scholarly journals Income and housing satisfaction and their association with self-rated health in different life stages. A fixed effects analysis using a German panel study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034294
Author(s):  
Anja Knöchelmann ◽  
Nico Seifert ◽  
Sebastian Günther ◽  
Irene Moor ◽  
Matthias Richter
Keyword(s):  
Fixed Effects ◽  
Panel Study ◽  
Population Based ◽  
Life Stages ◽  
Housing Satisfaction ◽  
Self Rated Health ◽  
Marginal Effects ◽  
Final Sample ◽  
Material Conditions ◽  
Average Marginal Effects

ObjectiveWe aim to investigate the effect of income and housing satisfaction on self-rated health in different life stages.DesignA population-based panel study (German Socio-Economic Panel).ParticipantsThe final sample consisted of 384 280 observations from 50 004 persons covering the period between 1994 and 2016.Outcome measuresAverage marginal effects were calculated based on fixed effects regressions to obtain the effect of changes in income and housing satisfaction on changes in self-rated health for each year of age. Self-rated health was assessed on a 5-point scale, with higher values indicating better health.ResultsChanges in income and housing satisfaction showed a small association with changes in self-rated health. The association was stronger for income, where it also varied considerably in different life stages. The average marginal effects for income satisfaction varied between 0.02 and 0.05 in men and 0.02 and 0.04 in women and peaked between the ages of 55–60. For housing satisfaction, average marginal effects ranged from 0.02 to 0.04 (men) and from 0.02 to 0.03 (women).ConclusionHigher satisfaction with housing and income was associated with better self-rated health. Therefore, studies on the social determinants of health should not only focus on objective material conditions but also on how individuals perceive and evaluate their situation.

scholarly journals Self-versus Proxy-Reported Pain in Children with Cerebral Palsy: A Population-Based Registry Study of 3783 Children

2020 ◽  
Vol 11 ◽  
pp. 215013272091152 ◽  
Author(s):  
Gunnar Hägglund ◽  
Amanda Burman-Rimstedt ◽  
Tomasz Czuba ◽  
Ann I. Alriksson-Schmidt
Keyword(s):  
Logistic Regression ◽  
Cerebral Palsy ◽  
Classification System ◽  
Population Based ◽  
Registry Study ◽  
Cross Sectional ◽  
Marginal Effects ◽  
Level I ◽  
Average Marginal Effects ◽  
Gmfcs Level

Objective: To assess how the prevalence of pain in a population-based sample of children and adolescents with cerebral palsy (CP) differ based on self- or proxy reporting. Methods: This cross-sectional registry study included 3783 children (58% boys), 1 to 18 years old, enrolled in the Swedish follow-up program for CP. Logistic regression was used to regress source of reporting (self or proxy) on the presence of general pain adjusted for age, sex, Gross Motor Function Classification System (GMFCS), and Communication Function Classification System (CFCS) levels, including marginal effects between source of reporting and adjusted covariates. Results: The pain item was self-reported in 45%, proxy-reported in 51%, and information was missing in 3%. Pain was reported in 44% of those who self-reported and in 41% of those who proxy-reported ( P = .04). The logistic regression showed that the average marginal effects of proxy versus self-reported pain were lower among children at GMFCS level IV (−0.14, 95% CI −0.17 to −0.03) and CFCS level I (−0.09, CI −0.16 to −0.01) and higher at CFCS level III (0.11, CI 0.00-0.22). There were no statistically significant differences in average marginal effects related to age, sex, or the other GMFCS and CFCS levels between proxy and self-reporting. Conclusions: Pain was more often reported by those who self-reported. However, after adjusting for age, sex, CFCS level, and GMFCS level, the proportion of reported pain was almost equal between self and proxy-reporting. Assuming that the self- and proxy-reported groups were not significantly different on relevant factors not controlled for the results indicate that presence of pain is equally reported by children and parents.

scholarly journals Health and Housework in Later Life: A Longitudinal Study of Retired Couples

2018 ◽  
Vol 75 (1) ◽  
pp. 184-194 ◽  
Author(s):  
Thomas Leopold ◽  
Florian Schulz
Keyword(s):  
Longitudinal Study ◽  
Health Status ◽  
Fixed Effects ◽  
Panel Study ◽  
Later Life ◽  
Life Stages ◽  
Health Issues ◽  
Fixed Effects Models ◽  
Housework Time ◽  
Domestic Outsourcing

Abstract Objectives To examine how changes in wives’ and husbands’ health influenced housework time and domestic outsourcing in retired couples. Method We estimated fixed-effects models to test hypotheses about the gendered influence of health declines on absolute and relative measures of time spent on routine and nonroutine housework as well as the probability of outsourcing housework. The data were obtained from 23 waves of the German Socio-Economic Panel Study, comprising N = 25,119 annual observations of N = 3,889 retired couples aged 60–85 years. Results Wives’ and husbands’ housework time declined with health status, but these effects were large only for serious health problems. We found evidence for within-couple compensation of spouses’ health declines, a mechanism that was limited to indispensable tasks of routine housework. The probability of getting paid help from outside the household increased with declining health, and this increase was more strongly tied to wives’ health declines than to husbands’ health declines. Discussion The results demonstrate the relevance of health status for the performance of housework in retired couples. The evidence attests to the resilience of couples during later-life stages in which health issues may severely inhibit domestic productivity.

scholarly journals Unmet Dental Care Needs among Korean National Health Insurance Beneficiaries Based on Income Inequalities: Results from Five Waves of a Population-Based Panel Study

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 124 ◽  
Author(s):  
Minsung Sohn ◽  
Xianhua Che ◽  
Hee-Jung Park
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Dental Care ◽  
Fixed Effects ◽  
Unmet Needs ◽  
Panel Study ◽  
Population Based ◽  
Income Quintile ◽  
Dental Needs

This study investigates whether self-employed beneficiaries experience greater difficulties in accessing dental care than insured employees based on their income level. This analysis uses 2011–2015 data from the Korea Health Panel, a population-based and nationally representative sample, covering 7083 participants aged 18 years and older. We measured barriers to dental access based on unmet needs or the inability to receive necessary dental care owing to the past year’s economic burdens. The type of health insurance and household income are considered independent variables. We applied multiple panel logistic regressions and two-panel logistic regression models with a fixed-effects approach to analyze the data. Self-employed beneficiaries were 1.16 times (95% confidence interval (CI) = 1.08–1.24) more likely to experience unmet dental needs than were insured employees. Insured employees and self-employed beneficiaries belonging to the lowest income bracket were 1.76 times (95% CI = 1.53–2.03) and 2.33 times (95% CI = 1.89–2.87) more likely to have unmet needs than those in the highest income bracket. Self-employed beneficiaries were 1.31 times (95% CI = 1.21–1.43) more likely to experience unmet dental needs caused by economic burdens than are insured employees. Insured employees of the lowest income quintile were 4.15 times (95% CI = 3.41–5.05) more likely to experience unmet needs caused by economic burdens, while the odds ratio for self-employed beneficiaries was 5.47 (95% CI = 4.05–7.39). Our findings indicate gaps in unmet dental needs between self-employed beneficiaries and insured employees. The government should adopt strategies to reduce unmet needs among marginalized groups and redefine the role of national health insurance.

scholarly journals Healthy ageing and the prediction of mortality and incidence dependence in low- and middle- income countries: a 10/66 population-based cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Christina Daskalopoulou ◽  
Martin Prince ◽  
Artemis Koukounari ◽  
Josep Maria Haro ◽  
Demosthenes B. Panagiotakos ◽  
...  
Keyword(s):  
Latin American ◽  
Functional Ability ◽  
Fixed Effects ◽  
Population Based ◽  
Healthy Ageing ◽  
World Health ◽  
Self Rated Health ◽  
Prediction Of Mortality ◽  
Increased Risk ◽  
Catchment Areas

Abstract Background In the absence of a consensus on definition and measurement of healthy ageing, we created a healthy ageing index tallying with the functional ability framework provided by the World Health Organization. To create this index, we employed items of functional ability and intrinsic capacity. The current study aims to establish the predictive validity and discrimination properties of this healthy ageing index in settings in Latin American, part of the 10/66 cohort. Methods Population-based cohort studies including 12,865 people ≥65 years old in catchment areas of Cuba, Dominican Republic, Venezuela, Mexico and Peru. We employed latent variable modelling to estimate the healthy ageing scores of each participant. We grouped participants according to the quintiles of the healthy ageing score distribution. Cox’s proportional hazard models for mortality and sub-hazard (competing risks) models for incident dependence (i.e. needing care) were calculated per area after a median of 3.9 years and 3.7 years, respectively. Results were pooled together via fixed-effects meta-analysis. Our findings were compared with those obtained from self-rated health. Results Participants with lowest levels, compared to participants with highest level of healthy ageing, had increased risk of mortality and incident dependence, even after adjusting for sociodemographic and health conditions (HR: 3.25, 95%CI: 2.63–4.02; sub-HR: 5.21, 95%CI: 4.02–6.75). Healthy ageing scores compared to self-rated health had higher population attributable fractions (PAFs) for mortality (43.6% vs 19.3%) and incident dependence (58.6% vs 17.0%), and better discriminative power (Harrell’s c-statistic: mortality 0.74 vs 0.72; incident dependence 0.76 vs 0.70). Conclusion These results provide evidence that our healthy ageing index could be a valuable tool for prevention strategies as it demonstrated predictive and discriminative properties. Further research in other cultural settings will assist moving from a theoretical conceptualisation of healthy ageing to a more practical one.

The effect of welfare reform on the health of the unemployed: evidence from a natural experiment in Germany

2020 ◽  
Vol 74 (3) ◽  
pp. 211-218
Author(s):  
Faraz V Shahidi ◽  
Carles Muntaner ◽  
Ketan Shankardass ◽  
Carlos Quiñonez ◽  
Arjumand Siddiqi
Keyword(s):  
Panel Study ◽  
Population Based ◽  
Welfare Benefits ◽  
Percentage Point Increase ◽  
Self Rated Health ◽  
Hartz Iv ◽  
Policy Measures ◽  
Linear Probability ◽  
The Unemployed ◽  
The Impact

BackgroundOver the past several decades, governments have enacted far-reaching reforms aimed at reducing the generosity and coverage of welfare benefits. Prior literature suggests that these policy measures may have deleterious effects on the health of populations. In this study, we evaluate the impact of one of the largest welfare reforms in recent history—the 2005 Hartz IV reform in Germany—with a focus on estimating its effect on the health of the unemployed.MethodsWe employed a quasi-experimental difference-in-differences (DID) design using population-based data from the German Socio-Economic Panel Study, covering the period between 1994 and 2016. We applied DID linear probability modelling to examine the association between the Hartz IV reform and poor self-rated health, adjusting for a range of demographic and socioeconomic confounders.ResultsThe Hartz IV reform was associated with a 3.6 (95% CI 0.9 to 6.2) percentage point increase in the prevalence of poor self-rated health among unemployed persons affected by the reform relative to similar but unaffected controls. This negative association appeared immediately following the implementation of the reform and has persisted over time.ConclusionGovernments in numerous European and North American jurisdictions have introduced measures to further diminish the generosity and coverage of welfare benefits. In line with growing concerns over the potential consequences of austerity and associated policy measures, our findings suggest that these reform efforts pose a threat to the health of socioeconomically disadvantaged populations.

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