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.     

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.     

Material hardship and self-rated health among low-income households in South Korea

Concerns over poverty and health inequality are growing in South Korea. Using advanced statistical methods including lagged-dependent variable and fixed-effects approaches, we investigated whether experiencing material hardship (MH) was associated with self-rated health (SRH) among low-income households in South Korea. This study found that the experience of MH was positively associated with higher likelihood of reporting poor SRH (OR = 1.42, p < .05) and that experiencing two or more items of MH presented more harmful influence on SRH (OR = 2.02, p < .001). This study also found that the negative association between MH and SRH was stronger among the unemployed households.     

Type of Volunteer Experience and Health Among Older Adult Volunteers

Abstract

The purpose of this investigation was to ascertain if the type of volunteer experience was related to the physical health or psychological well-being of older adult volunteers. A central pattern emerged from the data: the type of, as well as the number of, hours donated to a volunteer activity were associated with psychological well-being. Implications for social workers involved with volunteer programs and services are discussed in terms of volunteer recruitment and retention, and the need to develop more significant volunteer roles, especially for low-income older adults.     

Functional Independence of Community-Dwelling Older Adults in China and South Korea

ABSTRACT

Population aging is occurring at an unprecedented pace in China and South Korea. This study intended to identify and compare factors associated with older adults’ functional status in China and South Korea using data from 2 national surveys. The study sample consisted of adults aged 65 to 79 years old drawn from the Chinese Longitudinal Healthy Longevity Survey (2005; n = 4,898) and the Korean Longitudinal Study on Aging (2006; n = 4,152). The outcome variable, functional status, was defined as dependence in self-care tasks. Stepwise multiple regression analysis was used to assess the explanatory contributions of sociodemographics, health conditions, and health behaviors and activities to functional status. These Asian older adults shared certain commonalities in maintaining functional independence in their communities, and absence of diseases and higher cognition were associated with functional independence in both countries. Rural residence and outdoor activity were significant for Chinese older adults; for their South Korean peers, gender, employment status, drinking, and exercise were important. This study adds to a slowly growing body of knowledge of ways to improve the functional independence of community-dwelling older persons in these 2 Asian countries and beyond. More research is needed to identify cross-cultural and/or cross-country differences.     

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.     

Longitudinal health and disaster impact in older New Zealand adults in the 2010–2011 Canterbury earthquake series

ABSTRACT

Pre-existing longitudinal studies of people affected by disasters provide opportunities to examine the effects of these events on health. Data used in the current investigation were provided by participants in the New Zealand Health, Work and Retirement longitudinal surveys conducted in 2010, 2012 and 2014 (n = 428; aged 50–83), who lived in the Canterbury region of New Zealand during the 2010–2011 earthquakes. Latent profile growth analyses were used to identify groups of respondents who had similar pre–post-disaster physical and mental health profiles. These groups were compared in terms of demographic factors, personal impact of the earthquakes assessed in 2012 and the overall negative–positive impact of the earthquake assessed in 2014. There was little evidence of change in health status overtime. Groups did not differ in their experiences of threat or disruption, however those in poorest health reported greatest distress and a more negative overall impact of the earthquake. Although results suggest little impact of disasters on health of surviving older adults, pre-disaster vulnerabilities were associated with distress. Social workers and agencies responsible for disaster response can play a key role in pre-disaster planning and assessment of vulnerabilities of older adults to enhance potential for positive outcomes post-disaster.     

Health and Medical Services Use: A Matched Case Comparison Between CCRC Residents and National Health and Retirement Study Samples

Little is known about the health status of adults living in continuing care retirement communities (CCRC). Using matched-case control, 458 adults from the Health and Retirement Study (HRS) or a CCRC-based sample were compared on total comorbidity, self-rated health, home health services use, and hospitalizations. At year 2, the CCRC sample reported more comorbidities (96%) but significantly better self-rated health (96% good/excellent) than the HRS sample (93% comorbidity, 73% good/excellent; p < .01). There were no significant differences in frequency of home health use or hospitalization. Living in a CCRC appears to be associated with higher self-ratings of health in this sample.     

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.     

Utilization of Community-Based Social and Health Services Among Foreign Born Hispanic American Elderly

ABSTRACT

This study examined factors associated with the utilization of community-based social and health services among foreign born elderly Hispanic Americans. The data came from a nationwide probability sample of Hispanic Americans age 65 and older including 296 Mexico-born Mexican Americans, 571 Cuba-born Cuban Americans, and 247 respondents from other Hispanic countries. Being a Cuba-born Cuban American, living alone, having poorer self-rated health and living below poverty level were positively related with the utilization of community-based social services. Cuban Americans with more limitations in activities of daily living (ADL) used more community-based health services. Among Mexico-born Mexican Americans, those who lived alone used more social as well as health services while those who were married used more social services. Those with greater limitations in ADL used more health services. Among other foreign born Hispanic Americans, going to church, living alone and living below poverty status, were positively correlated with the utilization of social services. Respondents with better English language ability were less likely to use community based health services. Elderly men and people who rated their health as poorer or had more ADL limitations were more likely to use these services. Implications of these findings for health and social services are discussed.     

Age Differences in Stressors,Coping Resources,and General Well-Being Among Korean Immigrants

ABSTRACT

 This study explored 346 Korean immigrants living in California to examine: a) differences in stressors, coping resources, and general well-being (anxiety, depression, positive well-being, self-control, vitality, and general health) between younger (18–64 years old) and older (65–96 years old) Korean immigrants; and b) differences in associations of stressors and coping resources with general well-being in the 2 groups. Results revealed that the older immigrants experienced higher levels of socioeconomic stressors and psychological/physical problems. In addition, English-language problems, low education, and financial difficulties were more consistently associated with lower levels of general well-being in the older immigrants than in the younger immigrants. Social support, religious practice, and spiritual coping were more likely to alleviate the detrimental consequences of stressors on general well-being in the older immigrants than in the younger immigrants. To improve the general well-being of older Korean immigrants, the results suggest: a) emphasis of social and health care services with bilingual capability; b) improved social support systems; and c) utilization of spiritual assessments and interventions. Future research should extend the current study with longitudinal data of a more generalizable sample of Korean immigrants.     

The effects of physical and psychological health on life satisfaction among older adults with a physical disability in South Korea: focus on gender differences

This study aims to investigate whether (a) functional disabilities, self-rated health and depression influence life satisfaction among older adults with a physical disability, and (b) whether the effects of the predictors differ by gender. The study utilises 2008 Korea Welfare Panel Study data. The findings reveal that functional disabilities and depression are negatively associated with life satisfaction, whereas self-rated health is positively related with life satisfaction. In addition, the effects of functional disabilities and income on life satisfaction vary by gender. Implications for practice and policy are discussed.     

Materialist/postmaterialist values and their association with psychological health and health locus of control: A population-based study

This study investigates the association between Ronald Inglehart's materialist/postmaterialist index, a psychological aspect of the material pathway to inequalities in health, and health locus of control and psychological health. The data used is from the 2008 public health survey in Skåne, a cross-sectional postal questionnaire study with 28,198 respondents (response rate 54%), conducted in southern Sweden during the fall of 2008. Psychological health (GHQ12), health locus of control (external vs. internal) and the four-item Inglehart's index were assessed. A Multiple Logistic Regression Model was used to control for age, sex, country of origin, socioeconomic status and interpersonal trust. External locus of control was observed among 32.7% of the respondents. Poor psychological health was found in 18.2% of the women and 13.8% of the men. Materialist values were positively associated with low socioeconomic status, while a reverse association between postmaterialist values and low socioeconomic status was observed. External health locus of control was strongly and positively associated with materialist values among both men and women. Psychological health was not associated with materialist/postmaterialist values. The materialist/postmaterialist index, a psychological aspect of the material pathway to inequalities in health, is associated with health locus of control but not with mental health.     

Correlates of Treatment Retention Among Persons with Serious Mental Illness Receiving Integrated Care in a Community Mental Health Setting

ABSTRACT

Knowledge about methods to retain community mental health (CMH) clients in integrated primary and behavioral health care (PBHC) programs is needed to address longstanding health disparities. A preexisting data set that contained the clinical records of 446 PBHC program participants was used to examine whether baseline sociodemographic, health, and psychosocial characteristics predicted retention in care at 6 months post-enrollment. Results indicated that less than half of PBHC participants (43.7%) were retained in care, and approximately 17% of the variance in retention was explained by the inclusion of seven predictors in the model (overall health, medications, laboratory data, primary care provider, disorder type, transportation, and living arrangement). Clients with thought disorders were almost twice as likely as those with mood disorders to be retained in care, and greater frequency of prescribed medications also increased the likelihood of treatment continuation (ORs = 1.99 and 1.20, respectively). Future research should identify factors that improve retention in integrated PBHC programs overall, and among persons with mood disorders, in particular.     

The effects of socioeconomic inequalities of working life on health: implications for an ageing population

Abstract

This study examines suggestions that inequalities in health related to socioeconomic status (SES) will increase in older age. A representative sample of the New Zealand population aged 55–70 years (N = 6662) responded to a postal questionnaire with measures of health (SF-36), SES, and health-related behaviours. Hierarchical multiple regressions supported predictions that the SES of working life will continue to influence physical and mental health in early old age. The strongest predictor was self-reported economic living standards. This subjective measure of SES is an important construct for future investigations of health and wellbeing among older people in an ageing population.     

An Exploration of Mental Health Literacy Among African American Clergy

ABSTRACT

The purpose of this qualitative study was to explore African American clergy's mental health literacy with older congregants 60 years of age and older. Using a grounded theory approach, we recruited a purposive sample of 9 African American clergy representing diverse ages, denominations, locales, and educational levels. Data was coded and classified according to Kevin's (1976) Kevin, R. C. 1976. Factors influencing the judgment and referral of mental health presenting problems by clergymen and psychologists, Unpublished doctoral dissertation: University of Texas, Austin.  [Google Scholar] typology of pastoral counseling and Jorm et al.'s (1997) Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B. and Pollitt, P. 1997. “Mental health literacy”: A survey of the public's ability to recognize mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166: 182–186. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] conceptual model of mental health literacy. Findings from data analysis revealed study respondents were adherents of Kevin's Religious–Community (R–C) model. Additionally, the following themes emerged: loss of cognitive functioning, psychosocial stressors, religiosity, and appreciation for professional assistance, cultural barriers, and key informants/familiarity with formal mental health providers which partially maps onto Jorm et al.'s conceptual model of mental health literacy.     

Locus of control and the direction of lethal violence: Cross national analysis,research note

Previous work has suggested that economic development affects the direction of lethal violence through a civilizing process wherein there is a shift from an internal to an external locus of control. However, data were not available to measure locus of control. The present work assesses the relationship between a measure of control and the direction of lethal violence or SHR (suicide rate/(suicide + homicide rates)). Data representing 53 nations are merged from the world values survey and the world health organization. The results of a multiple regression analysis show that locus of control is unrelated to the direction of violence. While development fosters internal locus of control, the link between development and direction of violence is not explained by locus of control.     

Health and medical services use: a matched case comparison between CCRC residents and national health and retirement study samples

Little is known about the health status of adults living in continuing care retirement communities (CCRC). Using matched-case control, 458 adults from the Health and Retirement Study (HRS) or a CCRC-based sample were compared on total comorbidity, self-rated health, home health services use, and hospitalizations. At year 2, the CCRC sample reported more comorbidities (96%) but significantly better self-rated health (96% good/excellent) than the HRS sample (93% comorbidity, 73% good/excellent; p < .01). There were no significant differences in frequency of home health use or hospitalization. Living in a CCRC appears to be associated with higher self-ratings of health in this sample.     

社会医疗保险对老年人健康水平的影响：基于浙江省的实证研究

本研究根据2010年浙江省城乡老年人口生活状况调查的数据认为,对于老年人的社会医疗保险问题,不仅要关注保险覆盖面的扩大,更应关注不同保险项目参保老人之间的健康平等。在揭示医疗服务使用与健康水平负向关系这一主效应的基础上,研究发现,职工医保作为moderator可以改善使用较多医疗服务老人的健康水平,新农合的作用则相反。研究希望对医疗保险的改革思路进行反思,全民医保的改革思路不仅是医疗服务可及性的提高,更应该是不同社群享有平等的医疗福利,并最终促进健康结果的平等。     

Resilience among older caregivers in rural Namibia: The role of financial status,social support and health

Background: Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa. Method: Data were collected through a structured interview from (N = 147) caregivers from the Zambezi region. Results: Findings from this study show that employment and physical health were significantly associated with increased resilience in older caregivers. Discussion: Our findings point to the need for employment assistance and health services to improve the resilience of caregivers caring for people living with HIV and AIDS. We conclude that there is a need for more vigorous concerted efforts from public and private sector practitioners and policy makers to create more sustained formal employment opportunities and intervention programs aimed at improving the overall health of older HIV caregivers, especially those residing in rural HIV endemic communities in developing countries.