Gender Differences in Determinants of Self-Rated Health Among African American in Omaha Nebraska: A Church-Based Study

Abstract

This study assessed the gender differences in determinants of fair/poor self-rated health among African American churchgoers in Omaha, Nebraska. Using data collected from 353 African American (245 women and 108 men) by the Center for Reducing Health Disparities at the University of Nebraska Medical Center in 2017, univariate and multivariate logistic regressions were performed to examine the gender differences in the relationships between fair/poor self-rated health and potential health determinants. Overall, 14.3% of women and 17.6% of men reported fair/poor self-rated health. There was a significant association between depression and poor/fair self-rated health among women (p?=?0.044) and men (p?=?0.001). For women, the fully controlled model confirmed the crude association between perceived poor/fair self-rated health and heart disease (OR = 3.10) and education (OR = 2.19). For men, the final model identified significant determinants of perceived fair/poor self-rated health such as depression (OR = 12.51) and diabetes (OR = 3.89). When assessing gender differences in determinants of self-rated health, similarities are higher than differences between the two groups. In both groups, the presence of depression was the strongest determinant of poor health. Future research should assess the immunological aspects of the association between psychological factors and perceived chronic diseases.     

High Life Satisfaction: Exploring the Role of Health,Social Integration and Perceived Safety among Mexican Midlife and Older Adults

We sought to investigate the relationship of high life satisfaction with important physical health, mental health, social integration and perceived safety factors among midlife and older Mexican adults. We examined 2,200 midlife and older adults (aged 50–101 years) from the Mexican arm of the Study on global AGEing and adult health (SAGE) and used binary logistic regression models to identify key factors associated with high LSA. Our final logistic regression model revealed self-rated health, affect, interpersonal activities and perceived safety on street to be significantly associated with high life satisfaction. Results from this study add to the nascent literature on subjective well-being of midlife and older Mexicans. Although social work with older adults is not well established in Mexico, researchers and practitioners should collaborate on the development and implementation of social worker-led strategies for prevention and intervention to enhance well-being among midlife and older Mexicans.     

Relationships Among Caregiving,Income, Gender,and Health: A Cross-Sectional Examination of a Representative Sample of Older Americans

Although there is substantial evidence to support the effect of burden on caregivers, few studies have compared caregivers to their noncaregiving counterparts on the basis of health and well-being outcomes. This study examines the relationship between caregiving and health and whether other factors may have stronger influence on well-being measures. Using a nationally representative sample of older adults in the United States (N = 3,005), this study examines relationships between caregiving status, gender, and income, and 9 outcomes (self-rated physical and mental health, time since seeing a doctor, time since most recent pap smear or prostate-specific antigen [PSA] test, depression, loneliness, stress, anxiety), using logistic and linear regression models. Results support that paradoxically, caregiving was associated with increased likelihood of PSA test in male caregivers, although data also indicated higher levels of anxiety and stress, as might be expected. Income was associated with 8 of 9 outcomes, and gender predicted depression, anxiety, stress, and self-rated mental health. The study highlighted the importance of psychosocial stressors, such as income and gender, on the health outcomes of older adults who may be caregiving. Considering complexity of unique experience is necessary to accurately assess vulnerability to poor mental health or health-related outcomes.     

Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London

This ethnographic study was carried out in the aftermath of an epidemiological investigation, the first of its kind, on the health and social status of Somalis aged 60 years and over living in Tower Hamlets, east London. The main aims of the study are to explore views on mental health and well-being and identify sources of stress and support so as to gain greater understanding of background factors of life satisfaction and depression in 'first-generation' older Somali migrants in Tower Hamlets (males). Face-to-face interviews were conducted among 28 males in Somali with the help of a bilingual interpreter from the same age, sex and cultural background of participants. Several factors were perceived to decrease life satisfaction and increase vulnerability to depression in male Somalis, in particular low family support in the face of increasing physical disability, loneliness, inadequate access to community services and inability to return home. Social isolation, low level of control over one's life, helplessness and social degradation – ageism, perceived racial/religious discrimination and, to a lesser extent, racial harassment – were common themes identified in people who said to be depressed. Family support was the main buffer against depression; other coping resources were represented by religious practices and reliance on Somali peers. Avoidance coping seemed to encompass denial of depression in participants who had low mood. The study revealed multiple reasons for ill-being, in particular in people who had high expectations about medical and social care. Low levels of distress were found in Somalis who felt supported by their families. There is a need for social workers and other health professionals to advance discussions of mental-health issues in the community and for service providers to promote greater access to culturally relevant medical and social services for Somali elders in Tower Hamlets and strengthen their informal support networks.     

Part-time employment and worker health in the United States

A growing body of research has highlighted the consequences of part-time employment for workers’ health and well-being. However, these studies have yielded inconsistent results and relied on cross-sectional data. In addition, relatively little empirical research has explored whether the effect of working part-time on health varies by gender, particularly in the United States. Using longitudinal data from three waves of the General Social Survey panel (2010–2012–2014), our study examined the association between part-time employment and perceived health among U.S employees, and whether this association varied by gender. The results showed that part-time workers were less likely to report poor self-rated health than full-time workers, especially among males. The pattern of results was consistent across empirical approaches—including generalized estimating equations and random effects models, with an extensive set of covariates. Taken together, these findings suggest that for U.S. employees, working part-time appears to be beneficial or at least not detrimental to perceived health, which warrants further investigation.     

The Role of Internal Health Locus of Control in Relation to Self-Rated Health in Older Adults

ABSTRACT

The present study examined how internal health locus of control is associated with older adults’ self-rated health. Multivariate analyses with older participants (aged ≥ 60) in the MIDUS II (n = 1,533) showed that internal health locus of control was not only directly associated with positive ratings of health but also interacted with gender and race. The positive impact of internal health locus of control on self-rated health was particularly greater in females and Whites than their counterparts. Findings highlight the important role of internal health locus of control in the psychological mechanism of health and call attention to group-specific strategies for health promotion.     

Contributing Factors of Depressive Symptoms Among Elderly Korean Immigrants in Texas

This study examined various life stresses associated with relocation that may contribute to depressive symptoms among Korean immigrant elders in Texas. A sample of 120 elders was assessed using the Geriatric Depression Scale–Short Form and a 90-min face-to-face interview. Over 1/3 of respondents (37.5%) had symptoms of depression. Regression analyses (R² = .331) indicate that self-rated health, stressful life events, English language proficiency, satisfaction of visiting one's birth place, and watching TV were correlates of depressive symptoms among them. The findings of this observational study may be used as a baseline for designing service program for this population.     

Gender differences in the effect of social resources and social status on the retirement satisfaction and health of retirees

This study explores the effect of positive and negative social support, social reciprocity, and subjective social status on the retirement satisfaction and health of retirees and gender differences therein. Using cross-sectional data from the 2010 and 2012 waves of the Health and Retirement Study (HRS), we found that social support seems to matter more for the retirement satisfaction and health of women, while social reciprocity matters more for the health of men and subjective social status for the retirement satisfaction of men. Implications for the development of social programs and policies over the life course are discussed.     

The effect of community organisations’ participation and existence on self-rated health in China: evidence from China Health and Retirement Longitudinal Study

Using the China Health and Retirement Longitudinal Study cross-sectional survey in 2011 with an 80.51% response rate, an endogenous logit model is adopted to account for the relationship between social capital and self-rated health and the heterogeneity from gender, age and marital status on individual self-rated health status. Consequently, social capital at both individual and community levels is found to be positively correlated with better subjective self-rated health status. Furthermore, the social capital’s marginal effect of the male, high-income groups, the married are larger than that of the female, rural residents, low-income groups and the divorced. In addition, interclass correlation value from the partition of the fixed and random effect of social capital is significantly, ranging from 3.0 to 5.49%, indicating a significant proportion of the total variance in self-rated health that can be explained by community-level differences.     

The life satisfaction of elderly Chinese widows living alone and those living with adult children

Care of China's elderly population is of concern due to its projected growth as well as to changes in elder care patterns related to shifting social and economic conditions. Increases in life expectancy and, therefore, in the duration of widowhood, particularly for women, magnifies this concern. Studies that examine the living arrangements and life satisfaction of elderly widows in China are limited. This study of 147 elderly widows, both men and women, examined differences in the life satisfaction of those who live with their adult children and those who live alone. This study also examined whether the relationship between living arrangement and life satisfaction was moderated by levels of family and community support. According to study findings, elderly widows living alone have higher life satisfaction than those living with their adult children, and this effect remains with the introduction of controls for health status, family support, community support, gender, age, income and educational level. Further, neither family nor community support moderate the relationship between living arrangement and life satisfaction, although each exerts a direct effect on life satisfaction.     

社会分层与健康不平等的性别差异:基于生命历程的纵向分析

本研究考察在社会分层与性别分层的交互作用下,生命历程中的两个竞争性理论--“累积优势/劣势理论”和“年龄中和效应理论”,哪一个更能解释中国男性和女性所经历的健康不平等。本研究利用“中国健康与营养调查”（CHNS）追踪数据和成长曲线模型发现,性别对社会分层导致的健康不平等及其发展有独特的影响。与男性相比,女性在各个年龄阶段都处于健康劣势,这一劣势是因为女性从教育和收入所获得的健康回报比男性低。此外,女性之间因为教育和收入导致的健康不平等程度随年龄的增长而缩小,男性之间的健康不平等程度并不随年龄的增长而改变,因此,本研究不支持健康不平等的“累积优势/劣势假说”,而是在女性群体中支持“年龄中和效应理论”。     

Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences

In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers’ self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers’ self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers’ self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.     

Mechanisms of the Effect of Involuntary Retirement on Older Adults’ Self-Rated Health and Mental Health

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.     

Educational gradient of health in rural China

The aim of this paper is to examine whether and how rural residents’ educational attainment is associated with their self-rated health in China. Taking advantage of the National Exercise Facility Survey that was collected between December 2015 and March 2016, we find that educational attainment has a significant and positive correlation with self-rated health, net of the effects of age, gender, and geographical region. This correlation is mediated by factors such as perceived importance of exercise and healthy lifestyle. Relatively, people’s cognitive knowledge about health-related information and material resource access fail to play a significant mediating role. The findings highlight the non-material and non-cognitive attributes of educational attainment in shaping the gradient of health in the rural setting of China. Interventions that expand formal education to the mass and optimize teaching contents may offer an effective means to balance the health gradient.     

The interaction effects of scheduling control and work–life balance programs on job satisfaction and mental health

Jang SJ, Park R, Zippay A. The interaction effects of scheduling control and work–life balance programs on job satisfaction and mental health Int J Soc Welfare 2011: 20: 135–143 © 2010 The Author(s), International Journal of Social Welfare © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. The demands of balancing employment and family responsibilities strain the health and welfare of many employees worldwide, and social welfare policy analysts are increasingly attending to the factors that can alleviate such stress. The present study examined associations between the availability of work–life balance programs, employees' authority to arrange their own work hours, job satisfaction, and mental health among 1,293 employees in 50 companies in South Korea. The study is unique in its use of multilevel analysis in examining individual‐ and company‐level variables. The results add to the evidence regarding the positive relationship between the availability of scheduling control and work–life balance policies on the one hand, and job satisfaction and mental wellbeing, on the other.     

Impact of Geriatric Assessment and Self-Management Support on Community-Dwelling Older Adults with Chronic Illnesses

Purpose: The purpose of this study was to assess the effectiveness of interdisciplinary geriatric home-based assessment and self-management support services to community-dwelling older adults. Design: A quasi-experimental, pre-post test design tested two types of service delivery models. The first protocol included geriatric assessment services, with a brief self-management care plan intervention. The second protocol added a telephone support intervention. Results: All participants showed significant progress in improved self–efficacy, self-rated health, functional status and physical mobility (specifically lower extremity muscle strength), mental health (specifically reduced depression) and in reduced fall hazards in their physical home environment. The telephone support intervention protocol did not provide additional value to the first protocol. Implications: This study demonstrates the value of non-medical intervention strategies for community dwelling older adults with chronic illnesses.     

Treating Older Persons with Severe Mental Illness in the Community: Impact of an Interdisciplinary Geriatric Mental Health Team

Little information is available concerning community-based interventions to treat the growing number older persons with severe mental illness. This study examined treatment efficacy of a specialized interdisciplinary geriatric mental health team (mental health geriatric interdisciplinary teams or MHGITs) for 69 older clients with severe mental disorders. Depression, life satisfaction, health, and psychiatric and medical hospitalization data were gathered. A decrease in depressive symptoms and in psychiatric hospitalizations, and an increase in life satisfaction at 6 months were found. No change in health nor medical hospitalizations were reported. This study provides preliminary support for the feasibility and efficacy of a MGHIT approach in treating older community-dwelling adults with severe mental illnesses. Implications for social workers are discussed.     

Risk Factors and Intervention Programs for Depression in Nursing Home Residents: Nursing Home Staff Interview Findings

The in-depth qualitative interviews with 25 nursing home staff members were done to examine (a) their perceptions and experiences of risk factors for residents' depression, (b) current depression intervention programs, and (c) specific needs for staff training. The interviewees identified the residents' sense of loss and grief and feelings of isolation and loneliness as the causes of their depression and in-house activities and contract mental health services as current services aimed at reducing depression. They also pointed out the following barriers to providing effective depression interventions: too much dependence on antidepressant medication, low Medicaid reimbursement rate, staff shortage, residents' attitudes, and nursing home culture. The types of training that the staff members desired were: skills to monitor nonverbal signs and changes and to systematically screen different types of depression; education about antidepressants and their effects, side effects, and interaction effects with other medication; and systematic training in different types of psychosocial and behavioral interventions for late-life depression in residents with various levels of physical disabilities and cognitive impairments.     

The relationship between adverse childhood experiences,health and life satisfaction in adults with care experience: The mediating role of attachment

Adverse childhood experiences (ACEs) are associated with a plethora of negative outcomes. Research has also found that adults who were separated from parental care and lived in alternative care settings during childhood have high levels of ACEs and are more likely to have poor outcomes. A growing body of research has supported the importance of attachment as a mechanism underlying the relationship between ACEs and adult wellbeing. However, little work has examined the role that attachment may play in the outcomes of adults who resided in residential and foster care during childhood. The current study examined the role of attachment avoidance and anxiety in the associations between ACEs and mental health, physical health, and life satisfaction in a sample of 529 adults with alternative care experience from 11 nations. Attachment avoidance partially mediated the relationship between ACEs and life satisfaction, mental health, and physical health. Attachment anxiety partially mediated the relationship between ACEs and life satisfaction and mental health, but not physical health. Taken together, the present study suggests that both attachment anxiety and avoidance play important, but unique, roles in understanding the relationship between ACEs and health and wellbeing for adults with care experience. Implications and limitations are discussed.     

Pre–Post Release Health in US Adult Male Convicts

Abstract

This study sought to determine whether need for healthcare and reported health status among adult men (N?=?1,113) in US Federal prisons (in 12 states) changed from pre-release to 15?months after release by analyzing data collected by the Serious and Violent Offender Reentry Initiative (SVORI). Specifically, the study was guided by three questions: (1) were there changes in treatment for specific diseases; (2) were there changes in health status, need for care, and access to and satisfaction with healthcare; and (3) did various social determinants of health predict any of the health outcomes at 15-month follow-up. The analysis of SVORI data found that men reported lower physical and mental health status and declines in receiving treatment following release, but greater satisfaction with healthcare. Further, analysis found the best predictors of health status as being satisfied with access to health care as well as employment. The greatest declines were in mental health treatment, however those ceasing treatment did not report worse physical health status, mental health scores, housing, employment, or recidivism. Future research is needed to determine the significance of the link between employment, satisfaction with access to health care, and health status among ex-prisoners.