Lifetime childlessness has increased in Europe. The relationship between childlessness and psychological wellbeing varies by the wellbeing measures employed, life stage and societal context. Health-related predictors of childlessness (health selection) may mediate the relationship between childlessness and wellbeing and/or influence wellbeing directly. This paper examines the relationship between lifetime childlessness, depressive mood and quality of life in early old age using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) (N=21,295). Region-specific Ordinary Least Squares Analysis is performed to investigate this relationship and the mediating roles of health selection and marital status are explored. No main effect of childlessness is observed in any of the regions net of socio-demographic, economic and health factors. The significant role of health selection in this relationship is only evident in Eastern Europe. The findings of this study support a more in-depth analysis of the role of marital status in mediating the relationship between childlessness and psychological wellbeing. Consistent relationships between marital status and both measures of wellbeing support further analysis of marital selection in this regard

BackgroundLow health literacy is associated with poor health-related knowledge, illness self-management, health service use, health, and survival, and thus addressing issues related to low health literacy has been highlighted as a pressing international priority.ObjectiveTo explore views of a digital health promotion intervention designed to be accessible to people with lower levels of health literacy, in particular examining reactions to the interactive and audiovisual elements of the intervention.MethodsQualitative think-aloud interviews were carried out with 65 adults with type 2 diabetes in the UK, Ireland, USA, Germany, and Austria, with purposive sampling to ensure representation of people with lower levels of health literacy. Inductive thematic analysis was used to identify common themes. We then systematically compared views in subgroups based on country, health literacy level, age, gender, and time since diagnosis.ResultsMost participants from the chosen countries expressed positive views of most elements and features of the intervention. Some interactive and audiovisual elements required modification to increase their usability and perceived credibility and relevance. There were some differences in views based on age and gender, but very few differences relating to health literacy level or time since diagnosis.ConclusionsIn general, participants found the intervention content and format accessible, appropriate, engaging, and motivating. Digital interventions can and should be designed to be accessible and engaging for people with a wide range of health literacy levels.

PurposeThis paper aims to determine the potential for the spread of bacteria from raw meat and poultry during home food preparation to the surrounding kitchen environment, hands and prepared food due to unsafe handling practices, which are predicted by consumers' knowledge, behaviour and attitudes.Design/methodology/approachThe potential for transfer of E.coli and C. jejuni was monitored in a simulated domestic kitchen environment while food preparation was filmed (n=60 respondents). A survey was also administered.FindingsThe results of the study show that transfer of bacteria around the kitchen environment and onto prepared meals are predicted by a lack of thoroughly washing contaminated hands, knives and chopping boards both during and after meal preparation. A higher level of perceived importance of correct food handling behaviour is associated with higher levels of educational attainment and age and food risk perceptions are positively associated with age.Practical implicationsThe results highlight the importance of promoting preventative measures and the means of employing them specifically to the young and less educated public who do not frequently cook and prepare food.Originality/valueThis paper is the first to include a verifiable audit of consumer food safety behaviour, microbiological sampling of surfaces, food and hands as well as a consumer survey of knowledge, behaviour and attitudes.

Background. Health literacy has been separately associated with socio-economic status and worse health status and outcomes. However, the magnitude of the associations between health literacy and health status and outcomes may not be evenly distributed across society. This study aims to estimate and compare the associations between health status, health behaviours, and healthcare utilisation within different levels of social status in the Irish population. Materials and methods. Data from Ireland collected as part of the 2011 European Health Literacy Survey were analysed. General health literacy was measured on a 0–50 scale, low to high. There were four binary outcomes: long-standing health conditions, smoking, hospital visits in the last 12 months, and self-rated health status. Logistic regression analysis was conducted to estimate the likelihood of each health outcome. Health literacy was treated as the main independent variable. Marginal effects were calculated using the delta method to demonstrate the change in likelihood of each outcome associated with a 5-point increase in health literacy score. The sample was grouped into tertiles based on self-reported social status, and models were replicated and compared for each tertile. Models were adjusted for known correlates of health literacy and health: age, gender, and education. Analysis was conducted using Stata V14. Results. Higher health literacy scores were associated with a lower probability of having a limiting illness within the low social status group only. Higher health literacy scores were associated with a lower probability of three or more hospital visits in the past 12 months in the low and middle social status groups. For people in the low and middle social status groups, higher health literacy levels were associated with a lower probability of being a current smoker. The associations between health literacy and self-rated health status were similar in each social status group. Conclusions: Improvement in population health literacy may reduce the prevalence of long-term chronic health conditions, reduce smoking levels, and result in fewer hospital visits. Whilst improved health literacy should improve behaviours and outcomes in all groups, it should have a more marked impact in lower social status groups, and hence contribute to reducing the observed social disparities in these health outcomes.

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