scholarly journals Socioeconomic variation of multimorbidity in Colombian older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Silvia Marcela Ballesteros ◽  
José Moreno-Montoya ◽  
Wilhelmus Johannes Andreas Grooten ◽  
Pedro Barrera-López ◽  
José A. De la Hoz-Valle

AbstractMultimorbidity (MM) prevalence among older adults is increasing worldwide. Variations regarding the socioeconomic characteristics of the individuals and their context have been described, mostly in high-income settings. However, further research is needed to understand the effect of the coexistence of infectious diseases along with socioeconomic factors regarding MM. This study aims to examine the variation of MM regarding infectious diseases mortality after adjusting for socioeconomic factors. A cross-sectional multilevel study with a nationally representative sample of 17,571 Colombian adults of 60 years of age or older was conducted. Individual socioeconomic, demographic, childhood and health related characteristics, as well as group level variables (multidimensional poverty index and infectious diseases mortality rate) were analyzed. A two-level stepwise structural equation model was used to simultaneously adjust for the individual and contextual effects. Multimorbidity prevalence was 62.3% (95% CI 61.7–62.9). In the multilevel adjusted models, age, female sex, having functional limitations, non-white ethnicity, high body mass index, higher income, physical inactivity and living in urban areas were associated with multimorbidity among the sample for this study. The median odds ratio for multidimensional poverty was 1.18 (1.16–1.19; p = 0.008) and for infectious diseases was 1.25 (1.22–1.28; p = 0.014). This paper demonstrates that MM varies regarding the mortality of infectious diseases and shows a strong association between MM and poverty in a low-middle income country. Differences in the factors involved in the etiology of multimorbidity are expected among wealthy and poor countries regarding availability and prioritization of health services.

2021 ◽  
Author(s):  
Silvia Marcela Ballesteros ◽  
José Moreno-Montoya ◽  
Wilhelmus Johannes Andreas Grooten ◽  
Pedro Barrera-López ◽  
José A. De la Hoz-Valle

Abstract BackgroundMultimorbidity prevalence in the elderly is increasing worldwide. Variations regarding the socioeconomic characteristics of the individuals and their context have been described, mostly in high-income scenarios. This study aims to assess the magnitude and the socioeconomic factors associated with variations on multimorbidity in Colombia.MethodsA cross-sectional multilevel study with a nationally representative sample of 23 694 Colombian adults aged 60 years and older was conducted. Individual socioeconomic, demographic, childhood and health related characteristics, as well as group level variables (multidimensional poverty index and infectious diseases mortality rate) were analyzed. A two-level stepwise structural equation model was used to simultaneously adjust the individual and contextual effects. ResultsMultimorbidity prevalence was 62.3% (95% CI 61.7–62.9). In the multilevel adjusted models, age, female sex, having functional limitations, non-white ethnicity, high body mass index, higher income, physical inactivity, poverty during childhood and living in urban areas were associated with multimorbidity. The mediation analysis showed that living in rural areas was significantly associated with infectious disease mortality rate and other individual associations with multimorbidity were mediated by the multidimensional poverty variable. ConclusionsThis paper demonstrates a strong association between multimorbidity and poverty in a low-middle income country. Differences in the factors involved in the etiology of multimorbidity are expected among wealthy and poor countries regarding availability and prioritization of health services.


Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.


2019 ◽  
Vol 148 (1) ◽  
pp. 67-103 ◽  
Author(s):  
Mauricio Gallardo

Abstract A method to measure vulnerability to multidimensional poverty is proposed under a mean–risk behaviour approach. We extend the unidimensional downside mean–semideviation measurement of vulnerability to poverty towards the multidimensional space by incorporating this approach into Alkire and Foster’s multidimensional counting framework. The new approach is called the vulnerability to multidimensional poverty index (VMPI), alluding to the fact that it can be used to assess vulnerability to poverty measured by the multidimensional poverty index (MPI). The proposed family of vulnerability indicators can be estimated using cross-sectional data and can include both binary and metric welfare indicators. It is flexible enough to be applied for measuring vulnerability in a wide range of MPI designs, including the Global MPI. An empirical application of the VMPI and its related indicators is illustrated using the official MPI of Chile as the reference poverty measurement. The estimates are performed using the National Socioeconomic Characterisation Survey (CASEN) for the year 2017.


2021 ◽  
pp. 140349482110623
Author(s):  
Vibeke Ansteinsson ◽  
Ibrahimu Mdala ◽  
Rune Becher ◽  
Liv Grøtvedt ◽  
Simen E. Kopperud ◽  
...  

Aim: We investigated factors associated with the initiation and continuation of snus use in adolescents in Norway. The associations with adolescents’ own educational plans, the parents’ educational level(s) and tobacco habits were estimated. Methods: In this cross-sectional questionnaire-based study, 1465 patients aged 18–20 years participated. The questionnaire was administered at regular dental examinations in the public dental health service. To assess the association between individual factors and the initiation of tobacco habits, a generalised structural equation model with random effects at the clinic level was used. Binary responses were modelled using multilevel binary logistic regression, while the number of snus boxes used per month was modelled using a multilevel Poisson regression model. Results: Of current (daily and occasional) tobacco users, 85% were snus users, including dual users of both snus and cigarettes. The median age of snus initiation was 16 years. Both parental snus use and smoking were associated with an increased risk of snus initiation, snus use and a higher amount of use. An increased risk of using snus was associated with male gender and with no educational plans or planning for further vocational education. The amount of snus used was higher among current snus users with a prior smoking history and among those planning for further vocational education. Conclusions: These findings may aid in developing and targeting tobacco prevention strategies aimed at young people. Tobacco prevention measures should start at the elementary school level. The strong association with parental tobacco habits underlines the importance of parents’ influence on their children’s tobacco use.


The study was carried out to measure and analyse aspect based multidimensional poverty in rural and urban Haryana using a fuzzy set approach. The necessary data for the study was obtained from the 69th round conducted in 2012 by the NSSO on drinking water, sanitation, hygiene, and housing conditions. The Totally Fuzzy and Relative Approach was used. The fuzzy multidimensional poverty index for rural, urban and overall Haryana was calculated based on drinking water, sanitation, and housing conditions. The results revealed that 33.28 percent of households in Haryana overall were multidimentionally poor, with 36.64 percent of households in rural and 30.46 percent in urban areas. The government should lay the water connections and water pipes, construction of individual household latrines, sanitary complex for women, school, and sanitation housing schemes for all BPL families under schemes initiated by the government to overcome poverty based on these aspects.


2008 ◽  
Vol 16 (4) ◽  
pp. 465-483 ◽  
Author(s):  
Kelly A. Cotter ◽  
Aurora M. Sherman

Exercise self-efficacy is a powerful predictor of physical activity behavior, which enhances health and well-being for older adults. Social relations have been proposed as influential precursors for exercise self-efficacy. In a longitudinal study of 160 older adults with osteoarthritis (76.9% women), the authors found that social support (but not social strain) significantly predicted exercise self-efficacy in a structural equation model examining cross-sectional data: χ2(178, N = 160) = 264.57, p < .01; RMSEA = .06; CFI = .92; TLI = .90. When data were examined longitudinally, however, social strain (but not social support) significantly predicted lower exercise self-efficacy 1 year later: χ2(233, N = 160) = 288.64, p < .01; RMSEA = .04; CFI = .96; TLI = .95. Results support the negativity effect, suggesting that social strain might be the more potent aspect of social relations and should be the target of interventions.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259848
Author(s):  
Joseph R. Starnes ◽  
Chiara Di Gravio ◽  
Rebecca Irlmeier ◽  
Ryan Moore ◽  
Vincent Okoth ◽  
...  

Introduction Narrow, unidimensional measures of poverty often fail to measure true poverty and inadequately capture its drivers. Multidimensional indices of poverty more accurately capture the diversity of poverty. There is little research regarding the association between multidimensional poverty and depression. Methods A cross-sectional survey was administered in five sub-locations in Migori County, Kenya. A total of 4,765 heads of household were surveyed. Multidimensional poverty indices were used to determine the association of poverty with depression using the Patient Health Questionnaire (PHQ-8) depression screening tool. Results Across the geographic areas surveyed, the overall prevalence of household poverty (deprivation headcount) was 19.4%, ranging from a low of 13.6% in Central Kamagambo to a high of 24.6% in North Kamagambo. Overall multidimensional poverty index varied from 0.053 in Central Kamagambo to 0.098 in North Kamagambo. Of the 3,939 participants with depression data available, 481 (12.2%) met the criteria for depression based on a PHQ-8 depression score ≥10. Poverty showed a dose-response association with depression. Conclusions Multidimensional poverty indices can be used to accurately capture poverty in rural Kenya and to characterize differences in poverty across areas. There is a clear association between multidimensional poverty and depressive symptoms, including a dose effect with increasing poverty intensity. This supports the importance of multifaceted poverty policies and interventions to improve wellbeing and reduce depression.


Author(s):  
Darlene Mara dos Santos Tavares ◽  
Nayara Gomes Nunes Oliveira ◽  
Flavia Aparecida Dias Marmo ◽  
Joilson Meneguci

Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S583-S583
Author(s):  
Philip A Rozario ◽  
Emily Greenfield ◽  
Nancy Kusmaul

Abstract Social networks provide opportunities for engagement with others and structure the receipt and provision of emotional, instrumental, informational and appraisal support. Indeed scholars in this field have documented the importance of having strong social networks in influencing older adults’ well-being and quality of life. The three papers in this symposium draw on the convoy model of social relations and ecological model to examine and better understand the micro, mezzo, macro contexts that shape and influence how older people engage with and benefit from their networks in three areas: low-income senior housing communities, urban areas specifically targeting older Latinos with dementia, and disaster preparedness in micropolitan counties in eastern Iowa. The first paper, a cross-sectional study focusing on social connections in senior housing communities, examines levels of social networks, engagement, support and loneliness and their relationship with well-being outcomes. The second paper, a community-based participatory research project, reports an intervention that seeks to train natural helpers in a predominantly Latino urban neighborhood to identify and refer older Latinos with dementia to bilingual assessment services. The third paper, synthesizing findings from interventions targeting network building at the individual and state levels as well as a community-based network analysis, presents ways to strengthen networks at the mezzo and macro levels as well as environmental contexts that enable better disaster preparedness for community-based older adults. These papers will consider practice, policy and research implications in strengthening social networks and engagement to optimize older adults’ well-being in various settings.


Author(s):  
Hany M. Hassan ◽  
Mark R. Ferguson ◽  
Saiedeh Razavi ◽  
Brenda Vrkljan

Accessible and safe mobility is critical for those aged 65 years and older to maintain their health, quality of life, and well-being. Being able to move beyond one’s home and participate in activities in older adulthood requires consideration of both transportation needs and preferences. This paper aims to address a gap in evidence with respect to understanding factors that can affect older adults’ perceptions and willingness to use autonomous vehicles. In addition, it examines how these factors compare with those of younger adults to better understand the potential implications of this technology on mobility and quality of life. Using responses of those aged 65+ to a national survey of Canadians, structural equation modeling (SEM) was used to identify and quantify factors significantly associated with older adults’ willingness to use autonomous vehicles. The SEM results suggest that factors such as using other modes of transit (e.g., sharing rides as passenger, bicycle, public transit, commuter rail, ride and car sharing) as well as distance traveled by automobile, income, gender (being male), and living in urban areas, were all positively associated with older adults’ perceptions of using autonomous driving features. The findings also suggest that older Canadians are more concerned about autonomous vehicles than younger Canadians. This study provides valuable insights into factors that can affect the preferences of Canadians when it comes to autonomous technology in their automobiles. Such results can inform the way in which transportation systems are designed to ensure the needs of users are considered across both age and ability.


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