Health inequality and protective factors for post COVID-19 condition among older adults in Europe

Abstract

Abstract Background COVID-19 affected people and countries disproportionately and continues to impact health of people. The aim of this study was to investigate protective health and social factors for post-COVID conditions in adults aged 50 years and older in Europe using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE), which were collected from June to August 2021. Methods A study sample of 1,909 respondents who self-reported a positive COVID-19 test result was included in our multiple logistic regression models. Binary logistic regression was performed to assess whether having no post COVID-19 condition was associated with sociodemographic factors (sex, age, education and region) and health-related factors (BMI, comorbidity and COVID-19 vaccination status). Results In the fully-adjusted model, male sex (OR 1.54; CI1.24, 1.90), having tertiary or higher education (OR1.42; 95% CI 1.05, 1.92), healthy weight (BMI 18.5 to 24.9 kg/m2)(OR 1.46; 95% CI 1.11, 1.93), no underlying health condition (OR 1.68; CI 1.31, 2.15), COVID-19 vaccination (OR 1.39; CI 1.11, 1.75) and living in countries other than Visegrad group (OR 2.03; CI 1.53, 2.69) showed protective effects against post COVID-19 conditions. BMI in the high education group (mean 26.7 kg/m2) differed significantly as compared to medium (mean 28.3 kg/m2) and low education groups (mean 28.7 kg/m2). BMI of respondents without comorbidity (mean 26.5 kg/m2) was significantly lower than respondents with comorbidities (ranging from 27.4 to 29.0 kg/m2). Significant differences were observed in education levels and BMI between the Visegrad group and Non-Visegrad group (p<.001). Conclusions Our study suggests that high education attainment is a predictor for no post COVID-19 conditions and is associated with lower BMI and fewer underlying comorbidities. Health inequality associated with education attainment was particularly relevant in the Visegrad group. Key messages • Maintaining healthy weight and vaccination may protect older adults from post COVID-19 condition. • Our results highlight health inequality in which BMI was associated with comorbidities and educational attainment.