The association between hardship and self-rated health: does the choice of indicator matter?

Marshall, Gillian L.; Tucker-Seeley, Reginald

doi:10.1016/j.annepidem.2018.03.013

Cited by 39 publications

(41 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in line with a growing body of research that is identifying limitations to using traditional measures of socioeconomic status, such as income and education, when trying to describe the socioeconomic context of an individual’s health, health-related behaviors, and healthcare utilization. For example, some researchers are recommending that information about household or personal income be supplemented with other indicators of an individual’s financial and living situation, including current and anticipated demands on that income and different sources of material and psychological financial hardship and financial stress [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the study sample was not sufficient to take the next step of examining the association of these SRs with health and well-being within and across racial/ethnic groups and the extent to which they help explain racial/ethnic disparities that have been observed in previous research. However, there is evidence from previous studies suggesting a positive association of health status with education [ 30 , 51 – 54 ] and income [ 55 – 57 ] and a negative association of health status with financial strain [ 39 , 58 , 59 ]. Future research should focus on the pathway through which SRs influence health and healthcare use.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Racial-ethnic differences in prevalence of social determinants of health and social risks among middle-aged and older adults in a Northern California health plan

2020

View full text Add to dashboard Cite

Background Social determinants of health (SDoHs) and social risks (SRs) have been associated with adverse health and healthcare utilization and racial/ethnic disparities. However, there is limited information about the prevalence of SRs in non-“safety net” adult populations and how SRs differ by race/ethnicity, age, education, and income. Methods We analyzed weighted survey data for 16,247 White, 1861 Black, 2895 Latino, 1554 Filipino, and 1289 Chinese adults aged 35 to 79 who responded to the 2011 or 2014/2015 Kaiser Permanente Northern California Member Health Survey. We compared age-standardized prevalence estimates of SDoHs (education, household income, marital status) and SRs (financial worry, cost-related reduced medication use and fruit/vegetable consumption, chronic stress, harassment/discrimination, health-related beliefs) across racial/ethnic groups for ages 35 to 64 and 65 to 79. Results SDoHs and SRs differed by race/ethnicity and age group, and SRs differed by levels of education and income. In both age groups, Blacks, Latinos, and Filipinos were more likely than Whites to be in the lower income category and be worried about their financial situation. Compared to Whites, cost-related reduced medication use was higher among Blacks, and cost-related reduced fruit/vegetable consumption was higher among Blacks and Latinos. Younger adults were more likely than older adults to experience chronic stress and financial worry. Racial/ethnic disparities in income were observed within similar levels of education. Differences in prevalence of SRs by levels of education and income were wider within than across racial/ethnic groups. Conclusions In this non-“safety net” adult health plan population, Blacks, Latinos, and Filipinos had a higher prevalence of social risks than Whites and Chinese, and prevalence of social risks differed by age group. Our results support the assessment and EHR documentation of SDoHs and social risks and use of this information to understand and address drivers of racial/ethnic disparities in health and healthcare use.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Racial-ethnic differences in prevalence of social determinants of health and social risks among middle-aged and older adults in a Northern California health plan

2020

View full text Add to dashboard Cite

show abstract

“…Financial hardship, one indicator of SES, has been found to capture other dimensions of SES that relate to identifying those in need and availability of resources (Cook and Kramek, 1986; Mayer and Jencks, 1989; Beverly, 2001). Although there is no consensus on the measurement of financial hardship, some common indicators used in the Health and Retirement Study to operationalize this measure include: difficulty paying bills, food insecurity, and reduced intake of medications due to cost (Marshall and Tucker-Seeley, 2018; Tucker-Seeley et al, 2016; Kiely et al, 2015; De Castro et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Gender differences in the association between modifiable risk factors and financial hardship among middle-aged and older adults

Marshall

Bryson

Ronstant

et al. 2019

Preventive Medicine Reports

Self Cite

View full text Add to dashboard Cite

Objective To identify associations between modifiable risk factors (cigarette smoking, alcohol consumption, and obesity) and financial hardship (difficulty paying bills, food insecurity and medication need) among middle-aged and older Americans in a nationally representative sample. Methods This was a cross-sectional study of 8212 persons age 50 years and older who completed the core 2010 Health and Retirement Study survey and the psychosocial questionnaire. We ran separate multinomial logistic regressions to assess the association of three modifiable risk factors and three different financial hardship indicators. Results Adjusting for all covariates, compared to men of normal weight, men who were obese had a 1.4 greater odds of difficulty paying their bills (95% CI: 1.08–1.76); former smokers had a 1.8 greater odds of being food insecure (95% CI: 1.05–2.95); current smokers were twice as likely to be food insecure (95% CI: 1.21–3.73); Compared to women who never smoked, current smokers had a 1.5 greater odds of having difficulty paying their bills (95% CI: 1.11–2.02); current smokers had a 1.8 greater odds of being food insecure (95% CI: 1.13–2.91); and women who were obese had a 1.5 greater odds of reducing medication due to cost (95% CI: 1.11, 2.02). Conclusion Our findings contribute to the literature on health behaviors and financial hardship by highlighting the cyclical nature between different indicators of socioeconomic status, modifiable risk factors, and poor health outcomes among middle-aged and older adults. Furthermore, findings highlight how modifiable risk factors may culminate in financial hardship in later life.

show abstract

“…Economic insecurity leads to limited purchasing power and the ability to access prescribed medications, and reduces access to high-quality health care. 50 These economic processes, however, may have different implications for the SRH of AA men and AA women. As people age, men report worsening SRH, whereas women's poor SRH is heavily attributed to SES differences.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the Predictors of Self-rated Health of Economically Disadvantaged African American Men and Women: Evidence for Sponge Hypothesis

Cobb

Assari

2020

Int J Epidemiol Res

View full text Add to dashboard Cite

Background and aims: According to the sponge hypothesis, compared to men’s self-rated health (SRH), women’s SRH is more likely to reflect conditions other than chronic medical conditions (CMCs) such as psychiatric disorders (PDs). As a result, poor SRH is a weaker predictive factor for mortality risk for women than men. Most of this literature, however, is done in samples that are predominantly middleclass White. To test the sponge hypothesis among economically disadvantaged African Americans (AAs), this study compared low-income AA men and women for the effects of the number of PDs and CMCs on SRH. Materials and Methods: This cross-sectional study recruited a non-random sample (n=150) of economically disadvantaged AA adults with PD(s). Structured face-to-face interviews were used to collect data. SRH was measured using a single-item measure. PDs and CMCs were also self-reported. We applied linear regression models to test the interactions between SRH and the number of PDs and CMC as well as gender. Results: The number of PDs and CMCs were associated with SRH in the pooled sample of low-income AA adults with PD(s). However, we found a significant interaction between the number of PDs and gender. This interaction suggested a stronger association between PDs and SRH for AA women than AA men. Gender did not alter the association between the number of CMCs and SRH. Conclusion: The number of PDs is a determinant of SRH for low-income AA women but not AA men, supporting the sponge hypothesis.

show abstract

The association between hardship and self-rated health: does the choice of indicator matter?

Abstract: Research in this area can provide greater conceptual and measurement clarity on the hardship experience and further elucidate the pathway between specific hardships and poor health outcomes to inform intervention development.

Cited by 39 publications

References 61 publications

Racial-ethnic differences in prevalence of social determinants of health and social risks among middle-aged and older adults in a Northern California health plan

Racial-ethnic differences in prevalence of social determinants of health and social risks among middle-aged and older adults in a Northern California health plan

Gender differences in the association between modifiable risk factors and financial hardship among middle-aged and older adults

Investigation of the Predictors of Self-rated Health of Economically Disadvantaged African American Men and Women: Evidence for Sponge Hypothesis

Contact Info

Product

Resources

About