scholarly journals Creation and Validation of a Polysocial Score for Mortality Among Community-Dwelling Older Adults in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 164-164
Author(s):  
Yongjing Ping ◽  
Chenkai Wu ◽  
Michelle Odden ◽  
Robert Stawski ◽  
Hoda Magid
Keyword(s):  
Older Adults ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
The United States ◽  
Community Dwelling ◽  
Determinants Of Health ◽  
Stepwise Logistic Regression ◽  
Social Environments ◽  
Social Interventions

Abstract The interrelatedness between social determinants of health impedes researchers to identify important social factors for health investment. Since the older population had highly diverse social backgrounds, a new approach is needed to quantify the aggregate effect of social factors and develop person-centered social interventions. Participants ([n = 7383], 54.5% female) were aged 65 years or above who complete an additional psychosocial questionnaire in the Health and Retirement Study (HRS) at study entry in 2006 or 2008. Social determinants of health encompassing five social domains: economic stability, neighborhood and physical environment, education, community and social context, and health care system. Five-year mortality was calculated as the number of years from the interview date to the death date. We used the forward stepwise logistic regression to construct the polysocial score and multivariate logistic regressions to assess the associations between polysocial score and five-year mortality. Polysocial score (range: 7 to 59, mean±SD: 35.5±7.5) was created using 15 social determinants of health. Of the 7383 participants, 491 (30.8%), 599 (17.2%), and 166 (7.8%) deaths occurred over five years among participants with a low (0-29), intermediate (30-39), and high (40+) polysocial score, respectively. Participants with an intermediate (Odds Ratio [OR]=0.76; 95% CI, 0.65-0.89) or high (OR=0.46; 95% CI, 0.36-0.59) polysocial score had higher odds of death than those in the low category in the fully adjusted model, respectively. The polysocial approach may offer possible solutions to monitor social environments and suggestions for older adults to improve their social status for specific health outcomes.

scholarly journals Impact of COVID-19 Pandemic on Life-Space Mobility of Older Adults Living in Brazil: REMOBILIZE Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Monica R. Perracini ◽  
Juleimar Soares Coelho de Amorim ◽  
Camila Astolphi Lima ◽  
Alexandre da Silva ◽  
Francis Trombini-Souza ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Determinants Of Health ◽  
Health Inequalities ◽  
Social Determinants ◽  
Substantial Reduction ◽  
Community Dwelling ◽  
Determinants Of Health ◽  
Vulnerable Groups ◽  
Life Space ◽  
Social Restriction

Background: The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e., lockdown, stay-at-home) on the life-space mobility of older people.Objective: To investigate the immediate impact of COVID-19 pandemic on life-space mobility of community-dwelling Brazilian older adults and examine the social determinants of health associated with change in life-space mobility.Design: Baseline data from a prospective cohort study (REMOBILIZE Study).Setting: Community.Subject: A convenience snowball sample of participants aged 60 and older (n = 1,482) living in 22 states in Brazil.Methods: We conducted an online and phone survey using an adapted version of the Life-Space Assessment (LSA). Linear regression models were used to investigate social determinants of health on the change in LSA score.Results: Regardless of their gender and social determinants of health, participants showed a significant reduction in life-space mobility since COVID-19 pandemic outbreak. Life-space mobility reduction was higher among black individuals, those living alone and aged between 70 and 79. Other variables associated with change in life-space mobility, to a lesser extent, were sex, education and income.Conclusion: Social restriction measures due to pandemic caused substantial reduction in older adults' life-space mobility in Brazil. Social inequalities strongly affected vulnerable groups. Concerted actions should be put in place to overcome the deterioration in life-pace mobility amongst these groups. Failure in minimizing health inequalities amplified by the pandemic may jeopardize the desired achievements of the Decade of Healthy Aging.

Developing and Pilot Testing a Population-focused Nutrition Screen Incorporating Social Determinants of Health

2020 ◽  
Vol 11 (2) ◽  
pp. 74-89
Author(s):  
Kyle L Thompson ◽  
Melissa Gutschall ◽  
Amanda Bliss ◽  
Grace Herman ◽  
Madison Zimmerman ◽  
...  
Keyword(s):  
United States ◽  
Pilot Study ◽  
Social Determinants Of Health ◽  
Rural Community ◽  
Social Determinants ◽  
The United States ◽  
Community Dwelling ◽  
Low Risk ◽  
Determinants Of Health ◽  
Risk Status

Introduction: Given that nutrition status is directly related to a variety of health outcomes, nutrition screening is a prime focus of public health nutrition practice.  Objectives: The purposes of this pilot study were to develop and pilot test a Rural Adult Nutrition Screen (RANS) that includes criteria addressing social determinants of health and to explore possible applications of the screen development methodology in other settings. Methods: Mixed-methods research including interviews and survey dissemination was conducted among a rural southern Appalachian population in the United States.  Themes identified in the research were used to construct a preliminary rural adult nutrition screen (RANS-1).  The RANS-1 was pilot-tested among a sample of community-dwelling rural residents (n = 83), and was revised based on participant, administrator, and nutrition practitioner comments.  The revised screen, the RANS, was pilot-tested among a sample of attendees of a free community medical clinic (n = 37).   Nutrition risk as determined by the RANS was compared with the Nutrition Triage Score of the Patient-Generated Subjective Global Assessment (PG-SGA), the United States Department of Agriculture 6-item Household Food Security Survey Module (USDA-6), and nutrition assessment performed by a Registered Dietitian Nutritionist who was also credentialed as a Physician Assistant (RDN, PA).  Non-parametric statistical tests were used to compare the results of the PG-SGA NTS and the USDA-6 with the RANS regarding “at risk” and “low risk” status. Results: In this small pilot study, no statistically significant differences were found among either comparative instrument and the RANS in determination of “at risk” and “low risk” status.  The RDN, PA’s agreement with the RANS was 100%.  Conclusion:  This pilot study provides some evidence that the RANS may be used to screen rural, community-dwelling adults for nutrition needs in light of social determinants of health common in rural settings.  Further research and formal validation of the RANS are needed in order to establish this tool as a valid nutrition screen for use in the rural community setting.  Procedures used to develop the RANS may be applicable to the development of population-specific nutrition screens in other rural and urban global populations.

scholarly journals Relationship between Social Determinants of Health and Loneliness during COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 736-736
Author(s):  
Kalpana Padala ◽  
Prasad Padala ◽  
Christina Crawford ◽  
Clinton Gauss ◽  
Benjamin Wright ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Network ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Disease Transmission ◽  
Demographic Data ◽  
Internet Access ◽  
Community Dwelling ◽  
Determinants Of Health ◽  
Living Alone

Abstract Background Older adults are most vulnerable to social isolation and loneliness during the COVID-19 pandemic compared to other populations. Risk factors for loneliness include old age, rural living, number of medical comorbidities, and poor social networks. The objectives of this study were to examine the prevalence of loneliness in older adults during COVID-19 and determine the correlation between social determinants of health and loneliness. Methods A cross-sectional study was conducted in community dwelling older Veterans (N=132). Demographic data were collected along with variables related to social determinants of health. Loneliness data were collected with the 3-item loneliness questionnaire, and social network was assessed using the 6-item Lubben social network scale. Results Demographic data included: mean age 73.3 (±7.5) years, 93.2% male, 53.5% rural, 84.1% Caucasian, and 13.6% African American. The majority of the participants reported loneliness (65.6%). Mean Lubben social network score was 14.6 (±6.6). There was a strong negative correlation between loneliness and social network (p<0.0001, r=-0.57; 95% CI: -0.67, -0.44). The prevalence of loneliness was significantly greater in those living alone compared to those not living alone (p=0.017; 83.9% vs. 60.6%) and those lacking internet access compared to those with internet access (p=0.025; 86.4% vs. 61.5%). Conclusion Loneliness was found to be highly prevalent in an older cohort during the COVID pandemic. Routine inquiry about loneliness is important. Social determinants of health are likely correlated with the presence of loneliness in older adults and could be greatly impacted by policy decisions made to control community disease transmission.

Abstract 262: The Impact of Social Determinants of Health on Heart Failure Readmission in a Veteran Population: A Single Center Study

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Sunita K Mahabir ◽  
Neal Olarte ◽  
Ana M Palacio
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Social Factors ◽  
Determinants Of Health ◽  
Fiscal Year ◽  
Readmission Rates ◽  
Validated Questionnaire ◽  
The Impact

Background: Chronic heart failure (CHF) affects more than 5 million Americans and accounts for approximately 1 million hospitalizations annually. Readmission in CHF patients is associated with higher mortality and consumes a significant portion of hospital resources. Readmission rates may be higher when socioeconomic factors limit medication compliance and follow-up. In light of the high prevalence of CHF and the penalties associated with readmission rates, our study aims to identify factors that place our veterans with CHF at higher risk for readmission and in so doing, develop a profile for patients with a high risk of readmission that will benefit from focused intervention. Our goal is to use the information acquired in this study to reduce CHF readmission in the Miami VAMC by 10% over a 12-month period. Methods: This is an ongoing retrospective study conducted at the Miami VAMC. The Strategic Analysis for Improvement and Learning (SAIL) report was used to identify patients with CHF who were admitted to the Miami VAMC over fiscal year 2019 (FY19), the period from September 2018 to August 2019. Data was collected on various clinical baseline characteristics and social determinants of health from the patients' electronic health records for those admitted as well as for those with recurrent admissions within FY19. Using a previously validated questionnaire, identified patients will undergo further interview, in person or by phone, to identify social factors that may place them at higher risk for readmission. Results/Anticipated Results: A total of 185 patients were admitted during FY19 and of these, 38 had recurrent admissions. The mean time to readmission was 82 days. 76% of the patients readmitted had heart failure with reduced ejection fraction. Multiple co-morbidities were seen in the readmitted group, the commonest being hypertension (82%), diabetes (63%) and chronic kidney disease (39%). Thirty percent of those readmitted had a history of illicit drug use compared to 26% of those who were not readmitted. This population was also found to have multiple psychiatric co-morbidities - depression, anxiety and post-traumatic stress disorder. The odds of having one or more readmission within 12 months was 25% greater in those with psychiatric illness than in those without. Conclusion: Preliminary data analysis shows that psycho-social factors may play a role in recurrent admission in CHF patients. Further data will be collected to determine the impact of factors such as housing, education level and income on readmission risk so that patients at high risk can be identified and targeted with improved care co-ordination services to reduce this risk. As a unified health system, the VAMC is uniquely equipped with resources to address these disparities.

Pneumococcal vaccination in older adults: An initial analysis of social determinants of health and vaccine uptake

Vaccine ◽  
2020 ◽  
Vol 38 (35) ◽  
pp. 5607-5617 ◽  
Author(s):  
Justin Gatwood ◽  
Sohul Shuvo ◽  
Kenneth C. Hohmeier ◽  
Tracy Hagemann ◽  
Chi-Yang Chiu ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Pneumococcal Vaccination ◽  
Determinants Of Health ◽  
Vaccine Uptake ◽  
Initial Analysis
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