SOCIOECONOMIC INEQUALITIES IN SELF-REPORTED HEALTH AND PHYSICAL FUNCTIONING IN ARGENTINA: FINDINGS FROM THE NATIONAL SURVEY ON QUALITY OF LIFE OF OLDER ADULTS 2012 (ENCaViAM)

López, Santiago Rodríguez; Colantonio, Sonia Edith; Celton, Dora Estela

doi:10.1017/s0021932016000651

Cited by 12 publications

(10 citation statements)

References 47 publications

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“…Well-educated adults may possibly access sufficient and high-quality information [19,20,31], which helps them have a better understanding of what to options choose to guarantee healthy conditions. Thus, disadvantages in economic status and in education attainment contribute a lot to the inequalities in long-term care needs, which were consistent with the results of previous studies in developed countries [32][33][34][35]. The results of this study are discouraging for the following reasons when extending universal coverage of long-term care insurance.…”

Section: Discussionsupporting

confidence: 90%

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

2020

IJERPH

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Background: China has the largest number of aging people in need of long-term care, among whom 70% have chronic diseases. For policy planners, it is necessary to understand the different levels of needs of long-term care and provide long-term care insurance to ensure the long-term care needs of all people can be met. Methods: This study combines the 2013 wave of CHARLS survey and the Life Course Survey of 2014. The combination allows us to factor in both childhood and adulthood data to provide life-course analysis. We identified 7,734 older adults with chronic diseases for analysis. The need for long-term care is defined by the presence of functional limitations based on the performance of basic activities of daily living (ADLs) and of instrumental activities of daily living (IADLs). Two dummy variables, ADLs disability and IADLs disability, and two count variables, ADLs score and IADLs score, were defined to measure incidence and severity of long-term care need, respectively. The concentration index was used to capture the inequality in long-term care need, and a decomposition method based on Probit Regression and Negative Binomial Regression was exploited to identify the contribution of each determination. Results: At least a little difficulty was reported in ADLs and IADLs in 20.44% and 19.25% of respondents, respectively. The concentration index of ADLs disability, ADLs score, IADLs disability, IADLs score were −0.085, −0.109, −0.095 and −0.120, respectively, all of which were statistically significant, indicating the pro-poor inequality in the incidence and severity of long-term care need. Decomposition analyses revealed that family income, education attainment, aging, and childhood experience played a significant role in explaining the inequalities. Conclusions: The long-term care need among older adults with chronic disease is high in China and low socioeconomic groups had a higher probability of needing long-term care or need more long-term care. It is urgent to implement long-term care insurance, especially for the individuals from lower socioeconomic groups.

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Section: Discussionsupporting

confidence: 90%

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

2020

IJERPH

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“…Several studies have investigated the association between multimorbidity and health outcomes, both physical [6][7][8][20][21][22], and mental [6,8,23,24], but many were either small [7,21], not representative for the entire country [8,23], focused on a specific subgroup like elderly [6,7,21,22], or focused on a limited number of chronic diseases [24][25][26]. There are many papers on socio-economic inequalities in health, which clearly demonstrate that lower SES is associated with greater mortality [27,28], higher prevalence of multimorbidity [29] and worse health outcomes [30] To the best of our knowledge, none of them investigated how the association between multimorbidity and health varies by SES.…”

Section: Introductionmentioning

confidence: 99%

The disease burden of multimorbidity and its interaction with educational level

2020

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Introduction Policies to adequately respond to the rise in multimorbidity have top-priority. To understand the actual burden of multimorbidity, this study aimed to: 1) estimate the trend in prevalence of multimorbidity in the Netherlands, 2) study the association between multimorbidity and physical and mental health outcomes and healthcare cost, and 3) investigate how the association between multimorbidity and health outcomes interacts with socio-economic status (SES). Methods Prevalence estimates were obtained from a nationally representative pharmacy database over 2007–2016. Impact on costs was estimated in a fixed effect regression model on claims data over 2009–2015. Data on physical and mental health and SES were obtained from the National Health Survey in 2017, in which the Katz-10 was used to measure limitations in activities of daily living (ADL) and the Mental Health Inventory (MHI) to measure mental health. SES was approximated by the level of education. Generalized linear models (2-part models for ADL) were used to analyze the health data. In all models an indicator variable for the presence or absence of multimorbidity was included or a categorical variable for the number of chronic conditions. Interactions terms of multimorbidity and educational level were added into the previously mentioned models. Results Over the past ten years, there was an increase of 1.6%-point in the percentage of people with multimorbidity. The percentage of people with three or more conditions increased with +2.1%-point. People with multimorbidity had considerably worse physical and mental health outcomes than people without multimorbidity. For the ADL, the impact of multimorbidity was three times greater in the lowest educational level than in the highest educational level. For the MHI, the impact of multimorbidity was two times greater in the lowest than in the highest educational level. Each additional chronic condition was associated with a greater worsening in health outcomes. Similarly, for costs, where there was no evidence of a diminishing impact of additional conditions either. In patients with multimorbidity total healthcare costs were on average €874 higher than in patients with a single morbidity. Conclusion The impact of multimorbidity on health and costs seems to be greater in the sicker and lower educated population.

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“…For the cognitive function, a study conducted in England, in which socioeconomic inequality was considered in childhood (father's occupation) and in adulthood (occupation of the head of the household), found that older adults with a better SES had a better cognitive performance compared to those with a worse SES. 27 Specifically, it was reported that a lower SES in childhood resulted in a lower verbal memory, measured through the evocation of correct words (SII=-4.72; 95%CI:-5.84,-3.61), and a similar association was found (SII=-6.67; 95%CI:-5.84,-3.61) for the same indicator in adulthood. In our study, which used the verbal fluency test (which consists in correctly evoking as many animals as possible), we found a similar association in direction and magnitude (SII=-1.76; 95%CI:-2.72,-0.79).…”

Section: Discussionmentioning

confidence: 89%

Socioeconomic inequalities in health and nutrition among older adults in Mexico

et al. 2019

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Objective. To analyze the socioeconomic inequalities in health among the population of older adults in Mexico. Materials and methods. Analysis of two national health surveys in Mexico (Ensanut 2012 and Ensanut 100k) in which inequality gradients are estimated for various health and nutrition outcomes of older adults over 60 years, using the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). Results. Older adults with lower socioeconomic status had worse levels of cognition, instrumental activities of daily living, depressive symptoms, muscle mass, low weight, and anemia. Conclusions. Substantial socioeconomic inequalities in health were observed in this study. Given the rapid growth of the population of older adults in Mexico, our results indicate that urgent actions are necessary to achieve health equity in this population group, particularly universal access to health, as well as universal coverage of health services.

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SOCIOECONOMIC INEQUALITIES IN SELF-REPORTED HEALTH AND PHYSICAL FUNCTIONING IN ARGENTINA: FINDINGS FROM THE NATIONAL SURVEY ON QUALITY OF LIFE OF OLDER ADULTS 2012 (ENCaViAM)

Cited by 12 publications

References 47 publications

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

The disease burden of multimorbidity and its interaction with educational level

Socioeconomic inequalities in health and nutrition among older adults in Mexico

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