparities study that provides evidence relevant to this issue with respect to self-rated health. Mothers and offspring recruited in California's Bay Area between 1959 and 1967 were assessed during pregnancy with follow-up exams of offspring along with in-person interviews with mothers (at offspring ages 5, 9–11, 15–17) and offspring (at ages 15–17, ~50). Available data allow us to assess the importance of three potential life course pathways in the reproduction of inequalities in self-rated health – socioeconomic pathways, cognitive pathways and pathways involving emerging health itself. As expected we found that race and SES disparities in SRH are reproduced across generations. They are evident in mothers, not strong or significant in offspring at 15–17, but present once again in offspring at age ~50. Concerning potential pathways, we found that indicators of child health were related to adult SRH and played some role in accounting for race but not SES disparities in adult SRH. Cognitive abilities were unrelated to adult SRH with childhood SES controlled. Childhood SES was associated with adult SRH independent of other childhood factors and is reduced to non-significance only when offspring college attainment is controlled. Race and SES disparities in self-reported health in one generation are re-expressed in the next with strongest support for SES pathways in this transmission. PMID:27987434
Link, Bruce G; Susser, Ezra S; Factor-Litvak, Pam; March, Dana; Kezios, Katrina L; Lovasi, Gina S; Rundle, Andrew G; Suglia, Shakira F; Fader, Kim M; Andrews, Howard F; Johnson, Eileen; Cirillo, Piera M; Cohn, Barbara A
Extensive evidence leads us to expect that health disparities by race and socioeconomic status found in one generation might be reproduced in the next. To the extent that this occurs it is important to assess life course processes responsible for the reproduction. Prospective evidence concerning such life course processes is hard to come by as it requires long-term follow-up of individuals from childhood through adult life. We present data from the Child Health and Development Disparities study that provides evidence relevant to this issue with respect to self-rated health. Mothers and offspring recruited in California's Bay Area between 1959 and 1967 were assessed during pregnancy with follow-up exams of offspring along with in-person interviews with mothers (at offspring ages 5, 9-11, 15-17) and offspring (at ages 15-17, ∼50). Available data allow us to assess the importance of three potential life course pathways in the reproduction of inequalities in self-rated health - socioeconomic pathways, cognitive pathways and pathways involving emerging health itself. As expected we found that race and SES disparities in SRH are reproduced across generations. They are evident in mothers, not strong or significant in offspring at 15-17, but present once again in offspring at age ∼50. Concerning potential pathways, we found that indicators of child health were related to adult SRH and played some role in accounting for race but not SES disparities in adult SRH. Cognitive abilities were unrelated to adult SRH with childhood SES controlled. Childhood SES was associated with adult SRH independent of other childhood factors and is reduced to non-significance only when offspring college attainment is controlled. Race and SES disparities in self-reported health in one generation are re-expressed in the next with strongest support for SES pathways in this transmission.
Hurtado, David; Kawachi, Ichiro; Sudarsky, John
Although there is increasing evidence supporting the associations between social capital and health, less is known of potential effects in Latin American countries. Our objective was to examine associations of different components of social capital with self-rated health in Colombia. The study had a cross-sectional design, using data of a survey applied to a nationally representative sample of 3025 respondents, conducted in 2004-2005. Stratified random sampling was performed, based on town size, urban/rural origin, age, and sex. Examined indicators of social capital were interpersonal trust, reciprocity, associational membership, non-electoral political participation, civic activities and volunteering. Principal components analysis including different indicators of social capital distinguished three components: structural-formal (associational membership and non-electoral political participation), structural-informal (civic activities and volunteering) and cognitive (interpersonal trust and reciprocity). Multilevel analyses showed no significant variations of self-rated health at the regional level. After adjusting for sociodemographic covariates, interpersonal trust was statistically significantly associated with lower odds of poor/fair health, as well as the cognitive social capital component. Members of farmers/agricultural or gender-related groups had higher odds of poor/fair health, respectively. Excluding these groups, however, associational membership was associated with lower odds of poor/fair health. Likewise, in Colombians with educational attainment higher than high school, reciprocity was associated with lower odds of fair/poor health. Nevertheless, among rural respondents non-electoral political participation was associated with worse health. In conclusion, cognitive social capital and associational membership were related to better health, and could represent important notions for health promotion. Human rights violations related to political violence
Harris, Ricci; Cormack, Donna; Stanley, James; Rameka, Ruruhira
In this study, we examine race/ethnic consciousness and its associations with experiences of racial discrimination and health in New Zealand. Racism is an important determinant of health and cause of ethnic inequities. However, conceptualising the mechanisms by which racism impacts on health requires racism to be contextualised within the broader social environment. Race/ethnic consciousness (how often people think about their race or ethnicity) is understood as part of a broader assessment of the 'racial climate'. Higher race/ethnic consciousness has been demonstrated among non-dominant racial/ethnic groups and linked to adverse health outcomes in a limited number of studies. We analysed data from the 2006/07 New Zealand Health Survey, a national population-based survey of New Zealand adults, to examine the distribution of ethnic consciousness by ethnicity, and its association with individual experiences of racial discrimination and self-rated health. Findings showed that European respondents were least likely to report thinking about their ethnicity, with people from non-European ethnic groupings all reporting relatively higher ethnic consciousness. Higher ethnic consciousness was associated with an increased likelihood of reporting experience of racial discrimination for all ethnic groupings and was also associated with fair/poor self-rated health after adjusting for age, sex and ethnicity. However, this difference in health was no longer evident after further adjustment for socioeconomic position and individual experience of racial discrimination. Our study suggests different experiences of racialised social environments by ethnicity in New Zealand and that, at an individual level, ethnic consciousness is related to experiences of racial discrimination. However, the relationship with health is less clear and needs further investigation with research to better understand the racialised social relations that create and maintain ethnic inequities in health in
Harris, Ricci; Cormack, Donna; Stanley, James; Rameka, Ruruhira
In this study, we examine race/ethnic consciousness and its associations with experiences of racial discrimination and health in New Zealand. Racism is an important determinant of health and cause of ethnic inequities. However, conceptualising the mechanisms by which racism impacts on health requires racism to be contextualised within the broader social environment. Race/ethnic consciousness (how often people think about their race or ethnicity) is understood as part of a broader assessment of the ‘racial climate’. Higher race/ethnic consciousness has been demonstrated among non-dominant racial/ethnic groups and linked to adverse health outcomes in a limited number of studies. We analysed data from the 2006/07 New Zealand Health Survey, a national population-based survey of New Zealand adults, to examine the distribution of ethnic consciousness by ethnicity, and its association with individual experiences of racial discrimination and self-rated health. Findings showed that European respondents were least likely to report thinking about their ethnicity, with people from non-European ethnic groupings all reporting relatively higher ethnic consciousness. Higher ethnic consciousness was associated with an increased likelihood of reporting experience of racial discrimination for all ethnic groupings and was also associated with fair/poor self-rated health after adjusting for age, sex and ethnicity. However, this difference in health was no longer evident after further adjustment for socioeconomic position and individual experience of racial discrimination. Our study suggests different experiences of racialised social environments by ethnicity in New Zealand and that, at an individual level, ethnic consciousness is related to experiences of racial discrimination. However, the relationship with health is less clear and needs further investigation with research to better understand the racialised social relations that create and maintain ethnic inequities in health in
Mathis, Arlesia; Rooks, Ronica; Kruger, Daniel
Objective: By 2030, older adults will account for 20% of the U.S. population. Over 80% of older adults live in urban areas. This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. Methods: We selected 217 individuals aged 65+ living in a deindustrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and self-rated health (SRH) was analyzed using regression and GIS models. Neighborhood variables included social support and participation, perceived racism and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Results: Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH (p = 0.01). Additional analyses revealed Black seniors are 7% less likely to participate in social activities (p = 0.005) and 4% more likely to report experiencing racism (p < 0.001). Discussion: Given the increasing numbers of older adults living in urban neighborhoods, studies such as this one are important for well-being among seniors. Mitigating environmental influences in the neighborhood which are associated with poor SRH may allow urban older adults to maintain health and reduce disability. PMID:26703659
Background The deprived physical environments present in slums are well-known to have adverse health effects on their residents. However, little is known about the health effects of the social environments in slums. Moreover, neighbourhood quantitative spatial analyses of the mental health status of slum residents are still rare. The aim of this paper is to study self-rated mental health data in several slums of Dhaka, Bangladesh, by accounting for neighbourhood social and physical associations using spatial statistics. We hypothesised that mental health would show a significant spatial pattern in different population groups, and that the spatial patterns would relate to spatially-correlated health-determining factors (HDF). Methods We applied a spatial epidemiological approach, including non-spatial ANOVA/ANCOVA, as well as global and local univariate and bivariate Moran's I statistics. The WHO-5 Well-being Index was used as a measure of self-rated mental health. Results We found that poor mental health (WHO-5 scores < 13) among the adult population (age ≥15) was prevalent in all slum settlements. We detected spatially autocorrelated WHO-5 scores (i.e., spatial clusters of poor and good mental health among different population groups). Further, we detected spatial associations between mental health and housing quality, sanitation, income generation, environmental health knowledge, education, age, gender, flood non-affectedness, and selected properties of the natural environment. Conclusions Spatial patterns of mental health were detected and could be partly explained by spatially correlated HDF. We thereby showed that the socio-physical neighbourhood was significantly associated with health status, i.e., mental health at one location was spatially dependent on the mental health and HDF prevalent at neighbouring locations. Furthermore, the spatial patterns point to severe health disparities both within and between the slums. In addition to examining health
Goodman, Elizabeth; Huang, Bin; Schafer-Kalkhoff, Tara; Adler, Nancy E.
Purpose The cognitive, social, and biological transitions of adolescence suggest that subjective perceptions of social position based on the socioeconomic hierarchy may undergo important changes during this period, yet how such perceptions develop is poorly understood and no studies assess if changes in such perceptions influence adolescents’ health. This study describes adolescents’ subjective perceptions of familial socioeconomic status (SSS), how SSS changes over time, and how age, race, and objective socioeconomic status (SES) indicators influence SSS. In addition, the study determines if SSS independently influences adolescents’ self-rated health, an important predictor of morbidity and health service utilization. Methods 1179 non-Hispanic black and white baseline 7–12th graders from a Midwestern public school district completed a validated, teen-specific measure of SSS annually for 4 consecutive years. A parent provided information on SES. Markov modeling assessed transitions in SSS over time. Results SSS declined with age (p=.001) and stabilized among older teens. In addition to age, SES and race, but not gender, were significant correlates of SSS, but the relationships between these factors were complex. In cross-sectional and longitudinal analyses, black teens from families with low parent education had higher SSS than white teens from similarly educated families, while white teens from highly educated families had higher SSS than black teens from highly educated families. Lower SSS and changes in SSS predicted poor self rated health even when adjusting for race and objective SES measures. Conclusion Subjective evaluations of socioeconomic status predict adolescents’ global health ratings even when adjusting for the sociodemographic factors which shape them. PMID:17950168
Tøge, Anne Grete; Blekesaune, Morten
The Great Recession of 2008 has led to elevated unemployment in Europe and thereby revitalised the question of causal health effects of unemployment. This article applies fixed effects regression models to longitudinal panel data drawn from the European Union Statistics on Income and Living Conditions for 28 European countries from 2008 to 2011, in order to investigate changes in self-rated health around the event of becoming unemployed. The results show that the correlation between unemployment and health is partly due to a decrease in self-rated health as people enter unemployment. Such health changes vary by country of domicile, and by individual age; older workers have a steeper decline than younger workers. Health changes after the unemployment spell reveal no indication of adverse health effects of unemployment duration. Overall, this study indicates some adverse health effects of unemployment in Europe--predominantly among older workers.
Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro
To examine associations between work–family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011–2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work–family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04–2.97) for men and 3.54 (95% CI; 2.92–4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work–family conflict were likely to be more evident in the low income group only among women. Work–family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women. PMID:28207757
Okafor, Maria-Theresa C; Carter-Pokras, Olivia D; Picot, Sandra J; Zhan, Min
Although over 1.5 million African immigrants live in the US, few studies have examined the relationship of language acculturation to health outcomes among African immigrant adults. The primary objective of this research was to investigate the relationship between English proficiency and current self-rated health among African immigrant adults. Using a cross-sectional design, a secondary data analysis was performed on baseline data from the African immigrant adult subsample (n = 763) of the 2003 New Immigrant Survey, a longitudinal study of lawful permanent residents. Limited English proficiency (LEP), increased duration of US residence, older age at immigration, being male, less than 12 years of education, poor pre-migration health, and chronic disease were associated with good/fair/poor current self-rated health. Findings support consideration of pre-migration health and chronic disease in future acculturation and health studies, and provision of linguistically competent interventions for LEP African immigrants at risk for poor health outcomes.
Pinto, Juliana Martins; Fontaine, Anne Marie; Neri, Anita Liberalesso
Chronic diseases, signals and symptoms of health problems and objective losses in functionality are seen as strongly related to low levels of life satisfaction in old age. Among seniors, self-rated health is associated with both quality of health and life satisfaction, but its relationships with objective health measures are controversial. This study aimed at identifying the influence of self-rated health as a mediator of the relationships between objectives indicators of physical and mental health and the elderly's life satisfaction. Self-reporting and physical performance measures were derived from the data basis of the FIBRA Study, which investigated frailty and associated variables in a cross-sectional sample of 2164 subjects aged 65 and above, randomly selected in seven Brazilian cities. A model considering satisfaction as a dependent variable, the number of diseases, frailty, cognitive status and depressive symptoms as predictors and self-rated health as a mediating variable was tested through path analysis. The model fit the data well and explained 19% of life satisfaction's variance. According to the bootstrapping method, indirect effects were significant for all trajectories, suggesting that self-rated health is a mediator variable between physical and mental health and elderlýs life satisfaction. In conclusion, adverse conditions of physical and mental health can influence the elderlýs life satisfaction, mostly when they determine a decrease in their levels of self-rated health.
The purpose of this study is to assess the effects of helping others on self-rated health in middle and late life. Data are from a nationwide sample of middle-aged and older adults (N=1154). The findings indicate that women and Blacks are more likely than men or Whites to help others. Moreover, the results suggest that people who attend church more often are especially likely to help others. The data further reveal that people who help others are more likely to have a greater sense of self-worth and people with more self-esteem, in turn, tend to rate their health in a more favorable way. The findings help clarify issues in the assessment of helping others in middle and late life.
Mathis, Arlesia; Rooks, Ronica; Kruger, Dan
Objective: This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. Method: We selected 217 individuals aged 65+ living in a de-industrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and SRH was analyzed using regression models. Neighborhood variables included social support and participation, perceived racism, and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Results: Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH (p = .01). Additional analyses revealed Black seniors are 7% less likely to participate in social activities (p = .005) and 4% more likely to report experiencing racism (p < .001). Discussion: More than 80% of older adults live in urban areas. By 2030, older adults will account for 20% of the U.S.
Gunnarsson, Kristina; Vingård, Eva; Josephson, Malin
This study was an investigation of prevalence and associations between self-rated health and working conditions for small-scale enterprisers in a county in Sweden. A postal questionnaire was answered by 340 male and 153 female small-scale enterprisers in different sectors, with a response rate of 66%. For comparative purposes, data from a population study of 1,699 employees in private companies was included in the analyses. Differences were tested by Chi(2)-test and associations were presented as odds ratios (OR) with a 95% confidence interval (95% CI). The frequency of health problems in male enterprisers was higher than in employees in the private sector, while the frequency of health problems in female enterprisers was equal to that of the control employees. The main findings highlighted that male enterprisers reported higher rate of health problems and female enterprisers equal rate compared with employees in the private sector. Enterprisers stated musculoskeletal pain (women 59%, men 56%) and mental health problems (women 47%, men 45%) as the most frequent health problems. Poor job satisfaction, reported by 17% of the females and 20% of the male enterprisers, revealed an OR of 10.42 (95% CI 5.78-18.77) for poor general health. For the enterprisers, the most frequent complaints, musculoskeletal pain and mental health problems, were associated with poor job satisfaction and poor physical work environment. An association between poor general health and working as an enterpriser remained after adjusting for working conditions, sex and age.
Orban, Ester; Sutcliffe, Robynne; Dragano, Nico; Jöckel, Karl-Heinz; Moebus, Susanne
Previous research suggests that green environments positively influence health. Several underlying mechanisms have been discussed; one of them is facilitation of social interaction. Further, greener neighborhoods may appear more aesthetic, contributing to satisfaction and well-being. Aim of this study was to analyze the association of residential surrounding greenness with self-rated health, using data from 4480 women and men aged 45-75 years that participated in the German population-based Heinz Nixdorf Recall study. We further aimed to explore the relationships of greenness and self-rated health with the neighborhood environment and social relations. Surrounding greenness was measured using the Normalized Difference Vegetation Index (NDVI) within 100 m around participants' residence. As a result, we found that with higher greenness, poor self-rated health decreased (adjusted OR 0.90, 95% CI 0.82-0.98; per 0.1 increase in NDVI), while neighborhood satisfaction (1.41, 1.23-1.61) and neighborhood social capital (1.22, 1.12-1.32) increased. Further, we observed inverse associations of neighborhood satisfaction (0.70, 0.52-0.94), perceived safety (0.36, 0.22-0.60), social satisfaction (0.43, 0.31-0.58), and neighborhood social capital (0.53, 0.44-0.64) with poor self-rated health. These results underline the importance of incorporating green elements into neighborhoods for health-promoting urban development strategies.
Trump, David H
Self-rated general health is one element of the standard health assessment required of U.S. military service members upon completion of major deployments. A cohort study of 22,229 male U.S. Army and Air Force personnel returning from Europe or Southwest Asia in 2000 used survival analysis methods and Cox proportional hazard models to examine postdeployment self-rated health (SRH) status and subsequent hospitalization, separation, and ambulatory care visits. Self-rated health was fair/poor for 1.5% and good for 20.4%; 11% documented at least one health concern. During 30,433 person-years of follow-up (median, 1.5 person-years), there were 22.8 hospitalizations per 1,000 person-years and 4.0 ambulatory care visits per person-years. After adjustment, deployers with fair/poor SRH had an increased risk for hospitalization (hazard ratio [HRI, 1.6; 95% confidence interval [CI], 1.0,2.7); the risk was lower for those with good SRH (HR, 1.3; 95% CI,1.1,1.5). Deployers with fair/poor SRH health had an increased risk for illness-related ambulatory care visits (HR, 1.8, 95%; CI, 1.6,2.1) and administrative visits (HR, 1.4; 95% CI, 1.1,1.7), but not injury-related visits (HR, 1.2; 95% CI, 0.8,1.7). Self-reported low health status and other health concerns identify military members with higher levels of health care needs following return from major deployments.
Objectives: Despite the well-established association between self-rated health and mortality, research findings have been inconsistent regarding how men and women differ on this link. Using a national sample in the United States, this study compared American male and female older adults for the predictive role of baseline self-rated health on the short-term risk of mortality. Methods: This longitudinal study followed 1500 older adults (573 men (38.2%) and 927 women (61.8%)) aged 66 years or older for 3 years from 2001 to 2004. The main predictor of interest was self-rated health, which was measured using a single item in 2001. The outcome was the risk of all-cause mortality during the 3-year follow-up period. Demographic factors (race and age), socio-economic factors (education and marital status), and health behaviors (smoking and drinking) were covariates. Gender was the focal moderator. We ran logistic regression models in the pooled sample and also stratified by gender, with self-rated health treated as either nominal variables, poor compared to other levels (i.e. fair, good, or excellent) or excellent compared to other levels (i.e. good, fair, or poor), or an ordinal variable. Results: In the pooled sample, baseline self-rated health predicted mortality risk, regardless of how the variable was treated. We found a significant interaction between gender and poor self-rated health, indicating a stronger effect of poor self-rated health on mortality risk for men compared to women. Gender did not interact with excellent self-rated health on mortality. Conclusion: Perceived poor self-rated health better reflects risk of mortality over a short period of time for older men compared to older women. Clinicians may need to take poor self-rated health of older men very seriously. Future research should test whether the differential predictive validity of self-rated health based on gender is due to a different meaning of poor self-rated health for older men and women
McMullen, Carmit K.; Luborsky, Mark R.
Purpose: We explored self-rated health by using a meaning-centered theoretical foundation. Self-appraisals, such as self-rated health, reflect a cultural process of identity formation, whereby identities are multiple, simultaneously individual and collective, and produced by specific historical formations. Anthropological research in Philadelphia…
The purpose of this study is to develop and test a conceptual model that assesses the following theoretical linkages: (1) people who go to church more often tend to receive more spiritual support from fellow church members (i.e., encouragement to adopt religious teachings and principles); (2) individuals who get more frequent spiritual support are more likely to be humble; and (3) people with greater humility tend to rate their health more favorably. The data come from the third wave of a nationwide longitudinal survey of older adults. The data provide support for each of the conceptual linkages identified above.
The purpose of this study is to develop and test a conceptual model that assesses the following theoretical linkages: (1) people who go to church more often tend to receive more spiritual support from fellow church members (i.e., encouragement to adopt religious teachings and principles); (2) individuals who get more frequent spiritual support are more likely to be humble; and (3) people with greater humility tend to rate their health more favorably. The data come from the third wave of a nationwide longitudinal survey of older adults. The data provide support for each of the conceptual linkages identified above. PMID:20703366
Tyrovolas, Stefanos; Koyanagi, Ai; Panagiotakos, Demosthenes B; Haro, Josep Maria; Kassebaum, Nicholas J; Chrepa, Vanessa; Kotsakis, Georgios A
Edentulism is associated with various adverse health outcomes but treatment options in low- and middle-income countries (LMICs) are limited. Data on its prevalence and its effect on mental health and overall-health is lacking, especially from LMICs. Self-reported data on complete edentulism obtained by standardized questionnaires on 201,953 adults aged ≥18 years from 50 countries which participated in the World Health Survey (WHS) 2002-2004 were analyzed. Age and sex-standarized edentulism prevalence ranged from 0.1% (95% CI = 0.0-0.3) (Myanmar) to 14.5% (95% CI = 13.1-15.9) (Zimbabwe), and 2.1% (95% CI = 1.5-3.0) (Ghana) to 32.3% (95% CI = 29.0-35.8) (Brazil) in the younger and older age groups respectively. Edentulism was significantly associated with depression (OR 1.57, 95% CI = 1.23-2.00) and poor self-rated health (OR 1.38, 95% CI = 1.03-1.83) in the younger group with no significant associations in the older age group. Our findings highlight the edentulism-related health loss in younger persons from LMICs. The relative burden of edentulism is likely to grow as populations age and live longer. Given its life-long nature and common risk factors with other NCDs, edentulism surveillance and prevention should be an integral part of the global agenda of NCD control.
Tyrovolas, Stefanos; Koyanagi, Ai; Panagiotakos, Demosthenes B.; Haro, Josep Maria; Kassebaum, Nicholas J.; Chrepa, Vanessa; Kotsakis, Georgios A.
Edentulism is associated with various adverse health outcomes but treatment options in low- and middle-income countries (LMICs) are limited. Data on its prevalence and its effect on mental health and overall-health is lacking, especially from LMICs. Self-reported data on complete edentulism obtained by standardized questionnaires on 201,953 adults aged ≥18 years from 50 countries which participated in the World Health Survey (WHS) 2002–2004 were analyzed. Age and sex-standarized edentulism prevalence ranged from 0.1% (95% CI = 0.0–0.3) (Myanmar) to 14.5% (95% CI = 13.1–15.9) (Zimbabwe), and 2.1% (95% CI = 1.5–3.0) (Ghana) to 32.3% (95% CI = 29.0–35.8) (Brazil) in the younger and older age groups respectively. Edentulism was significantly associated with depression (OR 1.57, 95% CI = 1.23–2.00) and poor self-rated health (OR 1.38, 95% CI = 1.03–1.83) in the younger group with no significant associations in the older age group. Our findings highlight the edentulism-related health loss in younger persons from LMICs. The relative burden of edentulism is likely to grow as populations age and live longer. Given its life-long nature and common risk factors with other NCDs, edentulism surveillance and prevention should be an integral part of the global agenda of NCD control. PMID:27853193
Abada, Teresa; Hou, Feng; Ram, Bali
Using 1996/1997 to 2000/2001 data from the Canadian National Longitudinal Survey of Children and Youth, this paper examines the effects of harassment on self-rated and mental health status among Canadian adolescents aged 16-17 years. Forty-six percent of the children experienced harassment and victimization (verbal aggression, threat, and physical harm/assault) at school and 40% outside of school. Harassment at school, rather than otherwise, was associated with poor health status and higher levels of depression even when previous health conditions and socio-demographic variables were held constant. The relationship between harassment and mental health is particularly pronounced among girls, immigrant children and those living in single-parent households. Given the sizable proportion of adolescents as victims of harassment at school and its significant relationship with both health status and depression, the issue warrants serious public health attention through school-based intervention programs.
Tigani, Xanthi; Artemiadis, Artemios K; Alexopoulos, Evangelos C; Chrousos, George P; Darviri, Christina
Self-rated health (SRH) is an inclusive measure of public health that is correlated with quality of life and subsequent mortality. Extensive literature has identified multiple determinants of SRH in different populations. However, such studies on centenarians are scarce and parsimonious. Our objective is to identify SRH determinants in centenarians. This is a nationwide cross-sectional study on 400 Greek centenarians that was carried out between 2007 and 2010. SRH was evaluated by a simple question with a 5-point scale. Three categories of SRH were formed (very good/good/poor), which served as the dependent variable in multinomial regression models. Various sociodemographic, disease-related, lifestyle and psychosocial variables were assessed as candidate determinants of SRH. According to our results, SRH ratings among centenarians were better than that expected according to previous studies showing worse SRH ratings with increasing age in Greece. The 22.4% of the variance in SRH among centenarians was predicted by gender, habitat region and status, financial problems, disease presence and autonomy. Among lifestyle and psychosocial variables, obesity, good relationships with children, lack of feelings of loneliness, high optimism, adaptability and an internal health locus of control profile were independently associated with good SRH. These results indicate that SRH in individuals of extreme longevity were related to specific personal psychosocial factors that contribute to healthy aging and thus support the biopsychosocial model of health promotion.
Lima-Costa, M. Fernanda; Macinko, James; Mambrini, Juliana Vaz de Melo; Cesar, Cibele C.; Peixoto, Sérgio V.; Magalhães, Wagner C. S.; Horta, Bernardo L.; Barreto, Mauricio; Castro-Costa, Erico; Firmo, Josélia O. A.; Proietti, Fernando A.; Leal, Thiago Peixoto; Rodrigues, Maira R.; Pereira, Alexandre; Tarazona-Santos, Eduardo
Background Self-rated health (SRH) has strong predictive value for mortality in different contexts and cultures, but there is inconsistent evidence on ethnoracial disparities in SRH in Latin America, possibly due to the complexity surrounding ethnoracial self-classification. Materials/Methods We used 370,539 Single Nucleotide Polymorphisms (SNPs) to examine the association between individual genomic proportions of African, European and Native American ancestry, and ethnoracial self-classification, with baseline and 10-year SRH trajectories in 1,311 community dwelling older Brazilians. We also examined whether genomic ancestry and ethnoracial self-classification affect the predictive value of SRH for subsequent mortality. Results European ancestry predominated among participants, followed by African and Native American (median = 84.0%, 9.6% and 5.3%, respectively); the prevalence of Non-White (Mixed and Black) was 39.8%. Persons at higher levels of African and Native American genomic ancestry, and those self-identified as Non-White, were more likely to report poor health than other groups, even after controlling for socioeconomic conditions and an array of self-reported and objective physical health measures. Increased risks for mortality associated with worse SRH trajectories were strong and remarkably similar (hazard ratio ~3) across all genomic ancestry and ethno-racial groups. Conclusions Our results demonstrated for the first time that higher levels of African and Native American genomic ancestry—and the inverse for European ancestry—were strongly correlated with worse SRH in a Latin American admixed population. Both genomic ancestry and ethnoracial self-classification did not modify the strong association between baseline SRH or SRH trajectory, and subsequent mortality. PMID:26680774
Idler, Ellen; Leventhal, Howard; McLaughlin, Julie; Leventhal, Elaine
Self-rated health as a predictor of mortality has been studied primarily in large, representative populations, with relatively little progress toward understanding the information processing that individuals use to arrive at these ratings. With subsamples of National Health and Nutrition Examination Survey (NHANES) Epidemiologic Follow-up Study…
Yang, Tse-Chuan; Matthews, Stephen A; Shoff, Carla
Americans' distrust in the health care system has increased in the past decades; however, little research has explored the impact of distrust on self-rated health and even less is known about whether neighborhood social environment plays a role in understanding the relationship between distrust and self-rated health. This study fills these gaps by investigating both the direct and moderating associations of neighborhood social environment with self-rated health. Our analysis is based on the 2008 Philadelphia Health Management Corporation's household survey and neighborhood-level data. Findings from multilevel logistic regression show that after controlling for individual- and neighborhood-level covariates, distrust is directly and adversely related to self-rated health, and that neighborhood social affluence and stability are directly and negatively associated with the odds of reporting poor/fair health. Neighborhood disadvantage and crime rates are not directly related to self-rated health, but increase the odds of having poor/fair health via distrust. Overall, our results suggest that macro-level actions can alter individual's perception of residential environment and lead to improved health. To improve the public health in an urban setting, rebuilding confidence in the health care system is integral, and the policies that help establish safe and cohesive neighborhoods may reduce the adverse effect of distrust on self-rated health.
Abstract Objective Aiming at preparing the basis for evidence-based dental public health policy making in Slovenia, the objective of the study was to assess the strength of association between oral health status measured by the number of missing teeth and self-rated health (SRH). Methods The study was designed as a pooled individual-level data study from four national cross-sectional studies carried out in the period 2001-2012, based on CINDI Health Monitor methodology. Altogether, 34,412 participants were included. A logistic regression model with poor SRH as observed outcome and the number of teeth as explanatory factor (adjusted for selected biologic, socio-economic and health factors) was proposed. Results In the sample, women represented 55.7% and men 44.3%, median age was 45 years. Persons with more missing teeth more likely rated their health as poor. The association was persistent even when different confounding variables were included in the model. In the group with 1-5 missing teeth, in comparison to the group with none missing teeth, OR was 1.23 (p=0.049), whereas for the group with 6-10 missing teeth, OR was 1.32 (p=0.019); for the group with >10 missing teeth, but not all, OR was 1.77 (p<0.001), and for the group with all missing teeth, OR was 2.19 (p<0.001). Conclusions Study results showed clear association of SRH with dentate status, which confirms the oral-general health connection. This indicates the need for the development of proper dental public health policies for better oral health, and presents a new view on the importance of preserving teeth. PMID:28289473
Chow, Susan K Y; Chan, Wing Chi
This cross-sectional survey explored the depression status of new migrant women and its relationship with self-rated health in the Hong Kong Chinese context. A convenience sample of 68 migrant women volunteered to participate in the study. The data were collected by using the Problem Solving Inventory, the Center for Epidemiological Studies-Depression questionnaire, and a self-rated health scale. The respondents were found to have a lesser degree of problem-solving appraisal, compared with other populations, and almost half of the volunteers were found to be depressed. Approximately 50% of the women reported their general health as "excellent", "very good", or "good". The Pearson's correlation showed a positive significant correlation between problem-solving appraisal, depression, and self-rated health. The results of the regression analysis showed that family income, self-rated health, and problem-solving confidence are predictive factors of depression. Community nurses could consider using multidisciplinary interventions that focus on life-skills training in order to promote the psychological and general wellness of migrant women in addition to the use of counseling or medication interventions.
Mantovani, Efigênia Passarelli; de Lucca, Sérgio Roberto; Neri, Anita Liberalesso
This comparative, cross-sectional study analyzed negative self-rated health in elderly people, according to sociodemographic and health variables, use of public or private health services, functional performance, frailty and depressive symptoms. The participants lived in Belém (n = 571) and Campinas (n = 676), cities with different socioeconomic conditions, and the research formed part of a multicentric study on frailty (Fibra Study, Unicamp). Multivariate regression analysis showed that in both cities, negative self-rated health was associated with low education, three or more chronic diseases and sight deficiencies. In Belem, additional observations included associations with fatigue, three or more signs and symptoms and use of public health services; in Campinas, negative self-rated health was also associated with depressive symptoms. The associations suggest that poor health in old age is the result of an accumulation of deficits for lack of socioeconomic resources throughout life and that deficits are not sufficiently compensated for health services in old age.
Tucker-Seeley, Reginald D.; Harley, Amy E.; Stoddard, Anne M.; Sorensen, Glorian G.
Background: Self-rated health (SRH) has been shown to be predictive of morbidity and mortality. Evidence also shows that SRH is socioeconomically patterned, although this association differs depending on the indicator of socioeconomic status used. The purpose of this study was to determine the association between SRH and financial hardship among…
Zekeri, Andrew A
Using previous data from a random sample of 300 single mothers from rural Alabama, multiple regression analysis indicated that food insecurity and employment status had a modest effect on self-rated health status, while educational attainment and income had the greatest effect. These variables explained 29% of the variance in health status. Social and economic policies that affect educational attainment and income distribution may have important consequences for health status in these rural areas.
Teh, Jane K. L.; Tey, Nai Peng; Ng, Sor Tho
Objectives This paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia. Methods Data for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses. Results Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health. Conclusion Perceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people. PMID
Krueger, Patrick M.; Dovel, Kathryn; Denney, Justin T.
Existing research has found a positive association between countries’ level of democratic governance and the health of their populations, although that research is limited by the use of data from small numbers of high-income countries or aggregate data that do not assess individual-level health outcomes. We extend prior research by using multilevel World Health Survey (2002-2004) data on 313,554 individuals in 67 countries, and find that the positive association between democratic governance and self-rated health persists after adjusting for both individual- and country-level confounders. However, the mechanisms linking democracy and self-rated health remain unclear. Individual-level measures of socioeconomic status, and country-level measures of economic inequality and investments in public health and education, do not significantly mediate the association between democratic governance and self-rated health. The persistent association between democratic governance and health suggests that the political organization of societies may be an important upstream determinant of population health. PMID:26356825
Krueger, Patrick M; Dovel, Kathryn; Denney, Justin T
Existing research has found a positive association between countries' level of democratic governance and the health of their populations, although that research is limited by the use of data from small numbers of high-income countries or aggregate data that do not assess individual-level health outcomes. We extend prior research by using multilevel World Health Survey (2002-2004) data on 313,554 individuals in 67 countries, and find that the positive association between democratic governance and self-rated health persists after adjusting for both individual- and country-level confounders. However, the mechanisms linking democracy and self-rated health remain unclear. Individual-level measures of socioeconomic status, and country-level measures of economic inequality and investments in public health and education, do not significantly mediate the association between democratic governance and self-rated health. The persistent association between democratic governance and health suggests that the political organization of societies may be an important upstream determinant of population health.
Ortiz-Hernández, Luis; Tello, Blanca Lilia Gómez; Valdés, Jesús
Evidence of health inequities associated with sexual orientation has been gathered for industrialized countries. The situation for lesbians, gay males, and bisexuals (LGB) from middle- or low-income countries may be worse than those in industrialized nations. Here, we analyze the relationship of sexual orientation with self-rated health and cigarette and alcohol use among a representative sample of Mexican adolescents and youths between the ages of 12 and 29 years, in order to explore whether this association is mediated by discrimination and violence. Three dimensions of sexual orientation (affective attraction, sexual behavior, and identity) were assessed. The outcomes were self-rated health and cigarette and alcohol use. Compared to heterosexuals, LGB youths more frequently smoked >or=6 cigarettes per day, reported having experienced family violence, having crimes perpetrated against them, and having experienced violations of their rights. Among males, gays and bisexuals exhibited a higher risk of poor health than heterosexuals. Compared to heterosexual women, lesbians and bisexual women were more likely to consume alcohol. Many differences in self-rated health and substance use according to sexual orientation were explained by having experienced discrimination and violence. We concluded that lesbian and bisexual females have a higher prevalence of cigarette and alcohol use. It is necessary to develop policies and programs aimed at the reduction of substance abuse among LGB youths (focusing on females who engage in sexual contact with persons of the same gender) and to work against discrimination and violence experienced by LGB people, particularly against non-heterosexual males.
Ro, Annie; Geronimus, Arline; Bound, John; Griffith, Derek; Gee, Gilbert
Many studies, but not all, suggest that immigrant health worsens with duration of residence in the U.S. Cohort effects may explain the inconsistent findings; not only are cohort effects confounded with duration, but the timing of entry into the US may also create qualitatively different migration experiences. The present study tests for duration and cohort patterns among Asian immigrants to the United States across six year-of-entry cohorts (pre-1980, 1981-1985, 1986-1990, 1991-1995, 1996-2000, 2001-2005). Data come from the Asian American sample (n=44,002) from the 1994-2009 waves of the National Health Interview Survey. The data show cohort differences for self-rated health, such that more recent cohorts showed improved baseline health compared to older cohorts. After accounting for cohorts, there was no significant change in self-rated health by duration. Older cohorts actually showed improving self-rated health with longer duration. Obesity showed the opposite pattern; there were no differences across cohorts, but duration in the United States correlated with higher obesity. These results imply that immigrant health is not simply an issue of duration and adaptation, but underscore the utility of considering cohorts as broader contexts of migration. Collectively, the results encourage future research that more carefully examines the etiological mechanisms that drive immigrant health. PMID:25879262
Ro, Annie; Geronimus, Arline; Bound, John; Griffith, Derek; Gee, Gilbert
Many studies, but not all, suggest that immigrant health worsens with duration of residence in the United States. Cohort effects may explain the inconsistent findings; not only are cohort effects confounded with duration, but the timing of entry into the United States may also create qualitatively different migration experiences. The present study tests for duration and cohort patterns among Asian immigrants to the United States across six year-of-entry cohorts (pre-1980, 1981-85, 1986-90, 1991-95, 1996-2000, 2001-05). Data come from the Asian American sample (n = 44,002) of the 1994-2009 waves of the National Health Interview Survey. The data show cohort differences for self-rated health, such that more recent cohorts showed improved baseline health compared to older cohorts. After accounting for cohorts, there was no significant change in self-rated health by duration of residence. Older cohorts actually showed improving self-rated health with longer duration. Obesity showed the opposite pattern; there were no differences across cohorts, but duration in the United States correlated with higher obesity. These results imply that immigrant health is not simply an issue of duration and adaptation; instead, they underscore the utility of considering cohorts as broader contexts of migration. Collectively, the results encourage future research that more carefully examines the etiological mechanisms that drive immigrant health.
Klest, Bridget; Freyd, Jennifer J.; Hampson, Sarah E.; Dubanoski, Joan P.
Objectives To evaluate ethnic group differences in the association between trauma exposure and health status among an ethnically diverse sample originating in Hawai‘i. Design Across a ten-year period (1998–2008), participants (N = 833) completed five waves of questionnaire assessments. Trauma exposure was measured retrospectively at the most recent assessment (wave 5), socioeconomic resources (educational attainment and employment status) were measured at wave 1, and self-rated health was measured at each of the five waves. Results Results indicated that greater exposure to trauma was associated with poorer self-rated health, as were lower educational attainment and lower work status. In addition there was ethnic group variation in health ratings, as well as in how strongly trauma exposure predicted health status. Specifically, within Filipino American and Native Hawaiian ethnic groups, there was a stronger negative association between trauma exposure and self-rated health. Conclusion These results suggest complex interrelations among trauma, ethnicity, socioeconomic status, and physical health. Further understanding these relations may have implications for medical and behavioral interventions in vulnerable populations. PMID:22732011
Christian, Lisa M.; Iams, Jay; Porter, Kyle; Leblebicioglu, Binnaz
Background Biobehavioral correlates of self-rated health in pregnancy are largely unknown. Purpose The goals of this study were to examine, in pregnant women, associations of self-rated health with 1) demographics, objective health status, health behaviors and psychological factors and 2) serum inflammatory markers. Methods In the 2nd trimester of pregnancy, 101 women provided a blood sample, completed measures of psychosocial stress, health status, and health behaviors, and received a comprehensive periodontal examination. Results The following independently predicted poorer self-rated health: 1) greater psychological stress, 2) greater objective health diagnoses, 3) higher body mass index, and 4) past smoking (versus never smoking). Poorer self-rated health was associated with higher serum interleukin-1β (p = .02) and marginally higher macrophage migration inhibitory factor (p = .06). These relationships were not fully accounted for by behavioral/psychological factors. Conclusions This study provides novel data regarding factors influencing subjective ratings of health and the association of self-rated health with serum inflammatory markers in pregnant women. PMID:23765366
Jamil, Hikmet; Barkho, Evone; Broadbridge, Carissa L.; Ventimiglia, Matthew; Arnetz, Judith E.; Lami, Faris; Arnetz, Bengt B.
Background Research suggests that refugees are at an increased risk for poor health outcomes as compared to immigrants. However, prior studies have compared refugees and immigrants from different countries and have failed to isolate specific war-related factors. Objective To compare health outcomes and their determinants in refugees and immigrants from the same country of origin. Methods A cross-sectional study based on a convenient sample and on self-report participants were conducted at Southeast Michigan during the period September to December 2009. A validated survey was used to examine refugees (n = 75) and immigrants (n = 65) from Iraq. The survey covered socioeconomics, lifestyle, violence exposure, self-rated health, and number of medical conditions (high blood pressure, fatigue, and backache, shortness of breath, gastrointestinal disorders, skin problems, and musculoskeletal problems). Group differences and predictors of health outcomes were assessed. Results Refugees reported significantly more violence exposure than immigrants (p < 0.001). There were no significant differences in self-rated health or medical disorders between groups; however, violence exposure was the main predictor of health outcomes in refugees, whereas age was the main predictor in immigrants. Other predictors also varied by migratory group. Conclusion Even though migration status did not directly influence health outcomes, results suggest that factors associated with migration status, e.g., violence exposure and age, do impact health. Future studies need to more carefully define and control for country-specific variables. PMID:26644795
Meadows, Robert; Arber, Sara
This paper analyzes data from a nationally representative survey of adults in the United Kingdom (Understanding Society, N = 37,253) to explore the marital status/health nexus (using categories that include a measure of relationship distress) and to assess the role that sleep problems play as a potential mediator. Findings indicate how it is not just the "form" marital status takes but also the absence or presence of relationship distress that is essential to self-rated health. We demonstrate two further findings that: (1) sleep problems act as a mediator of the link between marital status/relationship distress and self-rated health, most notably for those in cohabiting relationships with medium/high distress or who have a history of relationship loss, and (2) the mediating role of sleep problems differs for divorced men and women.
Adverse economic shocks exert an influence on health perceptions, but little is known about the effect of sudden positive changes in a person’s financial situation on self-rated health, particularly among low income people. This paper explores the association between an increase in the amount of non-contribution pensions, public cash transfers given to Costa Rican elderly of low socio-economic status (SES) and changes in self-rated health over time. The analysis is based on data from CRELES, the “Costa Rican Study on Longevity and Healthy Aging”, which is based on a probabilistic sample of people born in 1945 or earlier, and living in Costa Rica by 2002. The fieldwork for the first and second waves of CRELES was conducted from 2004 to 2006, and from 2006 to 2008, respectively. The Costa Rican Government raised the amount of the non-contribution pension for the poor 100% before July 2007, and an additional 100% after that date. Due to the CRELES fieldwork schedule, the data have a natural quasi-experimental design, given that approximately half of CRELES respondents were interviewed before July 2007, independently of their status in receiving the public cash transfers. Using random effects ordered probit regression models, we find that people who experienced such increase report a greater improvement in self-rated health between waves than those who experienced a smaller increase and than the rest of the interviewees. Results suggest that increases in income may lead to a greater improvement in self-rated health. PMID:21440352
Background Self-Rated Health (SRH) correlates with risk of illness and death. But how are different questions of SRH to be interpreted? Does it matter whether one asks: “How would you assess your general state of health?”(General SRH) or “How would you assess your general state of health compared to persons of your own age?”(Comparative SRH)? Does the context in a questionnaire affect the answers? The aim of this paper is to examine the meaning of two questions on self-rated health, the statistical distribution of the answers, and whether the context of the question in a questionnaire affects the answers. Methods Statistical and semantic methodologies were used to analyse the answers of two different SRH questions in a cross-sectional survey, the MONICA-project of northern Sweden. Results The answers from 3504 persons were analysed. The statistical distributions of answers differed. The most common answer to the General SRH was “good”, while the most common answer to the Comparative SRH was “similar”. The semantic analysis showed that what is assessed in SRH is not health in a medical and lexical sense but fields of association connected to health, for example health behaviour, functional ability, youth, looks, way of life. The meaning and function of the two questions differ – mainly due to the comparing reference in Comparative SRH. The context in the questionnaire may have affected the statistics. Conclusions Health is primarily assessed in terms of its sense-relations (associations) and Comparative SRH and General SRH contain different information on SRH. Comparative SRH is semantically more distinct. The context of the questions in a questionnaire may affect the way self-rated health questions are answered. Comparative SRH should not be eliminated from use in questionnaires. Its usefulness in clinical encounters should be investigated. PMID:23046741
Gibbons, Joseph; Yang, Tse-Chuan
Despite recent declines, racial segregation remains a detriment to minority neighborhoods. However, existing research is inconclusive as to the effects racial segregation has on health. Some argue that racial segregation is related to poor health outcomes, whereas others suspect that racial segregation may actually lead to improved health for some minority communities. Even less is known about whether minority access to white neighborhoods improves health. We address these gaps with individual data from the 2010 Public Health Management Corporation's Southeastern Pennsylvania Household Health Survey and census tract data from the 2010 Decennial Census and the 2006-2010 American Community Survey. We implement logistic multilevel models to determine whether and how a resident's self-rated health is affected by the racial/ethnic segregation of their neighborhoods. Our key finding suggests that the effects of segregation on self-rated health depend on an individual's race/ethnicity, with blacks and Latino residents most likely to experience adverse effects. Particularly, minorities living in predominantly white communities have a significantly higher likelihood to report poor/fair health than they would in segregated minority neighborhoods. These findings make clear that access to white neighborhoods is not sufficient to improve minority health; fuller neighborhood integration is necessary to ensure all have health equity.
Gibbons, Joseph; Barton, Michael S
There exists controversy as to the impact gentrification of cities has on the well-being of minorities. Some accuse gentrification of causing health disparities for disadvantaged minority populations residing in neighborhoods that are changing as a result of these socioeconomic shifts. Past scholarship has suggested that fears of displacement and social isolation associated with gentrification lead to poorer minority health. However, there is a lack of research that directly links gentrification to minority health outcomes. We address this gap with individual data from the 2008 Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Health Survey and census tract data from the 2000 Decennial Census and the 2006-2010 American Community Survey. We implement logistic multilevel models to determine whether and how a resident's self-rated health is affected by gentrification of their neighborhoods. We find that while gentrification does have a marginal effect improving self-rated health for neighborhood residents overall, it leads to worse health outcomes for Blacks. Accounting for racial change, while gentrification leading to increases in White population has no measurable effect on minority health, "Black gentrification" leads to marginally worse health outcomes for Black respondents. These results demonstrate the limitations that improvements of neighborhood socioeconomic character have in offsetting minority health disparities.
Rohrer, James E.; Merry, Stephen P.; Thacher, Thomas D.; Summers, Matthew R.; Alpern, Jonathan D.; Contino, Robert W.
Context: Risks for poor self-rated overall health in rural areas of developing nations have not been thoroughly investigated. Purpose: The objective of this study was to assess potential risk factors for poor self-rated health among rural villagers in Peru. Methods: A door-to-door survey of villagers residing in the Pampas Grande region in Peru,…
Zhang, Wei; McCubbin, Hamilton; McCubbin, Laurie; Chen, Qi; Foley, Shirley; Strom, Ida; Kehl, Lisa
Focusing on Asian Americans, Hawaiians, and Caucasians in Hawaii, this study contributes to the literature by examining (1) the geographical distributions of education in relation to self-rated general health at neighborhood levels, and (2) the individual variations in self-rated health by ethnicity and education at both individual and neighborhood levels. Using the 2007 Hawaii Health Survey with linked zip-code information, and applying GIS (Geographic Information System) and binary logistic regression models, this study found that (1) there are significant between ethnic differences in self-rated health in Hawaii, with Hawaiians being the most disadvantaged population compared to Japanese, Chinese, and Caucasians; (2) individual socioeconomic characteristics are all related to self-rated health, and education (in particular) mediates the Japanese vs. Hawaiian and Chinese vs. Hawaiian health differences; (3) the neighborhood level of education has an independent effect on self-rated health over and above individual characteristics for the whole sample and it partially mediates the between ethnic health differences; and (4) the relative importance of education to self-rated health is more significant and salient for Caucasians and Japanese/Chinese than for Filipinos and Hawaiians. In sum, this study not only demonstrates a geographical profile of health and education distributions in Hawaii, but also reveals significant mediating effects of education, at both individual and neighborhood levels, in explaining the between and within ethnic differentials in self-rated health.
Zhang, Fengying; Zhao, Li; Feng, Xianqiong; Hu, Xiuying
To investigate adolescent students' self-rated health status and to identify the influencing factors that affect students' health status. A stratified cluster sampling method and the Self-assessed General Health Questionnaires were used to enroll 503 adolescent students from Sichuan Province, Southwest part of China. Most adolescent students perceived their self-rated health as “Fair” (29.4%), “Good” (52.1%), or “Very Good” (16.3%). Regarding the sleep quality, most of them rated them as “Fair” (24.9%), “Good” (43.1%), or “Very Good” (19.7%), but 59.7% students reported to sleep less than 8 hours a day, even a few reported to sleep less than 6 hours (4.4%) or more than 9 hours (9.7%). A considerable number of students (41.1%) reported that they “Never” or just “Occasionally” participated in appropriate sports or exercises. As to the dietary habit, a significant number of students (15.7%) reported that they “Never” or “Occasionally” have breakfast. Students from different administrative levels of schools (municipal level, county level, and township level) rated differently (P < 0.05) in terms of their self-rated health, Health Behaviors, Sleeping, Dietary behaviors, Safety Awareness, and Drinking and Smoking behaviors. In general, Chinese teenage students perceived their own health status as fairly good. However, attention needs to be paid to health problems of some of the students, such as lack of sleep and exercise and inadequate dietary habits, etc. More concerns need to be addressed to students from different administrative levels of schools, and strategies should be put forward accordingly. PMID:27058576
Camelo, Lidyane do V; Giatti, Luana; Barreto, Sandhi M
Using baseline data from ELSA-Brasil (N = 15,105), we investigated whether subjective social status, measured using three 10-rung "ladders," is associated with self-rated health and smoking, independently of objective indicators of social position and depression symptoms. Additionally, we explored whether the magnitude of these associations varies according to the reference group. Subjective social status was independently associated with poor self-rated health and weakly associated with former smoking. The references used for social comparison did not change these associations significantly. Subjective social status, education, and income represent distinct aspects of social inequities, and the impact of each of these indicators on health is different.
Olutola, Bukola G.; Ayo-Yusuf, Olalekan A.
Aim: This study examined the influence of the social context in which people live on self-ratings of their oral health. Method: This study involved a representative sample of 2,907 South African adults (≥16 years) who participated in the 2007 South African Social Attitude Survey (SASAS). We used the 2005 General Household Survey (n = 107,987 persons from 28,129 households) to obtain living environment characteristics of SASAS participants, including sources of water and energy, and household cell-phone ownership (a proxy measure for the social network available to them). Information obtained from SASAS included socio-demographic data, respondents’ level of trust in people, oral health behaviors and self-rated oral health. Results: Of the respondents, 76.3% self-rated their oral health as good. Social context influenced women’s self-rated oral health differently from that of men. Good self-rated oral health was significantly higher among non-smokers, employed respondents and women living in areas with higher household cell-phone ownership. Furthermore, trust and higher social position were associated with good self-rated oral health among men and women respectively. Overall, 55.1% and 18.3% of the variance in self-rated oral health were explained by factors operating at the individual and community levels respectively. Conclusion: The findings highlight the potential role of social capital in improving the population’s oral health. PMID:23202757
Calzada, Alberto; Liu, Jun; Wang, Hui; Nugent, Chris; Martinez, Luis
Self- assessed general health status is a commonly-used survey technique since it can be used as a predictor for several public health risks such as mortality, deprivation, and fear of crime or poverty. Therefore, it is a useful alternative measure to help assessing the public health situation of a neighborhood or town, and can be utilized by authorities in many decision support situations related to public health, budget allocation and general policy-making, among others. It can be considered as spatial decision problems, since both data location and spatial relationships make a prominent impact during the decision making process. This paper utilizes a recently-developed spatial intelligent decision system, named, Spatial RIMER(+), to model the self-rated health estimation decision problem using real data in the areas of Northern Ireland, UK. The goal is to learn from past or partial observations on self-rated health status to predict its future or neighborhood behavior and reference it in the map. Three scenarios in line of this goal are discussed in details, i.e., estimation of unknown, downscaling, and predictions over time. They are used to demonstrate the flexibility and applicability of the spatial decision support system and their positive capabilities in terms of accuracy, efficiency and visualization.
Thayer, Zaneta M; Kuzawa, Christopher W
Despite growing research emphasis on understanding the health effects of ethnic discrimination, little work has focused on how such exposures may influence a woman's biology and health during pregnancy. Understanding such effects is important given evidence that maternal stress experience in pregnancy can have long term effects on offspring health. Here we present data evaluating the relationship between perceived discrimination, self-rated health, and the stress hormone cortisol measured in late pregnancy among a diverse sample of women living in Auckland, New Zealand (N = 55). We also evaluated possible intergenerational impacts of maternal discrimination on stress reactivity in a subset of offspring (N = 19). Pregnant women were recruited from two antenatal care clinics in Auckland. Women were met in their homes between 34 and 36 weeks gestation, during which time a prenatal stress questionnaire was administered and saliva samples (morning and evening from two days) were obtained. Offspring cortisol reactivity was assessed at the standard six week postnatal vaccination visit. We found that 34% of women reported having experienced ethnic discrimination, with minority and immigrant women being more likely to report being angry or upset in response to discrimination experience compared with NZ-born women of European descent. Women reporting discrimination experience had worse self-rated health, higher evening cortisol and gave birth to infants with higher cortisol reactivity, all independent of ethnicity and material deprivation. These findings suggest that discrimination experience can have biological impacts in pregnancy and across generations, potentially contributing to the ethnic gradient in health.
Zinzow, Heidi M.; Amstadter, Ananda B.; McCauley, Jenna L.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Kilpatrick, Dean G.
Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview…
Guimarães, Joanna Miguez Nery; Werneck, Guilherme Loureiro; Faerstein, Eduardo; Lopes, Claudia S; Chor, Dora
Objectives Although there is evidence that socioeconomic conditions in adulthood are associated with worse self-rated health, the putative effect of early adverse life circumstances on adult self-rated health is not consistent. Besides, little is known on this subject in the context of middle-income countries. We aimed to investigate the association between indicators of socioeconomic position in early life and self-rated health in adulthood, taking into account the influence of current socioeconomic position. Design Cross-sectional. Participants 3339 civil servants (44.5% male) working at a public university in Rio de Janeiro, Brazil, participants of the Pró-Saúde cohort study. Measurements Through a lifecourse approach, we evaluated if seven indicators of participants’ socioeconomic position earlier in life were associated with worse self-rated health in adulthood. Ordinal logistic regression analysis with a proportional odds model was used. Results After adjusting for socioeconomic position in adulthood (education and income), the indicators of early socioeconomic position associated with poor self-rated health were as follows: not eating at home due to lack of money at the age of 12 (OR=1.29 95% CI 1.06 to 1.57) and having lived in a small city or rural area at the age of 12 (OR=1.51 95% CI 1.21 to 1.89). Conclusions Self-rated health was associated with two indicators of remarkable experiences of poverty in early life, even when socioeconomic conditions improved throughout life. Our findings have shown a long-term impact of extreme socioeconomic hardship during childhood and/or adolescence on the development of social inequalities in health. In terms of implications for public health, our work emphasises that health policies, usually focused on adult lifestyle interventions, should be complemented by initiatives aimed at reducing socioeconomic inequalities during the earliest stages of development, such as childhood and adolescence. PMID:25416056
Jalaludin, Bin B; Garden, Frances L
Mental health can be influenced by a number of neighbourhood physical and social environmental characteristics. We aimed to determine whether urban sprawl (based on population density) in Sydney, Australia, is associated with self-rated health and psychological distress. We used a cross-sectional multilevel study design. Individual level data on self-rated health and psychological distress were obtained from the 2006 and 2007 NSW Population Health Survey. We did not find significant associations between urban sprawl and self-rated health and psychological distress after controlling for individual and area level covariates. However, positive neighbourhood factors were generally associated with better self-rated health and lower psychological distress but few of these associations were statistically significant.
Oxenstierna, Gabriel; Magnusson Hanson, Linda L; Widmark, Maria; Finnholm, Kristina; Stenfors, Cecilia; Elofsson, Stig; Theorell, Töres
Few studies have considered the work environment in relation to workplace conflicts and those who have been published have included relatively few psychosocial work environment factors. Little research has been published on the consequences of workplace conflicts in terms of employee health. In this study, the statistical relationships between work and workplace characteristics on one hand and conflicts on the other hand are examined. In addition, the relationship between conflicts at work and self-rated health are described. The study population was derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2006; n=5,141. Among employees at workplaces with more than 20 employees (n=3,341), 1,126 (33.7%) responded that they had been involved in some type of conflict during the two years preceding the survey. Among the work and workplace characteristics studied, the following factors were independently associated with increased likelihood of ongoing conflicts: Conflicting demands, emotional demands, risk of transfer or dismissal, poor promotion prospects, high level of employee influence and good freedom of expression. Factors that decreased the likelihood of ongoing conflicts were: Good resources, good relations with management, good confidence in management, good procedural justice (fairness of decisions) and good social support. After adjustment for socioeconomic conditions the odds ratio for low self-rated health associated with ongoing conflict at work was 2.09 (1.60-2.74). The results provide a good starting point for intervention and prevention work.
Habib, Rima R; Elzein, Kareem; Hojeij, Safa
This research evaluated the association between women's self-rated health and a number of socioeconomic and environmental health indicators relating to drinking water services in an underserved Lebanese community. A population-based, cross-sectional survey using interviews was adopted to obtain information from female homemakers of 2,223 households in the town of Bebnine, Lebanon. The questionnaire included indicators on self-rated health, satisfaction with water quality, source of drinking water, occurrence of diarrhea, and socioeconomic variables, such as education, occupation, and perceived economic status. Self-rated health was categorized as poor, fair, and good. Odds ratios for poor and fair compared to good self-rated health values were calculated using multinomial logistic regression. A total of 712 women (32%) reported poor self-rated health. Women who perceived their household income to be worse than others in town were four times as likely to report poor health. Compared to women who were satisfied with drinking water quality, dissatisfied women were 42% more likely to report poor health. Women living in households reporting recent episodes of diarrheal illness had poorer health ratings than those without. The findings suggest a positive relationship between individual perceptions of water quality and self-rated health. Community concerns over their surrounding environment serve as a primary guide for infrastructural development and government policy.
Chen, He; Meng, Tianguang
Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between multivariate analyses
Koelmeyer, Rachel; English, Dallas R; Smith, Anthony; Grierson, Jeffrey
Despite a vast improvement in the survival of people living with HIV (PLHIV) since the introduction of combination antiretroviral treatment (cART), little change in the self-rated health of PLHIV has been observed since the introduction of cART in Australia. Difficulties with attaining employment or achieving financial security have been noted as some of the key challenges still facing PLHIV in the post-cART era. As a result, we investigated the independent association of a number of key social determinants of health with self-rated health among HIV-positive gay and bisexual men in Australia. Data from two recent national, cross-sectional surveys of PLHIV (the HIV Futures 5 and 6 surveys) were used. Logistic regression was used to assess the independent association of ethnicity, region of residence, education level, employment status, after-tax income, experience of HIV-related discrimination, level of social support, relationship status and recent sexual activity with reporting good-excellent self-rated health, after adjusting for clinical factors and other social determinants of health. Multiple imputation was used to estimate missing data for variables with >5% missing data. Of the 1713 HIV-positive gay/bisexual men who responded to the HIV Futures 5 and 6 surveys, information on self-rated health was available for 99.3%. Close to three-quarters of these respondents (72.1%) reported their self-rated health as good or excellent; the remainder (27.9%) reported their self-rated health as poor or fair. In multivariable analysis involving 89.3% of respondents, being employed, reporting recent sexual activity, a greater number of sources of social support and a higher weekly after-tax income were found to be independently associated with reporting good-excellent self-rated health. Despite the inability of this study to detect causal associations, addressing barriers to employment and sexual activity, and mechanisms to increase social support, is likely to have
Khawaja, Marwan; Mowafi, Mona
This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using chi (2) tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95-6.95) and 2.9 (CI: 2.09-4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities.
This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using χ2 tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95–6.95) and 2.9 (CI: 2.09–4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities. PMID:16739047
Zapata-Ossa, Helmer de J; Cubides-Munévar, Ángela M; Curcio, Carmen L; Villegas, Juan de D; Reyes-Ortiz, Carlos A
Introduction: Self-rated health (SRH) has beeen considered an important marker of quality of life and an independent predictor of mortality in older adults. Objective: To determine the prevalence of poor SRH and identify risk factors associated with poor SRH among older adults residing in the Commune 18 of the city of Cali, Colombia, in 2009. Methods: A population-based cross-sectional study with a single-stage cluster sampling design. Sample included 314 persons aged 60 and older. The dependent variable, SRH was dichotomized into good (excellent, very good, good) and poor (fair, poor). Independent variables were sociodemographic, biological, mental, functional and geriatric syndromes. Logistic regression was used for multivariate statistical modeling. Results: Overall, 40.1% reported poor SRH (women 42.9%, men 35.0%). Factors independently associated with poor SRH were diabetes mellitus, depression, fear of falling and frailty syndrome (frail and pre-frail vs. non-frail). Widowed men reported poorer health than married men while other marital status (single/separated/divorced) was associated with better self-rated health in women. Conclusion: Potential modifiable factors such as depression and frailty syndrome are important determinants for poor SRH in Colombian older adults. PMID:24892239
Thompson, Mark G; Gaglani, Manjusha J; Naleway, Allison; Thaker, Swathi; Ball, Sarah
As part of a prospective cohort study of 1354 female and 347 male healthcare personnel, we examined the stability of subjective social status over ~7 months and the prospective association between subjective social status and self-rated health status. Most (82%) subjective social status ratings were stable (within ±1 point). Lower baseline subjective social status among healthcare personnel was associated with more subsequent reports of fatigue and headache and worsening global self-rated health status. Healthcare personnel who placed themselves on the bottom half of the subjective social status ladder were four times more likely to experience a decline in global self-rated health status and half as likely to improve to excellent self-rated health status.
BADLEY, ELIZABETH M; CANIZARES, MAYILEE; PERRUCCIO, ANTHONY V; HOGG-JOHNSON, SHEILAH; GIGNAC, MONIQUE AM
Policy Points Despite beliefs that baby boomers are healthier than previous generations, we found no evidence that the health of baby boomers is substantially different from that of the previous or succeeding cohorts. The effects of increased education, higher income, and lower smoking rates on improving self-rated health were nearly counterbalanced by the adverse effect of increasing body mass index (BMI). Assumptions that baby boomers will require less health care as they age because of better education, more prosperity, and less propensity to smoke may not be realized because of increases in obesity. Context Baby boomers are commonly believed to be healthier than the previous generation. Using self-rated health (SRH) as an indicator of health status, this study examines the effects of age, period, and birth cohort on the trajectory of health across 4 generations: World War II (born between 1935 and 1944), older baby boomers (born between 1945 and 1954), younger baby boomers (born between 1955 and 1964), and Generation X (born between 1965 and 1974). Methods We analyzed Canada’s longitudinal National Population Health Survey 1994-2010 (n = 8,570 at baseline), using multilevel growth models to estimate the age trajectory of SRH by cohort, accounting for period and incorporating the influence of changes in education, household income, smoking status, and body mass index (BMI) on SRH over time. Findings SRH worsened with increasing age in all cohorts. Cohort differences in SRH were modest (p = 0.034), but there was a significant period effect (p = 0.002). We found marked cohort effects for increasing education, income, and BMI, and decreasing smoking from the youngest to the oldest cohorts, which were much reduced (education and smoking) or removed (income and BMI) once period was taken into account. At the population level, multivariable analysis showed the benefits of increasing education and income and declines in smoking on the trajectory of improving SRH were
Zhang, Wei; Ta, Van M
Focusing on Asian Americans, this study examines how self-rated physical and mental health depends on the layered social connections (including 4 types: family cohesion, relative support, friend support, and neighborhood cohesion), socioeconomic status, and immigration-related factors (including nativity, length of residence in the U.S., and proficiency of the English language). It draws on the 2002-2003 National Latino and Asian American Study, a nationally representative household survey of Latino and Asian Americans. Findings of this study include: (1) there are significant differences in self-rated physical health among Asian Americans of different national origin, but their self-rated physical health differences diminish after indicators of socioeconomic status and immigration-related factors are considered; (2) four types of social connections are all related to the self-rated physical and mental health of Asian Americans, but the patterns of the associations as well as the mechanisms linking the associations vary; and (3) family cohesion has independent and direct effects on both self-rated physical and mental health over and above controls and mediators, whereas the effects of other social connection measures are partially mediated by socioeconomic status and immigration-related factors. In sum, this study indicates the significant effects of social connections, socioeconomic status, and immigration-related factors on the self-rated physical and mental health of Asian Americans.
Dai, Yue; Zhang, Chen-Yun; Zhang, Bao-Quan; Li, Zhanzhan; Jiang, Caixiao; Huang, Hui-Ling
Abstract The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors. We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ2 test, a linear regression analysis, and a multiple-level model were performed to analyze the results. The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068–6.516, P = 0.000), age (−0.805, 95% CI: −1.394 to −0.135, P = 0.013), marital status (−1.260, 95% CI: −1.891 to −0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022–5.116, P = 0.000), and SRH −1.941, 95% CI: −3.194 to −0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ2 = 5.103, P < 0.001). Marital status (−2.133, 95
Deshpande, Anjali D.; Pruitt, Sandi L.; Jeffe, Donna B.
Purpose We determined the association of neighborhood foreclosure risk on the health status of a statewide sample of breast cancer survivors (n = 1047) and the extent to which covariates accounted for observed associations. Methods Measures of self-rated health and several covariates were obtained by telephone interview 1 year after diagnosis. We used the federal Housing and Urban Development agency's estimated census-tract foreclosure-abandonment-risk score and multilevel, logistic regression to determine the association of foreclosure risk (high, moderate versus low) with self-rated health (fair-poor versus good, very good, excellent) and whether covariates could explain the observed association. Results Women who resided in high-foreclosure-risk (HFR) areas were 2.39 times (95% CI: 1.83–3.13) more likely to report being in fair-poor health than women who lived in low-foreclosure-risk areas. The odds ratio (OR) was reduced for women who lived in high-foreclosure-risk versus low-foreclosure-risk areas after adjusting for income (HFR OR: 1.78; 95% CI: 1.01–3.15), physical activity (HFR OR: 1.74; 95% CI: 0.98–3.08), and perceived neighborhood conditions (HFR OR: 1.76; 95% CI: 1.02–3.05). Conclusions Breast cancer survivors who lived in census tracts with high- versus low-foreclosure risk reported poorer health status. This association was explained by differences in household income, physical activity, and perceived neighborhood conditions. PMID:21590510
This paper evaluates racial/ethnic differences in self-rated mental health for adults in the United States, while controlling for demographic and socioeconomic characteristics as well as length of stay in the country. Using data from the 2010 National Health Interview Survey Cancer Control Supplement (NHIS-CCS), binomial logistic regression models are fit to estimate the association between race/ethnicity and poor/fair self-reported mental health among US Adults. The size of the analytical sample was 22,844 persons. Overall prevalence of poor/fair self-rated mental health was 7.72%, with lower prevalence among Hispanics (6.93%). Non-Hispanic blacks had the highest prevalence (10.38%). After controls for socioeconomic characteristics are incorporated in the models, Hispanics were found to have a lower probability of reporting poor/fair self-rated mental health in comparison to non-Hispanic whites (OR = 0.70; 95% CI [0.55–0.90]). No difference was found for other minority groups when compared to the reference group in the final model. Contrary to global self-rated health, Hispanics were found to have a lower probability of reporting poor/fair self-rated mental health in comparison to non-Hispanic whites. No difference was found for non-Hispanic blacks when they were compared to non-Hispanic whites. Self-rated mental health is therefore one case of a self-rating of health in which evidence supporting the epidemiological paradox is found among adults in the United States. PMID:27688982
Mohseni, Mohabbat; Lindström, Martin
This paper investigates the relationship between anticipation that employers may discriminate against certain people (not specified, but not specifically the respondent) according to race, colour of skin, religion or cultural background, and self-rated health, adjusting for social capital in the form of generalised (horizontal) trust in other people. It also investigates ethnic differences in anticipated discrimination in relation to self-rated health. The 2004 Public Health Survey in the Scania region of Sweden is a cross-sectional study. Twenty-seven thousand nine hundred and sixty-three respondents aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to assess the association between anticipated discrimination and self-rated health. Multivariate analyses of self-rated health were performed in order to investigate the importance of possible confounders (age, country of origin, education, economic stress, and generalised trust) on this association. Of the men and the women, 28.7 and 33.2%, respectively, rated their health as poor. Of the respondents, 16.0 and 28.7% reported that they anticipated that 'most employers' or 'approximately 50% of employers' would discriminate, respectively. Respondents with high age, born outside Sweden, with low/medium education, economic stress, low horizontal trust, and with anticipation that most or approximately 50% of employers (among men born in Sweden and all women) would discriminate had significantly higher odds ratios of poor self-rated health. Multiple adjustments had a slight effect on the significant relationship between anticipated discrimination and poor self-rated health for both men and women. The introduction of generalised trust in the models reduced the odds ratios to a limited extent. In conclusion, the anticipation that employers may discriminate against certain people (not the respondent) according to race, colour of skin, religion or
Nguyen, Muoi T; Chan, Winnie Y; Keeler, Courtney
Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ tests and a 2-part model (logistics regression and generalized linear model regression for the first and second stages, respectively).Although predictive of any health expenditure, SRMH alone was not highly predictive of the dollar value of that health expenditure conditional on any spending. By comparison, the K6 measure was significantly and positively associated with the probability of any health expenditure as well as the dollar value of that spending. Taken together, both the K6 and SRMH measures suggest a positive relationship between poor mental health and the probability of any health expenditure and total expenditure conditional on any spending, even when adjusting for other confounding factors such as race/ethnicity, sex, age, educational attainment, insurance status, and some regional characteristics.Our results suggest that psychological distress and SRMH may represent potential pathways linking poor mental health to increased health care expenditure. Further research exploring the nuances of these relationships may aid researchers, practitioners, and policy makers in addressing issues of inflated health care expenditure in populations at risk for poor mental health.
Beck, Audrey N.; Finch, Brian K.; Lin, Shih-Fan; Hummer, Robert A.; Masters, Ryan K.
This paper uses data from the U.S. National Health Interview Surveys (N = 1,513,097) to describe and explain temporal patterns in black-white health disparities with models that simultaneously consider the unique effects of age, period, and cohort. First, we employ cross-classified random effects age–period–cohort (APC) models to document black-white disparities in self-rated health across temporal dimensions. Second, we use decomposition techniques to shed light on the extent to which socio-economic shifts in cohort composition explain the age and period adjusted racial health disparities across successive birth cohorts. Third, we examine the extent to which exogenous conditions at the time of birth help explain the racial disparities across successive cohorts. Results show that black-white disparities are wider among the pre-1935 cohorts for women, falling thereafter; disparities for men exhibit a similar pattern but exhibit narrowing among cohorts born earlier in the century. Differences in socioeconomic composition consistently contribute to racial health disparities across cohorts; notably, marital status differences by race emerge as an increasingly important explanatory factor in more recent cohorts for women whereas employment differences by race emerge as increasingly salient in more recent cohorts for men. Finally, our cohort characteristics models suggest that cohort economic conditions at the time of birth (percent large family, farm or Southern birth) help explain racial disparities in health for both men and women. PMID:24581075
Oshio, Takashi; Kobayashi, Miki
In this study we conduct a multilevel analysis to investigate the association between regional income inequality and self-rated health in Japan, based on two nationwide surveys. We confirm that there is a significant association between area-level income inequality and individual-level health assessment. We also find that health assessment tends to be more sensitive to income inequality among lower income individuals, and to degree of area-level poverty, than income inequality for the society as a whole. In addition, we examine how individuals are averse to inequality, based on the observed association between inequality and self-rated health.
Background Loneliness is associated with peer victimization, and the two adverse experiences are both related to ill health in childhood and adolescence. There is, however, a lack of knowledge on the importance of loneliness among victimized children. Therefore, possible modifying effects of loneliness on victimized school children’s self-rated health were assessed. Methods A population based cross-section study included 419 children in grades 1–10 from five schools. The prevalence of loneliness and victimization across grades was analyzed by linear test for trend, and associations of the adverse experiences with four health symptoms (sadness, anxiety, stomach ache, and headache) were estimated by logistic regression. Results In crude regression analysis, both victimization and loneliness showed positive associations with all the four health symptoms. However, in multivariable analysis, the associations of victimization with health symptoms were fully attenuated except for headache. In contrast, loneliness retained about the same strength of associations in the multivariable analysis as in the crude analysis. More detailed analyses demonstrated that children who reported both victimization and loneliness had three to seven times higher prevalence of health symptoms compared to children who reported neither victimization nor loneliness (the reference group). Rather surprisingly, victimized children who reported no loneliness did not have any higher prevalence of health symptoms than the reference group, whereas lonely children without experiences of victimization had almost the same prevalence of health symptoms (except for stomach ache) as children who were both victimized and lonely. Conclusions Adverse effects of loneliness need to be highlighted, and for victimized children, experiences of loneliness may be an especially harsh risk factor related to ill health. PMID:22643050
Introduction Women have in general poorer self-rated health than men. Both material and psychosocial conditions have been found to be associated with self-rated health. We investigated whether two such factors, financial insecurity and condescending treatment, could explain the difference in self-rated health between women and men. Methods The association between the two factors and self-rated health was investigated in a population-based sample of 35,018 respondents. The data were obtained using a postal survey questionnaire sent to a random sample of men and women aged 18-75 years in 2008. The area covers 55 municipalities in central Sweden and the overall response rate was 59%. Multinomial odds ratios for poor self-rated health were calculated adjusting for age, educational level and longstanding illness and in the final model also for financial insecurity and condescending treatment. Results The prevalence of poor self-rated health was 7.4% among women and 6.0% among men. Women reported more often financial insecurity and condescending treatment than men did. The odds ratio for poor self-rated health in relation to good self-rated health was 1.29 (95% CI: 1.17-1.42) for women compared to men when adjusted for age, educational level and longstanding illness. The association became, however, statistically non-significant when adjusted for financial insecurity and condescending treatment. Conclusion The present findings suggest that women would have as good self-rated health as men if they had similar financial security as men and were not treated in a condescending manner to a larger extent than men. Longitudinal studies are, however, required to confirm this conclusion. PMID:22937777
Silva-Costa, Aline; Griep, Rosane Härter; Rotenberg, Lúcia
Epidemiological evidence suggests that sleep duration and poor sleep are associated with mortality, as well as with a wide range of negative health outcomes. However, few studies have examined the association between sleep and self-rated health, particularly through the combination of sleep complaints. The objective of this study was to examine whether self-rated health is associated with sleep complaints, considering the combination of sleep duration, insomnia, and sleep sufficiency. This cross-sectional study was performed in the 18 largest public hospitals in the city of Rio de Janeiro, Brazil. A total of 2518 female nurses answered a self-filled multidimensional questionnaire. The adjusted odds ratios and 95% confidence intervals (CIs) estimated the chance of poor self-rated health in the presence of different combinations of sleep duration and quality. Compared with women who reported adequate sleep duration with no sleep quality complaints (reference group), the odds ratios (95% CI) for poor self-rated health were 1.79 (1.27–2.24) for those who reported only insufficient sleep, 1.85 (0.94–3.66) for only a short sleep duration, and 3.12 (1.94–5.01) for only insomnia. Compared with those who expressed all three complaints (short sleep duration, insomnia, and insufficient sleep), the odds ratio for poor self-rated health was 4.49 (3.25–6.22). Differences in the magnitude of the associations were observed, depending on the combination of sleep complaints. Because self-rated health is a consistent predictor of morbidity, these results reinforce the increasing awareness of the role of sleep in health and disease. Our findings contribute to the recognition of sleep as a public health matter that deserves to be better understood and addressed by policymakers. PMID:25961874
Du Rietz, Ebba; Kuja-Halkola, Ralf; Brikell, Isabell; Jangmo, Andreas; Sariaslan, Amir; Lichtenstein, Paul; Kuntsi, Jonna; Larsson, Henrik
There is scarcity of research investigating the validity of self-report of attention deficit hyperactivity disorder (ADHD) symptoms compared to other informants, such as parents. This study aimed to compare the predictive associations of ADHD symptoms rated by parents and their children across adolescence on a range of adverse socioeconomic and health outcomes in early adulthood. Parent- and self-rated ADHD symptoms were assessed in 2960 individuals in early (13-14 years) and late adolescence (16-17 years). Logistic regression analyses were used to compare the associations between parent- and self-rated ADHD symptoms at both time points and adverse life outcomes in young adulthood obtained from Swedish national registries. Both parent- and self-ratings of ADHD symptoms were associated with increased risk for adverse outcomes, although associations of parent-ratings were more often statistically significant and were generally stronger (OR = 1.12-1.49, p < 0.05) than self-ratings (OR = 1.07-1.17, p < 0.05). After controlling for the other informant, parent-ratings of ADHD symptoms in both early and late adolescence significantly predicted academic and occupational failure, criminal convictions and traffic-related injuries, while self-ratings of ADHD symptoms only in late adolescence predicted substance use disorder and academic failure. Our findings suggest that both parent- and self-ratings of ADHD symptoms in adolescence provides valuable information on risk of future adverse socioeconomic and health outcomes, however, self-ratings are not valuable once parent-ratings have been taken into account in predicting most outcomes. Thus, clinicians and researchers should prioritize parent-ratings over self-ratings.
Hill, Patrick L; Allemand, Mathias; Roberts, Brent W
The current study examined whether dispositional gratitude predicts physical health among adults, and if so, whether this relationship occurs because grateful individuals lead healthier lives, either psychologically or physically. Specifically, we examined whether psychological health, healthy activities, and willingness to seek help for health concerns mediated the link between gratitude and self-reported physical health, as well as if these mediational pathways are moderated by age, in a broad sample of Swiss adults (N = 962, M(age) = 52 years, age range: 19 to 84). Dispositional gratitude correlated positively with self-reported physical health, and this link was mediated by psychological health, healthy activities, and willingness to seek help for health concerns. However, the indirect effects for psychological health and healthy activities were stronger for older than younger adults. In other words, the mechanisms explaining why gratitude predicts health appear to differ across adulthood.
Musa, Ahmad S; Pevalin, David J; Shahin, Francis I
The purpose of this study was to explore associations of spiritual well-being, spiritual perspective, and religiosity with self-rated health in a convenience sample of 340 adult Jordanian Arab Christians. Data were collected through church and community groups. Results indicated that spiritual well-being and religiosity were positively associated with self-rated health, but in the final regression model only spiritual well-being retained a significant association after controlling for the other spiritual and religious measures. In conclusion, spirituality and religiosity are important to Jordanian Arab Christians' health and well-being, and the implications for nursing practice are explored.
Lee, Jung-A; Park, Jong Heon; Kim, Myung
This study evaluated the associations between social and physical environments and self-rated health (SRH) for urban and rural Korean adults, using data from the Korean Community Health Survey (KCHS) of 199,790 participants (115,454 urban and 84,336 rural). The main dependent variable was SRH, while the primary independent variables were social and physical characteristics. Urban residents reported better SRH than did rural residents. Five social environmental variables (trust of neighbors, residence in the area for over 20 years, exchanging help with neighbors, friend and fellowship activities, contact with relatives and neighbors over five times per month) were more prevalent among rural residents. Satisfaction with physical environment was more common among rural residents, but satisfaction with traffic and healthcare facilities was more common among urban areas. After adjusting for relevant factors, positive associations between SRH and trust of neighbors, exchanging help with neighbors, participation in social activities or organizations, and physical environment existed in both rural and urban populations. Also, in both areas, there was no demonstrated association between SRH and years of residence or frequency of contact with relatives. Our findings suggest the existence of an association between social and physical factors and perceived health status among the general population of Korea.
The purpose of this study was to see if feelings of God-mediated control are associated with change in self-rated health over time. In the process, an effort was made to see if a sense of meaning in life and optimism mediated the relationship between God-mediated control and change in health. The following hypothesized relationships were contained in the conceptual model that was developed to evaluate these issues: (1) people who go to church more often tend to have stronger God-mediated control beliefs than individuals who do not attend worship services as often; (2) people with a strong sense of God-mediated control are more likely to find a sense of meaning in life and be more optimistic than individuals who do not have a strong sense of God-mediated control; (3) people who are optimistic and who have a strong sense of meaning in life will rate their health more favorably over time than individuals who are not optimistic, as well as individuals who have not found a sense of meaning in life. Data from a longitudinal nationwide survey of older adults provided support for each of these hypotheses.
The purpose of this study was to see if feelings of God-mediated control are associated with change in self-rated health over time. In the process, an effort was made to see if a sense of meaning in life and optimism mediated the relationship between God-mediated control and change in health. The following hypothesized relationships were contained in the conceptual model that was developed to evaluate these issues: (1) people who go to church more often tend to have stronger God-mediated control beliefs than individuals who do not attend worship services as often; (2) people with a strong sense of God-mediated control are more likely to find a sense of meaning in life and be more optimistic than individuals who do not have a strong sense of God-mediated control; (3) people who are optimistic and who have a strong sense of meaning in life will rate their health more favorably over time than individuals who are not optimistic, as well as individuals who have not found a sense of meaning in life. Data from a longitudinal nationwide survey of older adults provided support for each of these hypotheses. PMID:21057586
He, Y. H.; Colantonio, A.; Marshall, V. W.
A study described situations of later-life career disruption in older workers in Canada (n=2,592); large numbers had experienced job interruption or loss. Disruptions were significantly associated with self-ratings of poor health. However, the causal relationship between unemployment and poor health was complex. (Contains 49 references.) (JOW)
Altman, Claire E.; Van Hook, Jennifer; Hillemeier, Marianne
There are concerns about the meaning of SRH and the factors individuals consider. To illustrate how SRH is contextualized, we examine how the obesity-SRH association varies across age, periods, and cohorts. We decompose SRH into subjective and objective components and used a mechanism-based APC model approach with four decades (1970s-2000s) and five birth cohorts of NHANES data (N=26,184). Obese adults rate their health more negatively than non-obese when using overall SRH with little variation by age, period, or cohort. However, when we decomposed SRH into objective and subjective components, the obesity gap widened with increasing age in objective SRH, but narrowed in subjective SRH. Additionally, the gap narrowed for more recently-born cohorts for objective SRH, but widened for subjective SRH. The results provide indirect evidence that the relationship between obesity and SRH is socially patterned according to exposure to information about obesity and the availability of resources to manage it. PMID:26811364
Zinzow, Heidi; Amstadter, Ananda B.; McCauley, Jenna L.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Kilpatrick, Dean G.
Objective The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants A national sample of 2,000 female college students participated in a structured phone interview between January and June, 2006. Methods Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results Logistic regression analyses showed that poor self-rated health was associated with low income (OR = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity. PMID:21823953
Höfelmann, Doroteia Aparecida; Diez Roux, Ana V; Antunes, José Leopoldo Ferreira; Peres, Marco Aurélio
Neighborhood problems constitute sources of chronic stress that may increase the risk of poor self-rated health. The associations of census tract level income and perceived neighborhood problems with self-rated health were examined in Florianópolis, Santa Catarina State, Brazil (1,720 adults). Odds ratios (OR) and their 95% confidence intervals (95%CI) of poor self-rated health were estimated through multilevel models. Residents in census tracts in the lower and intermediate tertiles of income reported poorer health than those in the highest tertile. OR of reporting poorer health was 2.44 (95%CI: 2.35- 2.54) in the higher tertile of social disorder (adjusting for mental health). The chances of reporting the poorer health with neighborhood problems ranged from 1.07 (95%CI: 1.03-1.11) to 2.02 (95%CI: 1.95-2.10) for the higher tertile of social disorder (physical health) and physical problem (health-related variables). Perceived neighborhood problems were independently associated with poor health. The perception of a neighborhood among its residents should be considered by health policymakers.
Jo, Heui Sug; Moon, Ji Young; Kim, Bong Gi; Nam, Eun Woo
Background This study explores the relationships between social capital, self-rated health, and happiness and suggests ways to improve the happiness level of a community. Methods The survey was conducted with 445 people using stratified random sampling in a medium-sized city in Korea. Collected information included socio-demographic characteristics, social capital, self-rated health, and happiness. Results Among the demographic characteristics, age had a statistically significant association with happiness level. People in their 40s (OR = 0.33, 95% CI = 0.13–0.88) and 50s (OR = 0.19, 95% CI = 0.06–0.57) were less happy than people of other ages. Married people (OR = 4.58, CI = 1.99–10.53) were more likely to have a high happiness level compared to unmarried people. Cognitive social capital (OR = 1.34, CI = 1.19–1.51) and self-rated health (OR = 2.22, CI = 1.59–3.09) were positively associated with happiness. Conclusion The results suggest that social capital and level of health are determinants of subjective happiness. Public policies and programs for improving social capital are needed to support happiness among community residents. PMID:26770893
Sundstrup, Emil; Jakobsen, Markus Due; Brandt, Mikkel; Jay, Kenneth; Aagaard, Per; Andersen, Lars Louis
Chronic musculoskeletal pain is widespread in the working population and leads to muscular fatigue, reduced work capacity, and fear of movement. While ergonomic intervention is the traditional approach to the problem, physical exercise may be an alternative strategy. This secondary analysis of a randomized controlled trial investigates the effect of strength training on muscular fatigue resistance and self-rated health among workers with chronic pain. Sixty-six slaughterhouse workers with chronic upper limb pain and work disability were randomly allocated to 10 weeks of strength training or usual care ergonomic training (control). At baseline and follow-up, participants performed a handgrip muscular fatigue test (time above 50% of maximal voluntary contraction force) with simultaneous recording of electromyography. Additionally, participants replied to a questionnaire regarding self-rated health and pain. Time to fatigue, muscle strength, hand/wrist pain, and self-rated health improved significantly more following strength training than usual care (all P < 0.05). Time to fatigue increased by 97% following strength training and this change was correlated to the reduction in fear avoidance (Spearman's rho = -0.40; P = 0.01). In conclusion, specific strength training improves muscular fatigue resistance and self-rated health and reduces pain of the hand/wrist in manual workers with chronic upper limb pain. This trial is registered with ClinicalTrials.gov NCT01671267.
Jakobsen, Markus Due; Jay, Kenneth
Chronic musculoskeletal pain is widespread in the working population and leads to muscular fatigue, reduced work capacity, and fear of movement. While ergonomic intervention is the traditional approach to the problem, physical exercise may be an alternative strategy. This secondary analysis of a randomized controlled trial investigates the effect of strength training on muscular fatigue resistance and self-rated health among workers with chronic pain. Sixty-six slaughterhouse workers with chronic upper limb pain and work disability were randomly allocated to 10 weeks of strength training or usual care ergonomic training (control). At baseline and follow-up, participants performed a handgrip muscular fatigue test (time above 50% of maximal voluntary contraction force) with simultaneous recording of electromyography. Additionally, participants replied to a questionnaire regarding self-rated health and pain. Time to fatigue, muscle strength, hand/wrist pain, and self-rated health improved significantly more following strength training than usual care (all P < 0.05). Time to fatigue increased by 97% following strength training and this change was correlated to the reduction in fear avoidance (Spearman's rho = −0.40; P = 0.01). In conclusion, specific strength training improves muscular fatigue resistance and self-rated health and reduces pain of the hand/wrist in manual workers with chronic upper limb pain. This trial is registered with ClinicalTrials.gov NCT01671267. PMID:27830144
Bethea, Traci N.; Lopez, Russell P.; Cozier, Yvette C.; White, Laura F.; McClean, Michael D.
Purpose To examine rural status and social factors as predictors of self-rated health in community-dwelling adults in the United States. Methods This study uses multinomial logistic and cumulative logistic models to evaluate the associations of interest in the 2006 US Behavioral Risk Factor Surveillance System, a cross-sectional survey of 347,790 non-institutionalized adults. Findings Self-rated health was poorer among rural residents, compared to urban residents (OR = 1.77, 95% CI: 1.54, 1.90). However, underlying risk factors such as obesity, low income, and low educational attainment were found to vary by rural status and account for the observed increased risk (OR = 1.03, 95% CI: 0.94, 1.12). There was little evidence of effect modification by rural status, though the association between obesity and self-rated health was stronger among urban residents (OR = 2.50, 95% CI: 2.38, 2.64) than among rural residents (OR = 2.18, 95% CI: 2.03, 2.34). Conclusions Our findings suggest that differences in self-rated health by rural status were attributable to differential distributions of participant characteristics and not due to differential effects of those characteristics. PMID:23083079
Novak, Dario; Suzuki, Etsuji; Kawachi, Ichiro
Objectives We investigated the associations between self-rated health and social capital among Croatian high school students. Design A cross-sectional survey among high school students was carried out in the 2013–2014 school year. Setting High schools in Croatia. Participants Subjects were 3427 high school students (1688 males and 1739 females), aged 17–18 years. Main outcome measure Self-rated health was assessed by the single item: “How do you perceive your health?”. Possible responses were arranged along a five-item Likert-type scale: 1 very poor, 2 poor, 3 fair, 4 good, 5 excellent. The outcome was binarised as ‘good health’ (excellent, good or fair) versus ‘poor health’ (poor or very poor). Methods We calculated ORs and 95% CIs for good self-rated health associated with family, neighbourhood and school social capital, while adjusting for gender, self-perceived socioeconomic status, psychological distress, physical activity and body mass index. We used generalised estimating equations using an exchangeable correlation matrix with robust SEs. Results Good self-rated health was significantly associated with higher family social capital (OR 2.43; 95% CI 1.55 to 3.80), higher neighbourhood trust (OR 2.02; 95% CI 1.48 to 2.76) and higher norms of reciprocity at school (OR 1.79; 95% CI 1.13 to 2.84). When all of the social capital variables were entered simultaneously, good self-rated health remained significantly associated with higher family social capital (OR 1.98; 95% CI 1.19 to 3.30), neighbourhood trust (OR 1.77; 95% CI 1.25 to 2.51) and reciprocity at school (OR 1.71; 95% CI 1.08 to 2.73). Conclusions Higher levels of social capital were independently associated with higher self-rated health among youth. Intervention and policies that leverage community social capital might serve as an avenue for health promotion in youth. PMID:26056122
Ard, Kerry; Colen, Cynthia; Becerra, Marisol; Velez, Thelma
This study provides an empirical test of two mechanisms (social capital and exposure to air pollution) that are theorized to mediate the effect of neighborhood on health and contribute to racial disparities in health outcomes. To this end, we utilize the Social Capital Benchmark Study, a national survey of individuals nested within communities in the United States, to estimate how multiple dimensions of social capital and exposure to air pollution, explain racial disparities in self-rated health. Our main findings show that when controlling for individual-confounders, and nesting within communities, our indicator of cognitive bridging, generalized trust, decreases the gap in self-rated health between African Americans and Whites by 84%, and the gap between Hispanics and Whites by 54%. Our other indicator of cognitive social capital, cognitive linking as represented by engagement in politics, decreases the gap in health between Hispanics and Whites by 32%, but has little impact on African Americans. We also assessed whether the gap in health was explained by respondents' estimated exposure to toxicity-weighted air pollutants from large industrial facilities over the previous year. Our results show that accounting for exposure to these toxins has no effect on the racial gap in self-rated health in these data. This paper contributes to the neighborhood effects literature by examining the impact that estimated annual industrial air pollution, and multiple measures of social capital, have on explaining the racial gap in health in a sample of individuals nested within communities across the United States.
Ard, Kerry; Colen, Cynthia; Becerra, Marisol; Velez, Thelma
This study provides an empirical test of two mechanisms (social capital and exposure to air pollution) that are theorized to mediate the effect of neighborhood on health and contribute to racial disparities in health outcomes. To this end, we utilize the Social Capital Benchmark Study, a national survey of individuals nested within communities in the United States, to estimate how multiple dimensions of social capital and exposure to air pollution, explain racial disparities in self-rated health. Our main findings show that when controlling for individual-confounders, and nesting within communities, our indicator of cognitive bridging, generalized trust, decreases the gap in self-rated health between African Americans and Whites by 84%, and the gap between Hispanics and Whites by 54%. Our other indicator of cognitive social capital, cognitive linking as represented by engagement in politics, decreases the gap in health between Hispanics and Whites by 32%, but has little impact on African Americans. We also assessed whether the gap in health was explained by respondents’ estimated exposure to toxicity-weighted air pollutants from large industrial facilities over the previous year. Our results show that accounting for exposure to these toxins has no effect on the racial gap in self-rated health in these data. This paper contributes to the neighborhood effects literature by examining the impact that estimated annual industrial air pollution, and multiple measures of social capital, have on explaining the racial gap in health in a sample of individuals nested within communities across the United States. PMID:27775582
Background With increasing life expectancy the number of people affected by multimorbidity rises. Knowledge of factors associated with health-related quality of life in multimorbid people is scarce. We aimed to identify the factors that are associated with self-rated health (SRH) in aged multimorbid primary care patients. Methods Cross-sectional study with 3,189 multimorbid primary care patients aged from 65 to 85 years recruited in 158 general practices in 8 study centers in Germany. Information about morbidity, risk factors, resources, functional status and socio-economic data were collected in face-to-face interviews. Factors associated with SRH were identified by multivariable regression analyses. Results Depression, somatization, pain, limitations of instrumental activities (iADL), age, distress and Body Mass Index (BMI) were inversely related with SRH. Higher levels of physical activity, income and self-efficacy expectation had a positive association with SRH. The only chronic diseases remaining in the final model were Parkinson’s disease and neuropathies. The final model accounted for 35% variance of SRH. Separate analyses for men and women detected some similarities; however, gender specific variation existed for several factors. Conclusion In multimorbid patients symptoms and consequences of diseases such as pain and activity limitations, as well as depression, seem to be far stronger associated with SRH than the diseases themselves. High income and self-efficacy expectation are independently associated with better SRH and high BMI and age with low SRH. Trial registration MultiCare Cohort study registration:ISRCTN89818205. PMID:24387712
Larsson, Margaretha; Sundler, Annelie Johansson; Ekebergh, Margaretha
The aim of this phenomenological study was to describe the phenomenon of health as experienced by adolescent girls in Sweden. Fifteen adolescent girls were interviewed with a focus on what made them feel well in their everyday life. This study reveals that the adolescent girl's health is a complex phenomenon interwoven with their lives. Health…
Lyyra, Tiina-Mari; Leskinen, Esko; Jylhä, Marja; Heikkinen, Eino
Although the relation between self-rated health (SRH) and mortality is widely known, most of the studies have relied in baseline measurements unheeding the dynamics of the phenomenon. Our aim was to analyze how SRH both as a constant and as a time-dependent covariate predicts mortality in older men and women and to compare these different approaches. Subjects consisted of 110 male and 208 female (n=318) residents in the city of Jyväskylä, central Finland, aged 75 years at the baseline in 1989. The follow-up data was gathered in 1994 and mortality was followed for 10 years. Results showed that poor SRH was strongly associated with higher mortality risk in women in all models. In men, the association was found only in time-dependent and 5 year follow-up models and these associations were explained by baseline health status. To conclude, our analyses showed that there are gender differences in association between SRH and mortality and that the use of time-dependent covariate in a Cox regression model enables advantage to be taken of all the information in a longitudinal study design.
Background China is in the midst of history's largest flow of rural-urban migration in the world; a flow that includes growing numbers of children and adolescents. Their health status is an important public health issue. This study compares self-rated physical and mental health of migrant and local adolescents in China, and examines to what extent layered social connections account for health outcomes. Methods In 2010, we conducted a cross-sectional study among middle school students in Pudong New Area, Shanghai. Information about health status, social connections, and demographic factors were collected using a questionnaire survey. After controlling for sociodemographic factors, we used the t-test, Chi-square analysis, and a series of regression models to compare differences in health outcomes and explore the effects of social connections. Results Migrant adolescents reported significantly higher rates of good physical health. However, they also had significantly fewer social connections, lower self-esteem, and higher levels of depression than their native peers. Family cohesion was associated with depressive symptoms and low self-esteem among all adolescents; peer association and social cohesion played major roles in migrants' well-being. Gender, age, and socioeconomic (SES) factors also affected adolescents' self-rated physical and mental health. Conclusions Self-rated data suggest that migrant adolescents enjoy a physical health advantage and a mental health disadvantage. Layered social connections, such as peer association and social cohesion, may be particularly important for migrants. A public health effort is required to improve the health status of migrant youth. PMID:22299776
Fisman, David; Gardy, Jennifer L.
Introduction While seasonal influenza vaccination is recommended for individuals with asthma, uptake in this population is low. We examined how self-rated health impacts reasons for not being immunized against influenza in Canadian adults with asthma, focusing on those who have never been immunized. Methods We pooled four cycles of the Canadian Community Health Survey (cycles 3.1(2005), 2007/08, 2009/10 and 2011/12), grouping individuals by whether their reasons for not having been vaccinated were perceptual or technical. We used a multivariable logistic regression model, adjusted for confounders, to quantify the relationship between self-rated health and their reported reasons for not vaccinating. Results Among the 9,836 respondents, 84.4% cited perceptual barriers as a reason for not being vaccinated. After adjusting for socio-demographic characteristics and province of residence, we determined that reporting perceptual barriers was associated with self-rated health status, with the adjusted odds ratios ranging from 1.42 (95%CI: 0.97, 2.09) to 2.64 (95%CI: 1.74, 3.99) for fair and excellent health versus poor health, respectively. Each increase in self-rated health category was associated with greater odds of citing a perceptual rather than technical barrier as a reason for non-vaccination. Discussion Self-reported health influences people’s perception of the need for influenza vaccination. Viewing the results through the lens of the precaution adoption process model suggests that personalizing communication around both the risk of influenza and the effectiveness of the vaccine may improve uptake amongst adults with asthma. PMID:28207823
Kaczynski, Andrew T.; Clennin, Morgan N.; Reed, Julian A.
We examined associations between adults’ use of a prominent rail-trail and their weight status and self-rated health. In 2014, a random-digit-dial survey of Greenville County, South Carolina, residents (n = 639) was used to collect data on trail use, height and weight, self-rated health, and demographics. Trail users were half as likely to be overweight or obese as trail nonusers (odds ratio [OR] = 0.56; 95% confidence interval [CI], 0.33–0.95). Similarly, trail users were significantly more likely to report high self-rated health than were trail nonusers (OR = 1.83; 95% CI, 1.13–2.97). Findings suggest that trail use is associated with healthier weight status and higher self-rated health and supports the development, maintenance, and promotion of trail resources. PMID:27978409
Rakowski, William; Wilcox, Victoria
Integrated ratings of global health status and reports of social involvements into single, combined variable. Used variable to predict mortality over three time periods. Data from 6,053 self-respondents aged 70 and older at baseline in 1984 showed that combined variable produced substantial effects on mortality, particularly for 1984-86 and…
Whitson, Heather E; Malhotra, Rahul; Chan, Angelique; Matchar, David B; Østbye, Truls
The objective of this study was to examine the prevalence and consequences of coexisting vision and cognitive impairments in an Asian population. Data were collected from 4508 community-dwelling Singaporeans aged 60 years and older. Cognition was assessed by the Short Portable Mental Status Questionnaire whereas vision, disability, and self-rated health (SRH) were determined by self-report. Vision impairment was present in 902 (18.5%) participants and cognitive impairment in 835 (13.6%), with 232 (3.5%) participants experiencing both impairments. Persons with the comorbidity experienced higher odds of disability than persons with either single impairment. The association of vision impairment with SRH was stronger among women (odds ratio [OR] = 6.79, 95% confidence interval [CI] = 4.64-9.92) than among men (OR = 1.71, 95% CI = 1.21-2.41). Concurrent cognitive and vision impairment is prevalent in older Singaporeans and is associated with high rates of disability. Gender differences in vision-dependent roles may affect the patient-perceived impact of this comorbidity.
Montero, J; Gómez Polo, C; Rosel, E; Barrios, R; Albaladejo, A; López-Valverde, A
Symmetric, aligned and luminous smiles are usually classified as 'beautiful' and aesthetic. However, smile perception is not strictly governed by standardised rules. Personal traits may influence the perception of non-ideal smiles. We aimed to determine the influence of personality traits in self-rated oral health and satisfaction and in the aesthetic preference for different strategically flawed smiles shown in photographs. Smiles with dark teeth, with uneven teeth, with lip asymmetry and dental asymmetry were ordered from 1 to 4 as a function of the degree of beauty by 548 participants, of which 50·7% were females with a mean age of 41·5 ± 17·6 years (range: 16-89 years). Self-assessment and oral satisfaction were recorded on a Likert scale. Personality was measured by means of the Big Five Inventory (extraversion, agreeableness, conscientiousness, neuroticism and openness), and the Life Orientation Test was used to measure optimism and pessimism. Of the four photographs with imperfect smiles, dental asymmetry was the most highly assessed in 63% of the sample, and the worst was lip asymmetry, in 43·7% of the sample. Some personality traits (above all conscientiousness and openness) were significantly correlated with the position assigned to the photographs with dental and lip asymmetry or with misaligned teeth. The extraversion, agreeableness and openness traits were correlated with the self-perceptions of oral health and aesthetics of the participants. Dental asymmetry seems to be better tolerated than lip asymmetry. Personality traits are weakly but significantly correlated with the aesthetic preference and oral health values, conscientiousness and openness being the most relevant domains in this sense.
Chen, Danhong; Yang, Tse-Chuan
Although there has been extensive research on the adverse impacts of perceived discrimination on health, it remains unclear how perceived discrimination gets under the skin. This paper develops a comprehensive structural equation model (SEM) by incorporating both the direct effects of perceived discrimination on self-rated health (SRH), a powerful predictor for many health outcomes, and the indirect effects of perceived discrimination on SRH through health care system distrust, neighborhood social capital, and health behaviors and health conditions. Applying SEM to 9,880 adults (aged between 18 and 100) in the 2008 Southeastern Pennsylvania Household Health Survey, we not only confirmed the positive and direct association between discrimination and poor or fair SRH, but also verified two underlying mechanisms: 1) perceived discrimination is associated with lower neighborhood social capital, which further contributes to poor or fair SRH; and 2) perceived discrimination is related to risky behaviors (e.g., reduced physical activity and sleep quality, and intensified smoking) that lead to worse health conditions, and then result in poor or fair SRH. Moreover, we found that perceived discrimination is negatively associated with health care system distrust, but did not find a significant relationship between distrust and poor or fair SRH. PMID:24581063
Chen, Danhong; Yang, Tse-Chuan
Although there has been extensive research on the adverse impacts of perceived discrimination on health, it remains unclear how perceived discrimination gets under the skin. This paper develops a comprehensive structural equation model (SEM) by incorporating both the direct effects of perceived discrimination on self-rated health (SRH), a powerful predictor for many health outcomes, and the indirect effects of perceived discrimination on SRH through health care system distrust, neighborhood social capital, and health behaviors and health conditions. Applying SEM to 9880 adults (aged between 18 and 100) in the 2008 Southeastern Pennsylvania Household Health Survey, we not only confirmed the positive and direct association between discrimination and poor or fair SRH, but also verified two underlying mechanisms: 1) perceived discrimination is associated with lower neighborhood social capital, which further contributes to poor or fair SRH; and 2) perceived discrimination is related to risky behaviors (e.g., reduced physical activity and sleep quality, and intensified smoking) that lead to worse health conditions, and then result in poor or fair SRH. Moreover, we found that perceived discrimination is negatively associated with health care system distrust, but did not find a significant relationship between distrust and poor or fair SRH.
Bez, Joelita Pessoa de Oliveira; Neri, Anita Liberalesso
The article seeks to investigate patterns of performance and relationships between grip strength, gait speed and self-rated health, and investigate the relationships between them, considering the variables of gender, age and family income. This was conducted in a probabilistic sample of community-dwelling elderly aged 65 and over, members of a population study on frailty. A total of 689 elderly people without cognitive deficit suggestive of dementia underwent tests of gait speed and grip strength. Comparisons between groups were based on low, medium and high speed and strength. Self-related health was assessed using a 5-point scale. The males and the younger elderly individuals scored significantly higher on grip strength and gait speed than the female and oldest did; the richest scored higher than the poorest on grip strength and gait speed; females and men aged over 80 had weaker grip strength and lower gait speed; slow gait speed and low income arose as risk factors for a worse health evaluation. Lower muscular strength affects the self-rated assessment of health because it results in a reduction in functional capacity, especially in the presence of poverty and a lack of compensatory factors.
Kim, Saerom; Kim, Chang-yup; You, Myung Soon
Objectives: Civic participation, that which directly influences important decisions in our personal lives, is considered necessary for developing a society. We hypothesized that civic participation might be related to self-rated health status. Methods: We constructed a multi-level analysis using data from the World Value Survey (44 countries, n=50 859). Results: People who participated in voting and voluntary social activities tended to report better subjective health than those who did not vote or participate in social activities, after controlling for socio-demographic factors at the individual level. A negative association with unconventional political activity and subjective health was found, but this effect disappeared in a subset analysis of only the 18 Organization for Economic Cooperation and Development (OECD) countries. Moreover, social participation and unconventional political participation had a statistically significant contextual association with subjective health status, but this relationship was not consistent throughout the analysis. In the analysis of the 44 countries, social participation was of borderline significance, while in the subset analysis of the OECD countries unconventional political participation was a stronger determinant of subjective health. The democratic index was a significant factor in determining self-rated health in both analyses, while public health expenditure was a significant factor in only the subset analysis. Conclusions: Despite the uncertainty of its mechanism, civic participation might be a significant determinant of the health status of a country. PMID:25652707
Sindelar, Jody L.; Falba, Tracy A.; Fletcher, Jason M.; Keenan, Patricia; Wu, Ran; Gallo, William T.
Background The objective of this study is to estimate occupational differences in self-rated health, both in cross-section and over time, among older individuals. Methods We use hierarchical linear models to estimate self-reported health as a function of 8 occupational categories and key covariates. We examine self-reported health status over 7 waves (12 years) of the Health and Retirement Study. Our study sample includes 9,586 individuals with 55,389 observations. Longest occupation is used to measure the cumulative impact of occupation, address the potential for reverse causality, and allow the inclusion of all older individuals, including those no longer working. Results Significant baseline differences in self-reported health by occupation are found even after accounting for demographics, health habits, economic attributes, and employment characteristics. But contrary to our hypothesis, there is no support for significant differences in slopes of health trajectories even after accounting for dropout. Conclusions Our findings suggest that occupation-related differences found at baseline are durable and persist as individuals age. PMID:19196689
Van de Velde, Sarah; Bambra, Clare; Van der Bracht, Koen; Eikemo, Terje Andreas; Bracke, Piet
This study examines whether health inequalities exist between lone and cohabiting mothers across Europe, and how these may differ by welfare regime. Data from the European Social Survey were used to compare self-rated general health, limiting long-standing illness and depressive feelings by means of a multi-level logistic regression. The 27 countries included in the analyses are classified into six welfare regimes (Anglo-Saxon, Bismarckian, Southern, Nordic, Central East Europe (CEE) (new EU) and CEE (non-EU). Lone motherhood is defined as mothers not cohabiting with a partner, regardless of their legal marital status. The results indicate that lone mothers are more at risk of poor health than cohabiting mothers. This is most pronounced in the Anglo-Saxon regime for self-rated general health and limiting long-standing illness, while for depressive feelings it is most pronounced in the Bismarckian welfare regime. While the risk difference is smallest in the CEE regimes, both lone and cohabiting mothers also reported the highest levels of poor health compared with the other regimes. The results also show that a vulnerable socioeconomic position is associated with ill-health in lone mothers and that welfare regimes differ in the degree to which they moderate this association.
Barrett, Austin G.; Mowen, Andrew J.; Graefe, Alan R.; Godbey, Geoffrey C.; Sciamanna, Christopher N.
We examined the relationship between self-rated health and use of parks and recreation program participation by using logistic regression to analyze data from representative national surveys conducted in 1991 and 2015. Neither park use nor program participation were significantly related to self-rated health in 1991; however, both were significantly related in 2015. The growing relationship between use of parks and recreation programs and self-rated health during this period is likely the result of broad national health promotion efforts and provides support for funding of capital and operational expenses for park and recreation services. PMID:28055820
Pitas, Nicholas A D; Barrett, Austin G; Mowen, Andrew J; Graefe, Alan R; Godbey, Geoffrey C; Sciamanna, Christopher N
We examined the relationship between self-rated health and use of parks and recreation program participation by using logistic regression to analyze data from representative national surveys conducted in 1991 and 2015. Neither park use nor program participation were significantly related to self-rated health in 1991; however, both were significantly related in 2015. The growing relationship between use of parks and recreation programs and self-rated health during this period is likely the result of broad national health promotion efforts and provides support for funding of capital and operational expenses for park and recreation services.
Berglund, Erik; Lytsy, Per; Westerling, Ragnar
Active traveling to a daily occupation means that an individual uses an active way of traveling between two destinations. Active travel to work or other daily occupations offers a convenient way to increase physical activity levels which is known to have positive effects on several health outcomes. Frequently used concepts in city planning and regional planning today are to create environments for active commuting and active living. Even then, little research has focused on traveling modes and subjective health outcomes such as self-rated health (SRH). This study aimed to explore and investigate associations between travel mode and health-related outcomes, such as self-rated health (SRH), body mass index (BMI) and overall physical activity, in an adult population in Sweden. A cross-sectional study was conducted in a randomly selected population-based sample (n = 1786, age 45-75 years); the respondents completed a questionnaire about their regular travel mode, demographics, lifestyle, BMI and SRH. Chi-square tests and logistic regressions found that inactive traveling was associated with poor SRH, a greater risk of obesity or being overweight and overall physical inactivity. In addition, lifestyle factors, such as choice of food and smoking habits, were associated with SRH, BMI and overall physical activity.
Meng, Qinqin; Xie, Zheng; Zhang, Tuohong
Introduction: The measurement of health status of the elderly remains one important topic. Self-rated health status (SRH) is considered to be a simple indicator to measure the health status of the old population. But some researchers still take a skeptical view about its reliability. This study aims to investigate the association between SRH indicator and health status of the elderly and discuss its subsequent public health implications. Methods: In a total 1096 people who were 60 years of age or older from 1784 households from a suburban area of Beijing were interviewed using multistage stratified cluster sampling. SRH was measured by a single question “please choose one point in this 0–100 scale, which can best represent your health today.” The disease status and physical functional status were also obtained. A multiple linear regression was conducted to test the associate between SRH and individual’s disease/functional status. Results: The average of SRH scores of the elderly was 72.49 ± 15.64 (on a 1–100 scale). The SRH scores declined not only with the severity of self-reported mental/disease status, but also with the decrease of physical functional status. Multiple linear regression showed that after adjustment for other variables, 2-week sickness, chronic diseases, hospitalization, and ability of self-care (washing and dressing) were able to explain 35% of the variation in SRH among the elderly. Among them, disease status and self-care ability were the most powerful predictor of SRH. After adjusting other variables, physical functional status could explain only 5% of the variation in SRH. Conclusion: Self-rated health reflects the disease/functional health status of the elderly. It is an easy-to-implement variable and it can reduce both recall bias and investigator bias, thus being widely used in health surveys. It is a cost-effective means of measuring the health status. However, the comparability of SRH in different populations should be
Kamen, Charles S.; Smith-Stoner, Marilyn; Heckler, Charles E.; Flannery, Marie; Margolies, Liz
Purpose/Objectives To describe factors related to diagnosis, identity disclosure, and social support among lesbian, gay, bisexual, and transgender (LGBT) patients with cancer, and to explore associations between these factors and self-rated health. Design Cross-sectional self-report survey design using descriptive and exploratory multivariate statistical approaches. Setting Online, Internet-based. Sample 291 LGBT patients (89% Caucasian; 50% gay, 36% lesbian, 7% bisexual, 3% transgender) with mixed cancers. Methods Participants completed a researcher-designed online survey assessing experiences of cancer diagnosis among LGBT patients at a single time point. Main Research Variables Demographics, which provider(s) delivered the patients’ cancer diagnoses, to whom patients had disclosed their LGBT identity, how they disclosed, who was on their social support team at the time of diagnosis, and current self-rated health. Findings 79% of participants reported disclosing their identities to more than one cancer care provider. Participants most commonly introduced the topic of LGBT identity themselves, sometimes as a way to correct heterosexual assumptions (34%). Friends were the most common members of LGBT patients’ support teams (79%). Four disclosure and support factors were consistently associated with better self-rated health. Conclusions Disclosure of LGBT identity is a common experience in the context of cancer care, and disclosure and support factors are associated with better self-reported health among LGBT patients. Implications for Nursing Creating safe environments for LGBT patients to disclose could improve cancer care delivery to this underserved population. Nurses and other providers should acknowledge and include diverse support team members in LGBT patients’ care. PMID:25542320
Evidence suggests that living in a socioeconomically deprived neighborhood is associated with worse health. Yet most research relies on cross-sectional data, which implicitly ignore variation in longer-term exposure that may be more consequential for health. Using data from the 1970 to 2011 waves of the Panel Study of Income Dynamics merged with census data on respondents' neighborhoods (N = 1,757), this study estimates a marginal structural model with inverse probability of treatment and censoring weights to examine: (1) whether cumulative exposure to neighborhood disadvantage from birth through age 17 affects self-rated health in early adulthood, and (2) the extent to which variation in such exposure helps to explain racial disparities therein. Findings reveal that prolonged exposure to neighborhood disadvantage throughout childhood and adolescence is strikingly more common among nonwhite versus white respondents and is associated with significantly greater odds of experiencing an incidence of fair or poor health in early adulthood.
Kobayashi, Tomoko; Kawachi, Ichiro; Iwase, Toshihide; Suzuki, Etsuji; Takao, Soshi
Despite accumulating evidence of associations between social capital and health in public health research, a criticism of the field has been that researchers have exclusively focused on concepts of social cohesion to the exclusion of individual-level approaches. In the present study, we evaluated the association between social capital measured by the Resource Generator (an individual-level assessment of access to social capital) and self-rated health among Japanese population in a cross-sectional study. A postal survey of 4000 randomly selected residents in Okayama City (western Japan) was conducted in February 2009. We divided the overall scores from the Resource Generator Japan scale into quartiles. Odds ratios (ORs) and 95% confidence intervals (CIs) for self-rated health were calculated separately by sex. Individuals with the highest quartile of scores had significantly lower odds of poor health compared to the lowest group after covariate adjustment among both men and women (men; OR: 0.45, 95% CI: 0.24-0.86, women; OR: 0.44, 95% CI: 0.25-0.79, respectively) and there were also significant dose-response relationships. In the sub-domains of Resource Generator Japan scale, a differential pattern was observed by sex. Women showed a clear dose-response relationship with health across all four sub-scales (domestic resources, expert advice, personal skills, and problem solving resources). In contrast, only the domain of expert advice exhibited a strong association with men's health. Among both men and women individual-level social capital measured by the Resource Generator was related to reduced odds of poor health even after taking into account individual confounders. Although we cannot exclude reverse causation due to the cross-sectional design, our study adds to the accumulating evidence of the potential utility of the Resource Generator for evaluating the relationship between individual-level access to social capital and health.
Min, Jong Won; Rhee, Siyon; Lee, Sang E; Rhee, Jessica; Tran, Thanh
The purpose of the study is (1) to compare the effects of factors on self-rated health (SRH) among older non-Hispanic Whites (NHW), Hispanic, and Asian Californians and (2) to provide estimated influence size of each factor on SRH. This study analyzed secondary data drawn from the 2005 California Health Interview Survey. Binary logit regressions were used to analyze data with the Jackknife replication sampling weights. Significant differences were found in SRH among the three groups. Hispanics and Asians reported poorer health than NHW. Socioeconomic status, acculturation, and health access significantly accounted for an association between ethnicity and SRH. However, the magnitudes of their effects on SRH varied across the groups and by the factors examined. This study discusses and concludes with some recommendations on the opportunities presented by the Affordable Care Act and Healthy People 2020.
Shirom, Arie; Toker, Sharon; Shapira, Itzhak; Berliner, Shlomo; Melamed, Samuel
The effects of exposure to terror on physical health were investigated by relating objective exposure to terror and fear of terror to self-rated health (SRH), a proxy measure of health status. Our respondents were apparently healthy (N=4,877, 38% women) adults who completed self-report questionnaires. Objective exposure was assessed by the number of terrorist attacks and their casualties in a respondent's urban area prior to her/his completion of the questionnaire. Using several alternative assessments, objective exposure to terror did not predict SRH for both the genders. As hypothesized, fear of terror negatively predicted SRH for both females and males (beta=-0.04, -0.05, respectively). The effects of subjective and objective exposure were not found to be more pronounced among women relative to men, thus disconfirming our hypotheses in this regard. Our findings suggest that living under continuous fear of terror may adversely influence physical health irrespective of objective exposure.
Malat, Jennifer; Timberlake, Jeffrey M; Williams, David R
Stress in the social environment can affect individual health. Election of the first Black President of the United States provides an opportunity to assess how a positive change in the macro-political climate impacts the health of Americans. Past research suggests that race-related political events influence the health of non-dominant racial groups. Yet many questions remain, including the types of events that affect health, the timing and durability of health effects, and whether effects are similar for Blacks and Hispanics in the United States. The present study uses data from the Ohio Family Health Survey, which was in the field from August 6, 2008 until January 24, 2009, to assess whether immediate changes in average self-rated health occurred after key events in the election of President Barack Obama. We find better average health ratings among Blacks and Hispanics immediately following Obama's nomination by the Democratic Party. Similar effects did not occur after the election or inauguration, and Whites showed no effect of any of the events. We discuss the implications of these findings in terms of the theoretical links between macro-level social conditions, race/ethnicity, and health.
Hashiba, Takafumi; Takeuchi, Kenji; Shimazaki, Yoshihiro; Takeshita, Toru; Yamashita, Yoshihisa
Chewing xylitol gum provides oral health benefits including inhibiting Streptococcus mutans plaque. It is thought to be especially effective in conditions where it is difficult to perform daily oral cleaning. Our study aim was to determine the effects of chewing xylitol gum on self-rated and objective oral health status under a condition interfering with oral hygiene maintenance. A randomized controlled intervention trial was conducted on 55 healthy ≥ 20-year-old men recruited from the Japan Ground Self Defense Force who were undergoing field training. Participants were randomly assigned to a test group (chewing gum; n = 27) or a control group (no gum; n = 28) and the researchers were blinded to the group assignments. The Visual Analog Scale (VAS) scores of oral conditions subjectively evaluated oral health, and the stimulated salivary bacteria quantity objectively evaluated oral health 1 day before field training (baseline) and 4 days after the beginning of field training (follow-up). VAS scores of all three oral conditions significantly increased in the control group (malodor: p < 0.001; discomfort: p < 0.001; dryness: p < 0.001), but only two VAS scores increased in the test group (malodor: p = 0.021; discomfort: p = 0.002). The number of salivary total bacteria significantly increased in the control group (p < 0.01), while no significant change was observed in the test group (p = 0.668). Chewing xylitol gum positively affects self-rated and objective oral health status by controlling oral hygiene under conditions that interfere with oral hygiene maintenance.
Social scientists have long demonstrated that socioeconomic resources benefit health. More recently, scholars have begun to examine the potential stratification in the health returns different groups receive for a given resource. Motivated by fundamental cause theory, this paper examines homeownership as a salient health resource with potentially stratified benefits. Homeowners have significantly greater housing quality, wealth, neighborhood quality and integration, and physical and mental health than renters. However, there are compelling theoretical reasons to expect the health advantage of homeownership to be unequally distributed across racial and ethnic groups. Regression analyses of 71,874 household heads in the United States from the 2012 March Current Population Survey initially suggest all homeowners experience a significant health advantage. Further examination finds robust evidence for a homeowner health advantage among Whites, on par with the difference between the married and divorced. The advantage among minority households is considerably smaller, and not significant among Latinos or Asians. Conditioning on a broad array of observable characteristics, White homeowners emerge as exceptionally healthy compared to White renters and all minority groups. This leads to the unexpected finding that racial/ethnic differences in health are concentrated among homeowners. The findings demonstrate the interactive nature of racial/ethnic stratification in health through both access to and returns from socioeconomic resources.
Lommel, Lisa L; Chen, Jyu-Lin
We systematically reviewed studies to identify the association between acculturation and self-rated health (SRH) and the impact of nativity and language use in Asian and Hispanic adult immigrants. Six electronic databases were searched. Data on nativity and limited English proficiency (LEP) was extracted and analyzed. Nine studies met review criteria. A positive association between acculturation and fair/poor SRH among Asians and Hispanics was found. For both Asians and Hispanics, six out of eight studies showed nativity and all three studies reporting LEP were associated with worse SRH compared to whites. Nativity and LEP were found to be risk factors for reporting worse SRH in Hispanics compared to Asians. The degree of association between nativity and LEP and worse SRH was found to vary by Asian and Hispanic subgroup. Further studies are needed to accurately assess the health status of these populations, which will be essential to eliminating disparities.
Fujino, Yoshihisa; Mizoue, Tetsuya; Tokui, Noritaka; Yoshimura, Takesumi
The association between many psychosocial factors and risk of suicide was examined. A cohort was conducted over 14 years of follow up among the general population (15,597 people) in Japan. A baseline survey of psychosocial characteristics was conducted by self-administrated questionnaire. The relative risks of occasional emotional stress, difficulty maintaining sleep, and reporting unhealthy as their self-rated health are 3.2 (95% CI: 1.3, 7.6), 2.4 (95% CI: 1.3, 4.3) and 2.6 (95% CI: 1.1, 6.2), respectively. The importance of these observations lie in its potential for improving physician and public awareness of psychosocial factors as an early indication of mental health morbidity.
Nordgren, Lena; Söderlund, Anne
Younger people with heart failure often experience poor self-rated health. Furthermore, poor self-rated health is associated with long-term sick leave and disability pension. Socio-demographic factors affect the ability to return to work. However, little is known about people on sick leave due to heart failure. The aim of this study was to investigate associations between self-rated health, mood, socio-demographic factors, sick leave compensation, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work, for people on sick leave due to heart failure. This population-based investigation had a cross-sectional design. Data were collected in Sweden in 2012 from two official registries and from a postal questionnaire. In total, 590 subjects, aged 23-67, responded (response rate 45.8%). Descriptive statistics, correlation analyses (Spearman bivariate analysis) and logistic regression analyses were used to investigate associations. Poor self-rated health was strongly associated with full sick leave compensation (OR = 4.1, p < .001). Compared self-rated health was moderately associated with low income (OR = .6, p = .003). Good self-rated health was strongly associated with positive encounters with healthcare professionals (OR = 3.0, p = .022) and to the impact of positive encounters with healthcare professionals on self-estimated ability to return to work (OR = 3.3, p < .001). People with heart failure are sicklisted for long periods of time and to a great extent receive disability pension. Not being able to work imposes reduced quality of life. Positive encounters with healthcare professionals and social insurance officers can be supportive when people with heart failure struggle to remain in working life.
Frankenberg, Elizabeth; Jones, Nathan R.
Although a relationship between poor self-reported health status and excess mortality risk has been well-established for industrialized countries, almost no research considers developing countries. We use data from Indonesia to show that in a low-income setting, as in more advantaged parts of the world, individuals who perceive their health to be…
Objectives. The purpose of this study is to examine the relationship between religiously based beliefs about suffering and health among older Mexicans. Methods. A nationwide survey of older Mexican Americans was conducted (N = 1,005). Questions were administered to assess beliefs about finding positive outcomes in suffering, the benefits of suffering in silence, other dimensions of religion, and health. Results. The findings suggest that older Mexican Americans who use their faith to find something positive in the face of suffering tend to rate their health more favorably. In contrast, older Mexican Americans who believe that it is important to suffer in silence tend to rate their health less favorably. Discussion. Moving beyond measures of church attendance to explore culturally relevant beliefs about suffering provides important insight into the relationship between religion and health among older Mexican Americans. PMID:21076086
Wang, Joyce M.; Lee, Lewina O.; Spiro, Avron
BACKGROUND This study examined gender differences in the impact of warfare exposure on self-reported physical health. METHODS Data are from the 2010 National Survey of Veterans, a nationally representative survey of veterans from multiple eras of service. Regression analyses assessed gender differences in the association between warfare exposure (deployment to a war zone, exposure to casualties) and health status and functional impairment, adjusting for sociodemographics. FINDINGS Women reported better health status but greater functional impairment than men. In men, those who experienced casualties only or both casualties and deployment to a war zone had worse health compared to those who experienced neither stressor or deployment to a war zone only. In women, those who experienced casualties only or both stressors reported worse health than those who experienced war zone only, who did not differ from the unexposed. No association was found between warfare exposure and functional impairment in women, but in men, those who experienced exposure to casualties or both stressors had greater odds of functional impairment compared to those who experienced war zone only or neither stressor. CONCLUSIONS Exposure to casualties may be more predictive of health than deployment to a war zone, especially for men. We did not find a stronger association between warfare exposure and health for women than men. Given that the expansion of women's military roles has allowed them to serve in direct combat, their degree and scope of warfare exposure is likely to increase in the future. PMID:25442366
the Health Risk Assessment Survey II (HRA IIv2). This survey is designed to identify physical and mental health concerns of Soldiers 90-180 days after ...distress responses after serving in a combat environment. These symptoms are typically mild to moderate in severity and usually remit over a period of...versions several times after it was introduced. The first major revision to the medical surveillance program was in the mid 1990s when researchers
Inaba, Yoji; Wada, Yuri; Ichida, Yukinobu; Nishikawa, Masashi
This paper aims to clarify the association between various social capital components at the municipal level (community social capital) and two quality-of-life factors at the individual level [individual self-rated life satisfaction and self-rated health (SRH)] based on data from a nationwide social capital survey that the authors carried out in 2013 in Japan (N = 3406 in 99 municipalities). The survey covers residents in Japan between the ages of 20 and 79 years. We focus on both contextual social capital and household income inequality in terms of the Gini coefficient at the municipality level since, to the best of our knowledge, no paper has explicitly dealt with municipalities in Japan as the units of contextual social capital and the Gini. Our analyses show that the subjective life satisfaction of individuals, after controlling for socioeconomic status and health at the individual level, is associate with both an income gap and social capital at the municipal level. Every component of community social capital in this study except for generalized reciprocity, both cognitive (generalized trust, particularized trust, and particularized reciprocity), and structural (three types of group participation and daily contacts with neighbors, friends/acquaintances, and colleagues), and the Gini coefficient on earned income were associated with self-rated life satisfaction at the individual level with statistical significance. However, SRH is associated only with cognitive social capital at the community level. SRH has no significant association with structural components of community social capital or with a community income gap in terms of the Gini coefficient on personal income. Judging from the results of estimates in the study, most of the components of community social capital at the municipal level seem to play an important role in enhancing self-rated life satisfaction. Life satisfaction may be associated with the broad atmosphere of the municipal level where one
Brunnberg, Elinor; Bostrom, Margareta Linden; Berglund, Mats
This survey, "Life and Health--Young People 2005," included all 15/16-year-old adolescents in mainstream schools in the county of Orebro, Sweden. Just students with a slight/mild or moderate hearing loss were included. There were 56 (1.9%) "hard-of-hearing (HH) students with multiple disabilities," 93 (3.1%) students who were…
Tay, J.; Kelleher, C.; Hope, A.; Barry, M.; Gabhainn, S. N.; Sixsmith, J.
Objective: To examine the influence of sociodemographic and neighbourhood factors on self rated health, quality of life, and perceived opportunities for change (as one measure of empowerment) in rural Irish communities. Design: Pooled data from cross sectional surveys two years apart. Setting: Respondents in four randomly selected rural district electoral divisions with a population size of between 750 and 2000. Participants: 1738 rural dwellers aged 15–93, 40.5% men, interviewed at two time points. Main outcome measures: Determinants of self rated health (SRH), quality of life (QOL), and perceived opportunities for change, rated on a closed option Likert scale and assessed in multivariate logistic regression models. Main results: Overall 23.8% of the sample reported poor SRH, 22.2% poor QOL, and 50.1% low perceived opportunities for change. Low financial security and dissatisfaction with work were each significantly associated with poor SRH (OR = 1.96 (1.50 to 2.56) and 1.54 (1.11 to 2.14)), with poor QOL (OR = 2.04 (1.56 to 2.68) and 1.87 (1.34 to 2.61). Concern about access to public services was significantly predictive of SRH (OR = 1.47 (1.11 to 1.94)) rather than access to health care (that is, hospital and GP services). There were distinct sex specific patterns and a generational effect for educational status in men. Variables associated with social networks and social support were less strongly predictive of SRH and QOL when economic measures were accounted for. Conclusion: Inter-relations between indicators of health status, wellbeing, and deprivation are not well studied in rural communities. Material deprivation has a direct influence on both health status and quality of life, although immediate sources of support are relatively well preserved. PMID:15483305
Marshall, Gillian L; Thorpe, Roland J; Szanton, Sarah L
This article examines the association between material hardships and self-rated mental health (SRMH) among older black Americans and determines whether the effect varies by race and ethnicity. Using data from the National Survey of American Life, multiple logistic regression models were specified on a sample of older white Americans (n = 289), African Americans (n = 1,135), and black Caribbean Americans (n = 377). Material hardship was measured as an index of seven items that occurred within the past year. Material hardship (odds ratio = 0.48; 95 percent confidence interval = 0.29-0.79) was associated with SRMH for both groups. None of the interactions were significant. The study concludes that material hardship may contribute to poorer SRMH among older African Americans and black Caribbean Americans. Future studies should examine these associations by using longitudinal designs, which may be better designed to confirm these results.
Murayama, Hiroshi; Nishi, Mariko; Matsuo, Eri; Nofuji, Yu; Shimizu, Yumiko; Taniguchi, Yu; Fujiwara, Yoshinori; Shinkai, Shoji
Little is known regarding the longitudinal effects of bonding and bridging social capital on health. This study examined the longitudinal associations of bonding and bridging social capital with self-rated health, depressive mood, and cognitive decline in community-dwelling older Japanese. Data analyzed in this study were from the 2010 (baseline) and 2012 (follow-up) Hatoyama Cohort Study. Bonding social capital was assessed by individual perception of homogeneity of the neighborhood (the level of homogeneity among neighbors) and of networks (the amount of homogeneous personal networks) in relation to age, gender, and socioeconomic status. Bridging social capital was assessed by individual perception of heterogeneity of networks (the amount of heterogeneous personal networks) in relation to age, gender, and socioeconomic status. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the effects of baseline social capital on poor health outcome at follow-up by logistic regression analysis. In total, 681 people completed baseline and follow-up surveys. The mean age of participants was 71.8 ± 5.1 years, and 57.9% were male. After adjusting for sociodemographics, lifestyle factors, comorbidity, functional capacity, baseline score of each outcome, and other bonding/bridging social capital, stronger perceived neighborhood homogeneity was inversely associated with poor self-rated health (OR = 0.55, 95% CI = 0.30-1.00) and depressive mood assessed by the Geriatric Depression Scale (OR = 0.58, 95% CI = 0.34-0.99). When participants who reported a depressive mood at baseline were excluded, stronger perceived heterogeneous network was inversely associated with depressive mood (OR = 0.40, 95% CI = 0.19-0.87). Neither bonding nor bridging social capital was significantly associated with cognitive decline assessed by the Mini-Mental State Examination. In conclusion, bonding and bridging social capital affect health in different ways, but they both have
Gollan, Tamar H.; Weissberger, Gali H.; Runnqvist, Elin; Montoya, Rosa I.; Cera, Cynthia M.
This study investigated correspondence between different measures of bilingual language proficiency contrasting self-report, proficiency interview, and picture naming skills. Fifty-two young (Experiment 1) and 20 aging (Experiment 2) Spanish-English bilinguals provided self-ratings of proficiency level, were interviewed for spoken proficiency, and…
Warnoff, Carin; Lekander, Mats; Hemmingsson, Tomas; Sorjonen, Kimmo; Melin, Bo; Andreasson, Anna
Objective Self-rated health is a powerful predictor of long-term health and mortality, hence the importance of a better understanding of its biological determinants. Previous studies have shown that low-grade inflammation is associated with poor self-rated health in clinical and healthy populations, but the evidence is sparse in men and completely lacking for men in late adolescence. The aim of this study was to investigate the association between low-grade inflammation and self-rated health among conscripts. It was hypothesised that high levels of inflammatory factors would be associated with poor self-rated health. Design Data from 49 321 men (18–21 years) conscripted for military service in 1969 and 1970 were used. Inflammation had been measured through erythrocyte sedimentation rate (ESR). Self-rated health had been assessed on a five-point scale, and was dichotomised into Good (‘Very good’/‘Good’/‘Fair’) versus Poor (‘Poor’/‘Very poor’). Data from 43 110 conscripts with normal levels of ESR, and who reported self-rated health remained after exclusion of those with ESR <1 and >11 mm/h. Associations were calculated using logistic regression analyses. Adjustments were made for body mass index, socioeconomic position, inflammatory disease, emotion regulation, smoking, risky use of alcohol and physical activity. Results High levels of ESR were associated with higher odds for poor self-rated health (OR: 1.077 for each unit mm/h increase in ESR, 95% CI 1.049 to 1.105). Conclusions The present study shows for the first time a significant association between a marker of inflammation and self-rated health in late adolescent men, adding to evidence of an association between low-grade inflammation and subjective health perception also in men, as previously demonstrated in women. Further support for inflammation as part of a general psychobiological process that underpins subjective health perception is hereby provided. PMID:27113233
García-Jimenez, María; Santoyo-Olsson, Jasmine; Ortiz, Carmen; Lahiff, Maureen; Sokal-Gutierrez, Karen; Nápoles, Anna María
Cancer self-efficacy (CSE) and spiritual well-being (SWB) have been associated with better self-rated health (SRH) among breast cancer survivors (BCS), but have not been well studied among Latina BCS (LBCS). Multivariate logistic regression analyses of secondary data from a cross-sectional population-based telephone survey of 330 LBCS explored relationships of language acculturation, CSE, and SWB subdomains of inner peace and faith with SRH. English proficiency was associated with SRH, independent of other covariates (OR=2.26, 95% CI 1.15, 4.45). Cancer self-efficacy attenuated this effect and was positively associated with SRH (OR=2.24, 95% CI 1.22, 4.10). Adding inner peace (a SWB subscale) attenuated the association of CSE and SRH (OR=1.67, 95% CI 0.88, 3.18). Inner peace remained associated with SRH (OR= 2.44, 95% CI 1.30, 4.56), controlling for covariates. Findings support the importance of a sense of inner peace and control over breast cancer to LBCS' perceived health. PMID:25418229
Shaw, Richard J.; Benzeval, Michaela; Popham, Frank
Introduction Nordic countries do not have the smallest health inequalities despite egalitarian social policies. A possible explanation for this is that drivers of class differences in health such as financial strain and labour force status remain socially patterned in Nordic countries. Methods Our analyses used data for working age (25–59) men (n = 48,249) and women (n = 52,654) for 20 countries from five rounds (2002–2010) of the European Social Survey. The outcome was self-rated health in 5 categories. Stratified by gender we used fixed effects linear regression models and marginal standardisation to instigate how countries varied in the degree to which class inequalities were attenuated by financial strain and labour force status. Results and Discussion Before adjustment, Nordic countries had large inequalities in self-rated health relative to other European countries. For example the regression coefficient for the difference in health between working class and professional men living in Norway was 0.34 (95% CI 0.26 to 0.42), while the comparable figure for Spain was 0.15 (95% CI 0.08 to 0.22). Adjusting for financial strain and labour force status led to attenuation of health inequalities in all countries. However, unlike some countries such as Spain, where after adjustment the regression coefficient for working class men was only 0.02 (95% CI −0.05 to 0.10), health inequalities persisted after adjustment for Nordic countries. For Norway the adjusted coefficient was 0.17 (95% CI 0.10 to 0.25). Results for women and men were similar. However, in comparison to men, class inequalities tended to be stronger for women and more persistent after adjustment. Conclusions Adjusting for financial security and labour force status attenuates a high proportion of health inequalities in some counties, particularly Southern European countries, but attenuation in Nordic countries was modest and did not improve their relative position. PMID:25313462
Boyington, Josephine E A; Howard, Daniel L; Holmes, DaJuanicia N
Objective. To explore racial differences in self-rated health (SRH) and its relationship to activities of daily living (ADLs) and mobility limitations among stroke survivors. Method. Data from 580 Black and White participants of the North Carolina Established Populations for Epidemiologic Studies of the Elderly (EPESE) were used to assess relationships between SRH, ADLs, and mobility variables. Fisher's exact tests, t tests, and logistic regression with backward selection (p < .20) were used. Results. No racial difference in SRH was found. SRH was significant in predicting ADL status among Whites only (OR = 0.23; CI = 0.08-0.69; p < .01). Participants older than 75 years had a greater likelihood of being in the lowest functioning ADL categories (OR = 2.31; CI = 1.48-3.60; p < .01). Discussion. Though no racial differences in SRH were found, the relationship between SRH, ADLs, and mobility status was moderated by race. SRH was predictive of limitations in Whites only. Observed differences suggest SRH construct may differ by race.
Pranjić, Nurka; Brković, Aida; Beganlić, Azijada
Aim To examine the relationship between quality of life, self-rated health, and well-being and to establish the relationship between discontent with familial financial situation and health in adolescents living in the Tuzla Canton. Method The study comprised a random sample of 356 high school students aged 16, coming from 15 different classes of 16 high schools in the Tuzla municipality. Data were obtained using a validated self-reporting questionnaire on demographic and socioeconomic background, structure, and dynamics of the adolescent’s family, life-style, perception, and satisfaction with the financial situation and current health status, as well as social relationships and health care provided in school settings. Results In 11% (n = 40) of students’ households several poverty indicators were present. Twenty three percent (n = 82) of the examinees were dissatisfied with the financial situation in their families, and 73% of them came from local, non-refugee families. They presented with progressive symptoms of unhappiness and expressed discontent with their health condition, and even self-hate in comparison with adolescents who were satisfied with the financial situation in their families (χ2 = 21.5; P = 0.001). The prevalence of self-rated mental symptoms was significantly lower among adolescents who were satisfied with their financial situation than in those who were dissatisfied (symptoms of depression 57/274 vs 40/82, P = 0.001; sadness 73/274 vs 45/82, P = 0.001; moroseness 34/274 vs 19/82, P = 0.001; under-sedation 29/274 vs 18/82, P = 0.001; bad marks and school failures 31/274 vs 20/82, P = 0.001; suicidal attempts 11/274 vs 7/82, P = 0.001, respectively). Using linear regression analysis we found that adolescents’ satisfaction with the financial situation was a major factor predicting depression (OR, 1.57; 95% CI, 1.158-1.855), loss of appetite (OR, 0.82; 95% CI, 0.561-1.235), distraction (OR, 1.19; 95% CI
Grigg, Angela; Thommasen, Harvey V.; Tildesley, Hugh; Michalos, Alex C.
Objective: To investigate the relative effect that diabetes has on self-rated health, satisfaction with various specific domains of life, and satisfaction with quality of life operationalized as happiness, satisfaction with life as a whole, and satisfaction with overall quality of life. Design: Mixed methods--mailed survey and chart review. Study…
Background Acculturation is for indigenous peoples related to the process of colonisation over centuries as well as the on-going social transition experienced in the Arctic today. Changing living conditions and lifestyle affect health in numerous ways in Arctic indigenous populations. Self-rated health (SRH) is a relevant variable in primary health care and in general public health assessments and monitoring. Exploring the relationship between acculturation and SRH in indigenous populations having experienced great societal and cultural change is thus of great importance. Methods The principal method in the Survey of Living Conditions in the Arctic (SLiCA) was standardised face-to-face interviews using a questionnaire. Very high overall participation rates of 83% were obtained in Greenland and Alaska, whilst a more conventional rate of 57% was achieved in Norway. Acculturation was conceptualised as certain traditional subsistence activities being of lesser importance for people’s ethnic identity, and poorer spoken indigenous language ability (SILA). Acculturation was included in six separate gender- and country-specific ordinal logistic regressions to assess qualitative effects on SRH. Results Multivariable analyses showed that acculturation significantly predicted poorer SRH in Greenland. An increased subsistence score gave an OR of 2.32 (P<0.001) for reporting poorer SRH among Greenlandic men, while an increased score for Greenlandic women generated an OR of 1.71 (P=0.01). Poorer SILA generated an OR of 1.59 in men (p=0.03). In Alaska, no evidence of acculturation effects was detected among Iñupiaq men. Among Iñupiaq women, an increased subsistence score represented an increased odds of 73% (p=0.026) for reporting poorer SRH. No significant effects of acculturation on SRH were detected in Norway. Conclusions This study shows that aggregate acculturation is a strong risk factor for poorer SRH among the Kalaallit of Greenland and female Iñupiat of Alaska, but
Letzring, Tera D; Edmonds, Grant W; Hampson, Sarah E
Personality traits change across the lifespan, and trait change, in addition to trait level, may be related to health. Longitudinal data from the Hawaii Personality and Health Cohort were used to investigate associations between changes in traits and self-rated health (SRH). Participants (N = 733, Mage = 44.4) completed measures of the Big Five personality traits and SRH twice approximately 3 years apart. Personality trait changes were associated with SRH change. Additionally, increases on Agreeableness, Conscientiousness, and Openness, and decreases on Neuroticism, predicted increases in SRH, even when controlling for gender and education. Relating correlated trait change at mid-life, when traits reach peak stability, to a consequential health outcome such as SRH change, demonstrates the value of treating both traits and health indicators as dynamic variables.
Park, Sunmin; Ahn, Jaeouk; Lee, Byung-Kook
Despite advertised health warnings regarding the deadly hazards of smoking, many people have not heeded recommendations to quit smoking. We examined factors that affect self-rated subjective health status (SRH) scores among lifestyle, nutrient intake and biochemical parameters, and the association of SRH scores and smoking status in a large Korean adult population. Adjusted odd ratios for SRH were calculated for smoking status, selected biochemical data, and food and nutrient intake obtained using the 24-hr recall method after covariate adjustment in the 2007-2012 Korean National Health and Nutrition Examination Survey (27,534 men and women aged ≥ 20 yr). Age, sex, income, education, drinking, exercise and stress levels were associated with SRH scores, regardless of smoking status (P < 0.001). Interestingly, people in any smoking status groups considered the well-known indicators for metabolic diseases (HDL cholesterol, glucose, aspartate aminotransferase, and alanine aminotransferase in the circulation), and the intake of fiber, total vitamins A, and vitamin C as indicators of SRH. Especially in current smokers, higher intake of nutritious food groups such as grains (OR = 1.227), vegetables (OR = 1.944), and milk (OR = 2.26) significantly increased the adjusted odds ratio of SRH. However, smoking status was not associated with SRH scores. In conclusion, SRH is affected by the indices related to health but not smoking status in Korean adults. The development of a new indicator of the direct adverse effects of smoking at regular health check-ups might be required to modulate the SRH in smokers and a nutritional education should not include the possible attenuation of adverse effects of smoking by good nutrition.
Waverijn, Geeke; Heijmans, Monique; Spreeuwenberg, Peter; Groenewegen, Peter P
Health literacy skills are important for health and self-management for people with chronic illness. Neighborhood social capital can provide resources, such as access to information and informal social control over unhealthy behavior. The benefit of these resources, and the access people have to these resources, might depend on levels of health literacy. We investigated whether neighborhood social capital is differentially related to the health of people with chronic illness according to health literacy skills. This study focused on health literacy skills in 4 domains related to the ability to access and understand health information and to the ability to perform self-management. We found a significant positive interaction between social capital and health literacy skills for accessing and understanding health information. This suggests that health literacy enhances people's ability to gain access to and use neighborhood resources to benefit health. There was no interaction effect between social capital and health literacy skills in the other 2 domains. More research is needed to investigate how people with chronic illness can benefit from knowledge, support, and other social resources for health and self-management also whether they have limited health literacy skills.
Jiao, Junfeng; Drewnowski, Adam; Moudon, Anne Vernez; Aggarwal, Anju; Oppert, Jean-Michel; Charreire, Helene; Chaix, Basile
This study analyzed the impact of area residential property values, an objective measure of socioeconomic status (SES), on self-rated health (SRH) in Seattle, Washington and Paris, France. This study brings forth a valuable comparison of SRH between cities that have contrasting urban forms, population compositions, residential segregation, food systems and transportation modes. The SOS (Seattle Obesity Study) was based on a representative sample of 1394 adult residents of Seattle and King County in the United States. The RECORD Study (Residential Environment and Coronary Heart Disease) was based on 7131 adult residents of Paris and its suburbs in France. Socio-demographics, SRH and body weights were obtained from telephone surveys (SOS) and in-person interviews (RECORD). All home addresses were geocoded using ArcGIS 9.3.1 (ESRI, Redlands, CA). Residential property values were obtained from tax records (Seattle) and from real estate sales (Paris). Binary logistic regression models were used to test the associations among demographic and SES variables and SRH. Higher area property values significantly associated with better SRH, adjusting for age, gender, individual education, incomes, and BMI. The associations were significant for both cities. A one-unit increase in body mass index (BMI) was more detrimental to SRH in Seattle than in Paris. In both cities, higher area residential property values were related to a significantly lower obesity risk and better SRH. Ranked residential property values can be useful for health and weight studies, including those involving social inequalities and cross-country comparisons.
Weyers, Simone; Peter, Richard; Boggild, Henrik; Jeppesen, Hans Jeppe; Siegrist, Johannes
Nursing staff are exposed to stressful work load which in turn is associated with poor physical and psychological health, sickness absence and job exit. The effort-reward imbalance (ERI) model is a validated approach to measure chronic psychosocial work stress by identifying nonreciprocity between occupational efforts spent and rewards received, and has been found to predict poor health. The aim of this cross-sectional study (n = 367 nurses and nurses aides) was first to test the psychometric properties of the Danish questionnaire measuring ERI, and secondly to analyse whether psychosocial work stress is associated with six indicators of poor self-rated health. Results derived from confirmatory factor analysis indicate satisfying psychometric properties. Elevated risks of poor self-rated health (odds ratios varying from 1.92 to 4.76) are observed in nursing staff characterized by high effort in combination with low reward. Effects are enhanced in those respondents who additionally exhibit a high level of work-related overcommitment. In conclusion, despite methodological limitations, this study contributes to the validation of the ERI questionnaire in Danish language. Furthermore, by documenting associations with poor self-rated health, it supports efforts of theory-guided prevention of work stress in health care professions.
Duke, Naomi; Macmillan, Ross
Education is a key sociological variable in the explanation of health and health disparities. Conventional wisdom emphasizes a life course--human capital perspective with expectations of causal effects that are quasi-linear, large in magnitude for high levels of educational attainment, and reasonably robust in the face of measured and unmeasured…
Hämmig, Oliver; Gutzwiller, Felix; Kawachi, Ichiro
We sought to examine the joint and independent contributions of working conditions and health-related behaviours in explaining social gradients in self-rated health (SRH). Nationally representative cross-sectional data from the Swiss Health Survey of 2007 were used for this study. Bi- and multivariate statistical analyses were carried out on a sample of 6950 adult employees of working age. We examined a comprehensive set of five health behaviours and lifestyle factors as well as twelve physical and psychosocial work factors as potential mediators of the relationship between social status and SRH. Analyses were stratified by sex and performed using two measures of social status, educational level and occupational position. Strong social gradients were found for SRH, but mainly in men whereas in women the associations were either not linear (educational level) or not statistically significant (occupational position). Social gradients were also found for most lifestyle and all physical and psychosocial work factors studied. These three groups of factors equally contributed to and largely accounted for the social gradients in SRH although not all of the individual factors turned out to be independent and significant risk factors for poor SRH. Such risk factors included physical inactivity and obesity, poor posture and no or low social support at work (both sexes), heavy smoking (men) and underweight, overweight, uniform arm or hand movements at work, monotonous work and job insecurity (women). In conclusion, social inequalities (or more precisely educational and occupational status differences) in SRH were more pronounced in men and can be attributed for the most part to a sedentary lifestyle and to a physically demanding and socially unsupportive and insecure work environment. Apart from this main finding and overall pattern, sex-specific risk profiles were observed with regard to SRH and need to be taken into consideration.
Taloyan, Marina; Wajngot, Alexandre; Johansson, Sven-Erik; Tovi, Jonas; Sundquist, Jan
Objective Several studies indicate that ethnicity may be a strong predictor of poor self-rated health (SRH). The aims of the present study were to investigate whether there was an association between ethnicity and poor SRH in subjects with type 2 diabetes and to determine if the association remained after adjusting for possible confounders such as age, gender employment, marital status, and education. Design A cross-sectional study based on a patient population in the town of Södertälje. An unconditional logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs). Setting Four primary health care centers. Subjects A total of 354 individuals were included: Assyrian/Syrian-born (n = 173) and Swedish-born (n = 181). Results The odds ratio for rating poor SRH for Assyrian/Syrian subjects with type 2 diabetes was 4.5 times higher (95% CI = 2.7–7.5) than for Swedish patients in a crude model. After adjusting for possible confounders, unemployed/retired people had 5.4 times higher odds for reporting poor SRH than employees (OR = 5.4; 95% CI = 2.3–12.5). Women had 1.8 times higher odds (95% CI = 1.0–3.0) for reporting poor SRH than men. In the final model poor SRH among Assyrians/Syrians decreased but still remained significant (OR=3.7; 95% CI = 2.5–6.6). Conclusions The findings in this study are important for planning primary health care services. They highlight the crucial importance of being aware of the subjective health status of immigrants fleeing from war in the Middle East and resettling in Sweden. PMID:20608888
Bécares, Laia; Nazroo, James; Albor, Christo; Chandola, Tarani; Stafford, Mai
Recent discourses in the area of neighbourhood effects on health have advocated for a relational perspective of space and place, focussing on the mutually reinforcing and reciprocal relationship between the environment and the individual. An example of such relationship is that of the interaction between area deprivation and individual ethnicity on reports of self-rated health, which we explored using cross-sectional data from the 2007 Citizenship Survey linked to the 2001 UK census. We aimed to examine whether the association between area deprivation and poor self-rated health differs for ethnic minority groups, as compared to white British people. Following from this, we also examined whether possible differential associations were mediated by ethnic density effects and perceptions of and satisfaction with neighbourhood characteristics. Results of random effects multilevel logistic regression models showed the detrimental association between area deprivation and self-rated health to be of greater magnitude and stronger for white British people than for ethnic minority people. This differential association was not mediated by ethnic density effects or perceptions of and satisfaction with neighbourhood characteristics.
Molina, Kristine M.; Alegría, Margarita; Mahalingam, Ramaswami
Background Few studies have examined the psychosocial mechanisms through which self-reported discrimination may influence the health status of Latinos. Purpose This study examined the mediating role of subjective social status in the US and psychological distress on the relation between everyday discrimination and self-rated physical health, and the moderating role of gender and ethnicity. Methods A US population-based sample of Latinos (N= 2,554) was drawn from the National Latino and Asian American Study. Respondents completed measures of everyday discrimination, subjective social status, psychological distress, and self-rated physical health. Results Path analysis revealed that among the total sample, subjective social status and psychological distress sequentially mediated the effect of everyday discrimination on self-rated physical health. Psychological distress was a more consistent mediator across Latino subgroups. Gender and ethnicity moderated the mediation model. Conclusions This study provides a systematic examination of how psychosocial mechanisms may operate differently or similarly across Latino subgroups. PMID:23054945
Landefeld, John C; Burmaster, Katharine B; Rehkopf, David H; Syme, S Leonard; Lahiff, Maureen; Adler-Milstein, Sarah; Fernald, Lia C H
Poverty, both absolute and relative, is associated with poorer health. This is of particular concern in middle- and low-income countries facing a significant and growing burden of disease. There has been limited research specifically on whether interventions that increase income may foster better health outcomes. The establishment of a "living wage" apparel factory in the Dominican Republic provided a minimum income standard for factory workers, thus creating a natural experiment through which to study the effects of increased income on health indicators. The primary component of the intervention was a 350% wage increase, but apparel workers in the intervention factory also received education and professional development and were exposed to an enhanced occupational health and safety program. Workers at the intervention factory (n = 99) were compared with workers at a matched apparel factory (n = 105). Data were collected via in-person interviews in July and August of 2011, which was 15-16 months after workers were initially hired at the intervention site. Primary analyses used employment at the intervention factory as the independent variable and examined associations with two dependent variables: subjective social status and self-rated health. Results showed that receiving a 350% higher wage was associated with substantially higher subjective social status scores, as well as higher global and comparative self-rated health scores; effects were strongest in women. Subjective social status and self-rated health are associated with future health outcomes, so these results indicate that income increases for apparel workers may have positive long-term health outcomes, particularly for women.
Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i) purpose of instrument, (ii) construct measured, (iii) contents of construct, (iv) local idioms employed, (v) structure of response sets, and (vi) comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS) in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64) aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old). The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Global Assessment of Psychosocial Disability (GAPD) were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC) = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14); CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20). The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7), "feeling that life is not worth living" (DSRS.10), and "feeling
Sanchez, Gabriel R.; Vargas, Edward D.
A growing body of research seeks to understand how language bias in survey research impacts our abilities to make generalizations in the study of racial and ethnic disparities. This research uses a wording experiment to assess self-rated health among a representative study of the Latino population (n=1,200). Our analysis shows that by manipulating only the translation of the category fair health into Spanish we are able to directly test the hypothesis that the translation of fair to regular in Spanish suppresses Latino self-rated health. We find convincing evidence through the use of logistic and multinomial logistic regressions that respondents provided with the term regular report poorer health when compared to those who were given the alternative translation of mas o menos. We also find that this translation effect is driven solely by a movement of respondents to choose fair rather than good health, which can in fact explain lower than expected health status rates in studies looking to explore differences between Latinos and non-Latinos. This research informs the study of racial and ethnic disparities, providing a detailed explanation for mixed findings in the Latino health disparities literature. PMID:26439110
Much of the literature on mental and physical health among religious LGB individuals has relied on small-N convenience samples. This study takes advantage of a unique, large-N, population-based dataset to test the relationship between religious identity, religious activity, and health, with a specific emphasis on Utah Mormons. In a surprising finding, Mormon LGBs report better mental health than non-Mormon LGBs, while their self-rated and physical health is not significantly different. However, there is some evidence that Mormon LGBs derive fewer health benefits from church attendance than their non-LGB Mormon counterparts. These results may nuance the conventional wisdom regarding the health dynamics of LGB individuals who identify with a conservative, heteronormative religious tradition, and plausible explanations are discussed.
OBJECTIVES: With an increasing number of studies highlighting regional social capital (SC) as a determinant of health, many studies are using multi-level analysis with merged and averaged scores of community residents’ survey responses calculated from community SC data. Sufficient examination is required to validate if the merged and averaged data can represent the community. Therefore, this study analyzes the validity of the selected indicators and their applicability in multi-level analysis. METHODS: Within and between analysis (WABA) was performed after creating community variables using merged and averaged data of community residents’ responses from the 2013 Community Health Survey in Korea, using subjective self-rated health assessment as a dependent variable. Further analysis was performed following the model suggested by WABA result. RESULTS: Both E-test results (1) and WABA results (2) revealed that single-level analysis needs to be performed using qualitative SC variable with cluster mean centering. Through single-level multivariate regression analysis, qualitative SC with cluster mean centering showed positive effect on self-rated health (0.054, p<0.001), although there was no substantial difference in comparison to analysis using SC variables without cluster mean centering or multi-level analysis. CONCLUSIONS: As modification in qualitative SC was larger within the community than between communities, we validate that relational analysis of individual self-rated health can be performed within the group, using cluster mean centering. Other tests besides the WABA can be performed in the future to confirm the validity of using community variables and their applicability in multi-level analysis. PMID:27292102
Levin-Aspenson, Holly F; Watson, David
Respondents may answer sensitive questions differently depending on the mode of assessment (e.g., questionnaire, interview). The possibility of differences in these mode effects across groups is an important assessment consideration given the implications for test-score validity and bias. Although differences in mode effects are highly relevant to issues in clinical assessment, research is limited and generally fails to make use of psychometrically sound methods. The present research argues for greater attention to demographic differences in mode effects with regard to the assessment of psychopathology. Analyses of differences in mode effects in depression assessment are presented for gender, age, and education based on data from 440 community adults. Depression symptom ratings from a structured clinical interview were regressed on a self-report state depression composite score; analyses tested for differences of intercept and slope across gender, age, and education. Neither slope nor intercept differences were found for gender, but intercept differences were obtained for both age and level of education. These results indicate that younger and better educated respondents receive somewhat lower than expected ratings of depression in interviews, given their level of self-rated symptoms. These findings suggest that use of a single mode of assessment over- or underpredicts depression in certain participants. More generally, they demonstrate the value of multimethod assessment of psychopathology and justify further inquiry into mode-effect differences in clinical assessment. (PsycINFO Database Record
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Background The association between self-rated health (SRH) and mortality is well documented in the literature, but studies on the subject among young adults in Latin America are rare, as are those evaluating this association using repeated SRH measures, beyond the baseline measurement. This study aims to evaluate the association between SRH evaluated at three data collection stages and mortality. Methods Cox regression models were used to examine the association between SRH (Very good, Good, Fair/Poor) varying over time and mortality, over a 10 year period, in a cohort of non-faculty civil servants at a public university in Rio de Janeiro, Brazil (Pró-Saúde Study, n = 4009, men = 44.4%). Results About 40% of the population changed their self-rating over the course of follow-up. After adjustment for self-reported physician-diagnosed chronic diseases and other covariates, men who reported “Fair/Poor” SRH showed relative hazard of death of 2.13 (CI95% 1.03-4.40) and women, 3.43 (CI95% 1.23-9.59), as compared with those who reported “Very good” SRH. Conclusions In a population of young adults, our findings reinforce the role of SRH as a predictor of mortality, even controlling for objective measures of health. PMID:22905737
Dai, Yue; Zhang, Chen-Yun; Zhang, Bao-Quan; Li, Zhanzhan; Jiang, Caixiao; Huang, Hui-Ling
The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors.We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ test, a linear regression analysis, and a multiple-level model were performed to analyze the results.The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068-6.516, P = 0.000), age (-0.805, 95% CI: -1.394 to -0.135, P = 0.013), marital status (-1.260, 95% CI: -1.891 to -0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022-5.116, P = 0.000), and SRH -1.941, 95% CI: -3.194 to -0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ = 5.103, P < 0.001). Marital status (-2.133, 95% CI: -2.768 to -1.499, P = 0
Huh, Jimi; Prause, Jo Ann; Dooley, C David
This study examines the physical health status of immigrants with specific considerations of Asian and Hispanic populations and explores possible mechanisms through which health outcomes of interest can be explained. Analyses of the National Health Interview Surveys (NHIS) of 2000 and 2001 revealed that foreign-born individuals reported fewer chronic diseases (hypertension, heart disease, asthma, cancer and diabetes) and had lower prevalences of various chronic diseases compared with U.S.-born whites, controlling for possible confounders and mediators. However, U.S-born minority groups did not show the health advantage seen in foreign-born immigrants, reflecting the importance of nativity distinctions in studying immigrant health. Despite having fewer chronic diseases, foreign-born Asians were more likely to rate their health negatively relative to their U.S.-born counterparts and to U.S.-born whites. In addition, our findings provide evidence that failure to consider comorbid status may attenuate the nativity effect on certain chronic diseases.
Schmiege, S; Hale, JW; Buchenau, M.; Sancar, F.
Rationale The social, emotional, and mental health benefits associated with gardening have been well documented. However, the processes underlying the relationship between garden participation and improvements in health status have not been sufficiently studied. Methods Using population-based survey data (n = 469 urban residents), objective street environment data, and area-level measures, this research used a path analytic framework to examine several theoretically based constructs as mediators between gardening history and self-reported health. Results The results showed that garden participation influenced health status indirectly through social involvement with one’s community, perceived aesthetic appeal of the neighborhood, and perceived collective efficacy. Gardeners, compared to non-gardeners, reported higher ratings of neighborhood aesthetics and more involvement in social activities, whereas aesthetics and involvement were associated with higher ratings of collective efficacy and neighborhood attachment. Collective efficacy, but not neighborhood attachment, predicted self-rated health. Gardening also directly influenced improved fruit and vegetable intake. The physical and social qualities of garden participation may therefore stimulate a range of interpersonal and social responses that are supportive of positive ratings of health. Conclusion This research suggests that community planners and health professionals should aim to strengthen the social and aesthetic relationships while designing environments and policies as a way to ignite intermediate processes that may lead to improved health status. PMID:26372933
Ruijsbroek, Annemarie; Droomers, Mariël; Groenewegen, Peter P; Hardyns, Wim; Stronks, Karien
The aim of this study was to examine whether changes over time in reported area crime and perceived area safety were related to self-rated general health and physical activity (PA), in order to provide support for a causal relationship between social safety and health. Additionally, we investigated whether social cohesion protects the residents against the negative impact of unsafe areas on health and PA. Multilevel logistic regression analyses were performed on Dutch survey data, including 47,926 respondents living in 2974 areas. An increase in area level unsafety feelings between 2009 and 2011 was associated with more people reporting poor general health in 2012 in that area, but was not related to PA. Changes in reported area crime were not related to either poor general health or PA. The social cohesion in the area did not modify the effect of changes in social safety on health and PA. The results suggest that tackling feelings of unsafety in an area might contribute to the better general health of the residents. Because changes in area social safety were not associated with PA, we found no leads that such health benefits were achieved through an increase in physical activity.
Reynolds, Megan M.; Brady, David
Previous research suggests that higher incomes, safe workplaces, job security and healthcare access all contribute to favorable health. Reflecting the interest of economic and political sociologists in power relations and institutions, union membership has been linked with many such influences on health. Nevertheless, the potential relationship…
van der Kooi, Anne L. F.; Stronks, Karien; Thompson, Caroline A.; DerSarkissian, Maral
Objectives. We investigated how much the Human Development Index (HDI), a global measure of development, modifies the effect of education on self-reported health. Methods. We analyzed cross-sectional World Health Survey data on 217 642 individuals from 49 countries, collected in 2002 to 2005, with random-intercept multilevel linear regression models. Results. We observed greater positive associations between educational levels and self-reported good health with increasing HDI. The magnitude of this effect modification of the education–health relation tended to increase with educational attainment. For example, before adjustment for effect modification, at comparable HDI, on average, finishing primary school was associated with better general health (b = 1.49; 95% confidence interval [CI] = 1.18, 1.80). With adjustment for effect modification by HDI, the impact became 4.63 (95% CI = 3.63, 5.62) for every 0.1 increase in HDI. Among those who completed high school, these associations were, respectively, 5.59 (95% CI = 5.20, 5.98) and 9.95 (95% CI = 8.89, 11.00). Conclusions. The health benefits of educational attainment are greater in countries with greater human development. Health inequalities attributable to education are, therefore, larger in more developed countries. PMID:24028233
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The study investigates the health effects of subjective class position stratified by objective social position. Four types of subjective class were analysed separately for individuals with manual or non-manual occupational background. The cross-sectional analysis is based on the Swedish Level-of-Living Survey from 2000 and includes 4,139…
Li, Fei; Chen, Jieyu; Yu, Lin; Jing, Yuan; Jiang, Pingping; Fu, Xiuqiong; Wu, Shengwei; Sun, Xiaomin; Luo, Ren; Kwan, Hiuyee; Zhao, Xiaoshan; Liu, Yanyan
Background: To examine whether stress management mediates the relationship between purpose in life and self-rated health status (SRH). Methods: A cross-sectional survey was conducted among 6840 teachers in 2013 in Guangzhou, China. Purpose in life was assessed through the Purpose in Life Subscale of the Psychological Well-being Scale. Stress management was assessed using the eight-item questionnaire adapted from the Health-promoting Lifestyle Profile II. SRH was assessed by the Suboptimal Health Measurement Scale Version 1.0. The mediation hypothesis was tested by the structural equation model for path analysis. Results: It was found that purpose in life had direct and indirect effects on SRH. The path analysis showed the total effect (β = 0.563) of purpose in life on SRH was comprised of a direct effect (β = 0.319) and an indirect effect (β = 0.244), which was mediated by stress management. Conclusions: By supporting the mediation hypothesis, our results indicate that stress management mediated the effect of purpose in life on SRH. Enhancement of teachers’ purpose in life and improvement of training skills of stress management should be incorporated in the strategy of improving teachers’ health. PMID:27438843
A recent systematic review and meta-analysis has shown the effect of indoor mildew odour on allergic rhinitis risk, but its relation to other common chronic health outcomes in adults has not been investigated. Therefore, it was aimed to examine the relationship of indoor mildew odour and common health outcomes in adults in a national and population-based setting. Data was retrieved from the United States National Health and Nutrition Examination Surveys, 2005-2006, including the available information on demographics, housing characteristics, self-reported health conditions and urinary concentrations of environmental chemicals. T test, chi-squared test and survey-weighted logistic regression modelling were performed. Of all American adults (n = 4979), 744 (15.1%) reported indoor mildew odour or musty smell in their households. People who reported indoor mildew odour or musty smell also reported poorer self-rated health, sleep complaints, chronic bronchitis, asthma attack, itchy rash, sneezing and poor vision. In addition, people who reported indoor mildew odour or musty smell also tended to reside in older housing that were built 20 years earlier. However, there were no significant statistical associations found between indoor mildew odour or musty smell and urinary concentrations of environmental chemicals, which was also found to be associated with old housing. People who lived in older housing with indoor mildew odour or musty smell tended to have chronic health problems. To protect occupants in old housing from chronic illnesses associated with indoor mildew odour, elimination of the odour sources should be explored in future research and therefore public health and housing programs. Graphical abstract Pathway from old housing to musty smell, environmental chemicals and then health outcomes.
Heshmat, Ramin; Qorbani, Mostafa; Safiri, Saeid; Eslami-Shahr Babaki, Amir; Matin, Nassim; Motamed-Gorji, Nazgol; Motlagh, Mohammad-Esmaeil; Djalalinia, Shirin; Ardalan, Gelayol; Mansourian, Morteza; Asayesh, Hamid; Kelishadi, Roya
Objective To assess the joint association of passive and active smoking with self-rated health and life satisfaction among Iranian children and adolescents. Methods Using a multistage random cluster sampling method, a representative sample of 14 880 school students were selected from urban and rural areas of 30 provinces of Iran. Data were gathered using a questionnaire, a weight scale and metre. Participants were classified into four groups based on their smoking patterns: ‘non-smoker’, ‘only active smoker’, ‘only passive smoker’ and ‘active and passive smoker’. Life satisfaction (LS) and self-rated health (SRH) were assessed by self-administered validated questionnaires based on the WHO-Global School-based student Health Survey (WHO-GSHS). Data were analysed using a t-test, χ2 test and multiple logistic regression. Results A total of 13 486 individuals (6640 girls and 6846 boys) out of 14 880 invited participated in the study (response rate 90.6%). LS and good SRH showed linearly negative associations with smoking status in both sexes. The proportions of LS and SRH categories were significantly different among all subsets of smoking status. Those classified as ‘non-smokers’ had the highest proportions of LS and good SRH, followed by ‘only passive smokers’ and ‘only active smokers’, while those with ‘active and passive smoking’ had the lowest proportions of LS and good SRH. In a multivariate model, students in the ‘active and passive smoking’ group had lower odds of LS (OR 0.43; 95% CI 0.32 to 0.57) and good SRH (OR 0.51; 95% CI 0.38 to 0.68) than those in the ‘non-smoker’ group. Students in the ‘only passive smoker’ group also had lower odds of LS (OR 0.75; 95% CI 0.67 to 0.83) and good SRH (OR 0.72; 95% CI 0.66 to 0.80) compared with the ‘non-smoker’ group. Conclusions Adolescents with different smoking habits and exposure patterns have poorer SRH and LS than non-smokers. Both active and passive smoking
Background Social conditions, social relationships and neighbourhood environment, the components of social capital, are important determinants of health. The objective of this study was to investigate the association of neighbourhood and individual social capital with consistent self-rated health in women between the first trimester of pregnancy and six months postpartum. Methods A multilevel cohort study in 34 neighbourhoods was performed on 685 Brazilian women recruited at antenatal units in two cities in the State of Rio de Janeiro, Brazil. Self-rated health (SRH) was assessed in the 1st trimester of pregnancy (baseline) and six months after childbirth (follow-up). The participants were divided into two groups: 1. Good SRH – good SRH at baseline and follow-up, and, 2. Poor SRH – poor SRH at baseline and follow-up. Exploratory variables collected at baseline included neighbourhood social capital (neighbourhood-level variable), individual social capital (social support and social networks), demographic and socioeconomic characteristics, health-related behaviours and self-reported diseases. A hierarchical binomial multilevel analysis was performed to test the association between neighbourhood and individual social capital and SRH, adjusted for covariates. Results The Good SRH group reported higher scores of social support and social networks than the Poor SRH group. Although low neighbourhood social capital was associated with poor SRH in crude analysis, the association was not significant when individual socio-demographic variables were included in the model. In the final model, women reporting poor SRH both at baseline and follow-up had lower levels of social support (positive social interaction) [OR 0.82 (95% CI: 0.73-0.90)] and a lower likelihood of friendship social networks [OR 0.61 (95% CI: 0.37-0.99)] than the Good SRH group. The characteristics that remained associated with poor SRH were low level of schooling, Black and Brown ethnicity, more children
Pega, Frank; Carter, Kristie; Kawachi, Ichiro; Davis, Peter; Blakely, Tony
It is hypothesized that unconditional (given without obligation) publicly funded financial credits more effectively improve health than conditional financial credits in high-income countries. We previously reported no discernible short-term impact of an employment-conditional tax credit for families on self-rated health (SRH) in adults in New Zealand. This study estimates the effect of an unconditional tax credit for families, called Family Tax Credit (FTC), on SRH in the same study population and setting. A balanced panel of 6900 adults in families was extracted from seven waves (2002-2009) of the Survey of Family, Income and Employment. The exposures, eligibility for and amount of FTC, were derived by applying government eligibility and entitlement criteria. The outcome, SRH, was collected annually. Fixed effects regression analyses eliminated all time-invariant confounding and adjusted for measured time-varying confounders. Becoming eligible for FTC was associated with a small and statistically insignificant change in SRH over the past year [effect estimate: 0.013; 95% confidence interval (CI) -0.011 to 0.037], as was an increase in the estimated amount of FTC by $1000 (effect estimate: -0.001; 95% CI -0.006 to 0.004). The unconditional tax credit for families had no discernible short-term impact on SRH in adults in New Zealand. It did not more effectively improve health status than an employment-conditional tax credit for families.
Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M.; Bohr, Vilhelm A.
The IARU Congress on Aging, Longevity and Health, held on 5–7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health. PMID:21820462
Rasmussen, Lene Juel; Sander, Miriam; Wewer, Ulla M; Bohr, Vilhelm A
The IARU Congress on Aging, Longevity and Health, held on 5-7 October 2010 in Copenhagen, Denmark, was hosted by Rector Ralf Hemmingsen, University of Copenhagen and Dean Ulla Wewer, Faculty of Health Sciences, University of Copenhagen and was organized by Center for Healthy Aging (CEHA) under the leadership of CEHA Managing Director Lene Juel Rasmussen and Prof. Vilhelm Bohr, National Institute on Aging, NIH, Baltimore, USA (associated to CEHA). The Congress was attended by approximately 125 researchers interested in and/or conducting research on aging and aging-related topics. The opening Congress Session included speeches by Ralf Hemmingsen, Ulla Wewer, and Lene Juel Rasmussen and Keynote Addresses by four world renowned aging researchers: Povl Riis (The Age Forum), Bernard Jeune (University of Southern Denmark), George Martin (University of Washington, USA) and Jan Vijg (Albert Einstein School of Medicine, USA) as well as a lecture discussing the art-science interface by Thomas Söderqvist (Director, Medical Museion, University of Copenhagen). The topics of the first six Sessions of the Congress were: Neuroscience and DNA damage, Aging and Stress, Life Course, Environmental Factors and Neuroscience, Muscle and Life Span and Life Span and Mechanisms. Two additional Sessions highlighted ongoing research in the recently established Center for Healthy Aging at the University of Copenhagen. This report highlights outcomes of recent research on aging-related topics, as described at the IARU Congress on Aging, Longevity and Health.
Charters, Thomas J; Harper, Sam; Strumpf, Erin C; Subramanian, S V; Arcaya, Mariana; Nandi, Arijit
The recent housing crisis offers the opportunity to understand the effects of unique indicators of macroeconomic conditions on health. We linked data on the proportion of mortgage borrowers per US metropolitan-area who were at least 90 days delinquent on their payments with individual-level outcomes from a representative sample of 1,021,341 adults surveyed through the Behavioral Risk Factor Surveillance System (BRFSS) between 2003 and 2010. We estimated the effects of metropolitan-area mortgage delinquency on individual health behaviors, medical coverage, and health status, as well as whether effects varied by race/ethnicity. Results showed that increases in the metropolitan-area delinquency rate resulted in decreases in heavy alcohol consumption and increases in exercise and health insurance coverage. However, the delinquency rate was also associated with increases in smoking and obesity in some population groups, suggesting the housing crisis may have induced stress-related behavioral change. Overall, the effects of metropolitan-area mortgage delinquency on population health were relatively modest.
Krause, Laura; Lampert, Thomas
This study investigates the relation between overweight/obesity and self-rated health (SRH), and whether this relation varies by social factors. Data was taken from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, baseline 2003‒2006). For the definition of overweight and obesity, body mass index was calculated based on standardized height and weight measurements. SRH of adolescents (n = 6813, 11‒17 years) was raised with the question: "How would you describe your health in general?" The response categories were "very good", "good", "fair", "poor", and "very poor". We dichotomized these responses into: "very good/good" vs. "fair/poor/very poor". Socio-economic status (SES) in the family of origin and adolescents' school type were analyzed as modifying factors. Prevalence and age-adjusted odds ratios with 95% confidence intervals were calculated by binary logistic regression models. We found that overweight and obese boys and obese girls reported fair to very poor SRH more often than their normal weight peers, and that these differences were more apparent in early than late adolescence. In addition, the relation between obesity and SRH was similarly strong in all sub-groups, but there was seldom a relation between overweight and SRH. In summary, the results show that obesity is linked to poor SRH regardless of SES and school type, while the relation between overweight and SRH varies by social factors among adolescents.
Background Pelvic girdle pain (PGP) in pregnancy is distinct from pregnancy-related low back pain (PLBP). However, women with combined PLBP and PGP report more serious consequences in terms of health and function. PGP has been estimated to affect about half of pregnant women, where 25% experience serious pain and 8% experience severe disability. To date there are relatively few studies regarding persistent PLBP/PGP postpartum of more than 3 months, thus the main objective was to identify the prevalence of persistent PLBP and PGP as well as the differences over time in regard to pain status, self-rated health (SRH) and family situation at 12 months postpartum. Methods The study is a 12 month follow-up of a cohort of pregnant women developing PLBP and PGP during pregnancy, and who experienced persistent pain at 6 month follow-up after pregnancy. Women reporting PLBP/PGP (n = 639) during pregnancy were followed up with a second questionnaire at approximately six month after delivery. Women reporting recurrent or persistent LBP/PGP at the second questionnaire (n = 200) were sent a third questionnaire at 12 month postpartum. Results A total of 176 women responded to the questionnaire. Thirty-four women (19.3%) reported remission of LBP/PGP, whereas 65.3% (n = 115) and 15.3% (n = 27), reported recurrent LBP/PGP or continuous LBP/PGP, respectively. The time between base line and the 12 months follow-up was in actuality 14 months. Women with previous LBP before pregnancy had an increased odds ratio (OR) of reporting ‘recurrent pain’ (OR = 2.47) or ‘continuous pain’ (OR = 3.35) postpartum compared to women who reported ‘no pain’ at the follow-up. Women with ‘continuous pain’ reported statistically significant higher level of pain at all measure points (0, 6 and 12 months postpartum). Non-responders were found to report a statistically significant less positive scoring regarding relationship satisfaction compared to responders
Pförtner, Timo-Kolja; Schmidt-Catran, Alexander W
In this study, we investigated whether self-rated health (SRH) can be predicted by in-work poverty and how between-persons and within-person differences in the poverty status of people who are working contribute to this relationship. We used a logistic random-effects model designed to test within-person and between-persons differences with data from a nationally representative German sample with 19 waves of data collection (1995-2013) to estimate effects of between-persons and within-person differences in working poverty status on poor SRH. Interactions by age and sex were tested, and models controlled for sociodemographic, socioeconomic, and work-related characteristics. We found significant differences in SRH between individuals with different working poverty status but no evidence that within-person differences in working poverty status are associated with poor SRH. The association between in-work poverty and SRH was significantly stronger for women but did not differ significantly by age. All findings were robust when including sociodemographic, socioeconomic, and working characteristics. In this sample of German adults, we found a polarization of poor SRH between the working nonpoor and the working poor but no causal association of within-person differences in working poverty status with SRH.
Health-related quality of life in Huntington's disease patients: a comparison of proxy assessment and patient self-rating using the disease-specific Huntington's disease health-related quality of life questionnaire (HDQoL).
Hocaoglu, Mevhibe B; Gaffan, E A; Ho, Aileen K
Huntington's disease (HD) is a fatal, neurodegenerative disease for which there is no known cure. Proxy evaluation is relevant for HD as its manifestation might limit the ability of persons to report their health-related quality of life (HrQoL). This study explored patient-proxy ratings of HrQoL of persons at different stages of HD, and examined factors that may affect proxy ratings. A total of 105 patient-proxy pairs completed the Huntington's disease health-related quality of life questionnaire (HDQoL) and other established HrQoL measures (EQ-5D and SF-12v2). Proxy-patient agreement was assessed in terms of absolute level (mean ratings) and intraclass correlation. Proxies' ratings were at a similar level to patients' self-ratings on an overall Summary Score and on most of the six Specific Scales of the HDQoL. On the Specific Hopes and Worries Scale, proxies on average rated HrQoL as better than patients' self-ratings, while on both the Specific Cognitive Scale and Specific Physical and Functional Scale proxies tended to rate HrQoL more poorly than patients themselves. The patient's disease stage and mental wellbeing (SF-12 Mental Component scale) were the two factors that primarily affected proxy assessment. Proxy scores were strongly correlated with patients' self-ratings of HrQoL, on the Summary Scale and all Specific Scales. The patient-proxy correlation was lower for patients at moderate stages of HD compared to patients at early and advanced stages. The proxy report version of the HDQoL is a useful complementary tool to self-assessment, and a promising alternative when individual patients with advanced HD are unable to self-report.
Building a new life in Australia: an analysis of the first wave of the longitudinal study of humanitarian migrants in Australia to assess the association between social integration and self-rated health
Chen, Wen; Ling, Li; Renzaho, Andre M N
Objectives To assess the relationship between social integration and physical and mental health among humanitarian migrants (HMs) in Australia. Design, setting and participants We used the recently released first wave of data from the 2013 ‘Building a New Life in Australia’ survey, which is an ongoing nationwide longitudinal study. A total of 2399 HMs participated in the survey. Main outcome measures Self-rated physical health was measured using four items selected from the SF-36 which is a generic measure of health status. The 6-item Kessler Screening Scale for Psychological Distress (K6) was used to measure mental health. Social integration was measured using four dimensions: economic integration, acculturation, social capital and self-identity. Results More than half (63%), 47% and 49% of participants self-rated well on the general health, physical function and role-physical dimensions, respectively and 46% reported not having any bodily pain. Seventeen per cent of participants had a serious mental illness. There was a positive relationship between social integration and physical and mental health. That is, factors associated with better health included less financial hardship (economic integration dimension), better English proficiency and self-sufficiency (acculturation dimension), having the capacity to communicate with locals, having friends from different ethnic/religious groups and attending a place of worship weekly or more often (social capital dimension) and feeling welcomed and having a strong sense of belonging in Australia (self-identity dimension). Conclusions Using a more comprehensive framework of social integration, we found that greater social integration was associated with better physical and mental health outcomes among HMs. Social integration should be embedded in HMs' resettlement programmes in order to reduce migration-related health inequities. PMID:28298368
Kim, Bum Jung; Lee, Yura; Sangalang, Cindy; Harris, Lesley M
Extensive research has demonstrated a relationship between socioeconomic factors and health among older adults, yet fewer studies have explored this relationship with older immigrants. This study aims to examine the influence of employment and self-rated economic condition on the subjective well-being of older Korean immigrants in the United States. Data were drawn from a cross-sectional study of 205 older Korean immigrants, aged 65 to 90, in Los Angeles County. Hierarchical regression was employed to explore the independent and interactive effects of employment status and self-rated economic condition. The study found that employment and self-rated economic status were positively associated with subjective well-being. Also, the interaction between employment and self-rated economic status was significantly associated with higher levels of subjective well-being, such that the influence of self-rated economic condition was stronger for unemployed older Korean immigrants compared with those who were employed. This population-based study provides empirical evidence that employment and self-rated economic condition are directly associated with subjective well-being for older Korean immigrants.
Health maintenance visit - women - ages 40 to 64; Physical exam - women - ages 40 to 64; Yearly exam - ... 64; Checkup - women - ages 40 to 64; Women's health - ages 40 to 64; Preventive care - women - ages ...
Health maintenance visit - men - over age 65; Physical exam - men - over age 65; Yearly exam - men - over age 65; Checkup - men - over age 65; Men's health - over age 65; Preventive care exam - men - over ...
Health maintenance visit - women - over age 65; Physical exam - women - over age 65; Yearly exam - women - over age 65; Checkup - women - over age 65; Women's health - over age 65; Preventive care exam - women - over ...
Health maintenance visit - men - ages 40 to 64; Physical exam - men - ages 40 to 64; Yearly exam - ... 64; Checkup - men - ages 40 to 64; Men's health - ages 40 to 64; Preventive care - men - ages ...
Health maintenance visit - women - ages 18 to 39; Physical exam - women - ages 18 to 39; Yearly exam - ... 39; Checkup - women - ages 18 to 39; Women's health - ages 18 to 39; Preventive care - women - ages ...
Jones, W. L.
Space age health care delivery is being delivered to both NASA astronauts and employees with primary emphasis on preventive medicine. The program relies heavily on comprehensive health physical exams, health education, screening programs and physical fitness programs. Medical data from the program is stored in a computer bank so epidemiological significance can be established and better procedures can be obtained. Besides health care delivery to the NASA population, NASA is working with HEW on a telemedicine project STARPAHC, applying space technology to provide health care delivery to remotely located populations.
gender such that energy level declined with older age for males, but energy level was lowest for females in the 35-49 age group. The correlations...psychosocial function," Journal of the American Medical Association, Vol. 185, 1963, pp. 914-919. Health Status 42 Koenig, H., "Depression and dysphoria among
Health maintenance visit - men - ages 18 to 39; Physical exam - men - ages 18 to 39; Yearly exam - ... 39; Checkup - men - ages 18 to 39; Men's health - ages 18 to 39; Preventive care exam - men - ...
Do perceived job insecurity and annoyance due to air and noise pollution predict incident self-rated poor health? A prospective analysis of independent and joint associations using a German national representative cohort study
Riedel, Natalie; Loerbroks, Adrian; Bolte, Gabriele; Li, Jian
Background Current economic and social change has contributed to increasing job insecurity and traffic-related pollution in residential areas. Both job insecurity and exposure to noise and air pollution are known determinants of population health and can concur in peoples' lives. This may hold true particularly for socially disadvantaged subpopulations. Nevertheless, the potential independent and joint links of those exposures to health have been rarely examined so far. We aimed to contribute to the scarce body of evidence. Methods Information on perceived job insecurity and exposures to noise and air pollution as expressed by annoyance as well as on self-rated health were gathered from 2 waves of the population-based German Socio-Economic Panel (2009 and 2011, N=6544). We performed multivariable Poisson regression to examine the independent and joint risk of poor health in 2011 by perceived job insecurity and annoyance due to noise and air pollution in 2009. Results After the 2-year follow-up in 2011, 571 (8.7%) participants rated their health as poor. The risk of reporting incident poor health was increased by roughly 40% in employees reporting high versus low perceived job insecurity and annoyance due to noise and air pollution, respectively. This risk increased when both exposures were present at higher levels (risk ratio=1.95 (1.49 to 2.55)). Conclusions Work-related and environmental exposures may accumulate and have a joint health impact. Elaboration on the link between occupational and residential exposures is warranted in the light of their concurrence and their implications for health inequities. PMID:28115332
Steptoe, Andrew; Deaton, Angus; Stone, Arthur A
Subjective wellbeing and health are closely linked to age. Three aspects of subjective wellbeing can be distinguished-evaluative wellbeing (or life satisfaction), hedonic wellbeing (feelings of happiness, sadness, anger, stress, and pain), and eudemonic wellbeing (sense of purpose and meaning in life). We review recent advances in the specialty of psychological wellbeing, and present new analyses about the pattern of wellbeing across ages and the association between wellbeing and survival at older ages. The Gallup World Poll, a continuing survey in more than 160 countries, shows a U-shaped relation between evaluative wellbeing and age in high-income, English speaking countries, with the lowest levels of wellbeing in ages 45-54 years. But this pattern is not universal. For example, respondents from the former Soviet Union and eastern Europe show a large progressive reduction in wellbeing with age, respondents from Latin America also shows decreased wellbeing with age, whereas wellbeing in sub-Saharan Africa shows little change with age. The relation between physical health and subjective wellbeing is bidirectional. Older people with illnesses such as coronary heart disease, arthritis, and chronic lung disease show both increased levels of depressed mood and impaired hedonic and eudemonic wellbeing. Wellbeing might also have a protective role in health maintenance. In an analysis of the English Longitudinal Study of Ageing, we identify that eudemonic wellbeing is associated with increased survival; 29·3% of people in the lowest wellbeing quartile died during the average follow-up period of 8·5 years compared with 9·3% of those in the highest quartile. Associations were independent of age, sex, demographic factors, and baseline mental and physical health. We conclude that the wellbeing of elderly people is an important objective for both economic and health policy. Present psychological and economic theories do not adequately account for the variations in patterns
Palmer, Keith T; Goodson, Nicola
Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter, we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered.
Palmer, Keith; Goodson, Nicola
Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses, and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered. PMID:26612237
Marques, Adilson; Peralta, Miguel; Martins, João; Catunda, Ricardo; Matos, Margarida Gaspar de; Saboga Nunes, Luís
Although self-rated wellbeing is an indicator of health status, it has been receiving little attention; its relationship with physical activity among adults remains inconclusive. The purpose of this study was to analyse the relationship between physical activity and several dimensions of self-rated wellbeing in European adults. This cross-sectional study was based on data from the European Social Survey round 6, 2012, comprising 40,600 European adults (18,418 men, 22,186 women) from 27 countries, with mean age 42.1±13.3. Meeting physical activity guidelines was assessed using World Health Organization criteria. Six dimensions of the self-rated wellbeing were assessed (evaluative wellbeing, emotional wellbeing, functioning, vitality, community wellbeing, supportive wellbeing). Men and women who attained physical activity recommended levels had better evaluative wellbeing (men, p=0.009; women, p<0.001), emotional wellbeing (men, p<0.001; women, p<0.001), functioning (men, p<0.001; women, p<0.001), vitality (men, p<0.001; women, p<0.001), supportive relationships (men, p<0.001; women, p<0.001), and wellbeing total score (men, p<0.001; women, p<0.001). Physical activity frequency was linearly associated with self-rated wellbeing in the 6 dimensions as well as the wellbeing total score (p<0.001). Attaining recommended physical activity levels is related to better self-rated wellbeing, and more frequent physical activity is linearly associated with better self-rated wellbeing in its 6 dimensions.
Do socioeconomic differences in health status increase as people age, reflecting cumulative advantage or disadvantage in health trajectories? Life course research hypothesises that cumulative advantage/disadvantage (CAD) is an important underlying social process that shape inequalities as people age. The objective of this study is to examine whether health trajectories are diverging as people age across socioeconomic positions (education, employment status and income). In a random sample of 3,665 respondents living in Switzerland (Swiss Household Panel 2004-2011), trajectories of self-rated health, body mass index, depression and medicated functioning were examined with multilevel regression models. The results showed that employment status and income were associated with diverging health trajectories among men; however, only a few associations supported the CAD hypothesis. Education was rarely associated with diverging health trajectories. In conclusion, little evidence was found to support the CAD model.
Dogra, Shilpa; Al-Sahab, Ban; Manson, James; Tamim, Hala
The purpose of the current study was to determine whether aging expectations (AE) are associated with physical activity participation and health among older adults of low socioeconomic status (SES). A cross-sectional analysis of a sample of 170 older adults (mean age 70.9 years) was conducted. Data on AE, physical activity, and health were collected using the 12 item Expectations Regarding Aging instrument, the Healthy Physical Activity Participation Questionnaire, and the Short Form-36, respectively. Adjusted linear regression models showed significant associations between AE and social functioning, energy/vitality, mental health, and self-rated general health, as well as physical activity. These results suggest that AE may help to better explain the established association between low SES, low physical activity uptake, and poor health outcomes among older adults.
... This information in Spanish ( en español ) Paying for health care More information on paying for health care Better ... Coping without insurance More information on paying for health care Explore other publications and websites Age Page: Choosing ...
The study investigated the role of immigration status on self-rated health, general health, and well-being among elderly persons by comparing two groups of elderly persons who immigrated from Eastern European countries to Israel-veterans and new immigrants. It also examined the factors that explain self-rated health in both groups. Data for this study (n = 784) were taken from a study based on structured home interviews of a random sample of Israeli Jewish elderly (70+) conducted in 1994. The results show that the new immigrants are younger and have higher education than the veterans, but their economic status is lower and they have a lower percentage of men and married persons. The new immigrants also rank themselves lower than the veterans on a variety of measures of health and psycho-social well-being. It is suggested that the stress caused by immigration and factors related to the standard of living and health services in the countries of origin outweigh the relative advantage that the new immigrants have, in terms of age and education, in influencing their health and well-being. Self-rated health among the new immigrants is explained mainly by objective measures of health, economic status and a feeling of control over life, while among the veterans it is explained by these variables as well as by other psycho-social variables such as self-esteem and social support. These findings suggest careful analyses of subjective evaluations of health in different socio-cultural subgroups in society for theoretical reasons and for purposes of planning interventions directed to promote health and psycho-social well-being of elderly persons on the community level.
Mestheneos, Elizabeth; Withnall, Alexandra
The health of ageing populations is a real concern across the world so that the concept of active ageing has been advocated as a framework for appropriate educational policies and programmes to support people as they grow older. The other elements discussed here are health and healthy life expectancy (HLE) acknowledging that as people age, they…
Leventhal, Elaine A.; And Others
Health behavior may be influenced by age, beliefs, and symptomatology. To examine age-related health beliefs and behaviors with respect to six diseases (the common cold, colon-rectal cancer, lung cancer, heart attack, high blood pressure, and senility), 396 adults (196 males, 200 females) divided into three age groups completed a questionnaire…
Tiedt, Andrew D.; Grant, Kaelin; Dale, William
Objectives. To describe the rationale for the pain presence, location, and intensity measures in the National Social Life, Health and Aging Project (NSHAP). Method. Responses to the pain presence, location (pain map), and intensity (verbal descriptor scale) items were analyzed by gender and age (62–69, 70–79, and 80–91). Pain intensity was dichotomized (none to mild vs moderate or higher) and compared by demographics, physical function, mood, and self-rated health. All analyses used Wald tests to compare sample means. Results. Participants completed the pain presence (n = 2,430/2,799), location (n = 2,558/2,799), and intensity (n = 2,589/2,799) items. Pain items varied by gender with women reporting more head, arm, hip/buttock, leg, and foot pain compared to men, (p < .05) at each individual site. Women also reported more intense pain compared to men—2.13 versus 1.94, respectively (p < .05). Pain items demonstrated remarkable similarity among age cohorts. Health indicators were significant and in the expected direction (p < .001). An increase in comorbidity, ADL and IADL dependence, worse self-rated health, and more depressive symptoms were each significantly more common among participants who reported moderate or greater pain compared to none to mild pain. Discussion. Pain presence, location, and intensity measures were successfully integrated into NSHAP Wave 2 and exhibit construct and external validity. PMID:25360020
Background There is limited evidence about the ways in which maternal age and mode of conception interact with psychological, sociodemographic, health and health service factors in governing pregnancy health. The aim of this study was to establish in what ways maternal age and mode of conception are associated with, health behaviours, health service use and self-rated physical and mental health during pregnancy. Method A prospective cohort study was conducted in a collaboration between universities, infertility treatment services and public and private obstetric hospitals in Melbourne and Sydney, Australia,. Consecutive cohorts of nulliparous English-literate women at least 28 weeks pregnant who had conceived through ART (ARTC) or spontaneously (SC) in three age-groups: 20–30; 31–36 and at least 37 years were recruited. Data were obtained via structured individual telephone interviews and self-report postal questionnaires at recruitment and four months postpartum. Study-specific questions assessed: sociodemographic characteristics; reproductive health; health behaviours and health service use. Standardized instruments assessed physical health: SF 12 Physical Component Score (PCS) and mental health: SF12 Mental Component Score (MCS); State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale. The main outcome measures were the SF 12 PCS, SF12 MCS scores and pregnancy-related hospital admissions. Results Of 1179 eligible women 791 (67%) participated, 27 had fertility treatment without oocyte retrieval and were excluded and 592/764 (78%) completed all pregnancy assessments. When other factors were controlled speaking a language other than English, having private health insurance and multiple gestation were associated with worse physical health and having private health insurance and better physical health were associated with better mental health. Pregnancy-related hospital admissions were associated with worse physical health and multiple gestation
Thomas, R K; Pol, L G
The U.S. health care industry has been hampered in the development of a mature marketing function in part due to characteristics unique to the industry. These characteristics include a lack of market data, poorly developed market research techniques, and a poor understanding of consumer behavior within the industry. Some of the deficiencies are being addressed through the development of an emerging field that is being referred to as "health demography." Health demography and those who have begun to refer to themselves as health demographers are drawing from the fields of demography, epidemiology, biostatistics, and the social sciences to formulate a new discipline uniquely related to the needs of today's health care marketers and planners. Those involved with health demography are developing databases and models for application to concrete problems in health care delivery. The development of this field is contributing to the advancement of the state of marketing in health care and serving to reduce many of the barriers that have retarded the development of a mature marketing function within the health care industry.
Yuan, Anastasia S. Vogt
Although perceived discrimination (especially due to race-ethnicity) decreases mental health, the influence of perceived discrimination due to other reasons on mental health needs to be explored. This study examines the relationship between perceived age discrimination and mental health and determines whether psychosocial resources explain or…
Rattan, Suresh I S
Ageing occurs in spite of complex pathways of maintenance and repair. There is no "enemy within", which has the specific evolution-selected function to cause ageing and death. This understanding of ageing should transform our approach towards interventions from therapeutic "anti-ageing" to maintaining health. But what is health? Ideally, health is a state of complete physical and mental independence in activities of daily living. But in pragmatic terms, health is a state of adequate physical and mental independence in activities of daily living. In order to identify a set of measurable, evidence-based and demonstratable parameters of health, robustness and resilience at various levels, the concept of homeodynamic space can be a useful one. Age-related health problems for which there are no clear-cut causative agents, except the complex process of ageing, may be better tackled by focusing on health mechanisms and their maintenance, rather than disease management and treatment. Continuing the disease-oriented research approaches are economically, socially and psychologically unsustainable as compared with health-oriented and preventive strategies, such as hormesis. Supporting health-oriented research is the urgency of our time.
Hirve, Siddhivinayak; Gómez-Olivé, Xavier; Oti, Samuel; Debpuur, Cornelius; Juvekar, Sanjay; Tollman, Stephen; Blomstedt, Yulia; Wall, Stig; Ng, Nawi
Background Comparing self-rating health responses across individuals and cultures is misleading due to different reporting behaviors. Anchoring vignettes is a technique that allows identifying and adjusting self-rating responses for reporting heterogeneity (RH). Objective This article aims to test two crucial assumptions of vignette equivalence (VE) and response consistency (RC) that are required to be met before vignettes can be used to adjust self-rating responses for RH. Design We used self-ratings, vignettes, and objective measures covering domains of mobility and cognition from the WHO study on global AGEing and adult health, administered to older adults aged 50 years and above from eight low- and middle-income countries in Africa and Asia. For VE, we specified a hierarchical ordered probit (HOPIT) model to test for equality of perceived vignette locations. For RC, we tested for equality of thresholds that are used to rate vignettes with thresholds derived from objective measures and used to rate their own health function. Results There was evidence of RH in self-rating responses for difficulty in mobility and cognition. Assumptions of VE and RC between countries were violated driven by age, sex, and education. However, within a country context, assumption of VE was met in some countries (mainly in Africa, except Tanzania) and violated in others (mainly in Asia, except India). Conclusion We conclude that violation of assumptions of RC and VE precluded the use of anchoring vignettes to adjust self-rated responses for RH across countries in Asia and Africa. PMID:24011254
Altman, E G; Hedeker, D; Peterson, J L; Davis, J M
We report on the development, reliability, and validity of the Altman Self-Rating Mania Scale (ASRM). The ASRM was completed during medication washout and after treatment by 22 schizophrenic, 13 schizoaffective, 36 depressed, and 34 manic patients. The Clinician-Administered Rating Scale for Mania (CARS-M) and Mania Rating Scale (MRS) were completed at the same time to measure concurrent validity. Test-retest reliability was assessed separately on 20 depressed and 10 manic patients who completed the ASRM twice during washout. Principal components analysis of ASRM items revealed three factors: mania, psychotic symptoms, and irritability. Baseline mania subscale scores were significantly higher for manic patients compared to all other diagnostic groups. Manic patients had significantly decreased posttreatment scores for all three subscales. ASRM mania subscale scores were significantly correlated with MRS total scores (r = .718) and CARS-M mania subscale scores (r = .766). Test-retest reliability for the ASRM was significant for all three subscales. Significant differences in severity levels were found for some symptoms between patient ratings on the ASRM and clinician ratings on the CARS-M. Mania subscale scores of greater than 5 on the ASRM resulted in values of 85.5% for sensitivity and 87.3% for specificity. Advantages of the ASRM over other self-rating mania scales are discussed.
Burdman, Geral Dene M.
This study of futurism is important to gerontology in order to bridge the gap between theory, policy statement, and actual practice in the field of aging. There is a need to prepare competent individuals for direct service, and to provide increased exposure to gerontology throughout the curriculum. (Author/LPG)
Mariño, R J
The emphasis of Australian Government policy is on the promotion of good health in later life and positive experiences with ageing. Conceptually, a new gerontology framework has replaced the study of disease, decline, loss and disability. Within this framework, health promotion offers a mechanism by which individuals can be assisted to create environments that offer better opportunities for continued participation in society and improved quality of health and self-care. Oral health is instrumental to older people's health, life satisfaction, quality of life and perception of self. Australia is culturally diverse, composed of numerous ethno-cultural groups coexisting within a larger, predominant culture, creating a multicultural and multiracial society. However, despite this cultural diversity, the well documented ageing profile of the Australian population and repeated calls for comprehensive geriatric assessment, the oral health of older adults remains a challenge for oral health providers and for society. A major challenge will be to translate existing knowledge and experience of disease prevention and health promotion into appropriate programmes for older adults. Health promotion is the key to improving oral health in later life as it encourages older adults to be proactive in regard to their health. Therefore, increased efforts should be directed towards identifying opportunities for health promotion activities and the development of community based models that encourage older people to improve and maintain their oral health. Ignoring opportunities for health promotion may increase inequalities in oral health and may lead to even greater demands for curative and oral rehabilitative services from these groups This article firstly provides a brief rationale for oral health promotion. Its second part explores the influence of culture on health beliefs, behaviours and outcomes in older adults and how oral health can relate to cultural background. The last section
The impact of a longer life on future health care expenditures will be quite moderate because of the high costs of dying and the compression of mortality in old age. If not age per se but proximity to death determines the bulk of expenditures, a shift in the mortality risk to higher ages will not significantly affect lifetime health care expenditures, as death occurs only once in every life. A calculation of the demographic effect on health care expenditures in Germany up until 2050 that explicitly accounts for costs in the last years of life leads to a significantly lower demographic impact on per-capita expenditures than a calculation based on crude age-specific health expenditures.
Braun, Edith; Woodley, Alan; Richardson, John T. E.; Leidner, Bernhard
This paper provides a theoretical review of self-rated competences questionnaires. This topic is influenced by the ongoing world-wide reform of higher education, which has led to a focus on the learner outcomes of higher education. Consequently, questionnaires on self-rated competences have increasingly been employed. However, self-ratings are…
Jacobson, Cara; Bailin, Alexandra; Milanaik, Ruth; Adesman, Andrew
This article examines the health implications of new age technology use among adolescents. As Internet prevalence has increased, researchers have found evidence of potential negative health consequences on adolescents. Internet addiction has become a serious issue. Pornography is now easily accessible to youth and studies have related pornography with several negative health effects. Cyberbullying has become a large problem as new age technologies have created a new and easy outlet for adolescents to bully one another. These technologies are related to increased morbidity and mortality, such as suicides due to cyberbullying and motor vehicle deaths due to texting while driving.
Torres, Luis R.; Kaplan, Charles; Valdez, Avelardo
Objectives Research on the health consequences of long-term injection drug use (IDU) is limited. This article examines these consequences among aging, male Mexican American injecting heroin users. Concern for this group is crucial, given its health disparities and the association of IDU with disease transmission. Method Aging, male Mexican American IDUs (N = 227) were recruited through intensive outreach. Participants self-reported health status, medical and substance use history, and completed behavioral and psychometric health scales. Results are compared to Hispanic national samples. Results Participants had significantly poorer self-rated health and negative health conditions. Selected medical conditions not associated with the heroin-use lifestyle (i.e., hypertension, diabetes, arthritis) were lower relative to the comparison samples. Discussion This population has a complex profile of health consequences linked to a heroin-using lifestyle. The study concludes that routine screening of infectious diseases and medical and behavioral conditions among aging substance using populations may contribute to reducing Hispanic health disparities. PMID:21451118
Thompson, Richard; Flaherty, Emalee G.; English, Diana J.; Litrownik, Alan J.; Dubowitz, Howard; Kotch, Jonathan B.; Runyan, Desmond K.
Objective Despite growing evidence of links between adverse childhood experiences (ACEs) and long-term health outcomes, there has been limited longitudinal investigation of such links in youth. The purpose of these analyses was to describe the patterns of exposure to ACEs over time and their links to youth health. Methods The current analyses used data from LONGSCAN, a prospective study of children at risk for or exposed to child maltreatment, who were followed from age 4 to age 18. The analyses focused on 802 youth with complete data. Cumulative exposure to ACEs between 4 and 16 was used to place participants in 3 trajectory-defined groups: chronic ACEs, early ACEs only, and limited ACEs. Links to self-reported age 18 health were examined using linear mixed models after controlling for earlier health status and demographics. Results The chronic ACEs group had increased self-reported health concerns and use of medical care at 18, but not poorer self-rated health status. The early ACEs only group did not significantly differ from limited ACEs on outcomes. Conclusions In addition to other negative outcomes, chronic ACEs appear to affect physical health in emerging adulthood. Interventions aimed at reducing exposure to ACEs and early mitigation of their effects may have lasting and widespread health benefits. PMID:25441654
National Inst. on Aging (DHHS/NIH), Bethesda, MD.
This document contains a glossary which defines 275 basic terms frequently used by gerontologists. The glossary is designed for use by a general population, including older persons and their families, students in the field of aging, librarians, medical reporters, health care providers, and others interested in older persons. It was developed to…
Pham-Kanter, Genevieve; Leitsch, Sara A.
Objectives This paper presents a description of the methods used in the National Social Life, Health, and Aging Project to detect the presence of chronic conditions and diseases associated with aging. It also discusses the validity and distribution of these measures. Methods Markers associated with common chronic diseases and conditions of aging were collected from 3,005 community-dwelling older adults living in the United States, aged 57–85 years, during 2006. Dried blood spots, physical function tests, anthropometric measurements, self-reported history, and self-rated assessments were used to detect the presence of chronic conditions associated with aging or of risk factors associated with the development of chronic diseases. Results The distribution of each measure, disaggregated by age group and gender, is presented. Conclusions This paper describes the methodology used as well as the distribution of each of these measures. In addition, we discuss how the measures used in the study relate to specific chronic diseases and conditions associated with aging and how these measures might be used in social science analyses. PMID:19204070
The rapid increase in admission rates to mental hospitals in many countries in recent decades threatens to create serious problems. These may be to some extent remediable in that social factors are important in deciding the chances of admission to hospital, as well as the frequency of suicide, which reaches a peak among the aged in most countries. All communities possess valuable assets in the form of existing links between the aged and their families which may be lost by indiscriminate community planning. Although some psychological decline is inevitable during senescence, it is becoming clear that much that once passed for the ineluctable effects of mental and physical aging is due to disease that may be ameliorated or cured. The relationship between mental and physical health is particularly close in old age, and the effective treatment of the aged person with a psychiatric disorder demands the full resources of general medicine as well as psychiatry. For successful rehabilitation a full community service for the aged and proper integration of the work of the family doctor with that of preventive and hospital services are essential. The possibilities of prevention can be enhanced by fostering physical well-being and healthy adjustment during earlier stages of life, as well as by ascertaining, and remedying as far as possible, the mental and physical disorders of the aged in the early stages of their development. There is great scope for biological, medical and sociological research to define reasons for the wide variations in mental and physical well-being in old age. PMID:14439413
Pinkerton, JoAnn V; Stovall, Dale W
Changes in ovarian hormone production may affect numerous health outcomes including vasomotor symptoms, cardiovascular disease (CVD), osteoporosis, cognition, depression, mood disorders, sexual function, and vaginal atrophy. We will compare age-related changes to those associated with reproductive aging and menopause and the effects of estrogen therapy on selected health outcomes. Hormone therapy (HT) reduces frequency and severity of hot flashes, prevents bone loss and osteoporotic fractures, and relieves vaginal atrophy. Nonhormone therapy trials with antidepressants or gabapentin for hot flash relief are promising. To date, clinical trial data are insufficient to recommend the use of HT for prevention or treatment of CVD, mood disorders, cognition, or sleep disorders. For some disease states, such as CVD and cognition, a "critical time window" has been proposed but not proven, such that estrogen use early in the menopause transition may be beneficial while estrogen use later in life would lead to increased health risks.
Malaspina, Dolores; Gilman, Caitlin; Kranz, Thorsten Manfred
The influence of paternal age on the risk for sporadic forms of Mendelian disorders is well known, but a burgeoning recent literature also demonstrates a paternal age effect for complex neuropsychiatric conditions, including schizophrenia, autism, bipolar disorder and even for learning potential, expressed as intelligence. Mental illness is costly to the patients, the family and the public health system, accounting for the largest portion of disability costs in our economy. The delayed onset of neuropsychiatric conditions and lack of physical manifestations at birth are common frequencies in the population that have obscured the recognition that a portion of the risks for mental conditions is associated with paternal age. Identification of these risk pathways may be leveraged for knowledge about mental function and for future screening tests. However, only a small minority of at-risk offspring are likely to have such a psychiatric or learning disorder attributable to paternal age, including the children of older fathers. PMID:25956369
Examining Associations between Self-Rated Health and Proficiency in Literacy and Numeracy among Immigrants and U.S.-Born Adults: Evidence from the Program for the International Assessment of Adult Competencies (PIAAC).
Prins, Esther; Monnat, Shannon
This paper uses data from the Program for the International Assessment of Adult Competencies (PIAAC) to analyze the relationship between self-reported health (SRH) and literacy and numeracy proficiency for immigrants compared to U.S.-born respondents and for Hispanic versus Asian immigrants. The research questions were: (1) Are literacy and numeracy scores associated with adults' SRH? (2) Are associations between SRH and literacy and numeracy proficiency moderated by immigrant status? (3) Among immigrants, are literacy and numeracy scores more strongly associated with SRH for Hispanics versus Asians? Immigrants had significantly lower literacy and numeracy scores, yet reported better health than U.S.-born respondents. Ordinal logistic regression analyses showed that literacy and numeracy were both positively related to SRH for immigrants and U.S.-born adults, and should therefore be viewed as part of the growing evidence that literacy is an independent and significant social determinant of health. Second, U.S.-born and immigrant adults accrued similarly positive health benefits from stronger literacy and numeracy skills. Third, although Hispanic immigrants were more disadvantaged than Asian immigrants on almost all socioeconomic characteristics and had significantly lower literacy and numeracy scores and worse SRH than Asian immigrants, both Hispanic and Asian immigrants experienced similar positive health returns from literacy and numeracy proficiency. These findings underscore the potential health benefits of providing adult basic education instruction, particularly for immigrants with the least formal schooling and fewest socioeconomic resources.
Mullola, Sari; Hintsanen, Mirka; Jokela, Markus; Lipsanen, Jari; Alatupa, Saija; Ravaja, Niklas; Keltikangas-Järvinen, Liisa
This study examined whether teacher-rated versus self-rated student temperaments are different in relation to the school grades in Maths and Mother language (ML) instruction in a nationally representative sample of Finnish Secondary School students (n?=?1,063, mean age 15.1 years). The results indicated that teacher-rated temperament was more…
Norris, Shane A.; Richter, Linda M.
Self-rating of pubertal development is the recommended method to assess puberty in large community-based surveys of adolescent development and behavior. The aim of this study was to validate for the first time pubertal self-assessment using the sexual maturation scale developed by Tanner among Black South African adolescents (n=182) aged between…
Mandal, Priyanka; Tank, Krishna; Monday, Tapas; Chen, Chih-Hung; Deen, M Jamal
A simple, low-power and wearable health analyzer for early identification and management of some diseases is presented. To achieve this goal, we propose a walking pattern analysis system that uses features such as speed, energy, turn ratio, and bipedal behavior to characterize and classify individuals in distinct walking-ages. A database is constructed from 74 healthy young adults in the age range of 18 to 60 years using the combination of inertial signals from an accelerometer and a gyroscope on a level path including turns. An efficient advanced signal decomposition method called improved complete ensemble empirical mode decomposition with adaptive noise (Improved CEEMDAN) was used for feature extraction. Analyses show that the gait of healthy able-bodied individuals exhibits a natural bipedal asymmetry to a certain level depending on the activity-type and age, which relate to individual's functional attributes rather than pathological gait. The analysis of turn ratio, a measure of activity-transition9 energy change and stability, indicated turning to be less locally stable than straight-line walking making it a more reliable measure for determining falls and other health issues. Extracted features were used to analyze two distinct walking-age groups of the healthy young adults based on their walking pattern, classifying 18-45 years old individuals in one group and 46-60 years old in the other group. Our proposed simple, inexpensive walking analyzer system can be easily used as an ambulatory screening tool by clinicians to identify at risk population at the early onset of some diseases.
Bolon, Kevin; Barling, Julian
Investigates the capacity of the Zung Self-Rating Depression Scale for providing specific multidimensional descriptors of depressive behavior. Ideational, physiological and behavioral depression factors were evident in data from 96 normal, white university student volunteers. (Author/RH)
Moore, Raeanne C; Eyler, Lisa T; Mausbach, Brent T; Zlatar, Zvinka Z; Thompson, Wesley K; Peavy, Guerry; Fazeli, Pariya L; Jeste, Dilip V
Psychological and psychosocial resources, including resilience and social support, have traditionally been studied in the context of the stress paradigm and, more recently, in the context of successful aging. This study used moderated mediation analyses to examine the role of perceived stress in the relationships between physical and mental health functioning and self-rated successful aging (SRSA) and whether differences between people in level of resilience and social support changes the role of perceived stress in these relationships. A cross-sectional study of 1,006 older adults (mean age: 77 years) completed scales addressing SRSA, physical and mental health functioning, perceived stress, resilience, and social support. Results indicated that the strength of relationships between both physical and mental health functioning and SRSA were reduced after accounting for variation in level of perceived stress. The role of perceived stress in the association between mental health functioning and SRSA was found to be stronger among participants with the highest levels of resilience, and the influence of perceived stress on the degree of relationship between physical health functioning and SRSA was stronger among those with greatest social support. These findings suggest that interventions to reduce perceived stress may help break the link between disability and poor well-being in older adults. The findings further suggest that the impact of such interventions might differ depending on psychological resources (i.e., resilience) for mental health disabilities and external resources (i.e., social support) for those with physical health problems. The complex interplay of these factors should be taken into account in clinical settings.
Kenney, W Larry; Craighead, Daniel H; Alexander, Lacy M
This brief review is based on a President's Lecture presented at the Annual Meeting of the American College of Sports Medicine in 2013. The purpose of this review was to assess the effects of climate change and consequent increases in environmental heat stress on the aging cardiovascular system. The earth's average global temperature is slowly but consistently increasing, and along with mean temperature changes come increases in heat wave frequency and severity. Extreme passive thermal stress resulting from prolonged elevations in ambient temperature and prolonged physical activity in hot environments creates a high demand on the left ventricle to pump blood to the skin to dissipate heat. Even healthy aging is accompanied by altered cardiovascular function, which limits the extent to which older individuals can maintain stroke volume, increase cardiac output, and increase skin blood flow when exposed to environmental extremes. In the elderly, the increased cardiovascular demand during heat waves is often fatal because of increased strain on an already compromised left ventricle. Not surprisingly, excess deaths during heat waves 1) occur predominantly in older individuals and 2) are overwhelmingly cardiovascular in origin. Increasing frequency and severity of heat waves coupled with a rapidly growing at-risk population dramatically increase the extent of future untoward health outcomes.
The purpose of this study is to develop and test a conceptual model that assesses the following theoretical linkages: (1) people who go to church more often tend to receive more spiritual support from fellow church members (i.e., encouragement to adopt religious teachings and principles); (2) individuals who get more frequent spiritual support are…
Zajacova, Anna; Hummer, Robert A; Rogers, Richard G
This article presents detailed estimates of relative and absolute health inequalities among U.S. working-age adults by educational attainment, including six postsecondary schooling levels. We also estimate the impact of several sets of mediating variables on the education-health gradient. Data from the 1997-2009 National Health Interview Survey (N = 178,103) show remarkable health differentials. For example, high school graduates have 3.5 times the odds of reporting "worse" health than do adults with professional or doctoral degrees. The probability of fair or poor health in mid-adulthood is less than 5 percent for adults with the highest levels of education but over 20 percent for adults without a high school diploma. The probability of reporting excellent health in the mid-forties is below 25 percent among high school graduates but over 50 percent for those adults who have professional degrees. These health differences characterize all the demographic subgroups examined in this study. Our results show that economic indicators and health behaviors explain about 40 percent of the education-health relationship. In the United States, adults with the highest educational degrees enjoy a wide array of benefits, including much more favorable self-rated health, compared to their less-educated counterparts.
... Grow Older (Office of Disease Prevention and Health Promotion) Also in Spanish Latest News What's the 'SuperAgers' ... Nurses feature in winter health video. Article: Health promotion among older adults in Austria: a qualitative study. ...
Background This study aimed to determine the relationship of health behaviors with the health locus of control and the sense of self-efficacy against the background of socio-economic factors and self-rated health among students of the Universities of the Third Age (U3As). Material/Methods The study included 320 U3A students, with mean age of 67.5 years. The following research tools were used: Health Behavior Inventory (HBI), Multidimensional Health Locus of Control Scale (MHLC), Generalized Self-Efficacy Scale (GSES), and an original survey of the author’s own design. Results Mean total HBI and GSES scores were 90.63 and 30.12, respectively. These results are satisfactory. A slight predominance of internal health locus of control was documented. A number of significant correlations were found between the HBI, GSES, and MHLC scores, except for the MHLC subscale expressing the influence of chance. Educational attainment was shown to have a significant impact on the scores for the positive attitude and proper dietary habits subscales of HBI, as well as on the GSES scores. Economic status of the participants influenced the levels of positive attitude, internal health locus of control, and self-efficacy. Furthermore, internal health locus of control was found to be modulated by subjective health of the respondents. The scores for external health locus of control and the influence of chance increased significantly with age. Conclusions The currently noticeable emphasis placed on lifelong education should serve as a good prognostic factor for health behaviors and personal health resources for years to come. PMID:26879981
BACKGROUND This study aimed to determine the relationship of health behaviors with the health locus of control and the sense of self-efficacy against the background of socio-economic factors and self-rated health among students of the Universities of the Third Age (U3As). MATERIAL AND METHODS The study included 320 U3A students, with mean age of 67.5 years. The following research tools were used: Health Behavior Inventory (HBI), Multidimensional Health Locus of Control Scale (MHLC), Generalized Self-Efficacy Scale (GSES), and an original survey of the author's own design. RESULTS Mean total HBI and GSES scores were 90.63 and 30.12, respectively. These results are satisfactory. A slight predominance of internal health locus of control was documented. A number of significant correlations were found between the HBI, GSES, and MHLC scores, except for the MHLC subscale expressing the influence of chance. Educational attainment was shown to have a significant impact on the scores for the positive attitude and proper dietary habits subscales of HBI, as well as on the GSES scores. Economic status of the participants influenced the levels of positive attitude, internal health locus of control, and self-efficacy. Furthermore, internal health locus of control was found to be modulated by subjective health of the respondents. The scores for external health locus of control and the influence of chance increased significantly with age. CONCLUSIONS The currently noticeable emphasis placed on lifelong education should serve as a good prognostic factor for health behaviors and personal health resources for years to come.
Wells, Yvonne; de Vaus, David; Kendig, Hal; Quine, Susan
The capacity to measure change is essential in examining successful adaptation to ageing. Few studies measuring change have compared findings using pre-post approaches (employing difference scores) with those from retrospective approaches (employing self-ratings). Where this has occurred, differences have been attributed either to ceiling and floor effects or to the operation of social comparison (Choi, 2002, 2003). Our study compared pre-post and retrospective measures of change in health, health behaviors, and wellbeing over periods of 1 and 3 years among retirees. Retrospective measures were found to be more positive than pre-post measures. This discrepancy was associated with floor and ceiling effects and with a robust self-image, but not with recency, social comparison, or social desirability response sets. Pre-post difference scores have limitations as indicators of change, particularly where ceiling effects operate. A retrospective perception of improvement, combined with deterioration in scores, may result from successful psychological adaptation as people grow older.
Marshall, Victor W.; Altpeter, Mary
The rapid growth of the population of older adults and their concomitant physical status and health needs have captured the attention, collaboration, and funding support of an array of leaders in the fields of aging and health care. To help fill the void of literature available to social workers interested in health promotion and aging, the…
Holahan, Carole K.; Suzuki, Rie
This study investigated adulthood predictors of health-promoting behavior in later aging. The participants were 162 members of the Terman Study of the Gifted (Terman et al., 1925), who responded in 1999 at an average age of 86 to a mailout questionnaire which included questions concerning their positive health behavior. Adulthood variables were…
Szucs, Thomas D
Health economics has experienced a substantial rise within the healthcare industry over the past few years. Several disciplines have developed new techniques to evaluate the economic impact of pharmaceuticals in clinical care. Clinicians, pharmacists, economists, epidemiologists, and operations researchers have contributed to this field. Given the economic reality that resources are limited and needs and expectations are not infinite, medical economists try to find solutions on how these resources can be allocated optimally, to maximize the production of health or what society perceives as health. Health economists differentiate allocation efficiency and production efficiency. From the perspective of a health insurance plan allocation efficiency is reached when those drug classes or clinical programs are covered that will produce most health per expenditure. This requires a common monetary metric of health gains across the broad spectrum of diseases, conditions, and health outcomes. Once it is decided to cover a specific treatment or clinical program, economists try to identify the most cost-effective product within a class of comparable choices using cost-effectiveness and cost-utility analyses. Both allocation and production efficiency are two critically important concepts for the economic success of biotech products. This article will provide a rationale why health economics is critically important for the future of healthcare and explains fundamental economic tools for evaluating products and services with special emphasis on gene-derived technologies.
Bauger, Lars; Bongaardt, Rob
In response to the ever-increasing longevity in Western societies, old age has been divided into two different periods, labelled the third and fourth age. Where the third age, with its onset at retirement, mostly involves positive aspects of growing old, the fourth age involves functional decline and increased morbidity. This article focuses on the entry to the third age and its potential for health promotion initiatives. Well-being is an important factor to emphasize in such health promotion, and this article views the lifestyle of third agers as essential for their well-being. The structural developmental theory of Robert Kegan delineates how a person's way of knowing develops throughout the life course. This theory is an untapped and salient perspective for health promotion initiatives in the third age. This article outlines Kegan's approach as a tool for developing psychologically spacious health promotion, and suggests future directions for research on the topic.
Marshall, Victor W; Altpeter, Mary
The rapid growth of the population of older adults and their concomitant physical status and health needs have captured the attention, collaboration, and funding support of an array of leaders in the fields of aging and health care. To help fill the void of literature available to social workers interested in health promotion and aging, the authors provide a conceptual clarification of the meaning of health and explain how health is a resource for optimal living and not merely the absence of disease. The authors analyze frameworks of health promotion and suggest that the ecological approach provides the ideal framework for devising successful strategies in the area of aging. Finally, using the example of promoting physical activity as a healthy aging strategy, they detail eight ways that social workers can provide leadership in promoting positive health in later life.
Buman, Matthew P; Hekler, Eric B; Bliwise, Donald L; King, Abby C
Sleep interventions have rarely explored reductions in night-to-night fluctuations [i.e. intra-individual variability (IIV)] in sleep, despite the negative impacts of such fluctuations on affective states and cognitive and physical symptoms. In a community-based randomized controlled trial we evaluated whether physical exercise reduced IIV in self-rated sleep outcomes among middle-aged and older adults with sleep complaints. Under-active adults 55 years and older (n = 66, 67% women) with mild to moderate sleep complaints were randomized to 12 months of a moderate-intensity endurance exercise (n = 36) or a health education control group (n = 30). Daily sleep logs, Pittsburgh Sleep Quality Index (PSQI) and in-home polysomnographic sleep recordings (PSG) were collected at baseline, 6 months and 12 months. Sleep log-derived means and IIV were computed for sleep-onset latency (SOL), time in bed, feeling rested in the morning, number of nighttime awakenings, and wake after final awakening (WAFA). Using intent-to-treat methods, at 6 months no differences in IIV were observed by group. At 12 months, SOL-based IIV was reduced in the exercise group compared with the control (difference = 23.11, 95% CI: 3.04-47.18, P = 0.025, Cohen's d = 0.57). This change occurred without mean-level or IIV changes in sleep-wake schedules. For all sleep variables, except SOL and WAFA, IIV changes and mean-level changes in each variable were negatively correlated (r = -0.312 to -0.691, P < 0.05). Sleep log-derived IIV changes were modestly correlated with mean-level PSQI and PSG-based changes at 12 months. Twelve months of moderate-intensity exercise reduced night-to-night fluctuations in self-rated time to fall asleep, and this relationship was independent of mean-level time to fall asleep.
De Martinis, Massimo; Sirufo, Maria Maddalena; Ginaldi, Lia
Allergy reactions are the most common immunological diseases and represent one of the most widespread and fast growing chronic human health problems among people over 15 years of age in developed countries. As populations get older worldwide, allergy manifestations in aged persons will occur more often in the future. To date, there has been much more studies on allergies in children than in adults. As the population ages, clinicians must be prepared to meet all the elderly's health care needs, including these new and emerging health issue. Allergic diseases represent an old/new emerging health issue. Because many common illnesses masquerade as atopic disease, the differential diagnosis of suspected allergic diseases becomes more expanded in an aging population. Research in the field needs to focus on both human and animal model systems to investigate the impact of the aging process on the immunologic pathways underpinning allergy and its different facets.
Kendig, Hal; Dykstra, Pearl A.; van Gaalen, Ruben I.; Melkas, Tuula
This article reviews and presents research findings on the relationships between parenthood and health over the life span. Existing research shows lacunae. The links between reproductive behavior and longevity generally focus on family size rather than contrasting parents and nonparents. Studies of marital status differentials in survival…
Schewe, C D; Spotts, H E
The health-care marketplace is aging by leaps and bounds and bringing with it new and different medical needs. As costs soar and public assistance programs dwindle in impact, health-care providers will need better marketing strategies to bring treatments to patients/consumers. This article looks at the research findings of behavioral scientists and offers guidelines for effective communication with aging audiences. Health-care providers can use these findings to design more effective advertising, promotional brochures, newsletters, and a host of other communication tools targeted at an older market. Health-care managers and other professionals should find the guidelines useful in their daily interactions with patients and colleagues.
Raymo, James M.; Liang, Jersey; Kobayashi, Erika; Sugihara, Yoko; Fukaya, Taro
In this paper, we investigate ways in which the relationship between health and labor force exit at older ages is moderated by family characteristics. Using two waves of data from a national sample of older Japanese men collected 1999 and 2002, we estimate logistic regression models for labor force exit beyond age 63 as a function of health change, family characteristics, and their interactions. We confirm that poor health is strongly associated with labor force exit and find evidence that moderating influences of family context depend upon the level of health. However, results are only partially consistent with hypotheses that the relationship between health and the likelihood of labor force exit should be stronger for (a) those with good health and family incentives to exit the labor force and (b) those with poor health and family incentives to remain in the labor force. PMID:23082037
DeVan, Allison E.; Seals, Douglas R.
The demographics of ageing are changing dramatically such that there will be many more older adults in the near future. This setting likely will produce a new “boomer-driven” epidemic of physiological dysfunction, disability and risk of chronic degenerative disorders, including cardiovascular diseases (CVD). Standing out against this dreary biomedical forecast are Masters athletes, a group of middle-aged and older adults who engage in regular vigorous physical training and competitive sport. Compared with their sedentary/less active (untrained) peers, Masters athletes who perform endurance training-based activities demonstrate a more favorable arterial function-structure phenotype, including lower large elastic artery stiffness, enhanced vascular endothelial function and less arterial wall hypertrophy. As such, they may represent an exemplary model of healthy or “successful” vascular ageing. In contrast, Masters athletes engaged primarily/exclusively in intensive resistance training exhibit less favorable arterial function-structure than their endurance-trained peers and, in some instances, untrained adults. These different arterial properties likely are explained in large part by the different intravascular mechanical forces generated during endurance vs. resistance exercise-related training activities. The more favorable arterial function-structure profile of Masters endurance athletes may contribute to their low risk of clinical CVD. PMID:22266948
Stephan, Yannick; Sutin, Angelina R.; Terracciano, Antonio
Subjective age, or how young or old individuals experience themselves to be relative to their chronological age, is a crucial construct in gerontology. Subjective age is a significant predictor of important health outcomes, but little is known about the criteria by which individuals' subjectively evaluate their age. To identify psychosocial and biomedical factors linked to the subjective evaluation of age, this study examined whether perceived age discrimination and markers of biological aging are associated with subjective age. Participants were 4776 adults (Mage = 68) from the 2008 and 2010 waves of the Health and Retirement Study (HRS) who completed measures of subjective age, age discrimination, demographic variables, self-rated health and depression, and had physical health measures, including peak expiratory flow, grip strength, waist circumference, systolic and diastolic blood pressure. Telomere length was available for a subset of participants in the 2008 wave (n = 2214). Regression analysis indicated that perceived age discrimination, lower peak expiratory flow, lower grip strength, and higher waist circumference were associated with an older subjective age, controlling for sociodemographic factors, self-rated health, and depression. In contrast, blood pressure and telomere length were not related to subjective age. These findings are consistent with the hypothesis that how old a person feels depends in part on psychosocial and biomedical factors, including the experiences of ageism and perceptible indices of fitness and biological age. PMID:25738579
Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.
... as you age. Here's how to keep the flame burning. By Mayo Clinic Staff Sexual health is ... Accessed June 3, 2014. Cunningham GR, et al. Treatment of male sexual dysfunction. http://www.uptodate.com/ ...
Puvill, Thomas; Lindenberg, Jolanda; Gussekloo, Jacobijn; de Craen, Anton J M; Slaets, Joris P J; Westendorp, Rudi G J
Self-rated health is routinely used in research and practise among general populations. Older people, however, seem to change their health perceptions. To accurately understand these changed perceptions we therefore need to study the correlates of older people's self-ratings. We examined self-rated, nurse-rated and physician-rated health's association with common disabilities in older people (the geriatric giants), mortality hazard and life satisfaction. For this, we used an age-representative population of 501 participant aged 85 from a middle-sized city in the Netherlands: the Leiden 85-plus Study. Participants with severe cognitive dysfunction were excluded. Participants themselves provided health ratings, as well as a visiting physician and a research nurse. Visual acuity, hearing loss, mobility, stability, urinal and faecal incontinence, cognitive function and mood (depressive symptoms) were included as geriatric giants. Participants provided a score for life satisfaction and were followed up for vital status. Concordance of self-rated health with physician-rated (k = .3 [.0]) and nurse-rated health (k = .2 [.0]) was low. All three ratings were associated with the geriatric giants except for hearing loss (all p < 0.001). Associations were equal in strength, except for depressive symptoms, which showed a stronger association with self-rated health (.8 [.1] versus .4 [.1]). Self-rated health predicted mortality less well than the other ratings. Self-rated health related stronger to life satisfaction than physician's and nurse's ratings. We conclude that professionals' health ratings are more reflective of physical health whereas self-rated health reflects more the older person's mental health, but all three health ratings are useful in research.
Johnson, Simon C; Sangesland, Maya; Kaeberlein, Matt; Rabinovitch, Peter S
The physiological responses to nutrient availability play a central role in aging and disease. Genetic and pharmacological studies have identified highly conserved cellular signaling pathways that influence aging by regulating the interface between nutrient and hormone cues and cellular growth and maintenance. Among these pathways, the mechanistic target of rapamycin (mTOR) has been most reproducibly shown to modulate aging in evolutionarily diverse organisms as reduction in mTOR activity extends life span from yeast to rodents. mTOR has been shown to play a role in a broad range of diseases, and is of particular interest to human health and aging due to the availability of clinically approved pharmacological agents targeting the mTOR complexes and other components of the mTOR signaling network. Characterizing the role of mTOR in aging and health promises to provide new avenues for intervention in human aging and disease through modulation of this signaling pathway.
Douglass, Carolinda; Henry, Beverly W.; Kostiwa, Irene M.
The Aging Game, a simulation activity, has been used successfully with medical students in the development of empathetic attitudes toward older adults. To date, the Aging Game has not been used extensively with allied health students. It has been viewed as too costly, time-consuming and labor-intensive. The purpose of this study was to examine the…
The United States Commissioner on Aging describes challenges posed by the increasing size of the older adult population, outlines gaps in knowledge regarding aging and the elderly, and calls for greater collaboration between the elderly and existing mental health networks. (AOS)
Perry, Gloria R.
Classes on lifestyling for the promotion of health for the elderly were offered to a senior citizens' group in a community center setting. The objectives of the sessions were: (1) to teach the importance of health maintenance and primary prevention throughout the aging process; (2) to disseminate information relative to diet, exercise, and stress…
Koutsogeorgou, Eleni; Davies, John Kenneth; Aranda, Kay; Zissi, Anastasia; Chatzikou, Maria; Cerniauskaite, Milda; Quintas, Rui; Raggi, Alberto; Leonardi, Matilde
Objectives: This paper examines the context of health promotion actions that are focused on/contributing to strengthening social capital by increasing community participation, reciprocal trust and support as the means to achieve better health and more active ageing. Method: The methodology employed was a literature review/research synthesis, and a…
Background A parental/family history of poor oral health may influence the oral-health-related quality of life (OHRQOL) of adults. Objectives To determine whether the oral health of mothers of young children can predict the OHRQOL of those same children when they reach adulthood. Methods Oral examination and interview data from the Dunedin Study's age-32 assessment, as well as maternal self-rated oral health data from the age-5 assessment were used. The main outcome measure was study members' short-form Oral Health Impact Profile (OHIP-14) at age 32. Analyses involved 827 individuals (81.5% of the surviving cohort) dentally examined at both ages, who also completed the OHIP-14 questionnaire at age 32, and whose mothers were interviewed at the age-5 assessment. Results There was a consistent gradient of relative risk across the categories of maternal self-rated oral health status at the age-5 assessment for having one or more impacts in the overall OHIP-14 scale, whereby risk was greatest among the study members whose mothers rated their oral health as "poor/edentulous", and lowest among those with an "excellent/fairly good" rating. In addition, there was a gradient in the age-32 mean OHIP-14 score, and in the mean number of OHIP-14 impacts at age 32 across the categories of maternal self-rated oral health status. The higher risk of having one or more impacts in the psychological discomfort subscale, when mother rated her oral health as "poor/edentulous", was statistically significant. Conclusions These data suggest that maternal self-rated oral health when a child is young has a bearing on that child's OHRQOL almost three decades later. The adult offspring of mothers with poor self-rated oral health had poorer OHRQOL outcomes, particularly in the psychological discomfort subscale. PMID:21736754
de Figueiredo, João Paulo; Cardoso, Salvador Massano
OBJECTIVE To evaluate the exploratory relationship between determinants of health, life satisfaction, locus of control, attitudes and behaviors and health related quality of life in an adult population. METHODS Observational study (analytical and cross-sectional) with a quantitative methodological basis. The sample was composed oy 1,214 inhabitants aged ≥ 35 in 31 civil parishes in the County of Coimbra, Portugal, 2011-2012. An anonymous and voluntary health survey was conducted, which collected the following information: demographic, clinical record, health and lifestyle behaviors; health related quality of life (Medical Outcomes Study, Short Form-36); health locus of control; survey of health attitudes and behavior, and quality of life index. Pearson’s Linear Correlation, t-Student, Wilcoxon-Mann-Whitney; One-way ANOVA; Brown-Forsythe’s F; Kruskal-Wallis; Multiple Comparisons: Tukey (HSD), Games-Howell and Conover were used in the statistical analysis. RESULTS Health related quality of life was shown to be lower in females, in older age groups, in obese/overweight individuals, widows, unassisted, those living alone, living in rural/suburban areas, those who did not work and with a medium-low socioeconomic level. Respondents with poor/very poor self-perceived health (p < 0.0001), with chronic disease (p < 0.0001), who consumed < 3 meals per day (p ≤ 0.01), who were sedentary, who slept ≤ 6 h/day and had smoked for several years revealed the worst health results. Health related quality of life was positively related with a bigger internal locus, with better health attitudes and behaviors (physical exercise, health and nutritional care, length of dependence) and with different areas of life satisfaction. CONCLUSIONS Better health related quality of life was associated with certain social, psychological, family and health characteristics, a satisfactory lifestyle, better socioeconomic conditions and a good internal locus of control over health attitudes and
Brown, Tyson H.; Richardson, Liana J.; Hargrove, Taylor W.; Thomas, Courtney S.
This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses. PMID:27284076
Brown, Tyson H; Richardson, Liana J; Hargrove, Taylor W; Thomas, Courtney S
This study examines how the intersecting consequences of race-ethnicity, gender, socioeconomics status (SES), and age influence health inequality. We draw on multiple-hierarchy stratification and life course perspectives to address two main research questions. First, does racial-ethnic stratification of health vary by gender and/or SES? More specifically, are the joint health consequences of racial-ethnic, gender, and socioeconomic stratification additive or multiplicative? Second, does this combined inequality in health decrease, remain stable, or increase between middle and late life? We use panel data from the Health and Retirement Study (N = 12,976) to investigate between- and within-group differences in in self-rated health among whites, blacks, and Mexican Americans. Findings indicate that the effects of racial-ethnic, gender, and SES stratification are interactive, resulting in the greatest racial-ethnic inequalities in health among women and those with higher levels of SES. Furthermore, racial-ethnic/gender/SES inequalities in health tend to decline with age. These results are broadly consistent with intersectionality and aging-as-leveler hypotheses.
Yoon, Hyung-Suk; Yang, Jae Jeong; Song, Minkyo; Lee, Hwi-Won; Han, Sohee; Lee, Sang-Ah; Choi, Ji-Yeob; Lee, Jong-koo; Kang, Daehee
Though various factors related to fluctuations in sleep duration have been identified, information remains limited regarding the correlates of short and long sleep duration among the Korean population. Thus, we investigated characteristics that could be associated with short and/or long sleep duration among middle-aged and elderly Koreans. A total of 84,094 subjects (27,717 men and 56,377 women) who participated in the Health Examinees Study were analyzed by using multinomial logistic regression models. To evaluate whether sociodemographic factors, lifestyle factors, psychological conditions, anthropometry results, and health conditions were associated with short and/or long sleep duration, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with sleep duration of 6–7 hours as the reference group, accounting for putative covariates. Regardless of sexual differences, we found that adverse behaviors and lifestyle factors including low educational attainment, unemployment, being unmarried, current smoking status, lack of exercise, having irregular meals, poor psychosocial well-being, frequent stress events, and poor self-rated health were significantly associated with abnormal sleep duration. Similarly, diabetes mellitus and depression showed positive associations with abnormal sleep duration in both men and women. Our findings suggest that low sociodemographic characteristics, adverse lifestyle factors, poor psychological conditions, and certain disease morbidities could be associated with abnormal sleep duration in middle-aged and elderly Koreans. PMID:25933418
Torres, Elisa M; Ehrhart, Mark G; Beidas, Rinad S; Farahnak, Lauren R; Finn, Natalie K; Aarons, Gregory A
Although often discussed, there is a lack of empirical research on the role of leadership in the management and delivery of health services. The implementation leadership scale (ILS) assesses the degree to which leaders are knowledgeable, proactive, perseverant, and supportive during evidence-based practice (EBP) implementation. The purpose of this study was to examine the psychometric properties of the ILS for leaders' self-ratings using a sample of mental health clinic supervisors (N = 119). Supervisors (i.e., leaders) completed surveys including self-ratings of their implementation leadership. Confirmatory factor analysis, reliability, and validity of the ILS were evaluated. The ILS factor structure was supported in the sample of supervisors. Results demonstrated internal consistency reliability and validity. Cronbach alpha's ranged from 0.92 to 0.96 for the ILS subscales and 0.95 for the ILS overall scale. The factor structure replication and reliability of the ILS in a sample of supervisors demonstrates its applicability with employees across organizational levels.
Beard, John R; Officer, Alana; de Carvalho, Islene Araujo; Sadana, Ritu; Pot, Anne Margriet; Michel, Jean-Pierre; Lloyd-Sherlock, Peter; Epping-Jordan, JoAnne E; Peeters, G M E E Geeske; Mahanani, Wahyu Retno; Thiyagarajan, Jotheeswaran Amuthavalli; Chatterji, Somnath
Although populations around the world are rapidly ageing, evidence that increasing longevity is being accompanied by an extended period of good health is scarce. A coherent and focused public health response that spans multiple sectors and stakeholders is urgently needed. To guide this global response, WHO has released the first World report on ageing and health, reviewing current knowledge and gaps and providing a public health framework for action. The report is built around a redefinition of healthy ageing that centres on the notion of functional ability: the combination of the intrinsic capacity of the individual, relevant environmental characteristics, and the interactions between the individual and these characteristics. This Health Policy highlights key findings and recommendations from the report.
Joyce, Kelly; Loe, Meika
Abstract This special monograph issue builds on sociology of health and illness scholarship and expands the analytical lens to examine how old people, healthcare professionals, and technology designers create, use, and modify science and technology to negotiate and define health and illness. Far from passive consumers, elders are technogenarians, creatively utilising and adapting technological artefacts such as walking aids and medications to fit their needs. This publication adds theoretical and empirical depth to our understanding of the multiple and overlapping socio-historical contexts surrounding ageing bodies and ageing enterprises, including the biomedicalisation of ageing that includes the rise of anti-ageing or longevity medicine; and the rise of gerontechnology industries and professions -- fields that largely accept the ageing body as a given. This collection sociologically investigates how and where these two trends overlap and diverge in relation to a global context of ageing and ageism, and calls for further scholarship in this area. Combining science and technology studies and sociology of health and illness frameworks together provides an empirical basis from which to analyse technogenarians in action, as well as the stakeholders and institutions involved in the ageing, health, and technology matrix.
Wurm, S; Wiest, M; Tesch-Römer, C
The present paper starts by introducing different perspectives of the aging process and includes biological, psychological, and sociological theories in its scope. The article addresses the issue of when "old age" begins and why a distinction is made between the third and fourth age. With increasing age, it becomes more and more difficult to differentiate between health-related losses due to illnesses or to aging. However, this can be important with respect to health behavior and health care. Having the best possible health in old age is an important factor for a good life in old age. Over their whole lives, from childhood to old age, people can actively contribute to their health in old age. But health is not the sole criterion for a good life in old age. Having interests and aims are just as important as being integrated in a social network. In old age, people often differ greatly and this is why there is such variety in what people consider to constitute a good life for themselves in old age.
Waters, William F; Gallegos, Carlos A
Middle-income countries like Ecuador are in the process of demographic and epidemiological transitions, and their populations are aging. The challenges associated with providing services to growing numbers of citizens who experience the inevitable deterioration associated with aging are mirrored by the manner in which aging is perceived in a culturally heterogeneous society. This paper presents the results of qualitative research conducted among older men and women in indigenous communities in the Ecuadorian highlands in order to investigate the perceptions regarding the ability of family and community networks to provide adequate and appropriate support for older persons in the context of their perceptions of health, health care, and aging. The principal findings are that: (i) perceptions of aging are shaped by chronic illness, fatigue, deteriorating sensory capacities, and vulnerability to accidents; (ii) barriers to health care are exacerbated among aging members of indigenous communities, although in some cases they can be addressed through traditional alternatives; (iii) the sense of identity shifts as aging people are increasingly unable to work the land and participate in community activities; and (iv) family and community support networks for older adults are not as strong as is generally thought. These findings represent the context within which issues related aging in a culturally heterogeneous society can be best understood and addressed.
Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang
The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries. PMID:26816664
Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang
The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries.
Hassel, Alexander Jochen; Danner, Daniel; Schmitt, Marina; Nitschke, Ina; Rammelsberg, Peter; Wahl, Hans-Werner
Although a body of research has targeted predictors of well-being and depression in old age, the consideration of oral health-related quality of life (OHRQoL) as a predictor of these major psychosocial endpoints has been rare in the previous literature. The objective of this study was to test whether OHRQoL is associated with well-being and depression, after controlling for relevant confounders; also, the mediating role of subjective health, a major predictor of both well-being and depression, has been explored. OHRQoL was measured by two commonly used assessment instruments, the geriatric oral health assessment index (GOHAI) and oral health impact profile (OHIP); well-being was assessed by the Philadelphia Geriatric Center Morale Scale (PGCMS) and depression by the self-rating depression scale (SDS). We used a subsample of 197 participants from the older cohort (1930-1932) of the Interdisciplinary Longitudinal Study of Adult Development. Regression models and structural equations modeling (SEM) were used for the test for study variable relationships. Both GOHAI and OHIP revealed significant associations to both PGCMS and SDS at the bivariate level. In regression analyses considering gender, household situation, subjective health, and both OHRQoL indicators, only OHIP remained a significant predictor of well-being and depression. In addition, supportive evidence for a mediating role of subjective health regarding the linkage between OHRQoL and an overall latent construct of well-being was found in the SEM analysis. In conclusion, OHRQoL is significantly linked with well-being and depression in old age, while subjective health is able to mediate the relationship. The generally underrated role of OHRQoL with respect to well-being and depression in late adulthood deserves more attention.
Despite acknowledging India's crucial need for health education for school aged children, government institutions have failed to provide the necessary support. Past experience has shown that while the government has drafted policy statements concerning school health, scant action has followed. What little has been done consists primarily of perfunctory medical check-ups of school children, a service mostly limited to urban centers. Evident from the current status of health education for the school aged, several changes must take place: 1) Government institutions must reach a consensus regarding the content of school health services. Since school health is intended to improve both children's health status and cognitive capability, such a service demands a comprehensive program that includes regular and complete health surveillance. And it also means that the schools themselves must be healthy environments, and that teachers must serve as role models of good health. 2) School health efforts must involve and be supported by the parents and the community. 3) Government policies must take into account children who are not attending school. This means both a long-term policy to solve the problem of drop-outs and a short-term policy of providing non formal education -- including health education -- for these children. 4) Of critical importance, the health and education sectors need to work together; they must have "joint responsibility." 5) A related issue is that both the health and education sectors accord a low priority to the issue of school health -- something that needs to change. 6) Finally, the government must change its generally weak commitment to providing school health services.
Mullan, Barbara A; Kothe, Emily J
Effective communication is a vital component of nursing care, however, nurses often lack the skills to communicate with patients, carers and other health care professionals. Communication skills training programs are frequently used to develop these skills. However, there is a paucity of data on how best to evaluate such courses. The aim of the current study was to evaluate the relationship between student self rating of their own ability and their satisfaction with a nurse training course as compared with an objective measure of communication skills. 209 first year nursing students completed a communication skills program. Both qualitative and quantitative data were collected and associations between measures were investigated. Paired samples t-tests showed significant improvement in self-rated ability over the course of the program. Students generally were very satisfied with the course which was reflected in both qualitative and quantitative measures. However, neither self-rated ability nor satisfaction was significantly correlated with the objective measure of performance, but self-rated ability and satisfaction were highly correlated with one another. The importance of these findings is discussed and implications for nurse education are proposed.
Wong, Rebeca; Michaels-Obregón, Alejandra; Palloni, Alberto; Gutiérrez-Robledo, Luis Miguel; González-González, César; López-Ortega, Mariana; Téllez-Rojo, Martha María; Mendoza-Alvarado, Laura Rosario
Objective To describe the third wave of the Mexican Health and Aging Study (MHAS), completed in 2012, and present preliminary results. Materials and methods Descriptive analyses by gender and age group of demographic and socioeconomic characteristics, health conditions and health behaviors, as well as social support and life satisfaction measures are presented. In addition, external validations are presented by comparing MHAS 2012 indicators with other national data sources. Results For the panel of older adults in the sample, the rate of health care insurance coverage increased greatly between 2001 and 2012, a significantly higher change in rural compared to urban areas. The results for 2012 are consistent with the previous two waves for the main indicators of health and physical disability prevalence, risk factors, and behaviors. Conclusions The MHAS offers a unique opportunity to study aging in Mexico, as well as to complete cross-national comparisons. The cumulative number of deaths in the cohort should support the study of mortality and its association with health outcomes and behaviors over the life cycle. In addition, the sub-samples of objective markers will enable methodological research on self-reports and associations of biomarkers in old age with similar health outcomes and behaviors. PMID:26172238
Thompson, Hilaire J.; Voss, Joachim G.
This article focuses on a synthesis of knowledge about healthy aging research in human beings and then synthesized nurse-led research in gerontology and geriatrics that use biomarkers. Healthy aging research has attracted considerable attention in the biomedical and basic sciences within the context of four major areas: (a) genetic variations as an expression of successful or unsuccessful aging; (b) caloric restriction as an intervention to slow the progression of aging; (c) immunological aging; (d) neurobiology of the aging brain. A systematic review of the literature was performed to identify nurse-led geriatric-related biomarker research. Nurse researchers who have chosen to integrate biomarkers as part of their research studies have been working in six focal areas, which are reviewed: health promotion within risk populations, cancer, vascular disease, Alzheimer’s disease, caregiving, and complementary therapies. The article provides a discussion of contributions to date, identifying existing gaps and future research opportunities. PMID:20077975
Guralnik, Jack M.; Jackson, Richard J.; Marottoli, Richard A.; Phelan, Elizabeth A.; Prohaska, Thomas R.
Optimal mobility, defined as relative ease and freedom of movement in all of its forms, is central to healthy aging. Mobility is a significant consideration for research, practice, and policy in aging and public health. We examined the public health burdens of mobility disability, with a particular focus on leading public health interventions to enhance walking and driving, and the challenges and opportunities for public health action. We propose an integrated mobility agenda, which draws on the lived experience of older adults. New strategies for research, practice, and policy are needed to move beyond categorical promotion programs in walking and driving to establish a comprehensive program to enhance safe mobility in all its forms. PMID:22698013
Jansà, Josep M
Foreign migration in Spain is at present a priority in the social and demographic context the country. At a worldwide level, trends in the evolution of population and social, political and economical indicators, appear to maintain for the coming years, the present trends on migrations from poor countries to the rich ones. In the health area, considering migration as a relatively recent phenomena in Spain, and considering that is mainly constituted by young and healthy population, there are not still data available on the main health needs of migrants related to aging. Data from other countries with a longer migrant tradition, shows mental health disorders and social and cultural barriers for adaptation, as basic health determinants for older migrants. Related to the effects in the health system, the inclusion of the aging factor in general population and migrant needs, offer an optimistic panorama for future planning. Migrant aging in Spain, despite of its middle and long term perspective, do require a progressive adaptation of knowledge and resources to cover future needs. Considering this coming future, health professionals do need to be trained in intercultural skills and knowledge.
Ryan, Rob; Garlick, Robyn; Happell, Brenda
There is currently considerable discussion about the impact of the aging population on the demand for health care services, however there is considerably less attention paid to the impact of mental health issues on the needs of the aged population. Nurses comprise the largest professional group within the mental health workforce in Australia. The availability of a high quality mental health nursing workforce will therefore be crucial to meeting the health needs of aging clients in the future, accompanied by an increased pressure to increase the proportion of care delivered in the community. There is however, a paucity of literature on the role and contribution of community mental health nurses specialising in the aged care field. The aim of this paper is to present the findings of a project designed to examine the role of mental health nursing within aged persons' community mental health teams in Victoria, Australia, with particular emphasis on the biopsychosocial interventions used. Fifteen participants from three community mental health services in Victoria participated in a focus group interview to share their insights and experiences. Data analysis revealed two main themes, the role of the nurse, and the specific functions of the nurse. This data is presented as a beginning contribution to the paucity of literature currently available in this important area.
Hanna, Gay Powell; Noelker, Linda S; Bienvenu, Beth
In advance of the White House Conference on Aging (WHCoA) in 1981, 1995, and 2005, the arts and aging communities held mini-conferences to ensure that arts, culture, and livability were part of larger public policy discussions. This article takes a historical look at recommendations from the 2005 WHCoA Mini-Conference on Creativity and Aging in America, including arts in health care, lifelong learning, and livability through universal design. Overarching recommendations in 2005 requested investments in research, including cost-benefit analyses; identification of best practices and model programs; program dissemination to broaden the availability of arts programs. The "Arts" is a broad term encompassing all forms of arts including music, theater, dance, visual arts, literature, multimedia and design, folk, and traditional arts to engage the participation of all older Americans; promotion of innovative public and private partnerships to support arts program development, including workforce development (e.g., artists, social workers, and health care providers); and public awareness of the importance of arts participation to healthy aging. Through the leadership of the National Endowment for the Arts and U.S. Department of Health and Human Services, thinking about the arts and aging has broadened to include greater emphasis on a whole-person approach to the health and well-being of older adults. This approach engages older adults in arts participation not only as audience members, but as vital members of their community through creative expression focusing on life stories for intergenerational as well as interprofessional collaboration. This article reviews progress made to date and identifies critical gaps in services for future consideration at a 2015 Mini-Conference on Creativity and Aging related to the WCHoA area of emphasis on healthy aging.
Wells, Yvonne; de Vaus, David; Kendig, Hal; Quine, Susan
The capacity to measure change is essential in examining successful adaptation to ageing. Few studies measuring change have compared findings using pre-post approaches (employing difference scores) with those from retrospective approaches (employing self-ratings). Where this has occurred, differences have been attributed either to ceiling and…
Madey, Scott F.; Chasteen, Alison L.
This experiment investigated how age-related health stereotypes affect people's judgments of younger and older patients' medical compliance. Previous research has shown that stereotypes of young adults include healthy components, but stereotypes of older adults include both healthy and unhealthy components (Hummert, 1990). We predicted that…
Ricciardi, Walter; Specchia, Maria Lucia; Marino, Marta
Population ageing is a major challenge for European Union (EU) society and economy, particularly for Italy, which is the oldest country in Europe. According to the World Health Organization, two-thirds of European citizens who have reached the retirement age suffer from at least two chronic conditions, with a strong pressure on healthcare systems. Moreover, EU countries already spend, on average, more than a quarter of their gross domestic product on social protection, above all pensions, health and long term care. The current financial crisis is putting a strain on this system. In this context, it becomes increasingly necessary to promote a healthy and independent ageing, by improving outcomes for patients and society while ensuring health systems sustainability. To this purpose a proactive approach to chronic diseases prevention (primary, secondary and tertiary) as well as an integrated healthcare approach and also patients' empowerment are required so as to make daily life more age-friendly. It is also necessary to share health and social best practices, adopt policies really effective against elderly social exclusion and strengthen older people participation in society. A joint effort of all key stakeholders is needed to create a society in which older people can play an active role.
Chalmers, J M
The ageing Australian population living in the new millennium has dental needs that are very different and more complex than those experienced by previous older adult cohorts during the twentieth century. A summary of the oral health status of older Australians is presented, together with a review of the important relationships between general health and oral health. The key to maintaining and improving older adults' oral health status is the use of oral health promotion strategies that focus not only on dental characteristics, but also on the life characteristics of older adults, and on their quality of life issues. Traditionally, there has been very limited geriatric oral health promotion, with several myths contributing to this situation. Contemporary geriatric oral health promotion in the new millenium has an evidence-based and planned approach. It encompasses not only the treatment of oral diseases and conditions, but has an increased focus on the prevention of oral diseases and conditions to enhance oral health status and older adults' quality of life. Using the Ottawa Charter and a functional dependence classification, a geriatric oral health promotion matrix is presented, using a specific example of Australian residential care.
Payne, Carolyn; Hedberg, E. C.; Kozloski, Michael; Dale, William
Introduction. National Social Life, Health, and Aging Project (NSHAP) included five unique mental health measures in Waves 1 and 2 that researchers can use to measure the overall emotional health of participants: depressive symptoms, happiness–unhappiness, anxiety symptoms, perceived stress, and felt loneliness. For each, we detail the rationale for its development and explain how to score, analyze, and interpret results. Method. NSHAP developed its measures by modifying traditional short-form scales to improve response efficiency and reduce respondent burden. Scoring protocols and interpretations were developed for each measure. U.S. population estimates for older adults born between 1920 and 1947 were generated using age-eligible samples from Waves 1 and 2. Results. NSHAP’s protocols yielded U.S. prevalence rates similar to other nationally representative studies of older adults and comparable between waves. Higher estimates of anxiety symptoms and perceived stress in Wave 2 compared with Wave 1 were explained by age, administration mode, and time period. Analytic strategies for longitudinal analyses are provided. In Wave 2, mental health generally was worse at older ages, with women having more symptoms at younger ages than men. Women had fewer anxiety symptoms at the oldest ages. Discussion. NSHAP’s mental health measures were successfully integrated into the project’s survey and showed acceptable external reliability as well as moderately stable individual characteristics across the 5 years between Waves 1 and 2. Depressive symptoms and unhappiness may form a mental health cluster in the elderly, distinct from anxiety symptoms, perceived stress, and felt loneliness. Gender differences in age-specific patterns of mental health were evident using the exact age of participants rather than the traditional decade groupings. Administration mode and time period (between 2005–2006 and 2010–2011) were determined to be potential confounds that need to be
Kowal, Paul; Chatterji, Somnath; Naidoo, Nirmala; Biritwum, Richard; Fan, Wu; Lopez Ridaura, Ruy; Maximova, Tamara; Arokiasamy, Perianayagam; Phaswana-Mafuya, Nancy; Williams, Sharon; Snodgrass, J Josh; Minicuci, Nadia; D'Este, Catherine; Peltzer, Karl; Boerma, J Ties
Population ageing is rapidly becoming a global issue and will have a major impact on health policies and programmes. The World Health Organization's Study on global AGEing and adult health (SAGE) aims to address the gap in reliable data and scientific knowledge on ageing and health in low- and middle-income countries. SAGE is a longitudinal study with nationally representative samples of persons aged 50+ years in China, Ghana, India, Mexico, Russia and South Africa, with a smaller sample of adults aged 18-49 years in each country for comparisons. Instruments are compatible with other large high-income country longitudinal ageing studies. Wave 1 was conducted during 2007-2010 and included a total of 34 124 respondents aged 50+ and 8340 aged 18-49. In four countries, a subsample consisting of 8160 respondents participated in Wave 1 and the 2002/04 World Health Survey (referred to as SAGE Wave 0). Wave 2 data collection will start in 2012/13, following up all Wave 1 respondents. Wave 3 is planned for 2014/15. SAGE is committed to the public release of study instruments, protocols and meta- and micro-data: access is provided upon completion of a Users Agreement available through WHO's SAGE website (www.who.int/healthinfo/systems/sage) and WHO's archive using the National Data Archive application (http://apps.who.int/healthinfo/systems/surveydata).
Wilcox, Sara; Altpeter, Mary; Anderson, Lynda A; Belza, Basia; Bryant, Lucinda; Jones, Dina L; Leith, Katherine H; Phelan, Elizabeth A; Satariano, William A
There is an urgent need to translate science into practice and help enhance the capacity of professionals to deliver evidence-based programming. We describe contributions of the Healthy Aging Research Network in building professional capacity through online modules, issue briefs, monographs, and tools focused on health promotion practice, physical activity, mental health, and environment and policy. We also describe practice partnerships and research activities that helped inform product development and ways these products have been incorporated into real-world practice to illustrate possibilities for future applications. Our work aims to bridge the research-to-practice gap to meet the demands of an aging population.
Hughes, Anne K; Lewinson, Terri D W
Many women experience changes in sexual health as they age, and discussing these changes with health care providers is an essential component of optimal health management. The purpose of this study was to understand aging women's perspectives about communicating with providers about sexual health. We used the integrative model of behavioral prediction as a theoretical lens to explore women's attitudes, perceived norms, and perceived self-efficacy that promote or inhibit the likelihood of communicating about sexual health. In this theory-based qualitative study, we interviewed 28 community-dwelling older women in the Midwestern United States. Through thematic analysis, we identified both positive and negative attitudes about communicating with providers. Women seemed most inclined to discuss sexual health if they perceived that important patient-provider conditions, such as trust and rapport, were in place. Despite situational obstacles and perceived norms, these women held strong beliefs about their abilities to discuss sexual health topics with providers.
Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L
This study assesses the prevalence of primary-care physician (PCP) bypass among rural middle-aged and older adults. Bypass is a behavior where people travel beyond local providers to obtain health care. This article applies a precise Geographic Information System (GIS)-based measure of bypass and examines the role of community and non-health-care-related characteristics on bypass. Our results indicate that bypass behavior among rural middle-aged and older adults is multifaceted. In addition to the perceived quality of local primary care, dissatisfaction with local services, such as shopping, creates an effect that increases the likelihood of bypass, whereas strong community ties decrease the likelihood of bypass. The results suggest that the "outshopping theory," where respondents select services in larger regional economic centers rather than local "mom and pop" providers, now extends to older adult health care selection.
Helbostad, Jorunn L.; Vereijken, Beatrix; Becker, Clemens; Todd, Chris; Taraldsen, Kristin; Pijnappels, Mirjam; Aminian, Kamiar; Mellone, Sabato
The European population is ageing, and there is a need for health solutions that keep older adults independent longer. With increasing access to mobile technology, such as smartphones and smartwatches, the development and use of mobile health applications is rapidly growing. To meet the societal challenge of changing demography, mobile health solutions are warranted that support older adults to stay healthy and active and that can prevent or delay functional decline. This paper reviews the literature on mobile technology, in particular wearable technology, such as smartphones, smartwatches, and wristbands, presenting new ideas on how this technology can be used to encourage an active lifestyle, and discusses the way forward in order further to advance development and practice in the field of mobile technology for active, healthy ageing. PMID:28335475
Helbostad, Jorunn L; Vereijken, Beatrix; Becker, Clemens; Todd, Chris; Taraldsen, Kristin; Pijnappels, Mirjam; Aminian, Kamiar; Mellone, Sabato
The European population is ageing, and there is a need for health solutions that keep older adults independent longer. With increasing access to mobile technology, such as smartphones and smartwatches, the development and use of mobile health applications is rapidly growing. To meet the societal challenge of changing demography, mobile health solutions are warranted that support older adults to stay healthy and active and that can prevent or delay functional decline. This paper reviews the literature on mobile technology, in particular wearable technology, such as smartphones, smartwatches, and wristbands, presenting new ideas on how this technology can be used to encourage an active lifestyle, and discusses the way forward in order further to advance development and practice in the field of mobile technology for active, healthy ageing.
Bernabé, Eduardo; Sabbah, Wael; Delgado-Angulo, Elsa K; Murasko, Jason E; Gansky, Stuart A
This study aimed to confirm whether the well-known income disparities in oral health seen over the life course are indeed absent in 9- to 11-yr-old children, and to explore the role of access to dental care in explaining the age-profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1-5, 6-8, 9-11, 12-14, and 15-17 yr), using survey logistic regression to control for family-, parental-, and child-level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9- to 11-yr-old children. Different age-patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9- to 11-yr-old children, was also seen in 15- to 17-, 12- to 14-, and 6- to 8-yr-old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9- to 11-yr-old children. Access to dental care could attenuate income gradients in oral health in other age groups.
Jasien, Joan; Daimon, Caitlin M.; Maudsley, Stuart; Shapiro, Bruce K.; Martin, Bronwen
Low bone mass density (BMD), a classical age-related health issue and a known health concern for fair skinned, thin, postmenopausal Caucasian women, is found to be common among individuals with developmental/intellectual disabilities (D/IDs). It is the consensus that BMD is decreased in both men and women with D/ID. Maintaining good bone health is important for this population as fractures could potentially go undetected in nonverbal individuals, leading to increased morbidity and a further loss of independence. This paper provides a comprehensive overview of bone health of adults with D/ID, their risk of fractures, and how this compares to the general aging population. We will specifically focus on the bone health of two common developmental disabilities, Down syndrome (DS) and cerebral palsy (CP), and will discuss BMD and fracture rates in these complex populations. Gaining a greater understanding of how bone health is affected in individuals with D/ID could lead to better customized treatments for these specific populations. PMID:22888344
Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E.
Objectives The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child’s development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Methods Using data from a national urban birth cohort study in the U.S., we estimate the effects of prenatal care on four markers of child health at age 5—maternal-reported health status, asthma diagnosis, overweight, and height. We implement a number of different strategies to address the issue of potential omitted variables bias as well as a large number of specification checks to validate the findings. Results and Conclusions Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children’s health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime helathcare on child health. PMID:22374319
Noonan, Kelly; Corman, Hope; Schwartz-Soicher, Ofira; Reichman, Nancy E
The broad goal of contemporary prenatal care is to promote the health of the mother, child, and family through the pregnancy, delivery, and the child's development. Although the vast majority of mothers giving birth in developed countries receive prenatal care, past research has not found compelling evidence that early or adequate prenatal care has favorable effects on birth outcomes. It is possible that prenatal care confers health benefits to the child that do not become apparent until after the perinatal period. Using data from a national urban birth cohort study in the US, we estimate the effects of prenatal care on four markers of child health at age 5-maternal-reported health status, asthma diagnosis, overweight, and height. Prenatal care, defined a number of different ways, does not appear to have any effect on the outcomes examined. The findings are robust and suggest that routine health care encounters during the prenatal period could potentially be used more effectively to enhance children's health trajectories. However, future research is needed to explore the effects of prenatal care on additional child health and developmental outcomes as well as the effects of preconceptional and maternal lifetime healthcare on child health.
Collins, Sandra K; Collins, Kevin S
With the workforce growing older and the supply of younger workers diminishing, it is critical for health care managers to understand the factors necessary to capitalize on their vintage employees. Retaining this segment of the workforce has a multitude of benefits including the preservation of valuable intellectual capital, which is necessary to ensure that health care organizations maintain their competitive advantage in the consumer-driven market. Retaining the aging employee is possible if health care managers learn the motivators and training differences associated with this category of the workforce. These employees should be considered a valuable resource of human capital because without their extensive expertise, intense loyalty and work ethic, and superior customer service skills, health care organizations could suffer severe economic repercussions in the near future.
Self-assessments of health are important because they appear to be good predictors of future physical health. To examine age differences in self-reports of health, the self-ratings of 149 adults (53.8 percent over 65 years of age; 46.2 percent 64 or younger; average age 57.1) were compared. Subjects were elderly participants in a community…
Ogletree, Roberta, Ed.; Doyle, Kathy, Ed.
This monograph presents a collection of papers related to health issues and aging: "Introduction" (Paul Simon); "Memory, Aging, and Cognition" (Rita E. Arras); "Internet Resources for the Elderly and Their Caregivers" (Kathleen Doyle); "Unintentional Injuries in the Homes of the Elderly: A Look at Current…
Burt, Vicki L.; Harris, Tamara
Describes third National Health and Nutrition Examination Survey (NHANES III), noting that upper age limit was removed and that older black, Mexican American, and white populations were oversampled. Sees NHANES III component for older adults providing multidimensional overview of physical and functional health status (osteoporosis; arthritis;…
Ebener, M; Hasselhorn, H M
Working life in Germany is changing. The work force is ageing and the number of people available to the labour market will - from now on - shrink considerably. Prospectively, people will have to work longer; but still today, most people leave employment long before reaching official retirement age. What are the reasons for this? In this report, a conceptual framework and the German lidA Cohort Study are presented. The "lidA conceptual framework on work, age, health and work participation" visualises determinants of employment (11 "domains") in higher working age, e. g., "work", "health", "social status" and "life style". The framework reveals 4 key characteristics of withdrawal from work: leaving working life is the result of an interplay of different domains (complexity); (early) retirement is a process with in part early determinants in the life course (processual character); retirement has a strong individual component (individuality); retirement is embedded in a strong structural frame (structure). On the basis of this framework, the "lidA Cohort Study on work, age, health and work participation" (www.lida-studie.de) investigates long-term effects of work on health and work participation in the ageing work force in Germany. It is the only large study in Germany operationalising the concept of employability in a broad interdisciplinary approach. Employees subject to social security and born in 1959 or in 1965 will be interviewed (CAPI) every 3 years (N[wave 1]=6 585, N[wave 2]=4 244) and their data will be linked (where consented) with social security data covering employment history and with health insurance data. The study design ("Schaie's most efficient design") allows for a tri-factor model that isolates the impact of age, cohort and time. In 2014, the second wave was completed. In the coming years lidA will analyse the association of work, health and work participation, and identify age as well as generation differences. lidA will investigate the
van Staveren, W. A.
The ageing process is—apart from chance or good luck—not only influenced by factors intrinsic to the individual, but also by extrinsic factors that include environmental and lifestyle variables. This paper deals with the epidemiological evidence for the role of dietary patterns and key nutritional concerns in relation to survival and ageing related disorders that present themselves in later life. Dietary patterns, such as the Mediterranean diet, characterized by mainly plant foods including protective factors e.g. vegetables, nuts and monounsaturated fatty acids and excluding harmful factors e.g. trans-fatty acids and foods with a high glycemic factor, appear to be relevant even in old age. Specific nutritional concerns focus on general undernutrition, vitamin D and vitamin B12. Prevalence of nutritional inadequacies, diagnostic criteria, causes and health consequences are described. The paper ends with recommendations for guidance on healthy diets for elderly people. An important challenge should be research to further expand the knowledge base, acknowledging the complexity of the ageing process and integrating different dimensions of research into human healthy ageing in properly designed studies. In the mean time reversing poor adherence to existing guidelines for a healthy diet remains a first challenge in public health nutritional practices. PMID:20495957
Background The health of the agricultural population has been previously explored, particularly in relation to the farming exposures and among professionally active individuals. However, few studies specifically focused on health and aging among elders retired from agriculture. Yet, this population faces the long-term effects of occupational exposures and multiple difficulties related to living and aging in rural area (limited access to shops, services, and practitioners). However, these difficulties may be counter-balanced by advantages related to healthier lifestyle, richer social support and better living environment. The general aim of the AMI cohort was to study health and aging in elderly farmers living in rural area through a multidisciplinary approach, with a main focus on dementia. Methods/design The study initially included 1 002 participants, randomly selected from the Farmer Health Insurance rolls. Selection criteria were: being 65 years and older; living in rural area in Gironde (South-Western France); being retired from agriculture after at least 20 years of activity and being affiliated to the Health Insurance under own name. The study started in 2007, with two follow-up visits over 5 years. Baseline visits were conducted at home by a neuropsychologist then by a geriatrician for all cases suspected of dementia, Parkinson’s disease and depression (to confirm the diagnosis), and by a nurse for others. A large panel of data were collected through standardised questionnaires: complete neuropsychological assessment, material and social living environment, psychological transition to retirement, lifestyle (smoking, alcohol and diet), medications, disability in daily living, sensory impairments and some clinical measures (blood pressure, depression symptomatology, anxiety, visual test, anthropometry…). A blood sampling was performed with biological measurements and constitution of a biological bank, including DNA. Brain MRI were also performed on
Biagi, Elena; Candela, Marco; Turroni, Silvia; Garagnani, Paolo; Franceschi, Claudio; Brigidi, Patrizia
The ageing process affects the human gut microbiota phylogenetic composition and its interaction with the immune system. Age-related gut microbiota modifications are associated with immunosenescence and inflamm-ageing in a sort of self-sustaining loop, which allows the placement of gut microbiota unbalances among both the causes and the effects of the inflamm-ageing process. Even if, up to now, the link between gut microbiota and the ageing process is only partially understood, the gut ecosystem shows the potential to become a promising target for strategies able to contribute to the health status of older people. In this context, the consumption of pro/prebiotics may be useful in both prevention and treatment of age-related pathophysiological conditions, such as recovery and promotion of immune functions, i.e. adjuvant effect for influenza vaccine, and prevention and/or alleviation of common "winter diseases", as well as constipation and Clostridium difficile-associated diarrhoea. Moreover, being involved in different mechanisms which concur in counteracting inflammation, such as down-regulation of inflammation-associated genes and improvement of colonic mucosa conditions, probiotics have the potentiality to be involved in the promotion of longevity.
Russell, Richard; Sweda, Jennifer R; Porcheron, Aurélie; Mauger, Emmanuelle
Redness or yellowness of the sclera (the light part of the eye) are known signs of illness, as is looking older than one's actual age. Here we report that the color of the sclera is related to age in a large sample of adult Caucasian females. Specifically, older faces have sclera that are more dark, red, and yellow than younger faces. A subset of these faces were manipulated to increase or decrease the darkness, redness, or yellowness of the sclera. Faces with decreased sclera darkness, redness, or yellowness were perceived to be younger than faces with increased sclera darkness, redness, or yellowness. Further, these manipulations also caused the faces to be perceived as more or less healthy, and more or less attractive. These findings show that sclera coloration is a cue for the perception of age, health, and attractiveness that is rooted in the physical changes that occur with age.
Spitzer, William J; Davidson, Kay W
Major economic, political, demographic, social, and operational system factors are prompting evolutionary changes in health care delivery. Of particular significance, the "graying of America" promises new challenges and opportunities for health care social work. At the same time, the Patient Protection and Affordable Care Act of 2010, evolution of Accountable Care Organizations, and an emphasis on integrated, transdisciplinary, person-centered care represent fundamental shifts in service delivery with implications for social work practice and education. This article identifies the aging shift in American demography, its impact on health policy legislation, factors influencing fundamentally new service delivery paradigms, and opportunities of the profession to address the health disparities and care needs of an aging population. It underscores the importance of social work inclusion in integrated health care delivery and offers recommendations for practice education.
Eisenhower, Abbey; Blacher, Jan; Baker, Bruce L.
The self-perceived physical health of mothers raising children with developmental delay (DD; N = 116) or typical development (TD; N = 129) was examined across child ages 3-9 years, revealing three main findings. First, mothers of children with DD experienced poorer self-rated physical health than mothers of children with TD at each age. Latent…
Lorente, Laura; Salanova, Marisa; Martínez, Isabel M; Vera, María
Traditionally, research focussing on psychosocial factors in the construction industry has focused mainly on the negative aspects of health and on results such as occupational accidents. This study, however, focuses on the specific relationships among the different positive psychosocial factors shared by construction workers that could be responsible for occupational well-being and outcomes such as performance. The main objective of this study was to test whether personal resources predict self-rated job performance through job resources and work engagement. Following the predictions of Bandura's Social Cognitive Theory and the motivational process of the Job Demands-Resources Model, we expect that the relationship between personal resources and performance will be fully mediated by job resources and work engagement. The sample consists of 228 construction workers. Structural equation modelling supports the research model. Personal resources (i.e. self-efficacy, mental and emotional competences) play a predicting role in the perception of job resources (i.e. job control and supervisor social support), which in turn leads to work engagement and self-rated performance. This study emphasises the crucial role that personal resources play in determining how people perceive job resources by determining the levels of work engagement and, hence, their self-rated job performance. Theoretical and practical implications are discussed.
Davidson, Fred; Henning, Grant
Presents a study of how well a set of language proficiency self-ratings fit the predictions of a probabilistic measurement model known as the Rasch Model. Applies the principles of the model to scalar rather than binary item response data. Concludes that scalar analysis of this kind is feasible with self-rating data. (Author/SED)
Aggarwal, Neelum T; Everson-Rose, Susan A; Evans, Denis A
The broad spectrum of economic and cultural diversity in the U.S. population correlates with and affects the study of behavioral aspects of health. The purpose of this article is to provide a selective overview of research findings from the Chicago Health and Aging Project (CHAP), which covers a socio-demographically diverse population in Chicago, with a focus on role-related psychosocial factors and observed racial/ethnic differences in aging outcomes. CHAP is a longitudinal, epidemiological study of common chronic conditions of aging with an emphasis on medical, psychosocial, and environmental risk factors for the decline in cognitive function across the older adult lifespan. We briefly summarize the study design and methods used in the CHAP study and characterize the study population and describe the psychosocial data, noting black-white associations as they relate to three common brain health outcomes: cognitive function and Alzheimer's Disease, stroke, and subclinical vascular disease as noted on neuroimaging.
Background Heat shock proteins (Hsp) are ubiquitously synthesised in virtually all species and it is hypothesised that they might have beneficial health effects. Recent studies have identified circulating Hsp as an important mediator in inflammation - the effects of low-grade inflammation in the aging process are overwhelming. While much is known about intracellular Hsp70, scant data exist on circulating Hsp70 in the aging context. Therefore, the objectives of this study were to investigate the effect of age and disease on circulating Hsp70 and, in particular, to evaluate the association between circulating Hsp70 and inflammatory parameters. Results Serum Hsp70, Interleukin (IL) -10, IL-6 and Tumor Necrosis Factor (TNF) alpha concentrations were determined in 90 hospitalised geriatric patients (aged 83 ± 6 years) and in 200 community-dwelling control subjects (100 elderly, aged 74 ± 5 years, and 100 young, aged 23 ± 3 years). In the community-dwelling elderly, serum Hsp70 and IL-10 concentrations were significantly lower and IL-6 was significantly higher when compared to healthy young control subjects. Elderly patients presenting inflammation (CRP serum levels ≥5 mg/L) showed significantly (p = 0.007) higher Hsp70 values; and Hsp70 correlated positively (p < 0.001) with IL-6 and CRP, but not with TNF-alpha or IL-10. A significant association was also noted between Hsp70 levels and the degree of dependency and cognitive decline in geriatric patients. Conclusions The present data provide new evidence that serum concentration of Hsp70 decreases with age in a normal population. Our study also shows that higher levels of Hsp70 are associated with inflammation and frailty in elderly patients. PMID:21443787
Hunt, R W
Daniel Callahan has argued that economic and social benefits would result from a policy of withholding medical treatments which prolong life in persons over a certain age. He claims 'the real goal of medicine' is to conquer death and prolong life with the use of technology, regardless of the age and quality of life of the patient, and this has been responsible for the escalation of health care expenditure. Callahan's proposal is based on economic rationalism but there is little evidence to suggest that substantial economic savings could be achieved. Moreover, his argument raises serious moral objections. A policy of withholding treatments from members of a social group involves elements of compulsion and discrimination, both of which would intrude on the doctor-patient relationship, undermine the autonomy of elderly patients, and invoke the slippery slope towards involuntary forms of euthanasia. Life-death decisions should be based on more than the one criterion of age, and take account of more relevant factors such as the patient's usual state of well-being, her/his expressed wishes, informed consent and the type of illness. Any move to the implementation and enforcement of the policy Callahan recommends would be rejected by health professionals and the public. PMID:8459434
Kulkarni, Chetan S.; Celaya, Jose Ramon; Biswas, Gautam; Goebel, Kai
This paper discusses experimental setups for health monitoring and prognostics of electrolytic capacitors under nominal operation and accelerated aging conditions. Electrolytic capacitors have higher failure rates than other components in electronic systems like power drives, power converters etc. Our current work focuses on developing first-principles-based degradation models for electrolytic capacitors under varying electrical and thermal stress conditions. Prognostics and health management for electronic systems aims to predict the onset of faults, study causes for system degradation, and accurately compute remaining useful life. Accelerated life test methods are often used in prognostics research as a way to model multiple causes and assess the effects of the degradation process through time. It also allows for the identification and study of different failure mechanisms and their relationships under different operating conditions. Experiments are designed for aging of the capacitors such that the degradation pattern induced by the aging can be monitored and analyzed. Experimental setups and data collection methods are presented to demonstrate this approach.
Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R. Paul
The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states. PMID:27594848
Davis, Adrian; McMahon, Catherine M; Pichora-Fuller, Kathleen M; Russ, Shirley; Lin, Frank; Olusanya, Bolajoko O; Chadha, Shelly; Tremblay, Kelly L
Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice.
Arboleya, Silvia; Watkins, Claire; Stanton, Catherine; Ross, R Paul
The intestinal microbiota has increasingly been shown to have a vital role in various aspects of human health. Indeed, several studies have linked alterations in the gut microbiota with the development of different diseases. Among the vast gut bacterial community, Bifidobacterium is a genus which dominates the intestine of healthy breast-fed infants whereas in adulthood the levels are lower but relatively stable. The presence of different species of bifidobacteria changes with age, from childhood to old age. Bifidobacterium longum, B. breve, and B. bifidum are generally dominant in infants, whereas B. catenulatum, B. adolescentis and, as well as B. longum are more prevalent in adults. Increasingly, evidence is accumulating which shows beneficial effects of supplementation with bifidobacteria for the improvement of human health conditions ranging from protection against infection to different extra- and intra-intestinal positive effects. Moreover, bifidobacteria have been associated with the production of a number of potentially health promoting metabolites including short chain fatty acids, conjugated linoleic acid and bacteriocins. The aim of this mini-review is to describe the bifidobacteria compositional changes associated with different stages in life, highlighting their beneficial role, as well as their presence or absence in many disease states.
Lee, Ju-Mi; Lee, Won Joon; Kim, Hyeon Chang; Choi, Wungrak; Lee, Jina; Sung, Kiho; Chu, Sang Hui; Park, Yeong-Ran; Youm, Yoosik
The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr). PMID:24876995
Searby, Adam; Maude, Phil; McGrath, Ian
Oral administration of methadone has been used as a treatment strategy for opiate addiction for many years. The state of Victoria, Australia, has a long-running methadone program with a large number of participants. Accordingly, a growing number of adults have utilised methadone maintenance treatment for a number of years and are now moving into older age due to advances in medical treatment and harm reduction initiatives. The objective of this review is to examine the literature pertaining to co-occurring mental illness in older methadone treatment participants and to explore the future challenges this growing cohort of ageing adults pose to aged persons’ psychiatry services. As part of a broader study into dual diagnosis in older adults, a search of the Scopus, ProQuest, and CINAHL journal databases was performed. Twenty abstracts from literature published within the previous 15 years (1999–2014) were identified that explored methadone maintenance programs and the older adults maintained on them. A number of researchers have identified the ageing methadone population to have a high degree of comorbid mental illness and psychological distress. Studies also indicate that individuals enrolled in methadone maintenance programs may engage in a degree of continual substance use, potentially leading to deleterious effects on their psychosocial function. An ageing methadone population experiencing a high degree of comorbid mental illness is likely to challenge aged persons’ psychiatry services. These services are likely to be increasingly called on to manage these individuals, particularly within Victoria where few substance use services exist for those over the age of 65. It is essential that aged persons’ psychiatry services prepare to provide care for these individuals in a responsive manner that is inclusive of both their mental health and substitution pharmacotherapy.
Bialystok, Ellen; Abutalebi, Jubin; Bak, Thomas H; Burke, Deborah M; Kroll, Judith F
With the population aging and a dramatic increase in the number of senior citizens, public health systems will be increasingly burdened with the need to deal with the care and treatment of individuals with dementia. We review evidence demonstrating how a particular experience, bilingualism, has been shown to protect cognitive function in older age and delay onset of symptoms of dementia. This paper describes behavioral and brain studies that have compared monolingual and bilingual older adults on measures of cognitive function or brain structure and reviews evidence demonstrating a protective effect of bilingualism against symptoms of dementia. We conclude by presenting some data showing the potential savings in both human costs in terms of demented patients and economic considerations in terms of public money if symptoms of dementia could be postponed.
Fink, Bernhard; Hufschmidt, Carla; Hirn, Thomas; Will, Susanne; McKelvey, Graham; Lankhof, John
The social significance of physical appearance and beauty has been documented in many studies. It is known that even subtle manipulations of facial morphology and skin condition can alter people’s perception of a person’s age, health and attractiveness. While the variation in facial morphology and skin condition cues has been studied quite extensively, comparably little is known on the effect of hair on social perception. This has been partly caused by the technical difficulty of creating appropriate stimuli for investigations of people’s response to systematic variation of certain hair characteristics, such as color and style, while keeping other features constant. Here, we present a modeling approach to the investigation of human hair perception using computer-generated, virtual (rendered) human hair. In three experiments, we manipulated hair diameter (Experiment 1), hair density (Experiment 2), and hair style (Experiment 3) of human (female) head hair and studied perceptions of age, health and attractiveness. Our results show that even subtle changes in these features have an impact on hair perception. We discuss our findings with reference to previous studies on condition-dependent quality cues in women that influence human social perception, thereby suggesting that hair is a salient feature of human physical appearance, which contributes to the perception of beauty. PMID:28066276
Duncan, Sylvia H; Flint, Harry J
In healthy adults microbial communities that colonise different regions of the human colon contribute nutrients and energy to the host via the fermentation of non-digestible dietary components in the large intestine. A delicate balance of microbial species is required to maintain healthy metabolism and immune function. Disturbance in this microbial balance can have negative consequences for health resulting in elevated inflammation and infection, that are contributory factors in diabetes and cancer. There is a growing awareness that the microbial balance in the colon may become increasingly perturbed with aging and therefore hasten the onset of certain diseases. Societal and dietary factors influence microbial community composition both in the short and long term in the elderly (>65 years old) whilst immunosenescence may also be linked to a perturbed distal gut microbiota and frailty in the elderly. Significant progress has been made in defining some of the dominant members of the microbial community in the healthy large intestine and in identifying their roles in metabolism. There is therefore an urgent need for better awareness of the impact of diet, prebiotic and probiotic strategies in driving human colonic microbial composition in order to understand the possibilities for maintaining healthy gut function and well-being in an increasingly elderly population. Here we review gut microbial changes associated with aging and how diet, prebiotics and probiotics may modulate the gut microbiota to maintain health in the elderly.
Fink, Bernhard; Hufschmidt, Carla; Hirn, Thomas; Will, Susanne; McKelvey, Graham; Lankhof, John
The social significance of physical appearance and beauty has been documented in many studies. It is known that even subtle manipulations of facial morphology and skin condition can alter people's perception of a person's age, health and attractiveness. While the variation in facial morphology and skin condition cues has been studied quite extensively, comparably little is known on the effect of hair on social perception. This has been partly caused by the technical difficulty of creating appropriate stimuli for investigations of people's response to systematic variation of certain hair characteristics, such as color and style, while keeping other features constant. Here, we present a modeling approach to the investigation of human hair perception using computer-generated, virtual (rendered) human hair. In three experiments, we manipulated hair diameter (Experiment 1), hair density (Experiment 2), and hair style (Experiment 3) of human (female) head hair and studied perceptions of age, health and attractiveness. Our results show that even subtle changes in these features have an impact on hair perception. We discuss our findings with reference to previous studies on condition-dependent quality cues in women that influence human social perception, thereby suggesting that hair is a salient feature of human physical appearance, which contributes to the perception of beauty.
Xu, Wei; Cai, Gong–Jie; Li, Guan–Nan; Cao, Jing–Jing; Shi, Qiong–Hua; Bai, Jie
Background The New Cooperative Medical Scheme (NCMS) for peasantries implemented in 2003 and the Urban Resident Basic Medical Insurance (URBMI) for the urban unemployed implemented in 2007 have many similarities. They both apply the financing mode of individual premiums plus government’s subsidies, and the voluntary enrollment. The Chinese government plans to integrate these two systems and build a unified basic medical insurance system for the unemployed in order to achieve the medical equity and increase the general health level. Thus, to analyze the main influencing factors of the enrollment of the urban unemployed and rural residents is very important for improving the system and securing the stability of the system during the transition. Methods The study uses data from the China Health and Nutrition Survey (CHNS) and adopts logistic regression models to test which factors influence the enrollment of the URBMI and the NCMS under the background of rather high enrollment rate of Chinese basic medical insurances and strong fiscal support of the Chinese government, especially whether health status or age influences enrollment of these two insurances greater. Results There is indeed some adverse selection in the URBMI and the NCMS. Whether the individual has chronic diseases have significant influence on enrollments of both the urban unemployed and rural residents, while whether the individual got ill in last four weeks just influences enrollments of the urban unemployed. Age influences enrollment greater than health status. The older the insured are, the larger the enrollment rates are. Conclusion Because of the active support for basic medical insurances of the Chinese government, the enrollment performance of the urban unemployed and rural residents has already changed. When implementing the new policy, the government should pay attention to the willingness to enroll in and the change of enrollment performance of the insured. Therefore, under the policy of
Atlanta Regional Commission, GA.
The aging network has been slow to embrace health promotion activities as core services to the aging population. Therefore, advocates for business and aging partnerships in health promotion activities must first educate their colleagues about the value of health promotion programs before looking for partners in the business community. The goal of…
Background Health state utility values (HSUVs) are important in the assessment of the cost effectiveness of new interventions. In the case of visual conditions, models generally tend have tended to be built around a set of health states defined by visual acuity (VA). The aim of this review was to assess the impact of VA on HSUVs in patients with diabetic retinopathy, diabetic macular oedema or age-related macular degeneration. Methods A systematic literature search was undertaken in major bibliographic databases to identify articles reporting on the relationship between HSUVs and vision. Data were extracted for population characteristics, visual levels and estimated utilities. Evidence from reported statistical models, where available, was considered in the evaluation of vision in the better-seeing eye and the worse-seeing eye. Due to the heterogeneity of included studies, a narrative synthesis was undertaken. Results Of the 17 relevant studies, 9 studies had data that could be used in the analysis of the impact of vision on HSUVs. Visual loss was associated with a marked impact on health utilities. However, the relationship was not comparable between conditions or by measure of HSUVs. Key results included the finding that overall, self-rated time-trade off estimates were more likely to discriminate between different VA levels than EQ-5D values. Additionally, a stronger correlation was observed between HSUVs and better-seeing eye VA compared to worse-seeing eye VA. Conclusions Visual acuity has a significant impact on HSUVs. Nevertheless, care must be taken in the interpretation and use of estimates in cost-effectiveness models due to differences in measures and population diversity. PMID:24304921
Pitt-Catsouphes, Marcie; James, Jacquelyn Boone; Matz-Costa, Christina
Workplace-based health and wellness programs (HWPs) may be an obvious yet under-utilized strategy for promoting positive health-related behaviors among older workers and for increasing their ability to continue to work. Given the unprecedented number of older adults who extend their labor force attachment beyond traditional retirement ages, a new vision of older adults' economic security and overall quality-of-life should take into account the intersections of aging, work, and health. The purpose of this article is to: (a) discuss the workplace as an increasingly important setting that can expand the reach and effectiveness of health promotion efforts; (b) examine current knowledge of barriers and facilitators that can affect older workers' participation in workplace-based HWPs; and (c) suggest new incentive structures that may increase older workers' engagement in these programs. We develop a rationale for our proposition that sustained participation in HWPs may improve the health status of older workers and reduce health care costs. It is our conclusion that there is significant potential for workplace-based HWPs to support older adults who want to or need to work.
Braun, Tina; Schmukle, Stefan C; Kunzmann, Ute
The primary goal of this study was to address the stability-despite-loss paradox of subjective well-being. Performance-based and self-evaluative measures of cognitive functioning were examined as predictors of subjective well-being in middle-aged and older adults using data from the Interdisciplinary Longitudinal Study of Adult Development (ILSE). Consistent with past work, subjective well-being remained relatively stable over a period of 12 years in both age groups, although performance-based and self-rated cognition declined over time. Cognitive status, as determined by standard psychometric tests of fluid cognitive abilities, was unrelated to longitudinal change in subjective well-being. A symmetrical measure of self-rated cognitive performance predicted intraindividual change in subjective well-being in middle-aged but not older adults. This pattern of findings helps clarify why many older people may be able to maintain their subjective well-being, while their cognitive abilities decline. (PsycINFO Database Record
Ruggiero, Kenneth J; Amstadter, Ananda B; Acierno, Ron; Kilpatrick, Dean G; Resnick, Heidi S; Tracy, Melissa; Galea, Sandro
Overall health status after a disaster may be associated with long-term physical morbidity and mortality. Little is known about factors associated with overall health status in the aftermath of disasters. We examined self-rated health in relation to disaster characteristics, social resources, and post-disaster outcomes in a sample of adults who experienced the 2004 Florida hurricanes. We interviewed a representative sample of 1,452 adults aged 18 years and older residing in the 33 Florida counties that were in the direct path of at least one of the 2004 hurricanes (Charley, Frances, Ivan, Jeanne). Overall health status was assessed using a self-rating format known to be predictive of mortality. Poor self-rated health was endorsed by 14.6% of the sample. Final multivariable models showed that poor self-rated health was associated with older age (p < 0.001), extreme fear during the hurricane (p = 0.03), low social support (p = 0.03), and depression (p = 0.003) since the hurricane. Self-rated health following the Florida hurricanes was strongly associated with two variables (social support and depression) that potentially can be mitigated through targeted interventions after disasters. Future work should evaluate secondary prevention strategies that can address general health-related concerns in the wake of a disaster.
Aichele, Stephen; Rabbitt, Patrick; Ghisletta, Paolo
In a 29-year study of 6,203 individuals ranging in age from 41 to 96 years at initial assessment, we evaluated the relative and combined influence of 65 mortality risk factors, which included sociodemographic variables, lifestyle attributes, medical indices, and multiple cognitive abilities. Reductions in mortality risk were most associated with higher self-rated health, female gender, fewer years as a smoker, and smaller decrements in processing speed with age. Thus, two psychological variables-subjective health status and processing speed-were among the top predictors of survival. We suggest that these psychological attributes, unlike risk factors that are more narrowly defined, reflect (and are influenced by) a broad range of health-related behaviors and characteristics. Information about these attributes can be obtained with relatively little effort or cost and-given the tractability of these measures in different cultural contexts-may prove expedient for prevention, diagnosis, and treatment of conditions related to increased mortality risk in diverse human populations.
Vogt, Dominique; Schaeffer, Doris; Messer, Melanie; Berens, Eva-Maria; Hurrelmann, Klaus
Health literacy is especially important for older people to maintain or enhance remaining health resources and self-management skills. The aim of the study was to determine the level of health literacy and the association between health literacy, demographic and socio-economic factors in German older adults aged 65 years and above stratified by age group. Health literacy was assessed via computer-assisted personal interviews using HLS-EU-Q47 on a representative sample of the German-speaking population. Descriptive statistics, bivariate analyses and logistic regression modelling stratified by age group were conducted to assess health literacy of 475 respondents aged 65 years and above. Overall, 66.3% of all respondents aged 65 years and above had limited health literacy. Limited health literacy was especially prevalent among respondents above 76 years of age (80.6%). Limited health literacy was associated with financial deprivation (OR: 3.05; 95% CI: 1.99-4.67) and limited functional health literacy (OR: 2.16; 95% CI: 1.29-3.61). Financial deprivation was strongest predictor for limited health literacy in the total sample and stratified by age group. Limited health literacy is a frequent phenomenon in German adults aged 65 years and above. Research on health literacy in old age and the role in health disparities is urgently needed.
Farley, Frank H.; Soper, Robert E.
Results show that individuals identified by the personality inventory as extravert or introvert differed significantly in the expected direction on the global self ratings. The results were also obtained for neuroticism. (Author/DEP)
Nascimento, Marília Augusta Sousa; Zucolotto, Daniela Cristina Candela; Sartorelli, Daniela Saes
This population-based cross-sectional study examined the relationship between self-rated living environment and excess body weight in a sample of 216 adults from Itirapuã, São Paulo State, Brazil. Logistic regression adjusted for gender and age showed that people living far from outdoor areas for physical exercise [OR = 2.05 (95%CI: 1.15; 3.66)] and primary schools [OR = 1.99 (95%CI: 1.13; 3.47)] had higher odds of excess weight. Satisfaction with the quality of available supermarkets [OR = 0.14 (95%CI: 0.03; 0.69) p = 0.02], adequate street lighting [OR = 0.37 (95%CI: 0.14; 0.96) p = 0.02], and pedestrians walking on sidewalks within one's line-of-sight [OR = 0.41 (95%CI: 0.18; 0.94) p = 0.03] were inversely associated with excess weight. The results suggest that small-town individuals' negative perceptions of their living environment are associated with excess weight.
Schwerdtle, Barbara; Kanis, Julia; Kübler, Andrea; Schlarb, Angelika A
The Children's Sleep Comic is a standardized self-report questionnaire for assessing insomnia in children ages 5-11 years. The goal of the present study is to introduce a revised version of this measure and to present psychometrics and a cut-off score. Therefore, the revised Children's Sleep Comic, the Sleep Self Report, the Children's Sleep Habits Questionnaire, and the Child Behavior Checklist were applied to a sample of 393 children and their parents. Of the parents who participated voluntarily, a subsample (n = 176) was interviewed on the phone to diagnose their children with sleep disorders according to the International Classification of Sleep Disorders, if applicable. The results indicated that the Children's Sleep Comic is a reliable self-rating instrument for diagnosing childhood insomnia. Internal consistency was α = 0.83; and convergent and divergent validity were adequate. The child-friendly format can foster a good therapeutic relationship, and thus establish the basis for successful intervention.
Brandt, Laura; Pintzinger, Nina M.; Tran, Ulrich S.
Aim To investigate abnormalities in automatic information processing related to self- and observer-rated alexithymia, especially with regard to somatization, controlling for confounding variables such as depression and affect. Sample 89 healthy subjects (60% female), aged 19–71 years (M = 32.1). 58 subjects were additionally rated by an observer. Measures Alexithymia (self-rating: TAS-20, observer rating: OAS); automatic information processing (priming task including verbal [illness-related, negative, positive, neutral] and facial [negative, positive, neutral] stimuli); somatoform symptoms (SOMS-7T); confounders: depression (BDI), affect (PANAS). Results Higher self-reported alexithymia scores were associated with lower reaction times for negative (r = .19, p < .10) and positive (r = .26, p < .05) verbal primes when the target was illness-related. Self-reported alexithymia was correlated with number (r = .42, p < .01) and intensity of current somatoform symptoms (r = .36, p < .01), but unrelated to observer-rated alexithymia (r = .11, p = .42). Discussion Results indicate a faster allocation of attentional resources away from task-irrelevant information towards illness-related stimuli in alexithymia. Considering the close relationship between alexithymia and somatization, these findings are compatible with the theoretical view that alexithymics focus strongly on bodily sensations of emotional arousal. A single observer rating (OAS) does not seem to be an adequate alexithymia-measure in community samples. PMID:26090893
Hahn, Joan Earle; FitzGerald, Leah; Markham, Young Kee; Glassman, Paul; Guenther, Nancy
Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3. PMID:22619708
Sivananthan, Saskia N; Chambers, Larry W
A rapid and feasible priority-setting method conducted within a limited budget was used to identify research topics that would have an influence on health services for older adults. Health and aging researchers, policy makers, and caregivers were recruited to complete Delphi surveys that generated and ranked topics and identified other potential researchers. An interdisciplinary team of researchers was selected to produce and submit a proposal to a peer-review-granting agency. This method can be adapted by organizations to determine the focus of their research agenda and to engage individuals for collaboration on future research projects.
Poulose, Shibu M; Miller, Marshall G; Shukitt-Hale, Barbara
Because of the combination of population growth and population aging, increases in the incidence of chronic neurodegenerative disorders have become a societal concern, both in terms of decreased quality of life and increased financial burden. Clinical manifestation of many of these disorders takes years, with the initiation of mild cognitive symptoms leading to behavioral problems, dementia and loss of motor functions, the need for assisted living, and eventual death. Lifestyle factors greatly affect the progression of cognitive decline, with high-risk behaviors including unhealthy diet, lack of exercise, smoking, and exposure to environmental toxins leading to enhanced oxidative stress and inflammation. Although there exists an urgent need to develop effective treatments for age-related cognitive decline and neurodegenerative disease, prevention strategies have been underdeveloped. Primary prevention in many of these neurodegenerative diseases could be achieved earlier in life by consuming a healthy diet, rich in antioxidant and anti-inflammatory phytochemicals, which offers one of the most effective and least expensive ways to address the crisis. English walnuts (Juglans regia L.) are rich in numerous phytochemicals, including high amounts of polyunsaturated fatty acids, and offer potential benefits to brain health. Polyphenolic compounds found in walnuts not only reduce the oxidant and inflammatory load on brain cells but also improve interneuronal signaling, increase neurogenesis, and enhance sequestration of insoluble toxic protein aggregates. Evidence for the beneficial effects of consuming a walnut-rich diet is reviewed in this article.
Michel, Jean-Pierre; Herrmann, François; Zekry, Dina
Analysis of prospective data collected between 1984 and 2008 by the CERN medical team (European Centre of Nuclear Research, Geneva) concerning 2040 former employees who were retired or had died stimulated our interest on the impact of inequalities in socioeconomic conditions, employment, lifestyle and classical risk factors on health and life expectancy. Such inequalities explain differences in life expectancy, potentially reaching several decades, between rich and poor countries (France vs Swaziland), but also within a given country (USA), a given city (Glasgow) or even a given enterprise (CERN) where all employees have the same level of healthcare insurance and access to treatment. Classical cardiovascular and neurovascular risk factors (smoking, arterial hypertension and lipid disorders) interact with socioeconomic status, intelligence, education, emotions and job responsibility/complexity, precipitating or preventing cardiovascular events. The same is true of dementia, for which midlife risk factors (obesity, arterial hypertension and hypercholesterolemia) should be considered in the psychosocioeconomic context, which influences cognitive reserves and thus affects the risk and severity of dementia in old age. Thus, in addition to lifestyle and classical risk factors, socioeconomic status appears as a major health determinant, by imposing behaviors and habits and by determining access to healthcare.
Houghton, Lesley A; Heitkemper, Margaret; Crowell, Michael; Emmanuel, Anton; Halpert, Albena; McRoberts, James A; Toner, Brenda
Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective. Although the majority of FGIDs, including globus, rumination syndrome, IBS, bloating, constipation, functional abdominal pain, sphincter of Oddi dyskinesia, pelvic floor dysfunction, and extra-intestinal manifestations, are more prevalent in women than men, functional chest pain, dyspepsia, vomiting, and anorectal pain do not appear to vary by gender. Studies suggest sex differences in somatic but not visceral pain perception, motility, and central processing of visceral pain; although further research is required in autonomic nervous system dysfunction, genetics and immunologic/microbiome. Gender differences in response to psychological treatments, antidepressants, fiber, probiotics, and anticholinergics have not been adequately studied. However, a greater clinical response to 5-HT3 antagonists but not 5-HT4 agonists has been reported in women compared with men.
Besèr, Aniella; Sorjonen, Kimmo; Wahlberg, Kristina; Peterson, Ulla; Nygren, Åke; Åsberg, Marie
Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD-10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self-rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self-rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert-format. Self-ratings performed by 317 clinically assessed participants were used to analyse the scale’s psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut-off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions. PMID:24236500
Kim, Min Jeong; Lee, Chul Won
The purpose of this study was to understand the health benefits of line dancing activity in Korean middle-aged women. This study explored how Korean middle-aged women perceive health benefits through lived experiences of line dancing in their leisure time. Three themes emerged related to health benefits: (1) psychological benefit, (2) physical benefit, and (3) social benefit. This finding suggested that serious leisure experience aids health enhancements in the lives of Korean middle-aged women. This study also discusses the research implication that continuous participation in leisure activity is necessary for health improvement in Korean middle-aged women. PMID:27389818
Bausell, R. Barker; Soeken, Karen L.
Although considerable data exist linking individual lifestyle variables to health outcomes, little is known about how the elderly differ from younger adults with respect to both their health seeking behavior and their beliefs about health. A national survey contrasted 155 persons aged 65 years of age or older with 1100 younger adults in order to…
GIURGIUTIU,VICTOR; REDMOND,JAMES M.; ROACH,DENNIS P.; RACKOW,KIRK A.
A project to develop non-intrusive active sensors that can be applied on existing aging aerospace structures for monitoring the onset and progress of structural damage (fatigue cracks and corrosion) is presented. The state of the art in active sensors structural health monitoring and damage detection is reviewed. Methods based on (a) elastic wave propagation and (b) electro-mechanical (NM) impedance technique are sighted and briefly discussed. The instrumentation of these specimens with piezoelectric active sensors is illustrated. The main detection strategies (E/M impedance for local area detection and wave propagation for wide area interrogation) are discussed. The signal processing and damage interpretation algorithms are tuned to the specific structural interrogation method used. In the high-frequency EIM impedance approach, pattern recognition methods are used to compare impedance signatures taken at various time intervals and to identify damage presence and progression from the change in these signatures. In the wave propagation approach, the acoustic-ultrasonic methods identifying additional reflection generated from the damage site and changes in transmission velocity and phase are used. Both approaches benefit from the use of artificial intelligence neural networks algorithms that can extract damage features based on a learning process. Design and fabrication of a set of structural specimens representative of aging aerospace structures is presented. Three built-up specimens, (pristine, with cracks, and with corrosion damage) are used. The specimen instrumentation with active sensors fabricated at the University of South Carolina is illustrated. Preliminary results obtained with the E/M impedance method on pristine and cracked specimens are presented.
GIURGIUTIU,VICTOR; REDMOND,JAMES M.; ROACH,DENNIS P.; RACKOW,KIRK A.
A project to develop non-intrusive active sensors that can be applied on existing aging aerospace structures for monitoring the onset and progress of structural damage (fatigue cracks and corrosion) is presented. The state of the art in active sensors structural health monitoring and damage detection is reviewed. Methods based on (a) elastic wave propagation and (b) electro-mechanical (E/M) impedance technique are cited and briefly discussed. The instrumentation of these specimens with piezoelectric active sensors is illustrated. The main detection strategies (E/M impedance for local area detection and wave propagation for wide area interrogation) are discussed. The signal processing and damage interpretation algorithms are tuned to the specific structural interrogation method used. In the high-frequency E/M impedance approach, pattern recognition methods are used to compare impedance signatures taken at various time intervals and to identify damage presence and progression from the change in these signatures. In the wave propagation approach, the acousto-ultrasonic methods identifying additional reflection generated from the damage site and changes in transmission velocity and phase are used. Both approaches benefit from the use of artificial intelligence neural networks algorithms that can extract damage features based on a learning process. Design and fabrication of a set of structural specimens representative of aging aerospace structures is presented. Three built-up specimens (pristine, with cracks, and with corrosion damage) are used. The specimen instrumentation with active sensors fabricated at the University of South Carolina is illustrated. Preliminary results obtained with the E/M impedance method on pristine and cracked specimens are presented.
Wilson, Robert S; Yu, Lei; James, Bryan D; Bennett, David A; Boyle, Patricia A
We tested the hypothesis that higher financial and health literacy is associated with better cognitive health in 755 older persons who completed a literacy measure (M = 67.9, SD = 14.5) and then had annual clinical evaluations for a mean of 3.4 years. In proportional hazards models, higher literacy was associated with decreased risk of developing incident Alzheimer's disease (n = 68) and results were similar for financial and health literacy subscales and after adjustment for potential confounders. In mixed-effects models, higher literacy was related to higher baseline level of cognition and reduced cognitive decline in multiple domains. Among the 602 persons without any cognitive impairment at baseline, higher literacy was associated with a reduced rate of cognitive decline and risk of developing incident mild cognitive impairment (n = 142). The results suggest that higher levels of financial and health literacy are associated with maintenance of cognitive health in old age.
Shearer, D.M.; Thomson, W.M.; Broadbent, J.M.; Poulton, R.
The long-term effects of poor maternal oral health are unknown. We determined whether maternal oral health when children were young was a risk indicator for caries experience in adulthood, using oral examination and interview data from age-5 and age-32 assessments in the Dunedin Study, and maternal self-rated oral health data from the age-5 assessment. The main outcome measure was probands’ caries status at age 32. Analyses involved 835 individuals (82.3% of the surviving cohort) dentally examined at both ages, whose mothers were interviewed at the age-5 assessment. There was a consistent gradient in age-32 caries experience across the categories of maternal self-rated oral health status (from the age-5 assessment): it was greatest among the probands whose mothers rated their oral health as “poor” or who were edentulous, and lowest among those whose mothers rated their oral health as “excellent”. Unfavorable maternal self-rated oral health when children are young should be regarded as a risk indicator for poor oral health among offspring as they reach adulthood. PMID:21248361
Oliveira, Albertina L; Silva, José T; Lima, Margarida P
ABSTRACT OBJECTIVE To validate the Escala de Autoeficácia para a Autodireção na Saúde (EAAS – Self-efficacy for Self-direction in Health Scale). METHODS Non-experimental quantitative study of EAAS validation, by confirmatory factorial analyses, evaluating a sample of 508 older adults from the north and the center of Portugal with mean age of 71.67 (from 51 to 96 years), to whom the Self-efficacy for Self-direction in Health Scale, the Rosenberg Self-esteem Scale, the Positive and Negative Affect Schedule, the Satisfaction with Life Scale, and the Instrumental Activities of Daily Living Scale were applied. The EAAS was developed from the theoretical constructs of self-efficacy and from self-directed learning within the PALADIN European project framework, aiming to develop an instrument able to assess the extent to which older adults take good care of their health. RESULTS The internal consistency was 0.87 (Cronbach’s alpha) and confirmatory factorial analyses enabled to find a model near the one theoretically proposed, indicating a structure consisting of four dimensions: physical exercise, healthy diet, engaging in health-related learning, and visits to health professionals. From the psychometric point of view, the model in four factors showed quite satisfactory fit indicators. CONCLUSIONS The Self-efficacy for Self-direction in Health Scale, with 16 items, is adequate to evaluate to what extent older adults have confidence in their ability to take care of their own health, with high degree of autonomy. PMID:27384970
Sharma, Bimala; Cosme Chavez, Rosemary; Jeong, Ae Suk; Nam, Eun Woo
The study assessed television viewing >2 h a day and its association with sedentary behaviors, self-rated health, and academic performance among secondary school adolescents. A cross-sectional survey was conducted among randomly selected students in Lima in 2015. We measured self-reported responses of students using a standard questionnaire, and conducted in-depth interviews with 10 parents and 10 teachers. Chi-square test, correlation and multivariate logistic regression analysis were performed among 1234 students, and thematic analysis technique was used for qualitative information. A total of 23.1% adolescents reported watching television >2 h a day. Qualitative findings also show that adolescents spend most of their leisure time watching television, playing video games or using the Internet. Television viewing had a significant positive correlation with video game use in males and older adolescents, with Internet use in both sexes, and a negative correlation with self-rated health and academic performance in females. Multivariate logistic regression analysis shows that television viewing >2 h a day, independent of physical activity was associated with video games use >2 h a day, Internet use >2 h a day, poor/fair self-rated health and poor self-reported academic performance. Television viewing time and sex had a significant interaction effect on both video game use >2 h a day and Internet use >2 h a day. Reducing television viewing time may be an effective strategy for improving health and academic performance in adolescents.
Robert, S; House, J S
Despite the general persistence and even increase of strong socioeconomic status (SES) differentials in health in the United States, research suggests that SES differentials in health may diminish or become nonexistent at older ages. However, most research has used only limited measures of SES (e.g. education, income), and has not thoroughly investigated intra-elderly age differences in this trend. The current study investigates how SES differentials in health vary by age in the United States, using fairly detailed age categories (through ages 85+), and 2 alternative indicators (home ownership and liquid assets) of a major additional dimension of SES, financial assets, which may be especially important at older ages. We address (a) how strongly financial assets are associated with health, considered both alone and net of education and income; (b) if the health effects of financial assets vary by age; and, more specifically, (c) if their effects are especially pronounced in older age, again considered both alone and net of or relative to education and income. Results show that financial assets, especially liquid assets, considered both alone and net of education and income, are associated with health throughout adulthood and old age, at least until ages 85+. Furthermore, financial assets remain associated with health until quite late in life and become more important relative to education and income at older ages for some measures of health.
Khurana, Sandhya; Venkataraman, Krishnan; Hollingsworth, Amanda; Piche, Matthew; Tai, T C
Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG), and curcumin have been acknowledged for having beneficial effects on cardiovascular health, while some have also been shown to be protective in aging. This review highlights the literature surrounding this topic on the prominently studied and documented polyphenols as pertaining to cardiovascular health and aging.
Oh, Young Sam; Cho, Youngmin
The Internet is increasingly used as an important source of health and medical-related information for people with chronic diseases. It is recognized that online health information seeking (OHIS) is influenced by individuals' multi-dimensional factors, such as demographics, socio-economic factors, perceptions of the Internet, and health conditions. This study applies the conservation of resource theory to examine relationships between various multi-dimensional factors, daily challenges, and OHIS depending on individuals' health conditions. The data used in this study was taken from the U.S. Health Tracking Survey (2012). In this study, Internet users aged 18 and older were classified into patients (N = 518) and healthy people (N = 677) based on their health status related to chronic diseases. Multiple regression analysis was used to examine the relationships between multi-dimensional factors (resources), self-rated health, and OHIS. Patients' various resources (e.g., age, income, education, having a smartphone, and health tracking) significantly predicted their self-rated health and OHIS; in addition, self-rated health significantly mediated the relationships between focal resources and OHIS. However, the mediating effects of self-rated health were not found in healthy people.
... April 18, 2012 Characteristics and Use of Home Health Care by Men and Women Aged 65 and Over ... and Roberto Valverde, M.P.H., Division of Health Care Statistics Abstract Objective —This report presents national estimates ...
Lin, Ching-Hua; Lu, Mei-Jou; Wong, Julielynn; Chen, Cheng-Chung
Physician-rating scales remain the standard in antidepressant clinical trials. The current study aimed to examine the discrepancies between physician-rating scales and self-rating scales for symptoms and functioning, before and after treatment, in newly hospitalized patients. A total of 131 acutely ill inpatients with major depressive disorder were enrolled to receive 20 mg of fluoxetine daily for 6 weeks. Symptom severity and functioning were assessed at baseline and again at week 6. Symptom severity was rated using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Zung Self-rating Depression Scale (ZDS). Functioning was measured by the Global Assessment of Functioning (GAF) and the Work and Social Adjustment Scale (WSAS). Pearson correlation coefficients (r) between HDRS-17 and ZDS and between GAF and WSAS were calculated at week 0 and week 6. Sensitivity to change was measured using effect sizes. One-hundred twelve patients completed the 6-week trial. After 6 weeks of treatment, correlations between HDRS-17 and ZDS or correlations between GAF and WSAS became larger from baseline to end point. All correlations were statistically significant (P < 0.001). Effect sizes measured by physician-rating scales (ie, HDRS-17 and GAF) were larger than by self-rating scales (ie, ZDS and WSAS). Correlations between baseline physician-rating scale scores and self-rating scale scores improved after 6 weeks of treatment. Physician-rating scales had larger effect sizes than self-rating scales. Physician-rating scales were more sensitive in detecting symptom or functional changes than self-rating scales.
O'Connell, J M
The purpose of this study was to analyse national health expenditures of OECD countries relative to their age structures. Using econometric techniques designed to analyse cross-sectional time series data, the ageing of the population was found to affect health spending in several countries while having no effect in others. In addition, the effect of income on health spending was lower than that generally reported in the literature. These findings suggest that unobserved country-specific factors play a major role in determining the amount of resources allocated to health services in a country. Such factors also determine if the ageing of the population with increased health spending.
Blagosklonny, Mikhail V.
Making headlines, a thought-provocative paper by Neff, Ehninger and coworkers claims that rapamycin extends life span but has limited effects on aging. How is that possibly possible? And what is aging if not an increase of the probability of death with age. I discuss that the JCI paper actually shows that rapamycin slows aging and also extends lifespan regardless of its direct anti-cancer activities. Aging is, in part, MTOR-driven: a purposeless continuation of developmental growth. Rapamycin affects the same processes in young and old animals: young animals' traits and phenotypes, which continuations become hyperfunctional, harmful and lethal later in life. PMID:23934728
Blagosklonny, Mikhail V
Making headlines, a thought-provocative paper by Neff, Ehninger and coworkers claims that rapamycin extends life span but has limited effects on aging. How is that possibly possible? And what is aging if not an increase of the probability of death with age. I discuss that the JCI paper actually shows that rapamycin slows aging and also extends lifespan regardless of its direct anti-cancer activities. Aging is, in part, MTOR-driven: a purposeless continuation of developmental growth. Rapamycin affects the same processes in young and old animals: young animals' traits and phenotypes, which continuations become hyperfunctional, harmful and lethal later in life.
Wang, Chengfang; Liu, Chunqing; Gao, Hanboya; Liu, Hui
To determine the functional age of an individual, a quantitative system for the assessment of aging status was developed in the present study. A total of 1579 subjects were selected randomly from patients undergoing physical examination. The index of organic mild impairment (IOMI) and IOMI corrected for age (COMI) were calculated. By receiver operating characteristic (ROC) curve analysis of the IOMIs of younger and elderly subjects, a cutoff value for COMI of 30% was obtained. About 95% of <30-year-old subjects were healthy. These data suggest that organs and systems reflect the aging status of an individual and may be a useful tool for evaluating health status.
Harris, Roma; Wathen, C Nadine; MacGregor, Jennifer C D; Dennhardt, Silke; Naimi, Anthony; Ellis, Kathleen S
Amid growing concern about the graying population, an emerging theme in public health discourse is that of "successful aging." In this article, we use a governmentality lens to analyze a Canadian health promotion video, titled "Make Health Last: What Will Your Last 10 Years Look Like?" and viewers' responses to its message. The video presents starkly different scenarios of the last decade of life, conveying a neo-liberal rationality in which health in old age is positioned as a matter of individual choice. Our analysis suggests that while viewers generally support the video's message of personal responsibility for health, some are uneasy about implied claims that age-related illness can be prevented by choosing to be healthy. We argue that the video's simplistic messaging about health in later life raises disturbing questions about health promotion campaigns that deny the "normal" aging body and blame the elderly for "deciding" not to remain youthful and healthy.
Cronin, Frances M; Segurado, Ricardo; McAuliffe, Fionnuala M; Kelleher, Cecily C; Tremblay, Richard E
Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.
Segurado, Ricardo; McAuliffe, Fionnuala M.; Kelleher, Cecily C.
Numerous studies have identified the effects of prematurity on the neonate’s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000–2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children’s general health and severity of behavior problems. The association between parent’s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32–36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%–6.2%), compared to 1% (0.2–2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies. PMID:26975048
Hoshino, Akiko; Usui, Kanae; Katsura, Toshiki
Objective: The aim of this study was to assess the “Health Care Town in Kyoto” project designed to promote health and safety for health conscious people in a small community. We conducted a survey involving the users of the salon and local residents to examine the effects of the activities in the salon. Methods: We recorded the activities of salon and conducted semi-structured interviews with ten local residents to ask their opinions about the salon. The data from the interviews were analyzed using the Grounded Theory Approach. We distributed a questionnaire and collected 215 valid responses (valid response rate: 67.8%). Results: 1) Purpose of using the salon was categorized into health consultation, conversation with others, rest and other purpose. 2) The significance of the salon for users was categorized into usability, acquisition of useful information, changes in daily habits and their maintenance, diversion, interaction with other people and acceptance by the shopping center. 3) The results of the questionnaire survey showed marked relations between Well-Being Index (WHO-5), age, employment and family budget, self-rated health and ability to perform daily activities (TMIG), whereas use of the salon was not associated with Well-Being Index (WHO-5). On the other hand, there were marked relations between loneliness (LSO), educational background and use of the salon, demonstrating that the facility helped its users reduce loneliness (LSO). Conclusion: In this town, the salon has served as a place providing effective preventive support for the health of individual users. PMID:25648536
Wardle, Jane; Wolf, Michael S.; von Wagner, Christian
Objectives: To review the evidence on the association between age and limited health literacy, overall and by health literacy test, and to investigate the mediating role of cognitive function. Method: The Embase, MEDLINE, and PsycINFO databases were searched. Eligible studies were conducted in any country or language, included participants aged ≥50 years, presented a measure of association between age and health literacy, and were published through September 2013. Results: Seventy analyses in 60 studies were included in the systematic review; 29 of these were included in the meta-analysis. Older age was strongly associated with limited health literacy in analyses that measured health literacy as reading comprehension, reasoning, and numeracy skills (random-effects odds ratio [OR] = 4.20; 95% confidence interval [CI]: 3.13–5.64). By contrast, older age was weakly associated with limited health literacy in studies that measured health literacy as medical vocabulary (random-effects OR = 1.19; 95% CI: 1.03–1.37). Evidence on the mediating role of cognitive function was limited. Discussion: Health literacy tests that utilize a range of fluid cognitive abilities and mirror everyday health tasks frequently observe skill limitations among older adults. Vocabulary-based health literacy skills appear more stable with age. Researchers should select measurement tests wisely when assessing health literacy of older adults. PMID:25504637
Rowlands, Ingrid J; Dobson, Annette J; Mishra, Gita D
Introduction Very little is known about the extent of physical health issues among young women in early adulthood and whether this is changing over time. Methods We used data from two national samples of young women aged 18–23 years, surveyed 17 years apart, who participated in the Australian Longitudinal Study on Women’s Health. We used multinomial logistic regression to compare the women’s physical health (i.e., self-rated health, common symptoms and conditions) and identify whether sociodemographic factors, health behaviours and stress explained any physical health differences between the samples. Results Women aged 18–23 years in 2013 (N = 17,069) were more likely to report poor self-rated health and physical symptoms (particularly urogenital and bowel symptoms) than women aged 18–23 years in 1996 (N = 14,247). Stress accounted for a large proportion of the physical health differences between the cohorts, particularly for allergies, headaches, self-rated health, severe tiredness, skin problems, severe period pain and hypertension. Conclusions Women’s health appears to be changing, with young women born in more recent decades reporting greater physical symptom levels. Changing socio-cultural and economic conditions may place pressure on young adults, negatively affecting their health and wellbeing. Assessing the extent to which social structures and health care policies are offering adequate support to young women may offer avenues for promoting positive health and wellbeing. PMID:26528902
Schlack, Robert; Ravens-Sieberer, Ulrike; Petermann, Franz
This study investigates self-rated mental health in terms of psychological problems, protective factors and health-related quality of life (HRQOL) in a nationally representative sample of adolescents (n = 6813) aged 11-17 involved in violence with varying frequency. Using MANCOVA and ANCOVA, youth with single and multiple histories of violent…
Briggs, Andrew M; Cross, Marita J; Hoy, Damian G; Sànchez-Riera, Lídia; Blyth, Fiona M; Woolf, Anthony D; March, Lyn
Persistent pain, impaired mobility and function, and reduced quality of life and mental well-being are the most common experiences associated with musculoskeletal conditions, of which there are more than 150 types. The prevalence and impact of musculoskeletal conditions increase with aging. A profound burden of musculoskeletal disease exists in developed and developing nations. Notably, this burden far exceeds service capacity. Population growth, aging, and sedentary lifestyles, particularly in developing countries, will create a crisis for population health that requires a multisystem response with musculoskeletal health services as a critical component. Globally, there is an emphasis on maintaining an active lifestyle to reduce the impacts of obesity, cardiovascular conditions, cancer, osteoporosis, and diabetes in older people. Painful musculoskeletal conditions, however, profoundly limit the ability of people to make these lifestyle changes. A strong relationship exists between painful musculoskeletal conditions and a reduced capacity to engage in physical activity resulting in functional decline, frailty, reduced well-being, and loss of independence. Multilevel strategies and approaches to care that adopt a whole person approach are needed to address the impact of impaired musculoskeletal health and its sequelae. Effective strategies are available to address the impact of musculoskeletal conditions; some are of low cost (e.g., primary care-based interventions) but others are expensive and, as such, are usually only feasible for developed nations. In developing nations, it is crucial that any reform or development initiatives, including research, must adhere to the principles of development effectiveness to avoid doing harm to the health systems in these settings.
The present paper reports a series of six studies, each investigating the power of self-rated analytical, creative, and practical abilities for predicting one of six individual-difference variables: cognitive development, modes of thinking, career interests, learning approaches, thinking styles, and personality traits. Contributing to the…
Greenan, James P.; Jarwan, Fathi A.
Little agreement between student self-ratings and teacher ratings appeared when 226 secondary special needs students and 78 teachers rated students' reasoning skills. Possible causes were the halo effect, students' lack of knowledge, and students' difficulty in understanding the ratings. (SK)
Vautier, Stephane; Mullet, Etienne; Jmel, Said
Structural invariance of self-rated satisfaction with life data was assessed using four data sets collected in earlier studies by using the Satisfaction With Life Scale. Three measurement models were compared to account for structural variability of the data. Strict structural invariance was rejected. Departure from the one-factor model was only…
Gotts, Sandra Harris
This article describes a self rating pre- and post-assessment instrument that has been developed at the Central Michigan University (CMU). Nine instructional modules have been developed and are being used in science methods courses at CMU. Each module focuses on an identified area of competency for elementary science teachers and contains a…
Braun, Edith M. P.; Sheikh, Hammad; Hannover, Bettina
Today, a major goal in higher education is the advancement of students' vocational competences. To assess the extent to which this goal is met, both competences acquired during university studies and later vocational success need to be measured. In our study, we collected self-ratings of competences (t1) and indicators of vocational success (t2)…
Tucker, Joan S.; Green, Harold D., Jr.; Zhou, Annie J.; Miles, Jeremy N. V.; Shih, Regina A.; D'Amico, Elizabeth J.
Associations of popularity with adolescent substance use were examined among 1793 6-8th grade students who completed an in-school survey. Popularity was assessed through both self-ratings and peer nominations. Students who scored higher on either measure of popularity were more likely to be lifetime cigarette smokers, drinkers, and marijuana…
Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Yee-Melichar, Darlene; Talbot, Elizabeth P
This study examined determinants of attitudes toward mental health services with a sample of American Indian younger-old-adults (aged 50-64, n = 158) and American Indian older-old adults (aged 65 and older, n = 69). Adapting Andersen's behavioral model of healthcare utilization, predisposing factors, mental health needs, and enabling factors were considered as potential predictors. Female and those with higher levels of social support tend to report more positive attitudes toward mental health services. Culture-influenced personal belief was associated with negative attitudes toward mental health services among American Indian younger-old -adults. Age and higher chronic medical conditions were significantly related to negative attitudes toward mental health services. Health insurance was positively associated with positive attitudes toward mental health services in the American Indian older-old adults. Findings indicate that practitioners should engage how culture, social support, and chronic conditions influence the response to mental health needs when working with older American Indians.
Advances in technology are transforming the way that health data is collected and used. This includes improvements in existing technology as well as innovations in mobile technology such as smartphone apps and wearables. Health data is strictly regulated under the EU Data Protection Directive 95/46/EC. Under current data protection rules, health data is broadly interpreted and will, in most circumstances not connected to the provision of healthcare, require organisations to obtain explicit consent from individuals for its collection and use. Further data protection compliance issues arise such as identifying who is a controller, ensuring transparency, using health data for research purposes and keeping health data secure. As the EU data protection landscape is due to change in the next few years and will affect the collection and use of health data, the forthcoming Data Protection Regulation also deserves attention.
MacNee, William; Rabinovich, Roberto A; Choudhury, Gourab
Ageing is associated with a progressive degeneration of the tissues, which has a negative impact on the structure and function of vital organs and is among the most important known risk factors for most chronic diseases. Since the proportion of the world's population aged >60 years will double in the next four decades, this will be accompanied by an increased incidence of chronic age-related diseases that will place a huge burden on healthcare resources. There is increasing evidence that many chronic inflammatory diseases represent an acceleration of the ageing process. Chronic pulmonary diseases represents an important component of the increasingly prevalent multiple chronic debilitating diseases, which are a major cause of morbidity and mortality, particularly in the elderly. The lungs age and it has been suggested that chronic obstructive pulmonary disease (COPD) is a condition of accelerated lung ageing and that ageing may provide a mechanistic link between COPD and many of its extrapulmonary effects and comorbidities. In this article we will describe the physiological changes and mechanisms of ageing, with particular focus on the pulmonary effects of ageing and how these may be relevant to the development of COPD and its major extrapulmonary manifestations.
Plach, Sandra K.; Napholz, Linda; Kelber, Sheryl T.
Depression in women with rheumatoid arthritis (RA) may be related to social role experiences, physical health, and age. The purpose of this study was to examine the social and health factors contributing to depression in two age groups of women with RA. One-hundred and thirty-eight midlife and late-life women with a diagnosis of RA participated in…
McCarron, M.; Gill, M.; McCallion, P.; Begley, C.
Consideration of the relationship between physical and mental health co-morbidities in ageing persons with Down syndrome (DS) and Alzheimer's dementia (AD) is of clinical importance both from a care and resource perspective. To investigate and measure health co-morbidities in ageing persons with Down syndrome with and without AD. Recorded physical…
Makai, Alexandra; Prémusz, Viktória; Füge, Kata; Figler, Mária; Lampek, Kinga
In this study we examined the health of the ageing population of East-Central Europe. Data derived from the 6th round of the European Social Survey. The aim of our research was to examine the most important factors that determine ageing people's health status. We paid particular attention to the social ties of our target group.
Lai, Daniel W. L.; Surood, Shireen
This study examined the relationships between service barriers and health status of aging South Asian immigrants. Data were obtained through a structured telephone survey with a random sample of 220 South Asians 55 years of age and older. The effect of the different types of service barriers on the physical and mental health of participants was…
At the 2003 World Health Forum conference, experts from around the world gathered to examine the issues surrounding global aging trends and to develop recommendations for the economic, health, and policy consequences of an aging population. The recommendations address a wide range of issues, but acknowledge the importance of community-based care, including long-term home care.
Karron, Jeffrey D.; Holmquist, Karsten G.; Flanagan, Rebecca J.; Mitchell, Randall J.
Background and Aims Adjacent flowers on Mimulus ringens floral displays often vary markedly in selfing rate. We hypothesized that this fine-scale variation in mating system reflects the tendency of bumble-bee pollinators to probe several flowers consecutively on multiflower displays. When a pollinator approaches a display, the first flower probed is likely to receive substantial outcross pollen. However, since pollen carryover in this species is limited, receipt of self pollen should increase rapidly for later flowers. Here the first direct experimental test of this hypothesis is described. Methods In order to link floral visitation sequences with selfing rates of individual flowers, replicate linear arrays were established, each composed of plants with unique genetic markers. This facilitated unambiguous assignment of paternity to all sampled progeny. A single wild bumble-bee was permitted to forage on each linear array, recording the order of floral visits on each display. Once fruits had matured, 120 fruits were harvested (four flowers from each of five floral displays in each of six arrays). Twenty-five seedlings from each fruit were genotyped and paternity was unambiguously assigned to all 3000 genotyped progeny. Key Results The order of pollinator probes on Mimulus floral displays strongly and significantly influenced selfing rates of individual fruits. Mean selfing rates increased from 21 % for initial probes to 78 % for the fourth flower probed on each display. Conclusions Striking among-flower differences in selfing rate result from increased deposition of geitonogamous (among-flower, within-display) self pollen as bumble-bees probe consecutive flowers on each floral display. The resulting heterogeneity in the genetic composition of sibships may influence seedling competition and the expression of inbreeding depression. PMID:19218584
Angelini, Viola; Cavapozzi, Danilo; Corazzini, Luca; Paccagnella, Omar
In this paper we investigate how age affects the self-reported level of life satisfaction among the elderly in Europe. By using a vignette approach, we find evidence that age influences life satisfaction through two counterbalancing channels. On the one hand, controlling for the effects of all other variables, the own perceived level of life…
Yadava, K N; Yadava, S S; Vajpeyi, D K
This article examines the prevalence of age-related diseases in different socioeconomic and demographic groups. The study is based on a sample of 267 aged persons (> 60 years) collected through a survey entitled "Aging and Health Conditions in Rural Area-A Sample Survey, 1990" conducted in the rural areas of the Varanasi district of Uttar Pradesh, a northern province of India. Various socio-behavioral factors are found to play a significant role in determining the health conditions of aged people. Also, illiteracy and poverty are found to have their own impact on health during aging. It is also noted that due to adverse familial relationships, many stress-related disorders occur which may result in the poor health of the elderly. Demands for old age pensions were made by most of the elderly people in the sample.
Shanahan, Michael J.; Hill, Patrick L.; Roberts, Brent W.; Eccles, Jacquelynne; Friedman, Howard S.
The Conscientiousness (C) of the self and significant others influences health by way of mediational chains involving socioeconomic attainment, the avoidance and neutralization of stressors, the promotion of health behaviors and the minimization of risk behaviors, and the management of symptoms and diseases. Yet, meta-analyses reveal that these…
Salzman, Stephanie A.; Girvan, James T.
A survey of health risk behaviors was administered to a representative sample of 7,776 Idaho students in grades 8-12. Respondents were 86% White, 6% Hispanic, 4% American Indian, 3% Asian, and 2% Black. These rural adolescents reported that they had engaged in some health risk behaviors at rates comparable to those of other U.S. adolescents: 57%…
Brody, Elaine M.; And Others
Examined 331 adult children with parents in nursing homes. Predictors of depression were poor health, time pressures, viewing parent as demanding, and lack of involvement with instrumental activities of daily living tasks. Emotional effects specific to parent's situation were predicted by poor health, negative perceptions of nursing home staff,…
Mullee, Mark A.; Coleman, Peter G.; Briggs, Roger S. J.; Stevenson, James E.; Turnbull, Joanne C.
The study reports on factors predicting the longevity of 328 people over the age of 65 drawn from an English city and followed over 20 years. Both the reported activities score and the individual's comparative evaluation of their own level of activity independently reduced the risk of death, even when health and cognitive status were taken into…
Chambers, Lori A; Wilson, Michael G; Rueda, Sergio; Gogolishvili, David; Shi, Maggie Qiyun; Rourke, Sean B
The growing number of people over age 50 with HIV requires research, policy, and practice to develop a more comprehensive understanding of the health consequences of HIV in older individuals. We conducted a scoping review of peer-reviewed and grey literature published since 1996 to explore the impacts of aging on the health of older people with HIV (50 years or older). We included 209 studies (two systematic reviews, 174 quantitative studies, 28 qualitative studies, and five mixed methods studies). Health topics addressed include: HIV- and aging-related comorbidities, disease progression, neurocognitive functioning, mental health conditions, psychological well-being, social supports, stigma, antiretroviral adherence, health care utilization/access, and sexual risk behaviour. We recommend that future research takes a broader view of health, looks at aging from a strength-based perspective and examines the issue using diverse perspectives (i.e., geographic location, multiple methods, time of diagnosis, time on antiretroviral therapy (ART), demographic diversity).
Wong, Albert; Wouterse, Bram; Slobbe, Laurentius C J; Boshuizen, Hendriek C; Polder, Johan J
Health care utilization is expected to rise in the coming decades. Not only will the aggregate need for health care grow by changing demographics, so too will per capita utilization. It has been suggested that trends in health care utilization may be age-specific. In this paper, age-specific trends in health care utilization are presented for different health care sectors in the Netherlands, for the period 1981-2009. For the hospital sector we also explore the link between these trends and the state of medical technology. Using aggregated data from a Dutch health survey and a nationwide hospital register, regression analysis was used to examine age-specific trends in the probability of utilizing health care. To determine the influence of medical technology, the growth in age-specific probabilities of hospital care was regressed on the number of medical patents while adjusting for confounders related to demographics, health status, supply and institutional factors. The findings suggest that for most health care sectors, the trend in the probability of health care utilization is highest for ages 65 and up. Larger advances in medical technology are found to be significantly associated with a higher growth of hospitalization probability, particularly for the higher ages. Age-specific trends will raise questions on the sustainability of intergenerational solidarity in health care, as solidarity will not only be strained by the ageing population, but also might find itself under additional pressure as the gap in health care utilization between elderly and non-elderly grows over time. For hospital care utilization, this process might well be accelerated by advances in medical technology.
Salas, C; Raftery, J P
A recent study by Zweifel et al. (Zweifel P, Felder S, Meiers M. Ageing of the population and health care expenditure: a red herring? Health Economics 1999; 8: 485-496) suggests that age is not related to health care expenditure among the elderly once 'closeness to death' is controlled for. If correct, this finding has major policy implications, but flaws in the econometric analysis undermine its credibility. We highlight two in particular, and propose methods to deal with them.
Todorova, Irina L G; Guzzardo, Mariana T; Adams, Wallis E; Falcón, Luis M
Puerto Rican adults in the United States mainland live with socioeconomic and health disparities. To understand their contextual experience of aging, we interviewed participants in the Boston Puerto Rican Health Study. Through a Thematic Analysis we identify themes and tensions: normalization and acceptance of aging; gratitude; the importance of aging within social networks; longing to return to Puerto Rico at older age. We address the tensions between 'acceptance' and fatalismo as a cultural belief, and a function of structural barriers. The experience of aging is discussed in the context of Puerto Rico's history and continued dependence on the United States.
Abrams, Alan P; Thompson, Lisa A
This article reviews the concepts of physiologic reserve, the principles of the normative aging process as exemplified by the cardiovascular, neurologic, and musculoskeletal systems. How these principles apply to oral health, and age-related changes in the oral cavity itself, is reviewed and suggests how they may affect disease management by oral health care providers. It does not focus on diseases related to aging, but rather aims to explore the normal physiologic changes associated with aging dentition and systemic changes related to age, thus enabling clinicians to obtain a better understanding of the presentation of older adults and how it may change their approach to diagnosis and treatment.
Westerhof, Gerben J; Miche, Martina; Brothers, Allyson F; Barrett, Anne E; Diehl, Manfred; Montepare, Joann M; Wahl, Hans-Werner; Wurm, Susanne
Evidence is accumulating on the effects of subjective aging-that is, how individuals perceive their own aging process-on health and survival in later life. The goal of this article is to synthesize findings of existing longitudinal studies through a meta-analysis. A systematic search in PsycInfo, Web of Science, Scopus, and Pubmed resulted in 19 longitudinal studies reporting effects of subjective aging on health, health behaviors, and longevity. The authors combine the outcomes reported in these studies using a random effects meta-analysis, assuming that there would be differences in effect sizes across studies. The meta-analysis resulted in an overall significant effect of subjective aging (likelihood ratio = 1.429; 95% confidence interval = 1.273-1.604; p < .001). The analyses revealed heterogeneity, with stronger effects for studies with a shorter period of follow-up, for studies of health versus survival, for studies with younger participants (average age of the studies varies between 57 and 85 years with a median of 63 years), and for studies in welfare systems where state provisions of welfare are minimal. However, effects did not vary either across different operationalizations of subjective aging or by study quality. Subjective aging has a small significant effect on health, health behaviors, and survival. Further theoretical conceptualizations and empirical studies are needed to determine how subjective aging contributes to health and survival.
Burris, Scott; Hitchcock, Laura; Ibrahim, Jennifer; Penn, Matthew; Ramanathan, Tara
Governments use statutes, regulations, and policies, often in innovative ways, to promote health and safety. Organizations outside government, from private schools to major corporations, create rules on matters as diverse as tobacco use and paid sick leave. Very little of this activity is systematically tracked. Even as the rest of the health system is working to build, share, and use a wide range of health and social data, legal information largely remains trapped in text files and pdfs, excluded from the universe of usable data. This article makes the case for the practice of policy surveillance to help end the anomalous treatment of law in public health research and practice. Policy surveillance is the systematic, scientific collection and analysis of laws of public health significance. It meets several important needs. Scientific collection and coding of important laws and policies creates data suitable for use in rigorous evaluation studies. Policy surveillance addresses the chronic lack of readily accessible, nonpartisan information about status and trends in health legislation and policy. It provides the opportunity to build policy capacity in the public health workforce. We trace its emergence over the past fifty years, show its value, and identify major challenges ahead.
Peterson, Candida C.
Administered quiz about positive and negative aspects of mental health in old age to 250 Australian adults (ages 17-81). Retirees scored lowest, with no significant differences among younger students versus nonstudents. Age was more important mediator of retirees' low scores than was gender, living with older person, or self-definition as retired.…
Feinberg, David R.
There is strong support for the idea that healthy vocal chords are able to produce fundamental frequencies (F0) with minimal perturbation. Measures of F0 perturbation have been shown to discriminate pathological versus healthy populations. In addition to measuring vocal chord health, F0 perturbation is a correlate of real and perceived age. Here, the role of jitter (periodic variation in F0) and shimmer (periodic variation in amplitude of F0) in perceived health and age in a young adult (males aged 18-33, females aged 18-26), nondysphonic population was investigated. Voices were assessed for health and age by peer aged, opposite-sex raters. Jitter and shimmer were measured with Praat software (www.praat.org) using various algorithms (jitter: DDP, local, local absolute, PPQ5, and RAP; shimmer: DDA, local, local absolute, APQ3, APQ5, APQ11) to reduce measurement error, and to ascertain the robustness of the findings. Male and female voices were analyzed separately. In both sexes, ratings of health and age were significantly correlated. Measures of jitter and shimmer correlated negatively with perceived health, and positively with perceived age. Further analysis revealed that these effects were independent in male voices. Implications of this finding are that attributions of vocal health and age may reflect actual underlying condition.
Samakouri, M; Bouhos, G; Kadoglou, M; Giantzelidou, A; Tsolaki, K; Livaditis, M
Self-rating Anxiety Scale (SAS), introduced by Zung, has been widely used in research and in clinical practice for the detection of anxiety. The present study aims at standardizing the Greek version of SAS. SAS consists of 20 items rated on a 1-4 likert type scale. The total SAS score may vary from 20 (no anxiety at all) to 80 (severe anxiety). Two hundred and fifty four participants (114 male and 140 female), psychiatric patients, physically ill and general population individuals, aged 45.40±11.35 years, completed the following: (a) a demographic characteristics' questionnaire, (b) the SAS Greek version, (c) the Spielberg's Modified Greek State-Trait Anxiety Scale (STAI-Gr.-X) and (d) the Zung Depression Rating Scale (ZDRS). Seventy six participants answered the SAS twice within a 12th-day median period of time. The following parameters were calculated: (a) internal consistency of the SAS in terms of Cronbach's α co-efficient, (b) its test-retest reliability in terms of the Intraclass Correlation Coefficient (ICC) and (c) its concurrent and convergent validities through its score's Spearman's rho correlations with both the state and trait subscales of STAI-Gr X and the ZDRS. In addition, in order to evaluate SAS' discriminant validity, the scale's scores of the three groups of participants (psychiatric patients, physically ill and general population individuals) were compared among each other, in terms of Kruskall Wallis and Mann Whitney U tests. SAS Cronbach's alpha equals 0.897 while ICC regarding its test-retest reliability equals 0.913. Spearman's rho concerning validity: (a) when SAS is compared to STAI-Gr.-X (state), equals it 0.767, (b) when SAS is compared to STAI-Gr. X (trait), it equals 0.802 and (c) when SAS is compared to ZDRS, it equals 0.835. The mentally ill scored significantly higher in SAS compared to both the healthy and the general population. In conclusion, the SAS Greek version presents very satisfactory psychometric properties regarding
... Everyone forgets things from time to time. Modest memory problems are a fairly common part of aging, ... medication side effects or underlying conditions contribute to memory loss. There's a difference, though, between normal changes ...
Currin, James B.; Hayslip, Bert, Jr.; Temple, Jeff R.
The purpose of this study was to explore the impact of age, historical change, and gender on perceptions of mental health and mental health services. Using multidimensional measures to assess such perceptions among older adults (1977, 1991, 2000), and younger adults (1991, 2000), we expected that older adults would have less positive mental health…
Schöllgen, Ina; Morack, Jennifer; Infurna, Frank J.; Ram, Nilam; Gerstorf, Denis
Well-being and physical health are central indicators of quality of life in old age. Research from a between-person difference perspective finds that people in better health than their peers also report higher well-being than their peers. However, we know very little about whether changes in one domain are accompanied by changes in the other…
Lau, Robin S; Johnson, Shanthi; Kamalanabhan, T J
This study examines life expectancy (LE) and healthy life expectancy (HLE) in India longitudinally over the period 2007 to 2020, providing projections into the future. Specifically, the Indian Healthy Life Expectancy Projection model was developed based on epidemiological data (mortality, disability rates) obtained from the World Health Organization and the Government of India. The current model contributed to 4 key findings: decreases in mortality but not in all age and gender groups; increasing disability in the Indian population over time; increase in LE and HLE into the future in all age and gender groups; and the largest gains in LE and HLE are in the older age bands starting from the 70+ age band in women and 65+ age band in men. This study sheds some light on the population health measures needed to improve the understanding of the determinants of health for the efficient allocation of resources and to inform policy in the planning of health and social services.
Sauer, Mark V
Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction.
Shanahan, Michael J; Hill, Patrick L; Roberts, Brent W; Eccles, Jacquelynne; Friedman, Howard S
The Conscientiousness (C) of the self and significant others influences health by way of mediational chains involving socioeconomic attainment, the avoidance and neutralization of stressors, the promotion of health behaviors and the minimization of risk behaviors, and the management of symptoms and diseases. Yet, meta-analyses reveal that these associations are moderated by factors that are not well understood. We propose the Life Course of Personality Model (LCP Model), which comprises a series of hypotheses that suggest how such mediational chains are subject to 2 sources of contingency. First, the mechanisms by which C translates into health and the avoidance of risk change from early childhood to late adulthood, involving processes that are specific to phases of the life course; also, however, C influences health by way of continuous processes extending over many decades of life. Second, C may be more consequential in some social contexts than in others, and when accompanied by some constellations of personality characteristics than by others. That is, the mediational processes by which C translates into health and the avoidance of disease are likely moderated by timing, social context (including the C of others), and other aspects of the individual's personality. We consider methodological implications of the LCP Model.
Delaruelle, Katrijn; Buffel, Veerle; Bracke, Piet
Researchers have recently been investigating the temporal variation in the educational gradient in health. While there is abundant literature concerning age trajectories, theoretical knowledge about cohort differences is relatively limited. Therefore, in analogy with the life course perspective, we introduce two contrasting cohort-specific hypotheses. The diminishing health returns hypothesis predicts a decrease in educational disparities in health across cohorts. By contrast, the cohort accretion hypothesis suggests that the education-health gap will be more pronounced among younger cohorts. To shed light on this, we perform a hierarchical age-period-cohort analysis (HAPC), using data from a subsample of individuals between 25 and 85 years of age (N = 232,573) from 32 countries in the European Social Survey (six waves: 2002-2012). The analysis leads to three important conclusions. First, we observe a widening health gap between different educational levels over the life course. Second, we find that these educational differences in the age trajectories of health seem to strengthen with each successive birth cohort. However, the two age-related effects disappear when we control for employment status, household income, and family characteristics. Last, when adjusting for these mediators, we reveal evidence to support the diminishing health returns hypothesis, implying that it is primarily the direct association between education and health that decreases across cohorts. This finding raises concerns about potential barriers to education being a vehicle for empowerment and the promotion of health.
Casado Marín, D
Over the last 30 years, the elderly population of developed countries has shown an unprecedented increase. This process has raised alarm about the future affordability of health care systems. In this context, we consider the effects of population aging on health care expenditure within a process involving several elements: the increasing number of elderly persons, variations in the health status of the elderly and the evolution of the cost of medical treatment. The main conclusion is that only a small part of the increase in expenditure is due to population aging. Furthermore, because the average health status of the elderly has improved with greater longevity, we suggest that most of the increase in health care expenditure can be attributed to the evolution of non-demographic factors. Such as health services utilization, treatment cost and the development of new medical technology. Unlike populations aging, these factors can be subjected to future regulation and consequently, can to a large extent be controlled.
Li, Xiaomin; Jiang, Quanbao; Li, Shuzhuo; Feldman, Marcus W
China's middle-aged and older women suffer from poorer health than men. Using national baseline data from the China Health and Retirement Longitudinal Study (CHARLS), a survey conducted from 2011 to 2012, this article applies logistic models to investigate the association between female fertility history (parity, early childbearing, late childbearing) and middle-aged and late-life health. We find that parity is related to the mid-late-life health of women. Women with four children or more are more likely to suffer from activities of daily living (ADL) impairment and poorer self-rated health than those with one to three children. Early childbearing is associated with ADL impairment; however, the correlation is mediated by socioeconomic status. Early childbearing is related to self-rated health in later life by an indirect-only mediation effect via educational attainment and personal income.
Khurana, Sandhya; Venkataraman, Krishnan; Hollingsworth, Amanda; Piche, Matthew; Tai, T. C.
Numerous studies have demonstrated the importance of naturally occurring dietary polyphenols in promoting cardiovascular health and emphasized the significant role these compounds play in limiting the effects of cellular aging. Polyphenols such as resveratrol, epigallocatechin gallate (EGCG), and curcumin have been acknowledged for having beneficial effects on cardiovascular health, while some have also been shown to be protective in aging. This review highlights the literature surrounding this topic on the prominently studied and documented polyphenols as pertaining to cardiovascular health and aging. PMID:24077237
GONZÁLEZ-GONZÁLEZ, César; WONG, Rebeca
We use longitudinal data from the Mexican Health and Aging Study to analyze the relationship between health and labor force participation of population aged 50 years and older in Mexico. The results confirm that health, measured through chronic diseases and difficulty to perform activities of daily living, has a powerful influence on labor force participation. We also find important differences by gender; hypertension and diabetes have effects in both, men and women; heart disease and stroke only in men. We provide concrete evidence on economic participation and highlight the importance of public policies to create adequate jobs for the population at middle and old age. PMID:25722646
Garry, P J; Wayne, S J; Vellas, B
In 1979, Dr. James S. Goodwin, M.D., assisted by Philip J. Garry, Ph.D., submitted a grant proposal to the United States Public Health Service/ National Institute on Aging (NIA) entitled, "A prospective study of nutrition in the elderly". This study was approved and funded by the NIA beginning in 1979. Initially, approximately 300 men and women over 65 years of age with no known medical illnesses and no prescription medications were selected for this study. The primary purpose of this multi disciplinary study, known in the literature as the New Mexico Aging Process Study (NMAPS), was to examine the role of nutrition and resultant changes in body composition and organ function in relation to the aging process and health status of the elderly. This was accomplished by following prospectively healthy elderly volunteers, obtaining in-depth information about dietary habits, lifestyle, body composition, organ function, cognitive status, vitamin metabolism, genetic markers, and biochemical measures of nutritional status and then examining these data in relationship to age and health status and changes in health status. Some of the specific aims of the study were modified over the course of this longitudinal study because of availability of University of New Mexico School of Medicine faculty with expertise in different areas of aging research. In 1988, Dr. Bruno Vellas from the University Hospital in Toulouse, France became an on-going visiting professor at the University of New Mexico School of Medicine. From 1988, until the study was terminated in 2003, Dr. Vellas has collaborated with the faculty involved in the NMAPS on a number of research projects. In this article, we provide information about the studies overall design and briefly describe some of the major finding of the NMAPS.
Due to the combination of population growth and population aging, increases in the incidence of chronic neurodegenerative disorders have become a societal concern, both in terms of decreased quality of life and increased financial burden. Clinical manifestation of many of these disorders takes years...
Percheski, Christine; Hargittai, Eszter
Objective: The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source. Participants: First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study.…
Grady, Sally C.; Maynard, Charles L.
Describes Building Ties Project, a program that provides comprehensive assistance to local interagency planning committees addressing mental health service needs of older adults, including training program development materials and consultation. Notes that in two years, project activities in 23 counties increased services, improved interagency…
German, Pearl S.
Reports that the elderly appear most influenced in health attitudes and behaviors by various factors within the setting so those who identify a major source of care tend to be higher utilizers, do less "shopping-around," and exhibit less negative behaviors such as needing care without seeking it. Discussion of the article follows. (Author)
Dahl, Kari Elisabeth; Wang, Nina J; Skau, Irene; Ohrn, Kerstin
OBJECTIVE. To investigate associations between oral health-related quality of life assessed with the Oral Health Impact Profile (OHIP)-14 and demographic factors, number of teeth present, dental visits, dental health behaviour and self-rated oral health in a representative sample of 20-80-year-old Norwegians. MATERIAL AND METHODS. The study was conducted in a stratified random sample of 3538 individuals. Questionnaires including questions on demographic factors, number of remaining teeth, dental visits, dental health behaviour, self-rated oral health and OHIP-14 were mailed to the sample. Bivariate and multivariate analyses were performed. RESULTS. The response rate was 69%. The mean OHIP-14 score was 4.1 (standard deviation = 6.2). No problem was reported by 35% of the respondents. The most frequently reported problems were: physical pain (56%), psychological discomfort (39%) and psychological disability (30%). When the effect of all independent variables was analysed in multivariate analysis, self-rated oral health, frequency of dental visits, number of teeth, age and sex were significantly (P < 0.05) associated with the prevalence of having problems and frequent problems. Self-rated oral health had the strongest association with having problems [odds ratio (OR) 4.5; 95% confidence interval (CI) 3.4-6.0] and with having frequent problems (OR 4.0; 95% CI 2.7-5.8). Dental health behaviour, use of floss and toothpicks and oral rinsing were not associated with having problems related to oral quality of life in multivariate analyses. CONCLUSION. In this Norwegian adult sample, self-rated oral health, frequency of dental visits, number of teeth, age and sex were associated with having problems as estimated using the OHIP-14.
Lyimo, Elizabeth J; Todd, Jim; Richey, Lisa Ann; Njau, Bernard
This study describes the social networks of secondary school students in Moshi Municipality, and their association with self-rated risk of human immunodeficiency virus (HIV) infection. A cross-sectional analytical study was conducted among 300 students aged 15-24 years in 5 secondary schools in Moshi, Tanzania. Bonding networks were defined as social groupings of students participating in activities within the school, while bridging networks were groups that included students participating in social groupings from outside of the school environs. A structured questionnaire was used to ask about participation in bonding and bridging social networks and self-rated HIV risk behavior. More participants participated in bonding networks (72%) than in bridging networks (29%). Participation in bridging networks was greater among females (25%) than males (12%, p<.005). Of 300 participants, 88 (29%) were sexually experienced, and of these 62 (70%) considered themselves to be at low risk of HIV infection. Factors associated with self-rated risk of HIV included: type of school (p<.003), family structure (p<.008), being sexually experienced (p<.004), having had sex in the past three months (p<.009), having an extra sexual partner (p<.054) and non-condom use in last sexual intercourse (p<.001), but not the presence or type of social capital. The study found no association between bonding and bridging social networks on self-rated risk of HIV among study participants. However, sexually experienced participants rated themselves at low risk of HIV infection despite practicing unsafe sex. Efforts to raise adolescents' self-awareness of risk of HIV infection through life skills education and HIV/acquired immunodeficiency syndrome risk reduction strategies may be beneficial to students in this at-risk group.
Khalaila, Rabia; Litwin, Howard
Objective To examine the longitudinal association between changes in health behaviors and depression, and to determine the mediating effect of health characteristics on this association. Method Based on the first and second waves of the Survey of Health, Aging and Retirement in Europe (SHARE)-Israel, depressive symptoms of 1,524 Israelis aged 50 or older were analyzed using logistic regression. Results Changes in physical activity and body weight are associated with depressive symptoms after adjusting for confounders. However, after adding measures of health, the respective correlations of weight gain and commenced physical activity with depression disappear, and the correlation between continued activity and depression is reduced. Discussion Changes in health behaviors are related to mental health in late life, but their effect is mediated by physical and functional health. Future interventions should nevertheless target older individuals who stop physical activity and those who remain inactive to lessen the risk of depression. PMID:24401321
Forbes, Scott C; Little, Jonathan P; Candow, Darren G
Skeletal muscle mass declines with age (i.e., sarcopenia) resulting in muscle weakness and functional limitations. Sarcopenia has been associated with physiological changes in muscle morphology, protein and hormonal kinetics, insulin resistance, inflammation, and oxidative stress. The purpose of this review is to highlight how exercise and nutritional intervention strategies may benefit aging muscle. It is well known that resistance exercise training increases muscle strength and size and evidence also suggests that resistance training can increase mitochondrial content and decrease oxidative stress in older adults. Recent findings suggest that fast-velocity resistance exercise may be an effective intervention for older adults to enhance muscle power and functional capacity. Aerobic exercise training may also benefit aging skeletal muscle by enhancing mitochondrial bioenergetics, improving insulin sensitivity, and/or decreasing oxidative stress. In addition to exercise, creatine monohydrate, milk-based proteins, and essential fatty acids all have biological effects which could enhance some of the physiological adaptations from exercise training in older adults. Additional research is needed to determine whether skeletal muscle adaptations to increased activity in older adults are further enhanced with effective nutritional interventions and whether this is due to enhanced muscle protein synthesis, improved mitochondrial function, and/or a reduced inflammatory response.
Perreira, Krista M; Telles, Edward E
Latin America is one of the most ethnoracially heterogeneous regions of the world. Despite this, health disparities research in Latin America tends to focus on gender, class and regional health differences while downplaying ethnoracial differences. Few scholars have conducted studies of ethnoracial identification and health disparities in Latin America. Research that examines multiple measures of ethnoracial identification is rarer still. Official data on race/ethnicity in Latin America are based on self-identification which can differ from interviewer-ascribed or phenotypic classification based on skin color. We use data from Brazil, Colombia, Mexico, and Peru to examine associations of interviewer-ascribed skin color, interviewer-ascribed race/ethnicity, and self-reported race/ethnicity with self-rated health among Latin American adults (ages 18-65). We also examine associations of observer-ascribed skin color with three additional correlates of health - skin color discrimination, class discrimination, and socio-economic status. We find a significant gradient in self-rated health by skin color. Those with darker skin colors report poorer health. Darker skin color influences self-rated health primarily by increasing exposure to class discrimination and low socio-economic status.
Perreira, Krista M.; Telles, Edward E.
Latin America is one of the most ethnoracially heterogeneous regions of the world. Despite this, health disparities research in Latin America tends to focus on gender, class and regional health differences while downplaying ethnoracial differences. Few scholars have conducted studies of ethnoracial identification and health disparities in Latin America. Research that examines multiple measures of ethnoracial identification is rarer still. Official data on race/ethnicity in Latin America are based on self-identification which can differ from interviewer-ascribed or phenotypic classification based on skin color. We use data from Brazil, Colombia, Mexico, and Peru to examine associations of interviewer-ascribed skin color, interviewer-ascribed race/ethnicity, and self-reported race/ethnicity with self-rated health among Latin American adults (ages 18-65). We also examine associations of observer-ascribed skin color with three additional correlates of health – skin color discrimination, class discrimination, and socio-economic status. We find a significant gradient in self-rated health by skin color. Those with darker skin colors report poorer health. Darker skin color influences self-rated health primarily by increasing exposure to class discrimination and low socio-economic status. PMID:24957692
Stewart, Tara L; Chipperfield, Judith G; Perry, Raymond P; Hamm, Jeremy M
This study assessed the extent to which older adults attribute a recent heart attack/stroke to "old age," and examined consequences for subsequent lifestyle behavior and health-care service utilization. Community-dwelling adults (N = 57, ages 73-98 years) were interviewed about their heart attack/stroke, and an objective health registry provided data on health-care utilization over a 3-year period. Endorsement of "old age" as a cause of heart attack/stroke negatively predicted lifestyle behavior change, and positively predicted frequency of physician visits and likelihood of hospitalization over the subsequent 3 years. Findings suggest the importance of considering "old age" attributions in the context of cardiovascular health events.
Park, Jungsun; Park, Jong-Tae; Kim, Soo Geun; Yoo, Cheol-In; Son, Junseok; Yim, Jun; Kim, Dae-Seong; Rhee, Kyung Young; Kim, Yangho
The rapid aging trend in South Korea will cause a growing shortage of labor and decreasing quality of the labor force. The purpose of this commentary is to recommend a health care strategy to maintain and promote the work ability of employees in an aging Korea. Strategies to promote the work ability require the collaboration of governmental agencies at the central and local levels. First, the common goal should be the reinforcement of follow-up measure in general medical examinations and the promotion of healthy lifestyles for workers. Second, collaborating activities should be performed among the Worker's Health Center, the Health Promotion Center, and community health centers. In conclusion, health care strategies for ensuring the work ability in an aging Korea require the collaboration of governmental agencies at the central and local levels.
Zapata, Heidi J; Quagliarello, Vincent J
Advances in bacterial deoxyribonucleic acid sequencing allow for characterization of the human commensal bacterial community (microbiota) and its corresponding genome (microbiome). Surveys of healthy adults reveal that a signature composite of bacteria characterizes each unique body habitat (e.g., gut, skin, oral cavity, vagina). A myriad of clinical changes, including a basal proinflammatory state (inflamm-aging), that directly interface with the microbiota of older adults and enhance susceptibility to disease accompany aging. Studies in older adults demonstrate that the gut microbiota correlates with diet, location of residence (e.g., community dwelling, long-term care settings), and basal level of inflammation. Links exist between the microbiota and a variety of clinical problems plaguing older adults, including physical frailty, Clostridium difficile colitis, vulvovaginal atrophy, colorectal carcinoma, and atherosclerotic disease. Manipulation of the microbiota and microbiome of older adults holds promise as an innovative strategy to influence the development of comorbidities associated with aging.
Nakazono, T T; Davidson, P L; Andersen, R M
Using data from population-based samples of adults participating in the ICS-II USA study, and using principal components analysis, we constructed oral health belief measures corresponding to the Health Belief Model (HBM) dimensions. Tests of validity and reliability were performed. Scales measuring perceived benefit of preventive practices and seriousness of oral disease had the highest validity and reliability. We used multiple regression analysis to examine sociodemographic predictors of perceived benefits of preventive practices. Race-ethnicity and age cohort were significant predictors among Baltimore and San Antonio adults. White adults and middle-aged persons in both research locations were more likely to believe in the benefit of preventive practices. Female gender, higher educational attainment, and better self-rated health were significant indicators of more positive oral health beliefs in every research location. Results also characterize persons who place lower value on preventive practices (i.e., males, less-educated persons, and those reporting poorer self-rated health). The design of effective dental public health messages and outreach efforts requires an analysis of the individual's health orientation and the factors influencing oral health beliefs. Oral health education interventions designed to improve health beliefs should contain an evaluation component for assessing the impact of education on health practices and oral health status.
Ybarra, Michele; Suman, Michael
The Internet is transforming the way in which consumers approach their health care needs. Sex and age are influential aspects of one's health as well as disease risk and are thus integral components of the emerging picture of health information seekers. Using data from Surveying the Digital Future, Year 4, a nationally representative, longitudinal telephone survey of Americans 12 years of age and older (n = 2010), we examine the reasons for, assessments of and actions taken as a result of health information found online among men and women and older and younger people. Although we tend to think of the Internet as a young person's technology, the percent of adults 60 years of age and older is similar to that of adolescents using the Internet as a health care information resource, thus suggesting an untapped opportunity with online interventions for older adults. Nonetheless, as age increases so too does the report of frustration with the experience. Men are more likely to report a positive seeking experience than women. Differences in Internet use fail to explain these observed sex and age differences in the seeking experience. Across the spectrum of age, sex and Internet skill, Internet health information seeking appears to enhance the patient-provider relationship.
Feng, Pu; Huang, Liquan; Wang, Hong
The mammalian taste bud is an onion-shaped epithelial structure with 50-100 tightly packed cells, including taste receptor cells, supporting cells, and basal cells. Taste receptor cells detect nutrients and toxins in the oral cavity and transmit the sensory information to gustatory nerve endings in the buds. Supporting cells may play a role in the clearance of excess neurotransmitters after their release from taste receptor cells. Basal cells are precursor cells that differentiate into mature taste cells. Similar to other epithelial cells, taste cells turn over continuously, with an average life span of about 8-12 days. To maintain structural homeostasis in taste buds, new cells are generated to replace dying cells. Several recent studies using genetic lineage tracing methods have identified populations of progenitor/stem cells for taste buds, although contributions of these progenitor/stem cell populations to taste bud homeostasis have yet to be fully determined. Some regulatory factors of taste cell differentiation and degeneration have been identified, but our understanding of these aspects of taste bud homoeostasis remains limited. Many patients with various diseases develop taste disorders, including taste loss and taste distortion. Decline in taste function also occurs during aging. Recent studies suggest that disruption or alteration of taste bud homeostasis may contribute to taste dysfunction associated with disease and aging.
The mammalian taste bud is an onion-shaped epithelial structure with 50–100 tightly packed cells, including taste receptor cells, supporting cells, and basal cells. Taste receptor cells detect nutrients and toxins in the oral cavity and transmit the sensory information to gustatory nerve endings in the buds. Supporting cells may play a role in the clearance of excess neurotransmitters after their release from taste receptor cells. Basal cells are precursor cells that differentiate into mature taste cells. Similar to other epithelial cells, taste cells turn over continuously, with an average life span of about 8–12 days. To maintain structural homeostasis in taste buds, new cells are generated to replace dying cells. Several recent studies using genetic lineage tracing methods have identified populations of progenitor/stem cells for taste buds, although contributions of these progenitor/stem cell populations to taste bud homeostasis have yet to be fully determined. Some regulatory factors of taste cell differentiation and degeneration have been identified, but our understanding of these aspects of taste bud homoeostasis remains limited. Many patients with various diseases develop taste disorders, including taste loss and taste distortion. Decline in taste function also occurs during aging. Recent studies suggest that disruption or alteration of taste bud homeostasis may contribute to taste dysfunction associated with disease and aging. PMID:24287552
Hategan, Ana; Bourgeois, James A; Goldberg, Jeremy
From 1943, when Leo Kanner originally described autism, and to the first objective criteria for "infantile autism" in DSM-III and the inclusion of Asperger's disorder in DSM-IV, the subsequent classification scheme for autistic disorders has led to a substantial change with the 2013 issuance of the DSM-5 by including subcategories into one umbrella diagnosis of autism spectrum disorder (ASD) (Baker, 2013). ASD is a lifelong neurodeve