Income-Related Mortality Inequalities and Its Social Factors among Middle-Aged and Older Adults at the District Level in Aging Seoul: An Ecological Study Using Administrative Big Data

This study investigated income-related health inequality at sub-national level, focusing on mortality inequality among middle-aged and older adults (MOAs). Specifically, we examined income-related mortality inequality and its social factors among MOAs across 25 districts in Seoul using administrative big data from the National Health Insurance Service (NHIS). We obtained access to the NHIS’s full-population micro-data on both incomes and demographic variables for the entire residents of Seoul. Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were calculated. The effects of social attributes of districts on SIIs and RIIs were examined through ordinary least squares and spatial regressions. There were clear income-related mortality gradients. Cross-district variance of mortality rates was greater among the lowest income group. SIIs were smaller in wealthier districts. Weak spatial correlation was found in SIIs among men. Lower RIIs were linked to lower Gini coefficients of income for both genders. SIIs (men) were associated with higher proportions of special occupational pensioners and working population. Lower SIIs and RIIs (women) were associated with higher proportions of female household heads. The results suggest that increasing economic activities, targeting households with female heads, reforming public pensions, and reducing income inequality among MOAs can be good policy directions.

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The association between childhood neighborhood relationship and mental health in middle and later life: Evidence from the China Health and Retirement Longitudinal Study

Archives of Public Health ◽

10.1186/s13690-021-00714-0 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Jian Sun ◽

Hongye Luo ◽

Chaofan Li ◽

Qianqiang Wang

Keyword(s):

Mental Health ◽

Older Adults ◽

Longitudinal Study ◽

Regression Models ◽

Later Life ◽

Ordinary Least Squares ◽

Middle Aged ◽

Logit Regression ◽

Neighborhood Relationship ◽

Research Gap

Abstract Background It is unclear that whether childhood neighborhood relationship is associated with mental health among middle-aged and older adults. To overcome this research gap, this study aimed to investigate the association between childhood neighborhood relationship and mental health among the middle-aged and older adults in China. Methods The data of this study was sourced from the 2014 and 2015 waves of China Health and Retirement Longitudinal Study. We used ordinary least squares and logit regression models to explore the association between childhood neighborhood relationship and mental health among the middle-aged and older adults in China. Results The regression results indicate that the middle-aged and older adults who lived in place where neighbors had close-knit relationships at childhood was significantly associated with decreased odds of suffering from depressive symptoms (OR = 0.4259, p < 0.001). Furthermore, compared to the middle-aged and older adults who lived in place where neighbors were not close-knit at childhood, those who lived in place where neighbors were close-knit at childhood had a reduced CES–D score (coefficient = − 2.7822, p < 0.001). Conclusion This study demonstrates the importance of living in place where neighbors had close-knit relationships at childhood. The integrated interventions, including maintaining close-knit neighborhood relationships and strengthening the construction of community, may be useful to improve mental health.

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Associations Between Perceived Environmental Pollution and Mental Health in Middle-Aged and Older Adults in East Asia

Asia Pacific Journal of Public Health ◽

10.1177/1010539520960993 ◽

2020 ◽

pp. 101053952096099

Author(s):

Takashi Yamashita ◽

Giyeon Kim ◽

Darren Liu ◽

Anthony R. Bardo

Keyword(s):

Mental Health ◽

Older Adults ◽

Environmental Pollution ◽

East Asian ◽

National Level ◽

Pollution Index ◽

Future Research ◽

Linear Regression Models ◽

Middle Aged ◽

Pollution Indicators

Given the widely used objective measures of environmental pollution in previous research, this study investigated subjective measures in relation to mental health among middle-aged and older adults in 3 East Asian countries—China, Japan, and South Korea. The samples from the 2010 East Asian Social Survey included 2502 Chinese, 1794 Japanese, and 871 South Korean adults aged 40 and older. Linear regression models were used to examine the associations between mental health measure (SF-12) and 4 perceived environmental pollution indicators (ie, air, water, noise, and pollution index). Greater perceived pollution indicators, as well as the perceived pollution index, were associated with poorer mental health, even after adjusting for covariates in all 3 countries. Although results need to be further verified in future research, national-level efforts to improve perceptions of environmental pollution may be useful to enhance the mental health of East Asian middle-aged and older adults.

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COVID19-related and all-cause mortality among middle-aged and older adults across the first epidemic wave of SARS-COV-2 infection in the region of Tarragona, Spain: results from the COVID19 TARRACO Cohort Study, March-June 2020

10.1101/2021.02.02.21251028 ◽

2021 ◽

Author(s):

Angel Vila-Corcoles ◽

Eva Satue-Gracia ◽

Angel Vila-Rovira ◽

Cinta de Diego-Cabanes ◽

Maria Jose Forcadell-Peris ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Nursing Home ◽

Cox Regression ◽

Middle Aged ◽

Mortality Risks ◽

Increased Risk ◽

Epidemic Period ◽

All Cause Mortality ◽

Related Mortality

SUMMARYBackgroundDirect and indirect COVID19-related mortality is uncertain. This study investigated COVID19-related and all-cause deaths among middle-aged and older adults during the first wave of COVID19 epidemic period, assessing mortality risks by pre-existing socio-demographic and medical underlying conditions.MethodsPopulation-based cohort study involving 79,083 individuals ≥50 years-old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (age/sex, comorbidities and medications/vaccinations history) were established at study start (01/03/2020) and main outcomes were COVID19-related deaths (occurred in patients diagnosed with the disease) and all-cause deaths occurred among cohort members between 01/03/2020-30/06/2020. Mortality risks were assessed by Cox regression analyses.ResultsCohort members were followed for 1,356,358 persons-weeks, occurring 576 all-cause deaths (124 COVID19-related). All-cause mortality rate was 42.5 deaths per 100,000 persons-week, being 22.8 in healthy/unrelated-COVID19 subjects, 236.4 in COVID19-excluded/PCR-negative subjects, 493.7 in COVID19-compatible/PCR-unperformed subjects and 4009.1 in COVID19-confirmed patients. In multivariable analyses, increasing age, sex male, nursing-home residence, cancer, neurologic, cardiac or liver disease, receiving diuretics, systemic corticosteroids, proton-pump inhibitors and benzodiazepines were associated with increased risk of all-cause mortality; conversely, receiving renin-angiotensin inhibitors and statins were associated with reduced risk. Age/years, sex male and nursing-home residence were strong predictors for COVID19-related mortality, but none comorbidity appeared significantly associated with an increased risk.ConclusionApart from direct COVID19-related deaths (which represented almost 22% of all-cause mortality), theoretically COVID19-excluded patients (PCR-negative) suffered considerable greater all-cause mortality than healthy/unrelated-COVID19 subjects, which could explain, in part, the large excess deaths observed across the COVID19 pandemic.

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COVID19-related and all-cause mortality risk among middle-aged and older adults across the first epidemic wave of SARS-COV-2 infection: a population-based cohort study in Southern Catalonia, Spain, March–June 2020

BMC Public Health ◽

10.1186/s12889-021-11879-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Angel Vila-Corcoles ◽

Eva Satue-Gracia ◽

Angel Vila-Rovira ◽

Cinta de Diego-Cabanes ◽

Maria Jose Forcadell-Peris ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Nursing Home ◽

Population Based ◽

Considerable Proportion ◽

Middle Aged ◽

Mortality Risks ◽

Increased Risk ◽

All Cause Mortality ◽

Related Mortality

Abstract Background Direct and indirect COVID19-related mortality is uncertain. This study investigated all-cause and COVID19-related deaths among middle-aged and older adults during the first wave of COVID-19 pandemic period, assessing mortality risks by pre-existing socio-demographic and medical underlying conditions. Methods Population-based cohort study involving 79,083 individuals ≥50 years-old in Tarragona (Southern Catalonia, Spain). Baseline cohort characteristics (age/sex, comorbidities and medications/vaccinations history) were established at study start (01/03/2020) and main outcomes were COVID19-related deaths (those occurred among patients with laboratory-confirmed COVID19) and all-cause deaths occurred among cohort members between 01/03/2020–30/06/2020. Mortality risks were assessed by Cox regression analyses. Results Cohort members were followed for 1,356,358 persons-weeks, occurring 576 all-cause deaths (124 COVID19-related deaths). Of the 124 deceased patients with a laboratory-confirmed COVID19, 112 (90.3%) died by (due to) COVID-19, while 12 (9.7%) died with COVID-19 (but likely due to other concomitant causes). All-cause mortality rate among cohort members across study period was 42.5 deaths per 100,000 persons-week, being 22.8 among healthy/unrelated-COVID19 subjects, 236.4 in COVID19-excluded/PCR-negative subjects, 493.7 in COVID19-compatible/PCR-unperformed subjects and 4009.1 in COVID19-confirmed patients. Increasing age, sex male, nursing-home residence, cancer, neurologic, cardiac or liver disease, receiving diuretics, systemic corticosteroids, proton-pump inhibitors and benzodiazepines were associated with increased risk of all-cause mortality; conversely, receiving renin-angiotensin inhibitors and statins were associated with reduced risk. Age/years (hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 1.06–1.10), sex male (HR: 1.82; 95% CI: 1.24–2.70), nursing-home residence (HR: 12.56; 95% CI: 8.07–19.54) and number of pre-existing comorbidities (HR: 1.14; 95% CI: 1.01–1.29) were significant predictors for COVID19-related mortality, but none specific comorbidity emerged significantly associated with an increased risk in multivariable analysis evaluating it. Conclusion COVID19-related deaths represented more than 20 % of all-cause mortality occurred among middle-aged and older adults during the first wave of the pandemic in the region. A considerable proportion (around 10 %) of these COVID19-related deaths could be attributed to other concomitant causes. Theoretically COVID19-excluded subjects (PCR-negative) suffered ten-times greater all-cause mortality than healthy/unrelated-COVID19 subjects, which points to the existence of considerable number of false negative results in earlier PCR testing and could explain part of the global excess all-cause mortality observed during the pandemic.

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