Socioeconomic Status, Race/Ethnicity, and Diurnal Cortisol Trajectories in Middle-Aged and Older Adults

Abstract Background Lack of information exists about the use of traditional and complementary medicine (TCM) use among middle-aged and older adults in India, which led to studying the estimates of past-12-month Ayurveda/Yoga/Naturopathy/Unani/Siddha/Homeopathy (AYUSH) practitioner and traditional health practitioner (THP) utilization in India. Methods The study included 72,262 individuals (45 years and older) from the cross-sectional 2017–2018 Longitudinal Ageing Study in India (LASI) Wave 1. Results The prevalence of past 12-month AYUSH practitioner utilization was 6.5%, THP use 7.0%, and AYUSH or THP use 13.0%. The rate of AYUSH practitioner utilization was determined by older age (≥60 years) (Adjusted Odds Ratio-AOR: 1.20, 95% Confidence Interval-CI: 1.07–1.34), having pain (AOR: 1.48, 95% CI: 1.29–1.69), any bone or joint diseases (AOR: 1.57, 95% CI: 1.35–1.82), current tobacco use (AOR: 1.30, 95% CI: 1.12–1.50), male sex (AOR: 0.76, 95% CI: 0.68–0.85), high subjective socioeconomic status (AOR: 0.72, 95% CI: 0.60–0.87), urban residence (AOR: 0.71, 95% CI: 0.57–0.88), diabetes (AOR: 0.66, 95% CI: 0.55–0.81), chronic heart disease (AOR: 0.52, 95% CI: 0.37–0.73), and having a health insurance cover (AOR: 0.36, 95% CI: 0.30–0.44). The rate of THP utilization was determined by depressive symptoms (AOR: 1.17, 95% CI: 1.01–1.35), sleep problems (AOR: 1.28, 95% CI: 1.08–1.51), having pain (AOR: 1.82, 95% CI: 1.55–2.15), current tobacco use (AOR: 1.35, 95% CI: 1.22–1.51), having health insurance cover (AOR: 0.41, 95% CI: 0.33–0.51), hypertension (AOR: 0.82, 95% CI: 0.71–0.95), diabetes (AOR: 0.50, 95% CI: 0.39–0.65), urban residence (AOR: 0.25, 95% CI: 0.19–0.34), and high subjective socioeconomic status (AOR: 0.70, 95% CI: 0.58–0.85). Conclusion A moderate prevalence of AYUSH practitioner and THP use among middle-aged and older adults in India was found and several factors associated with AYUSH practitioner and THP use were identified.

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The Effects of Socioeconomic Status on Participation in Care Among Middle-Aged and Older Adults

Journal of Aging and Health ◽

10.1177/0898264308329000 ◽

2009 ◽

Vol 21 (2) ◽

pp. 314-335 ◽

Cited By ~ 12

Author(s):

Jacqueline C. Wiltshire ◽

Velma Roberts ◽

Roger Brown ◽

Gloria E. Sarto

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Middle Aged

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Hypertension, socioeconomic status and depressive symptoms in Chinese middle-aged and older adults: Findings from the China health and retirement longitudinal study

Journal of Affective Disorders ◽

10.1016/j.jad.2019.04.002 ◽

2019 ◽

Vol 252 ◽

pp. 237-244 ◽

Cited By ~ 6

Author(s):

Yinzi Jin ◽

Yanan Luo ◽

Ping He

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Depressive Symptoms ◽

Longitudinal Study ◽

Middle Aged

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Age differences in associations of different indicators of socioeconomic status with social isolation: A cross-sectional study

10.21203/rs.3.rs-15624/v1 ◽

2020 ◽

Author(s):

Lixia Ge ◽

Bee Hoon Heng ◽

Woan Shin Tan

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Social Isolation ◽

Employment Status ◽

Age Groups ◽

Cross Sectional Study ◽

Community Dwelling ◽

Middle Aged ◽

Housing Type ◽

Cross Sectional

Abstract Background Socioeconomic status is a crucial determinant of social isolation. However, little is known whether the associations between different indicators of socioeconomic status and social isolation vary across age groups. This study examined the association of individual socioeconomic status indicators with social isolation in three age groups: young (21-44 years), middle-aged (45-64 years), and older adults (≥65 years). Methods Cross-sectional data for 1,930 representative community-dwelling adults aged 21 and above in the Central region of Singapore was used. The 6-item Lubben Social Network Scale was used to assess social isolation. Socioeconomic status was measured using education level, employment status, personal income, housing type and self-perceived money sufficiency). Separate logistic regression analyses were conducted to examine the association between each SES indicator and social isolation in each age group. Results Each socioeconomic indicator showed a clear gradient with social isolation and significant age disparities were found in their relationship. Socioeconomic status indicators significantly associated with social isolation were income (R2 change=2.5%) and self-perceived money insufficiency (R2 change=1.5%) in young adults, education (R2 change=0.5%), employment status (R2 change=1.3%), income (R2 change=0.8%), housing type (R2 change=1.9%) and self-perceived money insufficiency (R2 change=2.0%) in middle-aged adults, and housing type (R2 change=1.3%) and self-perceived money insufficiency (R2 change=3.7%) in older adults when adjusting for demographics and other indicators. Conclusions The influence of individual socioeconomic status indicators on social isolation varied across age groups. This study provides a rationale for the choice of socioeconomic status indicator and specific interventions need to target different socioeconomic status groups for different age groups.

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Immigrant–Native Disparities in Happiness among Middle-Aged and Older Adults in Western European Countries: The Moderating Role of Social Capital

Journal of Aging and Health ◽

10.1177/0898264321990282 ◽

2021 ◽

pp. 089826432199028

Author(s):

Nan Jiang ◽

Jeanette A. J. Renema

Keyword(s):

Older Adults ◽

Social Capital ◽

Socioeconomic Status ◽

Linear Regression Models ◽

Middle Aged ◽

Cross Sectional ◽

Older Immigrants ◽

Moderating Role ◽

Different Levels

Objective: This study investigated native–immigrant disparities in happiness among middle-aged and older adults in Denmark, Germany, and the Netherlands and the moderating role of social capital associated with such disparities. Methods: Cross-sectional data from 2583 respondents aged 50 years or older from 10 origin countries from the 2015 wave of the Migrants’ Welfare State Attitudes survey were used to estimate linear regression models. Results: Older immigrants experienced different levels of happiness compared with native-born individuals. Immigrants’ socioeconomic status and other standard predictors accounted for much of the native–immigrant gap. Depending on origin countries, social capital had differential moderating roles compared to nonimmigrants. Conclusion: Immigrants were not always worse off than native-born residents; they showed a “happiness advantage” after controlling for socioeconomic status and related covariates. Social capital plays an important role in narrowing the immigrant–native gap in happiness.

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Combined Effects of Race and Educational Attainment on Physician Visits Over 24 Years in a National Sample of Middle-Aged and Older Americans

Hospital Practices and Research ◽

10.34172/hpr.2020.04 ◽

2020 ◽

Vol 5 (1) ◽

pp. 17-23

Author(s):

Shervin Assari

Keyword(s):

Older Adults ◽

Disease Management ◽

Health Behaviors ◽

Educational Attainment ◽

Minority Groups ◽

Middle Aged ◽

Physician Visits ◽

Highly Educated ◽

Race Ethnicity

Background: The literature on Minorities’ Diminished Returns (MDRs) have shown worse than expected health of the members of racial and ethnic minority groups particularly Blacks. Theoretically, this effect can be in part due to weaker effects of educational attainment on preventive care and disease management in highly educated racial and ethnic minorities. Objectives: The current study explored the racial and ethnic differences in the effect of baseline educational attainment on % adherance to the routine physician visits among middle-aged and older adults in the US. Methods: This is a prospective study with 24 years of follow up. The Health and Retirement Study (HRS: 1992-2016) included 10880 middle-aged and older adults who were Hispanic, non-Hispanic, Black or White. The independent variable was educational attainment. The dependent variable was adherance to the routine physician visits (%). Age, gender, marital status, income, health behaviors (smoking and drinking) and health (depression, self-rated health, and chronic diseases) were the covariates. Race and ethnicity were the focal moderators. Linear regression was used for data analysis. Results: Overall, higher educational attainment was associated with higher % of adherance to the routine physician visits over the course of follow-up, net of all confounders. Race showed a significant statistical interaction with educational attainment suggesting of a smaller effect of high education attainment on % adherance to the routine physician visits for Black than White middle-aged and older adults. A similar interaction could not be found for the comparison of Hispanic and non-Hispanic middle-aged and older adults. Conclusion: Educational attainment is associated with a larger increase in preventive and disease management doctor visits for White than Black middle-aged and older adults. This is a missed opportunity to improve the health of highly educated middle-aged and older adults. It is not race/ethnicity or class that shapes health behaviors but race/ethnicity and class that shape people’s prohealth behaviors. At least some of the racial health disparities is not due to low SES but diminished returns of SES.

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THE IMPACT OF SOCIOECONOMIC STATUS ON AGE TRAJECTORY OF BODY MASS INDEX AMONG MIDDLE-AGED AND OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.532 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S148-S148

Author(s):

Yu-Chun Lin ◽

Yu-Hung Chang

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Socioeconomic Status ◽

Body Mass ◽

Low Income ◽

Income Group ◽

Primary Study ◽

Annual Income ◽

Middle Aged ◽

The Impact

Abstract Body weight tends to decrease along with age. Weight loss and low body mass index (BMI) in the elderly, associated with socioeconomic status, are both strong predictors of subsequent mortality.This study aims to investigate the relation between income and BMI changes in later life. We used data from the Taiwan Longitudinal Study in Aging (TLSA) from 1999 to 2007. There were 5,131 participants aged 50 and over, who were excluded for those without primary study variables. Income was evaluated by asking the amount of annual income, including salary, pension, rent, interest, welfare benefit, etc. Participants’ BMI were assessed in each survey. General estimating equation models were performed to examine the association between age, annual income, and their interaction with BMI adjusting for covariates including sex, education, marital status, smoking, exercise frequency, appetite, and number of comorbidities. Totaling 11,350 person-times was in three follow-up surveys, which left 9,723 person-times of observations after exclusion. After adjusted for covariates, the low income group compared to the higher income, would have higher estimated BMI at age of 50 (BMI= 24.75 kg/m2 and 24.19 kg/m2 respectively), and more rapid reduction (-0.08 kg/m2 per year), while relatively stable BMI was found in higher income group (0.01 kg/m2 per year, slope difference= 0.10 kg/m2 per year, 95% confidence interval [CI] = 0.03-0.17). In conclusion, compared to invariable BMI observed among individuals with higher financial status, the economically disadvantaged experienced BMI decline with age among middle-aged and older adults.

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