The Latent Dimensions of Poor Self-Rated Health: How Chronic Diseases,Functional and Emotional Dimensions Interact Influencing Self-Rated Health in Italian Elderly

Self-Rated Health (SRH) is becoming one of the most popular indicator of population health. Nevertheless, a limited understanding still remains about the elements to which individuals refer when evaluating their health and how those elements act and interact in the evaluation process. In this study we use a structural equation model with latent variables to identify direct and indirect influences of various health dimensions (chronic morbidity, functional abilities and emotional health) and socio-demographic covariates (age, gender and education) on poor SRH. The sample consists of 25,183 Italian elderly aged 65 years and over, interviewed in the 2005 National Health Interview Survey. The results have pointed out the higher direct effect of psychological and emotional health on SRH, while the higher total effect is caused by chronic morbidity, which influences SRH both directly and altering functional and emotional health. Growing older, being a woman and having a low education negatively impacts on SRH. However, this is almost completely the result of the indirect effect exerted by the covariates, while their direct effect is not significant (gender), negative (age) or very modest (education).     

不平等的再生产：从社会经济地位到健康不平等--基于CFPS2010的实证分析

本文利用2010年中国家庭追踪调查（ CFPS ）数据,探索性分析了社会经济地位影响健康不平等的两个中介机制－－健康预防机制和健康恢复机制。研究结果表明,健康预防机制中,社会经济地位影响生活方式,进而影响自评健康水平的假设得到部分验证,其中营养水平的中介效应得到验证;健康恢复机制中,社会经济地位影响医疗保健能力,进而影响自评健康水平的假设得到部分验证,其中医疗保健支付能力的中介效应得到证明。最后,分析发现,＂看病贵＂比＂看病难＂更能影响民众的健康状况。     

Aging of Indian Women in India: The Experience of Older Women in Formal Care Homes

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for ‘pay and stay homes’, an emerging type of old age home in India. Majority of the 97 women residents of ‘pay and stay’ homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.     

Impact of Social Changes and Birth Cohort on Subjective Well-Being in Chinese Older Adults: A Cross-Temporal Meta-analysis, 1990–2010

Over the past several decades, the proportion of older adults in the Chinese population has steadily increased during a period of substantial social change; the effect of these changes on older adults warrants examination. The present study explored changes in subjective well-being (SWB) in older adults by birth cohort and the social factors influential in these changes. We performed a cross-temporal meta-analysis using data from 20,713 adults over 60 years of age; data were obtained from 61 studies that used the Memorial University of Newfoundland Scale of Happiness. The dynamics of SWB in older adults were evaluated as a function of time. The mean SWB score decreased by 4.98 over the measured period, indicating a decrease of .52 standard deviations between 1990 and 2010. In addition, SWB in older adults was significantly correlated with high social connectedness and low overall threat. Specifically, urbanization level, Gini coefficient, personal medical expenditure, and birth rate were strong predictors of SWB. Our research demonstrates that social connectedness and overall threat contribute to SWB in Chinese older adults. As SWB is significantly related to the mental and physical health of older adults, the present study may serve as a useful reference for health care agencies and policy-makers.     

Older women on the U.S.-Mexico border: exploring the health of Hispanics and non-Hispanics Whites

Research on ethnicity and socioeconomic status (SES) suggests that Hispanics are more likely than non-Hispanic Whites to experience poverty and low levels of education, which may relate to poorer health status. This study used a health survey to examine income, education, ethnicity, birthplace, and age on self-reported health factors of women age 60 and older on the U.S.-Mexico border. Results show that income, age, and education were significantly associated with several health factors (Physical Health, Emotional Health, General Health, Energy Level, and Activity Potential). Older women with lower SES, regardless of ethnicity, reported poorer health than younger-old women with higher SES.     

Intergenerational Profiles of Socioeconomic (Dis)advantage and Obesity During the Transition to Adulthood

Investigations of socioeconomic status (SES) and health during the transition to adulthood in the United States are complicated by the later and more varied transitions in residence, employment, schooling, and social roles compared with previous generations. Parental SES is an important influence during adolescence but cannot sufficiently capture the SES of the independent young adult. Typical, single SES indicators based on income or education likely misclassify the SES of young adults who have not yet completed their education or other training, or who have entered the labor force early with ultimately lower status attainment. We use a latent class analysis (LCA) framework to characterize five intergenerational SES groups, combining multidimensional SES information from two time points—that is, adolescent (parental) and young adult (self) SES data. Associations of these groups with obesity, a high-risk health outcome in young adults, revealed nuanced relationships not seen using traditional intergenerational SES measures. In males, for example, a middle-class upbringing in adolescence and continued material advantage into adulthood was associated with nearly as high obesity as a working poor upbringing and early, detrimental transitions. This intergenerational typology of early SES exposure facilitates understanding of SES and health during young adulthood.     

The Relationships between Activity and Quality of Life for Older Men and Women at Different Ages in Taiwan

This study investigated the relationships between types of activity and quality of life (QOL) for older men and women at different ages. Based on cross-sectional data that included 220 community-dwelling elderly persons aged 65 and older in southern Taiwan, the results showed that the participation rates in many activities declined with age for both genders. Social activity and solitary leisure activity were significantly associated with QOL for old-old men, but not for young-old men. Only social activity was significantly associated with QOL for young-old women, but there was no significant association between any activity and QOL for old-old women.     

Measuring Social Capital in Hamilton, Ontario

Social capital has been studied by academics for more than 20?years and within the past decade there has been an explosion of growth in research linking social capital to health. This paper investigates social capital in Hamilton, Ontario by way of a telephone survey of 1,002 households in three neighbourhood groups representing high, mixed and low socio-economic status (SES). A Social Capital Measurement Tool is proposed as a straightforward way to account for differences in social capital perceptions and actions among residents. Consistent with the literature, the paper found that there was a strong association between social capital perceptions and health, particularly mental health and life stress. Social capital was greater in the high and mixed SES neighbourhoods and much weaker in the low SES neighbourhoods. With respect to social capital actions, both volunteering and voting was associated with positive overall health and mental health. Finally, the paper identified the social capital ??elite????respondents with high or above average perceptions and who participated in the two social capital actions??voting and volunteering. Prominent among the social capital elite in Hamilton is the ??health wealthy?? senior, a positive development for the continued social well-being of the city.     

Older Women on the U.S.-México Border: Exploring the Health of Hispanics and Non-Hispanic Whites

ABSTRACT

Research on ethnicity and socioeconomic status (SES) suggests that Hispanics are more likely than non-Hispanic Whites to experience poverty and low levels of education, which may relate to poorer health status. This study used a health survey to examine income, education, ethnicity, birthplace, and age on self-reported health factors of women age 60 and older on the U.S.-México border. Results show that income, age, and education were significantly associated with several health factors (Physical Health, Emotional Health, General Health, Energy Level, and Activity Potential). Older women with lower SES, regardless of ethnicity, reported poorer health than younger-old women with higher SES.     

From the Editor

This study examined risk factors associated with self-reported health (SRH) in a genetically informative sample of older African American female twins. An interview was conducted with a national sample of 180 African American female twin pairs. Questions included: SRH, demographics, health behaviors, chronic diseases, and functional status. SRH was dichotomized into negative (fair/poor) and positive (good/very good/excellent). Logistic regression for clustered data was used to estimate the odds ratios and 95% confidence intervals. In multivariable analyses, IADL limitations (OR?=?1.5, 95% CI?=?1.7–2.0) and a chronic disease index (OR?=?1.9, 95% CI?=?1.4–2.5) were associated with negative SRH. In multivariate within-twin pair analysis, controlling for genetics/shared familial environment, IADLs (OR?=?1.8, 95% CI?=?1.1–2.7), and increasing numbers of chronic diseases (OR?=?2.0, 95% CI?=?1.3–3.2) remained significantly associated with negative SRH.     

Acculturation and Self-rated Health Among Asian Immigrants: The Role of Gender and Age

Using the 2002–2003 National Latino and Asian American Study (NLAAS), we examine the relationship between acculturation and poor-to-fair self-rated health (SRH) among Asian immigrants (N?=?1639). Using latent class analysis, we construct a multidimensional measure of acculturation that considers dimensions of involvement in U.S. culture as well as attachment to Asian ethnic cultures and identify three classes of Asian immigrants: the assimilated, who most strongly adhere to U.S. culture; the integrated, who align with both U.S. and Asian ethnic cultures; and the separated, who are almost exclusively attached to Asian ethnic cultures. Logistic regression results revealed that among the pooled sample of Asian immigrant adults, the separated are significantly more likely to report poor-to-fair SRH than the assimilated. We then tested for gender and age differences in the acculturation–SRH relationship, and found that stratifying by gender yields noticeably different patterns. Among Asian immigrant women, the probability of reporting poor-to-fair SRH increases with age for the separated and the integrated, while it declines with age for the assimilated. Conversely, among Asian immigrant men, the probability of reporting poor-to-fair SRH increases most steeply with age for the assimilated, while it is shallower for the separated and the integrated. Future research should continue to develop a dynamic understanding of acculturation and examine its association with other health outcomes, including how these relationships differ across subsets of immigrant groups.

     

Impact of Acts of Discrimination on Quality of Life Among Injecting Drug Users in Delhi, India

The study examines the association between quality of life (QOL) and discrimination perpetrated against a vulnerable population like injecting drug users (IDU). Given that QOL affects self efficacy which in turn affects behavior, it is relevant to examine QOL among IDUs in the context of HIV prevention, and to study whether discriminations and human rights abuses impact QOL in this population. A cross sectional study was conducted in two research sites in Delhi, India among 343 IDUs recruited through a respondent driven sampling. A Hindi version of the WHOQOL Bref survey along with a survey questionnaire of discrimination were used to interview participants. After controlling for demographic characteristics, experiencing physical and verbal abuse (OR: 0.46, CI 0.27–0.79),arrests and imprisonment for carrying needles and/or using drugs (OR: 0.53, CI 0.31–0.90) and lacking health information (OR: 0.49, CI 0.29–0.85)was associated with lower social QOL, while being denied health care services was associated with lower psychological QOL. The more discrimination experienced, the lower was the quality of life in the social and psychological domains. Participants’ perceived well being in the four domains was related to their living conditions, discriminatory acts and to perceptions of social support. Discriminatory acts and abuses appeared to have a greater toll on their psychological well being and social relationships, thus indicating the need for human rights advocacy in order to influence law enforcement practices and to reduce stigma, while expanding social support through an extended comprehensive IDU programme.     

Quality of Life Predictors and Normative Data

This study identifies predictors and normative data for quality of life (QOL) in a sample of Portuguese adults from general population. A cross-sectional correlational study was undertaken with two hundred and fifty-five (N = 255) individuals from Portuguese general population (mean age 43 years, range 25–84 years; 148 females, 107 males). Participants completed the European Portuguese version of the World Health Organization Quality of Life short-form instrument and the European Portuguese version of the Center for Epidemiologic Studies Depression Scale. Demographic information was also collected. Portuguese adults reported their QOL as good. The physical, psychological and environmental domains predicted 44 % of the variance of QOL. The strongest predictor was the physical domain and the weakest was social relationships. Age, educational level, socioeconomic status and emotional status were significantly correlated with QOL and explained 25 % of the variance of QOL. The strongest predictor of QOL was emotional status followed by education and age. QOL was significantly different according to: marital status; living place (mainland or islands); type of cohabitants; occupation; health. The sample of adults from general Portuguese population reported high levels of QOL. The life domain that better explained QOL was the physical domain. Among other variables, emotional status best predicted QOL. Further variables influenced overall QOL. These findings inform our understanding on adults from Portuguese general population QOL and can be helpful for researchers and practitioners using this assessment tool to compare their results with normative data.     

Families,social life,and well-being at older ages

As people age, many aspects of their lives tend to change, including the constellation of people with whom they are connected, their social context, their families, and their health—changes that are often interrelated. Wave I of the National Social Life, Health, and Aging Project (NSHAP) has yielded rich information on intimate ties, especially dyads and families, and on social connections generally. Combined with extensive biological and other health measures, NSHAP enables researchers to address key questions on health and aging. We begin with recent findings on intimate dyads, then move to social participation, and finally to elder mistreatment. Among dyads, we find that whereas sexual activity drops sharply with age for both women and men, gender differences in partner loss as well as psychosocial and normative pressures constrain women’s sex more than men’s. However, surviving partnerships tend to be emotionally and physically satisfying and are marked by relatively frequent sex. In contrast to sex, nonsexual intimacy is highly prevalent at older ages, especially among women. Older adults are also socially resilient—adapting to the loss of social ties by increasing involvement with community and kin networks. Despite these social assets, older adults remain vulnerable to mistreatment. Overall, these findings yield a mixed picture of gender-differentiated vulnerabilities balanced by proactive adaptation and maintenance of social and dyadic assets.     

Sense of Place and Health in Hamilton, Ontario: A Case Study

The concept of sense of place has received considerable attention by social scientists in recent years. Research has indicated that a person's sense of place is influenced by a number of factors including the built environment, socio-economic status (SES), well-being and health. Relatively few studies have examined sense of place at the neighbourhood level, particularly among communities exhibiting different levels of SES. This article investigates sense of place among three neighbourhood groups in Hamilton, Ontario representing areas of low, mixed and high SES. It analyses data from a 16-point sense of place scale derived from the Hamilton Household Quality of Life Survey carried out in 2010-2011 among 1,002 respondents. The paper found that sense of place was highest among residents of the high SES neighbourhood group as well as among home owners, people residing in single-detached homes, retired residents and those living in their neighbourhood for more than 10?years. From a health perspective, the paper found that a strong association existed between sense of place and self-perceived mental health across the three neighbourhood groups. Furthermore, by way of regression modeling, the paper examined the factors influencing health-related sense of place. Among the sample of respondents, a strong connection was found between housing, particularly home ownership, and high levels of health-related sense of place.     

Family structure and socio-economic differentials in fertility

Abstract The long standing research on the relation of socio-economic status and fertility has recently given way to a focus on those factors which account for class differentials. Although class differences in fertility seem to be diminishing, the basic relationship remains inverse.(2) In an attempt to explain class differentials in fertility, researchers have begun to look at such variables as age at marriage(3), value orientations(4), and non-fiunilial activity.(5) Bumpass demonstrated that age at marriage is an interaction variable which greatly attenuates the relationship between social class and fertility. He found that the relationship was inverse among women marrying before age 19, but direct among women who were 23 years or older at first marriage. Clifford examined value orientations as an intervening variable in the socio-economic status-fertility relationship. Modern and traditional value orientations did aid in interpreting the relationship, but other factors were also operative. Kupinsky found that the non-familial activity of women decidedly influenced socio-economic differentials infertility. Thelabour force participation of women had a greater effect on reducing fertility among upper-status women than among those of lower status. This relationship was also influenced by the rural-urban background of the women.     

Disability pathways preceding death in England by socio-economic status

The role of socio-economic status (SES) in the last years of life is an under-researched aspect of health inequalities. This study examines disability patterns preceding death using data from the English Longitudinal Study of Ageing. We use repeated measures latent class analysis to identify the most common pathways preceding death in terms of walking ability and limitations in activities of daily living. Three pathways emerge: one characterized by consistently low disability; a second by a constant high level of functional limitations; and a third by medium impairment. We examine how different SES indicators predict belonging to each disability pathway. Conditional on income, higher wealth is associated with a lower likelihood of belonging to the high disability pathway. Contrary to our expectations, we find no educational gradient in the pathways preceding death. Health inequalities in the last years of life seem to exist especially between individuals with different levels of wealth.     

Which Aspects of Elderly Living Conditions are Important to Predict Mortality? The Complex Role of Family Ties at Home and in Institutions

Social Indicators Research - Besides health and socio-economic status, the social relationships maintained during elderly play an important role in shaping the living conditions at older ages. In...     

Gay and lesbian perceptions of discrimination in retirement care facilities

Much research on older gay, lesbian, bisexual and transgender (GLBT) adults has focused on refuting the widely held misconceptions people have about GLBT lifestyles. To date, however, few studies on older GLBTs have examined their social and health care needs. Further, most studies have collected survey samples of older GLBT adults in large metropolitan areas and have not specifically addressed discrimination or bias in retirement care facilities. In the current exploratory study on perceptions of discrimination and bias in retirement care facilities, we surveyed a wide age range GLBT adults in a smaller metropolitan area of fewer than 400,000 people to discover the perceptions of both younger and older GLBTs. We surveyed perceptions of discrimination in retirement care facilities, sources of perceived discrimination, and suggestions for how discrimination might be reduced or eliminated in those settings. Respondents indicated that administration, care staff, and residents of retirement care facilities themselves were all potential sources of discrimination, and that education addressing awareness and acceptance of GLBTs is one potential remedy for discrimination against GLBTs in retirement care facilities. Respondents also indicated a strong desire for the development of GLBT-exclusive or GLBT-friendly retirement care facilities. Chi-square analyses of responses to the discrimination questions and respondents' demographic characteristics revealed significant differences with regard to age, income, gender, community size, and education level of the respondents.