Changes In Self-rated Health Research Articles

Interaction effects of the COVID-19 pandemic and regional deprivation on self-rated health: a cross-sectional study

BackgroundRecent studies have attempted to analyze the changes in self-rated health (SRH) during the coronavirus disease 2019 (COVID-19) pandemic. However, the results have been inconsistent. Notably, SRH is subjective, and responses may vary across and within countries because of sociocultural differences. Thus, we aimed to examine whether the interaction effects between the COVID-19 pandemic and regional deprivation influenced SRH in South Korea.MethodsThe study population comprised 877,778 participants from the Korea Community Health Survey. The data were collected from 2018 to 2021. Multiple regression analysis was employed to determine the relationship between SRH and the interaction between the COVID-19 pandemic status and the socioeconomic level of residential areas.ResultsThe post-pandemic groups (odds ratio [OR] = 2.25, P < .0001; OR = 2.29, P < .0001) had significantly higher odds of reporting favorable SRH than the pre-pandemic groups (OR = 0.96, P < .0001). However, the difference in ORs based on regional socioeconomic status was small.ConclusionsSRH showed an overall increase in the post-pandemic groups relative to that in the disadvantaged pre-pandemic group. Possible reasons include changes in individuals’ health perceptions through social comparison and the effective implementation of COVID-19 containment measures in South Korea. This paradoxical phenomenon has been named the “Eye of the Hurricane,” as the vast majority of people who had not been infected by the virus may have viewed their health situation more favorably than they ordinarily would.

Changes in Accelerometer-Measured Physical Activity and Sedentary Time Across Retirement Transition as a Predictor of Self-Rated Health.

Retirement transition has been shown to associate with changes in physical activity (PA) and self-rated health (SRH), but their interrelationship is less studied. The aim was to investigate changes in accelerometer-measured total PA, moderate to vigorous PA (MVPA), and sedentary time across retirement transition as a predictor of SRH. Data from the Swedish Retirement Study and the Finnish Retirement and Aging study were harmonized and pooled. Data from 3 waves (about 12mo apart) were included: 1 preretirement (wave 1) and 2 postretirement follow-ups (wave 2-3). A totally of 245 participants (27% men) were included. Thigh-worn accelerometers were used to collect data for PA variables (wave 1-2), and SRH was obtained from the questionnaire (wave 1-3). Between wave 1 and 2, total PA decreased with 11 (CI, -22 to -1)minutes per day, MVPA was stable (0 [CI, -3 to 3]min), and sedentary time decreased nonsignificantly with 9 (CI, -20 to 1)minutes. SRH changed between all 3 waves (all P < .001). At preretirement, 10 more minutes of MVPA was associated with greater odds of better SRH when adjusting for accelerometer wear-time, cohort, sex, age, and occupational status (odds ratio: 1.11 [95% CI, 1.02-1.22]). This association was no longer statistically significant when additionally adjusting for marital status, body mass index, and smoking. No significant associations were observed between changes in the PA variables during retirement transition and SRH at postretirement follow-ups. This study showed a cross-sectional association between MVPA and greater odds of reporting better SRH before retirement. No longitudinal associations were observed between changes in the PA variables from before to after retirement and later changes in SRH.

중고령 장애인의 주관적 건강 궤적 영향요인-비장애인과의 비교

This study examines whether and how self-rated health (SRH) changes among middle-aged and older adults with disabilities compared to adults without disabilities. From the Korean Welfare Panel Survey encompassing the 7th (2012) to the 16th (2021). the study extracted 836 adults with disabilities aged 50 or older and 4,258 adults without disabilities. Potential growth models (unconditional and conditional models) were analyzed to identify subjective health changes and factors influencing such changes. Multi-group comparison analysis method was adopted to examine differences by disability. In the unconditional model analysis, the SRH of both adults with disabilities and adults without disabilities tended to decrease gradually over time. Adults with disabilities had a lower initial value of SRH than adults without disabilities, but there was little difference in the rate of change. In the conditional model analysis, gender, age, household income, health checkups, risk of drinking, family relationship satisfaction, social relationship satisfaction, and leisure activity satisfaction variables were the factors affecting the initial values of SRH of adults with and without disabilities. Looking at the influencing factors by disability, it was found that the effect of education training was significant for adults with disabilities, and the effect of smoking was significant for adults without disabilities.The effects of age and smoking were more significant in adults without disabilities, and the effects of the number of years of education and health checkups were more significant in adults with disabilities. Volunteer activities are positively associated with the rate of change in SRH regardless of disability. On the other hand, dangerous drinking had a significant effect on the rate of change in SRH of adults with disabilities, and having medical checkups had a significant effect on that of adults without disabilities. The results suggest that health promotion policies and services for middle-aged and older adults with disabilities need to reflect their characteristics compared or contrasted with middle-aged and older adults without disabilities.

Do Health and Housing Attributes Motivate Residential Moves Among Older Chinese Adults? Evidence From an 8‑Year Follow‑up Study.

Despite the widespread belief in aging-in-place as the preferred housing arrangement for older adults, they are increasingly embracing moving. The person-environment fit theory explains that environmental changes due to residential moves can pose health risks, discouraging older people from moving. However, it also suggests that moves may be suitable when living conditions no longer meet their physical needs. The correlation between older people's health, housing, and their subsequent moving or staying actions in China remains underexplored. Using alternative operating variables of key concepts and the China Family Panel Studies 2012-2018 data sets, this study examines the effects of health and housing status on older people's residential moves in China. The study outlines changes in health indicators and housing characteristics during multiple moves, as well as examines the relationship between the health and housing status of older adults and moving over a relatively long period of time using both regression models with lagged explanatory variables and fixed effects binary choice models. The results reveal that: (1) higher rates of subsequent moves were observed among older adults with better self-rated health, positive self-rated health changes, and no ADL impairment, but no significant associations were found between most health variables and moving; and (2) the correlation between older persons' house ownership/type and their residential moves was significant and consistent over time, steady and lasting. Potential mechanisms explaining the association between specific housing types and ownership statuses on moving are discussed. The findings encourage a focus on the positive benefits of moving in later life and how to provide additional housing options for older individuals.

A longitudinal study on self-rated health changes in disabled older people.

There is a growing demand for quality healthcare for senior citizens among the disabled older population, considering their rising numbers. This study examines the longitudinal change in the health status of disabled older people and determines its effects on social exclusion and differences based on age at disability onset. The analysis was performed using a multilevel growth model on the health data for disabled older people (≥60 years) derived from the Korea Welfare Panel Study (KWePS). The following findings were observed based on the stated model: (1) The Self-Rated Health (SRH) of disabled older people increased over time, with significant individual differences in the initial status and growth rate; (2) The domains of economic and social network exclusion were associated with changes in the health status of disabled older people; and (3) The longitudinal effects of social exclusion on SRH changes in disabled older people varied according to the age at disability onset. Based on these results, strategies and implications for the development of health-promoting interventions for disabled older people were presented.

Social Networks as a Key Health Determinant in Acute Illness Recovery: A Lesson from the COVID-19 Pandemic

BackgroundThe COVID-19 pandemic highlighted the importance of considering social determinants of health in health outcomes. Within this spectrum of determinants, social networks garnered attention as the pandemic highlighted the negative effects of social isolation in the context of social distancing measures. Postpandemic, examining the role social networks play in COVID-19 recovery can help guide patient care and shape future health policies. This study aimed to investigate the relationship between social networks and self-rated health change, as well as physical function, in patients recovering from COVID-19 pneumonia. MethodsThis was a retrospective cohort study utilizing clinical data from 2 New York City hospitals and a 9-month follow-up survey of COVID-19 pneumonia survivors. We evaluated a composite Social Network Score from the 6-item Lubben Social Network Scale and its association with 2 outcomes: 1) self-rated health change and 2) physical function. ResultsA total of 208 patients were included in this study. A 1-point increase in the Social Network Score was associated with greater odds of both same or improved self-rated health change (odds ratio [OR] 1.07, 95% CI 1.02-1.12, P = .01), as well as unimpaired physical function (OR 1.08, 95% CI 1.03-1.14, P < .01). ConclusionThis study emphasized the importance of social networks as a social determinant of health among patients recovering from COVID-19 hospitalization. Targeted interventions to enhance social networks may benefit not only COVID-19 patients but also individuals recovering from other acute illnesses.

Abstract MP35: Long-Term Trajectories of Self-Rated Health Are Similar Following Incident Diabetic Foot Disease and Acute Myocardial Infarction Among Adults With Diabetes in the Atherosclerosis Risk in Communities (ARIC) Study

Introduction: Incident diabetic foot disease is associated with significant morbidity and mortality. However, data are lacking on long-term patient-reported outcomes. We aimed to evaluate trajectories of self-rated health among adults with diabetes before and after incident foot disease compared to incident acute myocardial infarction (MI), another major diabetes complication. Methods: We conducted a longitudinal analysis of participants in the ARIC Study with diabetes and incident diabetic foot disease (N=749 hospitalizations, N=73 outpatient encounters) or incident MI (N=703). Diagnosis and procedure codes from active hospitalization surveillance and Medicare claims were used to identify events; only MI events were adjudicated. Self-rated health was collected during annual telephone calls and rated from 1 (poor) to 4 (excellent); a score of 0 was assigned to deaths. We used linear regression to examine changes in self-rated health from 1 year pre-event (baseline). Relative effects of index event type over time were estimated by repeated-measures ANOVA. Results: Self-rated health was similar between groups at baseline ( Figure ). Participants with MI had sharper declines from baseline at 1 year post-event than those with diabetic foot disease (-0.93 vs -0.50 points, P&lt;0.01), largely due to higher mortality (29.4% after MI vs 15.9% after diabetic foot disease). Self-rated health stabilized in the outpatient diabetic foot group after 2 years post-event, whereas it continued to decline over 10 years following both MI and inpatient diabetic foot disease ( Figure ). Conclusions: Our findings suggest outpatient diabetic foot disease is primarily associated with a short-term drop in self-rated health, but inpatient diabetic foot disease is associated with long-term declines in self-rated health similar to those experienced after MI. These results reinforce the importance of early diagnosis and treatment of foot disease and of including patient-reported outcomes to measure sequelae of diabetes complications.

Association between changed self-rated health and the risk of venous thromboembolism in Malmö Preventive Program: a cohort study.

Poor self-rated health (SRH) is associated with incident arterial cardiovascular disease in both sexes. Studies on the association between SRH and incident venous thromboembolism (VTE) show divergent results in women and no association in men. This study focuses on the association between change in SRH and incident VTE in a cohort of 11,558 men and 6682 women who underwent a baseline examination and assessment of SRH between 1974 and 1992 and a re-examination in 2002-2006. To investigate if changes in SRH over time affect the risk of incident VTE in men and women. During a follow-up time from the re-examination of more than 16years, there was a lower risk for incident VTE among women if SRH changed from poor at baseline to very good/excellent (HR 0.46, 95% CI 0.28; 0.74) at the re-examination. Stable good SRH (good to very good/excellent at the re-examination, HR 0.60, 95% CI 0.42; 0.89), or change from good SRH at baseline into poor/fair at the re-examination (HR 0.68, 95% CI 0.51; 0.90) were all significantly associated with a reduced risk for VTE. All comparisons were done with the group with stable poor SRH. This pattern was not found among men. Regardless of a decreased or increased SRH during life, having an SRH of very good/excellent at any time point seems to be associated with a decreased risk of VTE among women.

Do Health and Well-Being Change Around the Transition to Informal Caring in Early Adulthood? A Longitudinal Comparison Between the United Kingdom and Germany

PurposeProviding care in early adulthood may have long-term consequences, given the importance of this life stage for life-course transitions. This study aimed to analyze how the transition into caring during young adulthood (17–29 years old) influenced health and life satisfaction in the United Kingdom and Germany. MethodsDatasets were from 10 annual waves of the UK Household Longitudinal Study and the German Socioeconomic Panel between the years 2009–2018. We used propensity score matching to match young adult carers (YACs) to similar noncarers to address the endogeneity of unpaid care provision. Then we applied piecewise growth curves to observe changes in self-rated health (United Kingdom N = 2,851; Germany N = 454) and life satisfaction (United Kingdom N = 2,263; Germany N = 449) between YAC and noncarers before, during, and after the onset of care. We assessed carer status, weekly hours spent on care, and duration of care. ResultsIn the United Kingdom, life satisfaction decreased and the probability of reporting poor health increased after becoming a YAC, particularly for those who reported caring for more weekly hours. However, no such differences were found between YAC and noncarers in Germany. DiscussionThe onset and intensity of caring responsibilities during early adulthood influenced health and life satisfaction in the United Kingdom but not in Germany. One possible interpretation for these differences may be attributed to the different welfare contexts in which YACs are providing informal care. Our results highlight the importance of identifying and supporting the needs of young adults who are providing informal care while making key life-course transitions.

The Association Between Family Support and Changes in Self-Rated Health Among Chinese Older Adults: How Living Arrangements Moderate the Association?

ObjectivesThe study intends to investigate the association between family support and older adult health as well as the interaction between family support and living arrangements on their health. DesignCross-sectional study. Setting and ParticipantsSamples included in the final analysis (N = 11,430) come from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). MethodsMultiple logistic regression analysis was used to analyze the associations between family supports, multiplicative interaction of family supports and living arrangements, and self-rated health change. Subgroup analysis on disabled older adults was supplemented. ResultsOlder adult individuals who received functional support, provided financial support, and had frequent emotional communication with their children in the past year reported better self-rated health. Moreover, having frequent emotional communication with children could bring better self-rated health for the older adults living with spouses and children (ORbetter vs same = 2.765, P < .01) and empty nesters who lived without children (ORbetter vs same = 1.551, P < .05). Conclusions and ImplicationsOur findings imply that functional support and emotional support may play an increasingly important role in the health of Chinese older individuals. The interaction between emotional support and 2 living arrangements mentioned above is relevant to better health of older individuals. We advocate for culturally tailored Age-Friendly Communities augmenting the geriatric health care framework. While bolstering social support for seniors, prioritizing fundamental needs is paramount for those with disabilities.

CHANGES IN PHYSICAL ACTIVITY, SEDENTARY TIME, AND SELF-RATED HEALTH ACROSS THE RETIREMENT TRANSITION

Abstract The aim was to investigate concurrent changes in accelerometer-measured total physical activity (TPA), moderate-to-vigorous physical activity (MVPA) and sedentary time, and changes in self-rated health across the retirement transition. Data from two longitudinal studies was pooled: the Swedish Retirement Study (SRS) and the Finnish Retirement and Aging (FIREA) study that used similar methods. Data from three waves (each approximately 12 months apart) was included: one pre-retirement (wave 1, W-1) and two post-retirement follow-ups (W-2 and W-3). In total, 245 participants (27% men, mean age 64 years at W-1) were included. Thigh-worn accelerometers were used to collect data for TPA, MVPA and sedentary time at W-1 and W-2 and processed through ActiPASS and harmonized for time spent in different physical activity intensities. To be included in the analyses, a minimum of 4 days with at least 10 hours of accelerometer wear time during waking hours at both W-1 and W-2 was required. Questionnaires were used to collect data for self-rated health at W-1, W-2, and W-3. Ordinal regression models showed that 10 more minutes of MVPA at W-1 was significantly associated with higher odds of reporting better self-rated health at W-1 (OR: 1.12 [1.02-1.22]) in non-manual workers only. The association between MVPA and self-rated health was non-significant in the fully adjusted models. No significant associations were observed between changes in TPA, MVPA or sedentary time during retirement transition, and self-rated health at post-retirement follow-ups. In conclusion, this study showed a significant cross-sectional association between MVPA and better self-rated health before retirement.

The association between change and stability in subjective health ratings and dementia risk: a multi‐cohort study in Swedish and Danish twins

AbstractBackgroundPoorer self‐rated health (SRH) is associated with increased dementia risk (Stephan et al., 2021). However, it is unclear whether genetic and/or environmental variance accounts for this risk. Although SRH declines with age (Finkel et al. 2020), it is unknown whether rates of change in SRH are independently associated with dementia outcomes. Using a validated latent dementia index (LDI) (Beam et al., 2022), we tested whether stability and change components of SRH predicted LDI via genetic and environmental pathways in two international cohorts of twins.MethodOur data consisted of two samples of monozygotic (MZ) and dizygotic (DZ) twins. We used data from the Swedish Adoption Twin Study of Aging (SATSA; Ntwins = 548, Npairs = 339) and the Longitudinal Study of Aging Danish Twins (LSADT; Ntwins = 3238, Npairs = 2561). Bivariate Cholesky decompositions and three‐level growth‐curve models with predictive intercepts and slopes were used for our cross‐sectional and longitudinal analyses respectively. All models were estimated in Mplus (Muthen &amp; Muthen, 2017) using maximum likelihood with robust standard errors.ResultsCross‐sectional model results indicate that those with poorer SRH have lower LDI scores (b = ‐0.01, p = .008), even after adjusting for shared genetic covariance, age, sex, education, and depressive symptoms. Predictive growth models indicate that rates of change in SRH are negatively associated with LDI after adjusting for age, sex, education, and depressive symptoms (b = ‐0.17, p = .032). The degree of genetic confounding in the association between rates of change and LDI was inconclusive.ConclusionOur study provides novel insights into the relationship between individual ratings of health and dementia risk. SRH predicted dementia likelihood after controlling for genetic confounding, opening up the possibility that subjective ratings of health account for unique variance in dementia risk. Additionally, changes in SRH also predicted dementia likelihood beyond their mean score. Taken together these results highlight the importance of subjective health measures in understanding dementia risk.

Short-term impact of a neighbourhood-based intervention on mental health and self-rated health in Hamilton, Ontario, Canada.

The Hamilton Neighbourhoods Study aimed to measure the short-term impact of a neighbourhood-based intervention known as the City of Hamilton's Neighbourhood Action Strategy on health and neighbourhood outcomes. A quasi-experimental study with 881 intervention participants across six targeted neighbourhoods and 173 control participants was conducted to investigate changes in self-rated health and mental health from baseline to follow-up. There was evidence of small improvements in mental health in two neighbourhoods, but there was no change in self-rated health. Place-based interventions aimed at high poverty neighbourhoods may have only modest impacts on health in the short-term.

COVID-19 Infections, Pandemic-Related Social and Economic Impacts, and Changes to Mental and Self-Rated Health Among Latinx Immigrant Housecleaners in New York City: The Safe and Just Cleaners Study.

Objectives. To estimate impacts of COVID-19 infections and social and economic sequelae on mental and self-rated health among Latinx immigrant housecleaners in New York City. Methods. From March to June 2021, we conducted a follow-up study with 74% retention of 402 housecleaners initially surveyed before the pandemic between August 2019 and February 2020. We measured rates of self-reported COVID-19 infections, COVID-19 antibodies, and pandemic-related social and economic sequelae and examined predictors of mental and self-rated health changes using logistic regression models. Results. Fifty-three percent reported COVID-19 infections, consistent with the rate demonstrating COVID-19 antibodies. During shutdown of nonessential services, from March 22 to June 8, 2020, 29% worked as housecleaners, although this was not associated with higher COVID-19 infection rates. COVID-19-related stigma at work, lost earnings owing to COVID-19 infections, housing insecurity, food insecurity, and unsafe homes, including experiencing intimate partner verbal abuse, were statistically associated with changes in mental or self-rated health compared with prepandemic measures. Conclusions. The disproportionate impact and virtually nonexistent safety net housecleaners experienced during the first year of the pandemic highlight the importance of inclusive stopgap measures to mitigate economic insecurity and its sequelae. (Am J Public Health. 2023;113(8):893-903. https://doi.org/10.2105/AJPH.2023.307324).

Challenges Accessing Food, Water, Healthcare Services, and Medications During the COVID-19 Pandemic Among Adults in Puerto Rico and Their Association with Self-Rated Health: Assessments of PR-CEAL.

The COVID-19 pandemic created challenges in accessing food, water, medications, and healthcare services some of which are linked with lower self-rated health (SRH). These challenges have already been documented in the US, but it remains unknown how the pandemic affected access to food, water, medications and healthcare services, and how these challenges relate to SRH in this group, a population experiencing profound health disparities and limited resources prior to the pandemic. To assess associations between challenges accessing food, water, healthcare, and medications during the COVID-19 pandemic and SRHamong adults in Puerto Rico. Cross-sectional analysis of Puerto Rico-CEAL. Adults (>18 years; n=582) completed an online survey (December 30, 2021-February 8, 2022). Presence of each challenge during the past 30 days was measured and analyzed individually and combined (0, 1, >2). SRH (rated from poor-excellent) was measured before and at pandemic. Change in SRH was calculated. Adjusted Poisson models with robust variance errors estimated prevalence ratios (PR). Experiencing food, water, medication, and healthcare challenges (vs. not) were associated with pandemic fair-poor SRH (PR=1.44, 95%CI=1.06-1.97;PR=1.59, 95%CI=1.15-2.18;PR=1.38, 95%CI=1.05-1.81; and PR=1.56,95%CI=1.15-2.12, respectively). Experiencing 2+ challenges (vs. none) was associated with pandemic fair-poor SRH (PR=1.77, 95%CI=1.22-2.55). Additionally, experiencing food, medication, and healthcare challenges (vs. not) was associated with decreased SRH (PR=1.35, 95%CI=1.08-1.69;PR=1.24, 95%CI=1.01-1.51; and PR=1.25, 95%CI=1.01-1.54, respectively), as well as experiencing 2+ challenges (vs. none;PR =1.49, 95%CI=1.15-1.92). Challenges accessing food, water, medications, and healthcare services during the pandemic were associated with fair-poor SRH and decreased SRHin Puerto Rico. Public health policy should ensure access to basic needs.

Self-rated health among older adults in India: Gender specific findings from National Sample Survey.

The self-rated health (SRH) is a widely adopted indicator of overall health. The sponge hypothesis suggests that predictive power of SRH is stronger among women compared to men. To gain a better understanding of how gender influences SRH, this study examined whether and what determinants of gender disparity exist current self-rated health (SRHcurrent) and change in SRH (SRHchange) among older adults in Indian setting. We used cross-sectional data from the 75th National Sample Survey Organizations (NSSO), collected from July 2017 to June 2018. The analytical sample constitutes 42,759 older individuals aged 60 years or older with 21,902 older men and 20,857 older women (eliminating two non-binary individuals). Outcome measures include two variables of poor/worse SRH status (SRHcurrent and SRHchange). We have calculated absolute gaps in the prevalence of poor SRHcurrent and worse SRHchange by background characteristics. We carried out binary logistic regression models to examine the predictors of poor SRHcurrent and worse SRHchange among older adults. The overall absolute gender gap in poor SRHcurrent was 3.27% and it was 0.58% in worse SRHchange. Older women had significantly higher odds of poor SRHcurrent [AOR = 1.09; CI = 0.99, 1.19] and worse SRHchange [AOR = 1.09; CI = 1.02, 1.16] compared to older men. Older adults belonging to middle-aged, oldest-old, economically dependent, not working, physically immobile, suffering from chronic diseases, belonging to Muslim religion, and Eastern region have found to have higher odds of poor SRHcurrent and worse SRHchange. Educational attainments showed lower odds of have poor SRHcurrent and worse SRHchange compared to those with no education. Respondents belonging to richest income quintile and those who were not covered by any health insurance, belonging to Schedule caste, OBC, Western and Southern regions are found to have lower odds of poor SRHcurrent and worse SRHchange. Compared to those in the urban residence, respondents from rural residence [AOR = 1.09; CI = 1.02, 1.16] had higher odds of worse SRHchange. Supporting the sponge hypothesis, a clear gender gap was observed in poor current SRH and worse change in SRH among older adults in India with a female disadvantage. We further found lower socioeconomic and health conditions and lack of resources as determinants of poor current SRH and its worse change, which is crucial to address the challenge of the older people's health and their perception of well-being.

Polypharmacy and the Change of Self-Rated Health in Community-Dwelling Older Adults.

Polypharmacy is associated with poorer self-rated health (SRH). However, whether polypharmacy has an impact on the SRH progression is unknown. This study investigates the association of polypharmacy with SRH change in 1428 participants of the Berlin Initiative Study aged 70 years and older over four years. Polypharmacy was defined as the intake of ≥5 medications. Descriptive statistics of SRH-change categories stratified by polypharmacy status were reported. The association of polypharmacy with being in SRH change categories was assessed using multinomial regression analysis. At baseline, mean age was 79.1 (6.1) years, 54.0% were females, and prevalence of polypharmacy was 47.1%. Participants with polypharmacy were older and had more comorbidities compared to those without polypharmacy. Over four years, five SRH-change categories were identified. After covariate adjustment, individuals with polypharmacy had higher odds of being in the stable moderate category (OR 3.55; 95% CI [2.43-5.20]), stable low category (OR 3.32; 95% CI [1.65-6.70]), decline category (OR 1.87; 95% CI [1.34-2.62]), and improvement category (OR 2.01; [1.33-3.05]) compared to being in the stable high category independent of the number of comorbidities. Reducing polypharmacy could be an impactful strategy to foster favorable SRH progression in old age.

Does the association between religiosity, spirituality and self-rated health change with religious affiliations? Evidence from an Indian large-scale survey

ABSTRACT The rapid growth of the elderly in India has raised research questions about their quality of life, health, and social support. The current study aims to understand the factors influencing older adults’ self-rated health (SRH), focusing on religiosity and spirituality in India. The present study used data from India’s Longitudinal Ageing Study’s first wave (LASI), 2017–18. The levels of poor SRH decreased with an increasing degree of religious and spiritual participation. In the present study, religious attendance was a significant predictor of SRH among Christians, Muslims, and Hindus. Spirituality was found to be a significant predictor of SRH only among Hindus. Besides [prayer, participation in religious services and mediation], age, sex, place of residence, level of education, daily living activities, and chronic illness status were significant predictors of SRH. The current study also showed that older people have a significantly high incidence of poor SRH, regardless of their spiritual and religious backgrounds. There is a need to focus on elderly-friendly health and social care policies and programs considering socio-cultural aspects to minimize the burden of poor SRH.

Perceived Racism and Health Among Black Americans: The Role of Racial Identity as a Moderator Over Time

Perceived racism is an important health stressor, but few studies explore resources that moderate the association between perceived racism and health over time. Most previous research models racial identity as a main effect and its moderating potential remains unclear. In this study, I use the Stress Process Model to test whether racial identity moderates the association between perceived racism and changes in self-rated health among Black Americans. Data from the American Changing Lives study are used to test this research question ( n = 388). Strength of racial identity moderates the association between perceived racism and changes in self-rated health. A strong racial identity buffers the relationship between perceived racism and health for low levels of racism. However, a strong racial identity exacerbates this association for those experiencing high levels of racism. These findings suggest that racial identity may be a protective factor, but it does not buffer against chronic exposure to racism. This study contributes to the existing literature by highlighting that whether racial identity is health-protective against perceived racism depends on the level of perceived racism Black Americans experience. Future studies should continue investigating the conditions under which racial identity buffers the perceived racism-health association.

Neighbourhood transportation, elapsed years, and well-being after surrendering the driver's licence in older Japanese adults: The JAGES longitudinal study

This study aimed to examine how the associations between surrendering driving licence and changes in self-rated health and social interactions among older adults differ by the years elapsed since surrendering and the number of public transportation systems (PTS) in the neighbourhood. We used the 2013 and 2016 survey data from the Japan Gerontological Evaluation Study targeting residents aged ≥65 years in 30 municipalities in Japan. Two-waves longitudinal data from 4894 older adults were evaluated. Based on the difference-in-differences method, the interaction terms of respondents’ driving status, which was the categorical exposure variable representing respondents’ driving status for three years during the study period, and a dummy variable of year (2016) were used as explanatory variables in logistic regression analyses to examine changes in outcomes (poor self-rated health and infrequent meeting with friends) between 2013 and 2016 by driving status during this period. Analyses were stratified based on neighbourhood PTS (‘more PTS’ and ‘fewer PTS’ groups). We found that, while surrendering licence within three years was associated with increased probability of poor self-rated health in more PTS group, the confidence interval was large. Although surrendering licence within three years was associated with decreased social interactions, this association weakened if licence was surrendered more than three years ago. These associations were not markedly affected by neighbourhood PTS. Our findings suggested that, regardless of neighbourhood PTS, support and care to promote social interactions at or shortly after surrendering licence may be beneficial to the well-being of older adults who lost their driving licence.