The Prospective Association Between Socioeconomic Status and Falls Among Community-Dwelling Older Men

Author(s):  
Saman Khalatbari-Soltani ◽  
Fiona Stanaway ◽  
Cathie Sherrington ◽  
Fiona M Blyth ◽  
Vasi Naganathan ◽  
...  

Abstract Background Socioeconomic status (SES) has been suggested as a risk factor for falls but the few prospective studies to test this have had mixed results. We evaluated the prospective association between SES and falls in the Concord Health and Ageing in Men Project (CHAMP). Methods CHAMP is a population-based prospective cohort study of men aged ≥70 years in Sydney, Australia. Incident falls were ascertained by triannual telephone calls for up to 4 years. SES was assessed with 4 indicators (education, occupation, source of income, home ownership) and cumulative SES score. We tested for interaction between SES indicators and country of birth and conducted stratified analyses. Results We evaluated 1624 men (mean age: 77.3 ± 5.4 years). During a mean ± SD follow-up of 42.6 ± 8.7 months, 766 (47%) participants reported ≥1 incident falls. In nonstratified analyses, there were no associations between SES indicators and falls. In stratified analyses, falls rates were higher among Australian-born men with less formal education (incidence rate ratio [IRR] 1.66, 95% confidence interval [CI] 1.16–2.37, compared with those with more education) and those with low occupational position (1.45; 1.09–1.93). However, among men born in non-main English-speaking countries the rate of falls was lower among those with low educational level and no associations were evident for occupational position. Conclusions Lower educational level and occupational position predicted a higher falls rate in Australian-born men; the opposite relationship was evident for educational level among migrants born in non-main English-speaking countries. Further studies should test these relationships in different populations and settings and evaluate targeted interventions.

1994 ◽  
Vol 38 (4) ◽  
pp. 339-350 ◽  
Author(s):  
Anthony N. Galanos ◽  
Ronald P. Strauss ◽  
Carl F. Pieper

This study examined the hypothesis that sociodemographic characteristics such as age, education, race, and gender would be predictive of Multidimensional Health Locus of Control Subscale scores in a population-based sample of 342 community dwelling elderly individuals. Bivariate analysis revealed associations between black race, lower socioeconomic status, and lower education on the Chance and Powerful Others Subscales. While the multivariate analysis revealed no predictors for the Internal Subscale, a higher socioeconomic status, white race, and a higher level of education continued to predict low scores on the Chance Subscale when controlling for all other variables. Scores on the Powerful Others Subscale appeared to be a function of socioeconomic status and gender. Of note, the higher the education level for both men and women, the lower the scores on the Chance and Powerful Others Subscales. This sex by education interaction term reached statistical significance for the Chance Subscale. The results demonstrate the measurable influence of sociodemographic variables on the health beliefs of community dwelling elderly individuals.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kirubakaran Balasubramaniam ◽  
Sanne Rasmussen ◽  
Peter Fentz Haastrup ◽  
Kaspar Suadicani ◽  
Jens Søndergaard ◽  
...  

Abstract Background A prerequisite for general practitioners (GPs) being able to refer patients with gynecological cancer alarm symptoms for further investigations is that individuals present the symptoms to the GP. Not all symptoms are presented to the GP, and knowledge of barriers for healthcare-seeking is sparse. The aim of this study was to analyze associations between age, socioeconomic status, and common barriers (“being too embarrassed”, “being too busy”, “worried about wasting the doctors time” and “worried what the GP might find”) towards GP contact with gynecological alarm symptoms. Methods Nationwide population-based study in Denmark based on a random sample of 51 090 women aged 20 years or older. A web-based questionnaire regarding experience of four predefined alarm symptoms of gynecological cancer, decisions about contact to GPs, and barriers towards GP contact was distributed. Information about socioeconomic status was collected from Statistics Denmark. Results A total of 26 466 women (54.5%) completed the questionnaire. The proportion of women with no contact to the GP varied between 64.6% and 78.1% for postmenopausal bleeding and pain during intercourse, respectively. Between 32.3% (bleeding during intercourse) and 45.3% (postmenopausal bleeding) of the women reported no barriers for GP contact. The proportions of reported barriers ranged from 7.5% for being too embarrassed (pelvic pain) to 26.8% for being too busy (bleeding during intercourse). Women aged 40–59 years had lower odds of reporting “being too embarrassed” and “worried about wasting the GP´s time”, while women aged 60 + years of age had lower odds of reporting “being too busy” compared to the youngest age group. Women in the highest income groups had lower odds of reporting “being too embarrassed” and “wasting the GP´s time” compared to those with a low income, while those with high educational level had lower odds of reporting “being too embarrassed” and “worried what the GP might find” compared to those with low educational level. Conclusions More than half of the respondents with no contact to the GP, reported one or more barriers towards GP contact. Lower age and socioeconomic status were significantly associated with higher odds of reporting barriers. As this may explain the differences in healthcare seeking behavior, healthcare planners, policy makers and clinicians should be aware of these findings.


2021 ◽  
pp. 140349482110608
Author(s):  
Anu Molarius ◽  
Mikael Hasselgren

Aim: To examine differences in the prevalence of self-reported diagnosed asthma by socioeconomic status and the contribution of lifestyle factors to these differences. Methods: The study was based on 28,531 persons aged 18 years or older who answered a survey questionnaire sent to a random population sample in mid-Sweden in 2017. The overall response rate was 44%. Socioeconomic status was measured with educational level and economic difficulties, and lifestyle factors with physical activity, smoking, snuff use, risk-drinking of alcohol and obesity. The associations between socioeconomic status and asthma were analysed using multivariate logistic regression. Results: The overall asthma prevalence was 9% among women and 7% in men and decreased with increasing age. Educational level was not independently associated with asthma, but a statistically significant odds ratio (with 95% confidence intervals) for the prevalence of asthma was observed for economic difficulties 1.5 (1.3–1.7). Also, physical inactivity 1.2 (1.1–1.3) and obesity 1.6 (1.4–1.8) were associated with increased asthma prevalence. Smoking and risk-drinking were not statistically significantly associated with asthma whereas snuff users had a higher prevalence of asthma among women. Adjusting for lifestyle factors did not affect the association between socioeconomic status and asthma. Conclusions: In this population-based study, self-reported diagnosed asthma was independently associated with economic difficulties but not with educational level. Lifestyle factors did not explain the association between economic difficulties and asthma prevalence. This applies to both men and women as well as younger and older age groups.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marcel Ballin ◽  
Oskar Antonsson ◽  
Viktor Rosenqvist ◽  
Peter Nordström ◽  
Anna Nordström

Abstract Background Dog ownership (DO) has been associated with higher levels of self-reported walking and physical activity. However, compared to device-based measures, self-reported measures of physical activity may suffer from bias due to recall and social desirability. They are also incapable of quantifying light-intensity physical activity (LPA) and step volume, both of which may have important health benefits, especially for older adults. In this study, we investigated the association of DO with accelerometer-measured physical activity of different intensities and daily steps in 70-year-old individuals. Methods This was a population-based cross-sectional study including 1406 participants aged 70 years [54.1% female] who participated in a health survey in Umeå, Sweden between February 2017–November 2019. All participants self-reported DO [yes/no]. Daily averages of LPA, moderate-to-vigorous-intensity physical activity (MVPA), and steps per day [steps/d] were measured for 1 week using hip-mounted Actigraph GT3X+ accelerometers. Associations were investigated using linear- and logistic regression models, adjusted for sociodemographic and health-related factors, date of examination, and accelerometer wear time. Results The prevalence of DO was 14.1% [N = 199]. After adjustment for all covariates, DO was associated with 19.2 more minutes/d of LPA [95% CI, 8.8–29.6], 11.4 more minutes/d of MVPA [95% CI, 8.0–14.9] and 1738 more steps/d [95% CI, 1326–2149]. DO was also associated with twice the odds of meeting the physical activity recommendations [OR, 2.07, 95% CI, 1.48–2.90]. Exploratory interaction analyses showed that the association between DO and steps/d was stronger [Pinteraction = 0.030] in female [β = 2165, 95% CI, 1585–2744] than in male [β =1255, 95% CI, 664–1845], with a similar trend for MVPA [Pinteraction = 0.082]. Conclusions In this study of community-dwelling 70-year-old individuals, DO was associated with higher levels of daily LPA, MVPA, and steps. With the limitation of the observational design of the study, these findings add knowledge regarding the beneficial role that DO may play for promoting physical activity in the older population. In turn, these findings could support the development and evaluation of targeted interventions seeking to promote dog-friendly environments and facilitate dog walking in the community.


Author(s):  
Guillermo Cruces ◽  
Gary S. Fields ◽  
David Jaume ◽  
Mariana Viollaz

During the 2000s Chile achieved rapid economic growth and improved most labour market indicators: the unemployment rate fell; the mix of employment by occupational position and sector improved; the educational level of the employed population, the percentage of registered workers, and labour earnings increased; and all poverty and inequality indicators decreased. The economy suffered a recession during the international crisis of 2008, but recovered quickly. The chapter shows that some labour market indicators were negatively affected by the crisis. The unemployment rate was the only indicator that did not return to its pre-crisis level by the end of the period studied.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S760-S760
Author(s):  
XinQi Dong ◽  
Melissa Simon

Abstract Elder mistreatment (EM) is increasingly recognized as a global health concern. Among U.S. minority and immigrant populations, the social contexts and psychological consequences associated with EM remain poorly understood. Further population-based epidemiological studies using standard EM measures are required to advance the field. To address this gap and to challenge prior assumptions regarding Asian populations, this purpose of this symposium is to improve our understanding of EM epidemiology in an older minority population. Data were drawn from the Population-based Study of Chinese Elderly in Chicago (PINE), a longitudinal, representative, population-based study of 3,157 community-dwelling Chinese older adults in the greater Chicago area. Session 1 will examine the transmission between child mistreatment, intimate partner violence, and EM. Session 2 will take a typology approach to capture the multifaceted family relationships, and will further examine which family typologies were associated with greater likelihood of EM, while which typologies were protective against EM. Session 3 will explore the positive and negative aspects of social support from spouse, family, and friends in relationship to EM subtypes, including psychological, physical, financial and sexual mistreatment, and caregiver neglect. Session 4 will examine the relationship between broad, moderate, and strict definitions of EM and likelihood of experiencing anxiety. Last, Session 5 will explore the differential relationships between EM subtypes and depressive symptoms. In summation, this symposium challenges popular conceptions of the “model minority myth” and aims to increase the practical and clinical relevance of EM epidemiology in community, research, healthcare, and policy settings.


2021 ◽  
Vol 11 (8) ◽  
pp. 107
Author(s):  
Hirohito Tsuboi ◽  
Yui Takakura ◽  
Hiromasa Tsujiguchi ◽  
Sakae Miyagi ◽  
Keita Suzuki ◽  
...  

To make the Japanese version of the CESD-R—a revised version of the Center for Epidemiologic Studies depression scale (CES-D)—in the assessment of depressive symptoms in a general population. The English version of CESD-R was translated into Japanese, and back-translated into English by three native speakers of Japanese and English; then, we selected the version most completely consistent with the original items. The CESD-R was applied to 398 community-dwelling people (191 men: 48.0%, and 207 women: 52.0%) who were over 40 years old. The Japanese version of the CES-D was also carried out in the same population. Factor analysis was performed. Additionally, the correlations between the CESD-R and CES-D results were identified. The CESD-R scores showed a significantly positive correlation with CES-D scores (r = 0.74, p < 0.0005). Analysis of the CESD-R yielded a Cronbach’s alpha result of 0.90. Factor analysis revealed one principal factor in the CESD-R, whereas the original CES-D had two factors because of reversed items. The Japanese version of the CESD-R appears to have the reliability to be applicable for assessing depressive symptoms in population-based samples. However, because the Japanese expressions for some items might be unusual, our study population was also limited; further studies on other populations and on incorporating improved Japanese terminology will be needed.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Chen ◽  
K Alexanderson

Abstract Background Working-aged colorectal cancer (CRC) patients have a much better survival nowadays, indicating the importance of their future work situation. We aimed to investigate trajectories of sickness absence and disability pension (SADP) days before and after CRC diagnosis and in references, and risk factors associated with different trajectories. Methods A longitudinal, population-based matched cohort study of 4735 CRC survivors in Sweden aged 19-62 when first diagnosed with CRC in 2008-2011, and 18,230 matched references was conducted, using microdata linked from several nationwide registers. The annual SADP net days for 2 years before through 5 years after diagnosis date were computed. A group-based trajectory model was used to depict SADP trajectories. Associations between trajectory membership, and sociodemographic and clinical variables were tested by chi2 test and multinomial logistic regression. Results Four trajectories of SADP days/year for CRC survivors were identified: “only increase around diagnosis” (52% of all, n = 2481), “slight increase after diagnosis” (27%), “high then decrease moderately after diagnosis” (13%), and “constantly very high” (8%). Educational level (R2=0.022), Charlson's Comorbidity Index (R2=0.029), and prediagnostic mental disorders (R2=0.066) were the strongest factors determining the SADP trajectory groups. In references, three trajectories (”constantly low” (80% of all), “constantly moderate and decrease gradually” (12%), and “very high then decrease overtime” (8%)) were identified. Conclusions Approximately 80% of CRC survivors return to a low level of SADP (0-60 days/year) at 5 years postdiagnosis. Prediagnostic status of mental disorders, somatic comorbidity, and low educational level are good indicators of future high SADP levels for CRC survivors. Key messages Most of working-age colorectal cancer survivors have low levels of sickness absence and disability pension days five years after their diagnosis. Trajectory analyses based on population-based register data can be used as a good approach in understanding future work situation regarding sick leave among working-age cancer survivors.


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