Self-perceived health status, gender, and work status

Castillo M, Rodríguez-Blázquez C. Health state perception of people close to retirement age: Relationship with lifestyle habits and subjects' characteristics

Aim

Societal ageing increases the need for correct and healthy ageing to ensure the well-being of older adults. Practical strategies are needed to acquire healthy habits for the ageing process. This study aims to analyse the lifestyle habits of subjects who are retired or close to retirement and identify factors that could influence their perceived health and that could be related to these habits.

Methods

A Spanish observational, descriptive, cross-sectional study of subjects close to retirement-age. Socio-demographic, family, work, leisure, social, and clinical-psychological indicators were evaluated.

Results

1,700 participants (581 employed; 714 retirees; 405 other-status) were included, average age 63 years, 52% women. Most reported a satisfactory social life (90%), were in live-in relationships (74%), non-smoking (80%), followed a Mediterranean diet (73%), and took medicines daily (70%). Perceived health (EQ-VAS) was 75.9/100, with low disability (12-WHODAS) (7.4/100) and moderate/severe depression. Women reported higher disability (p < 0.001) and depression (p < 0.001), a better social life, and healthier lifestyle, but lower physical/work activity. Retirees reported less depression, better social life, healthier lifestyle, higher physical/work activity, and better sleeping habits. The multivariate model showed a significant association of health-status with disability level, number of chronic diseases, sleep habits, exercise, diet, and alcohol consumption. When depression level was introduced, age and being a woman were also related.

Conclusions

Retirement does not mean worse health but rather an opportunity to reinforce favourable health activities and improve lifestyle factors. Incorporating the differences related to gender and employment status in health-perception will facilitate the design of healthy ageing strategies.

Complex Sex Differences in Life Expectancy in French Guiana

In the complex context of French Guiana, different vulnerabilities and different risk factors between genders may lead to complex differences in health outcomes, mortality, and life expectancy. Our aim was, thus, to compare male and female mortality and life expectancy, to compare it between French Guiana and mainland France, and to look at temporal trends and the main specific causes of death in order to identify actionable singularities. National databases were used to obtain life expectancy at birth, at 20, 40, and 60 years, and mortality statistics. Standardized death rates and causes of death for French Guiana and mainland France were obtained through the CEPIDC, which analyzes information from death certificates. When comparing with mainland France, life expectancy at birth was significantly shorter both in males and females (mean = -2.9 years); life expectancy at 20 years, which allows to remove the effect of the greater child mortality in French Guiana, was also shorter in French Guiana for males (mean = -1.8 years) and females (mean = -2 years). The differences between mainland France and French Guiana regarding life expectancy at 40 and 60 years (mean = -1.5 and -1.3 years) was mainly found among females, males in French Guiana life expectancy at 40 and 60 years was closer to that in mainland France (mean = -0.8 and -0.6 years). Although they have a greater life expectancy at birth than men, women in French Guiana are substantially more affected by overweight/obesity and type 2 diabetes. The observed patterns of life expectancy at different ages presumably reflect the burden of external causes and AIDS in males and perhaps metabolic diseases in women.

Assessment of Post-COVID Symptoms Using the C19-YRS Tool in a Cohort of Patients from the First Pandemic Wave in Northwestern Spain

Introduction: The emergence or persistence of symptoms after acute SARS-CoV-2 infection has made it necessary to develop tools to detect them and assess their impact on patients' quality of life. One of these tools is the COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) scale. We present the results of this tool in a cohort of first pandemic wave patients. Methods: A cross-sectional study of patients with confirmed SARS-CoV-2 infection from March to May 2020 in Lugo (northwestern Spain). C19-YRS was administered via phone 10 months after the acute infection to both former inpatients and outpatients. Electronic medical records were reviewed and relevant data from the acute episode were collected. The main outcome was the presence of impairment in different areas measured by the C19-YRS scale. Results: The answer rate was 63.2%. The mean age was 54 ± 16 years, 38.4% were male and 190 (42.9%) had some comorbidity. Eighty-seven patients (19.6%) required hospitalization and 10 (2.3%) required intensive care unit admission. Ten (3.5%) patients lost their job due to the pandemic. Two hundred seventy-six patients (62.3%) related any symptoms; fatigue (37.2%) and exertional dyspnea (33.4%) were the most common with significant worsening in both cases compared with the situation before the infection. Subgroup analysis showed that more symptom domains were impaired in women than men. Older patients, those with comorbidity and those who needed hospital admission, demanded more health resources after the acute infection. Discussion: C19-YRS is useful for the detection and quantification of symptoms after COVID-19 and provides relevant social, health, and occupational information.

Mental wellbeing and perception of health in the era of COVID-19 pandemic: A cross-sectional study in the general population

PURPOSE

This study was aimed at evaluating mental wellbeing and health perception in the general population during the coronavirus disease 2019 (COVID-19) pandemic and at highlighting the correlation between them and selected variables.

DESIGN AND METHODS

This descriptive and cross-sectional study was carried out in 374 individuals, who were remotely administered two scales ("Perception of Health Scale [PHS]" and "Warwick-Edinburgh Mental Wellbeing Scale [WEMWBS]") and a demographic and clinical questionnaire.

FINDINGS

PHS mean score was 53.24 ± 7.69 and the total WEMWBS score was 52.95 ± 10.75. A positive statistically significant correlation was found between PHS and WEMWBS (p < 0.05). Gender, marital status, and education levels conditioned mental well-being in a statistically significant. Suffering from a chronic disorder, COVID-19 symptoms, or having a family member affected by COVID-19 infection influenced the health perception.

PRACTICAL IMPLICATIONS

Exposing the factors affecting the health and mental wellbeing perceptions of individuals, especially during the pandemic period, can guide policymakers.

Hierarchical Cluster Analysis of Human Value Priorities and Associations with Subjective Well-Being, Subjective General Health, Social Life, and Depression across Europe

Human values are a central component in understanding individuals’ choices. Using the Schwartz’s Values instrument, this study aimed to identify patterns of human value priorities of 35,936 participants across 20 European countries and analyse their relations with subjective well-being (SWB), subjective general health (SGH), social life, and depression indices in Europe. A hierarchical cluster analysis of data from the seventh European Social Survey (ESS) round 7, based on the higher order dimensions of the Schwartz values model, allowed identifying four European groups with distinct indicators. Indices of SWB, SGH, social life, and depression showed statistically significant differences among the four different sociodemographic groups. The graphical representation of the monotonic correlations of each of these indices with the value priorities attributed to the ten basic human values was ordered according to the Schwartz circumplex model, yielding quasi-sinusoidal patterns. The differences among the four groups can be explained by their distinct sociodemographic characteristics: social focus, growth focus, strong social focus, and weak growth focus. The results of this study suggest a rehabilitation of the notion of hedonism, raising the distinction between higher and lower pleasures, with the former contributing more to well-being than the latter.

Factors associated with self-rated health in a Norwegian population of older people participating in a preventive home visit program: a cross-sectional study

Background

Assessing self-rated health by preventive home visits of older people can provide information about the person’s well-being, quality of life and risk of developing illness. The aim of this study was to examine associations between self-rated health and factors related to demographics, lifestyle, health conditions and medical diagnoses by older people participating in a preventive home visit program.

Methods

A cross-sectional study including 233 participants (age 75–79) from three municipalities of Western Norway was conducted. Data were collected through preventive home visits performed by six nurses, using a questionnaire including self-rated health assessment and questions and tests related to demographics (e.g. education and housing), lifestyle (e.g. social activities, alcohol and smoking), health conditions (e.g. sensory impairment, pain and limited by disease) and medical diagnoses. Descriptive and inferential statistics including linear block-wise regression model were applied.

Results

The block-wise regression model showed that the variables Limited by disease and Pain were negatively associated with self-rated health and Use internet was positively associated. The model had a R² 0.432. The variable that contributed to largest change in the model was Limited by disease (R² Change; 0.297, p-value< 0.001).

Conclusions

In the present study, being limited by disease and pain were strongly associated with poor self-rated health, indicating that these are important factors to assess during a preventive home visit. Also, digital competence (Use internet) was associated with a better self-rated health, suggesting that it could be useful to ask, inform and motivate for the use of digital tools that may compensate for or improve social support, social contact and access to health -related information.

Investigating self-perceived health and quality of life: a longitudinal prospective study among beginner recreational exercisers in a fitness club setting

OBJECTIVES

This study investigated self-perception of overall health (SPH) and quality of life (QoL) at onset and after 3, 6 and 12 months of fitness club membership. Also, we compared SPH and QoL between those who reported regular use of the fitness club (≥2 exercise sessions/week the last month) with those who did not (one exercise session/week or no exercise the last month).

DESIGN

Longitudinal prospective study.

SETTING

25 fitness clubs in Oslo, Norway.

PARTICIPANTS

In total, 250 newly registered fitness club members (equal numbers of men and women, mean age=36.4±11.3 years, mean body mass index=25.7±4.4) were recruited. At onset (n=250), after 3 (n=224), 6 (n=213) and 12 months (n=187), the participants answered an electronic questionnaire, covering background variables, exercise involvement, perceived SPH and QoL.

OUTCOME MEASURES

SPH was measured by a single-item question, rating health status from poor to excellent on a 5-point scale. High SPH was dichotomised as excellent or good, and low SPH as moderate, fair or poor. QoL was measured on a 7-item scale, rating five statements and dichotomised according to a total max sum score of 35, with low QoL ≤25 and high QoL >25.

RESULTS

Repeated measurements did not show any changes in SPH. In QoL, we observed an improvement in QoL sum score and a significant increase in mean scores for two out of five statements at 12 months follow-up: 'In most ways, my life is close to my ideal' (p=0.036) and'If I could live my life over, I would change almost nothing' (p<0.001). Regular use of the fitness club was associated with high SPH (OR 3.532 (95% CI 1.60-7.82), p=0.002) and high QoL (OR 1.914 (95% CI 0.95-3.86), p=0.069). The results were unchanged after adjusting for confounders.

CONCLUSION

Regular attendance at a fitness club was associated with high SPH and high QoL at 12 months follow-up.

[Socioeconomic inequalities in health among the elderly population in Spain]

OBJECTIVE

To examine socioeconomic inequalities in health in the older population in Spain.

METHOD

A systematic search and review of the literature published between 2000 and 2017 in English and Spanish was conducted in Social Science Citation Index, Sociology Database, Scopus, PubMed and Embase. Primary and secondary studies analysing these inequalities in Spain were included. Two researchers were responsible for the selection of the studies and the extraction of the information (first author, year of publication, region, design, population/sample, socioeconomic and health indicators used, and main results).

RESULTS

A total of 89 articles were included, corresponding to 87 studies. Of the studies, 81.6% were cross-sectional, 88.5% included only non-institutionalised population and 35.6% were carried out at a national level. The studies analysed social inequalities in the following health indicators: functional status (n=29), morbidity (n=19), self-perceived health (n=18), mental and emotional health (n=10), cognitive status (n=7), quality of life (n=9), mortality (n=15) and life expectancy (n=2). Socioeconomic inequalities were detected in all of them, although the magnitude varied depending on the socioeconomic and health indicator used. The educational level and the ecological indexes were the indicators that detected more inequalities in health. The impact of inequalities by sex was different in functional status, morbidity, self-perceived health, mental and emotional health and mortality.

CONCLUSION

There are socioeconomic inequalities in health among the elderly population and their magnitude varies by sex in some of the health indicators. The increase in educational level and the maintenance of sufficient pensions can be key policies that contribute to the reduction of inequalities in this population group.

[Social inequalities in health among the elderly population: review of indicators used in Spain]

OBJECTIVE

To identify the indicators of social position used to evaluate inequalities in health among the population aged 65 and over in Spain.

METHOD

A systematic search of the literature published in English and Spanish since 2000 in health and social databases was carried out. Primary and secondary studies analyzing these inequalities in Spain were included. The indicators used were identified, as well as the advantages and limitations pointed out by the authors. The main findings were synthesized in a review of the literature.

RESULTS

We included 87 studies, described in 89 articles. The socioeconomic indicators employed were both individual and ecological. Among the former, educational level was the most analyzed socioeconomic variable (n=73). Other individual variables used were occupation (n=17), objective economic level (n=16), subjective economic level (n=4), housing and household material wealth (n=6), relationship with work activity (n=5), and mixed measures (n=5). Among the ecological indicators, simple (n=3) and complex indices (n=7) were identified. The latter had been constructed based on several indicators, such as educational level and unemployment. Inequalities in multiple health indicators were analyzed, self-perceived health being the only indicator assessed according to all the socioeconomic indicators described.

CONCLUSIONS

A wide variety of indicators is identified for the evaluation of social inequalities in health among the elderly population. There have not been sufficiently assessed from a gender perspective; this is a line of interest for future research.

Gender differences in psychosocial predictors of self-perceived health status in the elderly: Evidence from a Brazilian community study

This article aims to identify the psychosocial factors associated with self-perceived health status in the Brazilian elderly population and to present differences related to gender. The data were collected by questionnaire, including sociodemographic and behavioral questions, and scales for psychological dimensions. Self-perceived health status is related to level of education, physical activity, and self-efficacy in the total population. Regarding gender differences, self-rated health status among men is related to education level and self-efficacy and in women to level of education, physical activity, social support, and self-efficacy. These results can inform future health promotion interventions.

Relationship between housework and perceived happiness of middle-aged and older women in Taiwan-The moderating effect of health condition

In this study, we investigated how physical health moderates the effect of housework on the perceived well-being in a sample of middle-aged and older women living with a partner in Taiwan. Two main findings were identified: First, the health status of middle-aged and older women moderates the relationship between their sense of housework fairness and perceived happiness. Second, the health status of their spouse moderates the relationship between their housework performance and perceived happiness.