Fair Health Status Research Articles

Racial Disparities in Foot Examination among People with Diabetes in Brazil: A Nationwide Survey, 2019.

To assess the absence of diabetic foot examination in Brazil and how ethnicity affected this outcome. This is an analysis of a nationwide survey held in Brazil in 2019. Participants with diabetes and that were 15 years of age or older were eligible for inclusion in the analysis. Adjusted Poisson regression with robust variance was used to calculate prevalence ratios (PRs) and 95% confidence intervals (95% CIs) of never having had the foot examined, with separate models according to ethnicity. Stata 14.2 was used for all calculations. We included 6216 individuals with diabetes; 52.1% (95%CI: 50.0%-54.2%) reported never having had their feet examined by a health care professional and 61% self-declared as Black (Black and Brown [Brazilian mixed race]). A higher frequency of negligence was observed among Black individuals (55.3%; 52.5%-58.1%) than among White individuals (48.2%; 45.0%-51.5%). Negligence was higher between 15- to 39-year-old participants (PR = 1.34, 1.14-1.57), lower educational level (PR = 1.37, 1.13-1.65), higher alcohol consumption (PR = 1.18, 1.06-1.31), fair health status (PR = 1.11, 1.01-1.21), and diabetes diagnosis of up to 10 years (PR = 1.42, 1.28-1.57). Among Blacks, tobacco use and other factors increased the frequency of the outcome, whereas participation in the Brazilian Unified Health System primary care program was a protection factor (P<.05). Black Brazilians with diabetes had higher negligence of foot examination by health care professionals. Strengthening primary care would help mitigate systemic racism in Brazil.

Exploring the Relationship between Health Literacy and Depression among Individuals with Chronic Conditions: Insights from the KCHS.

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a sample of 77,133 subjects primarily dealing with hypertension and diabetes, the study employed various analytical tools to identify factors associated with an increased risk of depression. Results: These factors included marital status (OR 1.47, 95% CI 1.40-1.54), residential district (OR 1.43, 95% CI 1.39-1.50), unemployment (OR 1.47, 95% CI 1.41-1.54), enrollment in the national basic living security program (OR 1.50, 95% CI 1.40-1.62), unmet healthcare needs (OR 2.32, 95% CI 2.14-2.51), fair subjective health status (OR 1.74, 95% CI 1.63-1.90), poor subjective health status (OR 4.33, 95% CI 4.05-4.63), and stress (OR 4.56, 95% CI 4.36-4.77). Notably, individuals with higher health literacy showed a significantly lower susceptibility to depression (OR 0.74, 95% CI 0.68-0.75), underscoring the importance of health literacy as a critical factor in mental health outcomes. Conclusions: Such initiatives could serve as effective preventive measures against depression in this vulnerable population.

Can the return of rural labor improve the physical health of left-behind parents-evidence from rural China.

Objectively In objective terms, the return of rural labor force shortens the spatial distance with parents, leading to changes in caregiving support, emotional support, and financial support for parents, thereby affecting the health status of parents. This article, using data from the Chinese Family Panel Studies, analyzes the characteristics of the health status of parents with and without returning migrant children. By employing multiple linear regression models, PSM models, and IV-2SLS methods to address endogeneity bias, the study preliminarily explores the impact of rural labor force return on parental health. The results show that: (1) among the 5,760 older adult individuals, 1866 of them have returning migrant chil-dren, while the remaining 3,894 do not have returning migrant children. (2) Parents' health status generally follows a normal distribution, with a small proportion of parents having very poor or very good health. The proportions of parents with relatively poor, fair, and relatively good health status range between 20 and 40%. Among parents with returning chil-dren, 40.12% have relatively poor health status, 45.01% have fair health status, and a small proportion have very poor or very good health status. In contrast, among parents without returning children, the proportions of parents with relatively poor, fair, and rela-tively good health status are 21.69, 33.21, and 38.45%, respectively. When parents tran-sition from not having returning children to having returning children, their health status decreases by 0.541 levels, indicating a negative impact of rural labor force return on par-ents' health. Based on the analysis results, this article provides policy recommendations from three aspects: how to increase the income of returning labor force, improve the rural pension system, and enhance the concept of children supporting their parents.

Health Status and Mental Health of Transgender and Gender-Diverse Adults

This cross-sectional study examines self-reported poor or fair health status, frequent mental distress, and depression among transgender and gender-diverse respondents compared with cisgender respondents to the 2014 to 2022 Behavioral Risk Factor Surveillance System.

How rural is All of Us? Comparing characteristics of rural participants in the National Institute of Health's All of Us Research Program to other national data sources.

The National Institute of Health's All of Us Research Program represents a national effort to develop a database to advance health research, especially among individuals historically underrepresented in research, including rural populations. The purpose of this study was to describe the rural populations identified in the All of Us Research Program using the only proxy measure currently available in the dataset. Currently, the All of Us Research Program provides a proxy measure of rurality that identifies participants who self-reported delaying care due to far travel distances associated with living in rural areas. Using the All of Us Controlled Tier Dataset v6, we compared sociodemographic and health characteristics of All of Us rural participants identified via this proxy to rural US residents from nationally representative data sources using chi-squared tests. 3.1% of 160,880 All of Us participants were rural, compared to 15%-20% of US residents based on commonly accepted rural definitions. Proportionally more rural All of Us participants reported fair or poor health status, history of cancer, and history of heart disease (P<.01). The All of Us measure may capture a subset of underserved participants who live in rural areas and experience health care access barriers due to distance. Researchers who use this proxy measure to characterize rurality should interpret their findings with caution due to differences in population and health characteristics using this proxy measure rural compared to other commonly used rural definitions.

Nutritional and Lifestyle Features in a Mediterranean Cohort: An Epidemiological Instrument for Categorizing Metabotypes Based on a Computational Algorithm.

Background and Objectives: Modern classification and categorization of individuals' health requires personalized variables such as nutrition, physical activity, lifestyle, and medical data through advanced analysis and clustering methods involving machine learning tools. The objective of this project was to categorize Mediterranean dwellers' health factors and design metabotypes to provide personalized well-being in order to develop professional implementation tools in addition to characterizing nutritional and lifestyle features in such populations. Materials and Methods: A two-phase observational study was conducted by the Pharmacists Council to identify Spanish nutritional and lifestyle characteristics. Adults over 18 years of age completed questionnaires on general lifestyle habits, dietary patterns (FFQ, MEDAS-17 p), physical activity (IPAQ), quality of life (SF-12), and validated well-being indices (LS7, MEDLIFE, HHS, MHL). Subsequently, exploratory factor, clustering, and random forest analysis methods were conducted to objectively define the metabotypes considering population determinants. Results: A total of 46.4% of the sample (n = 5496) had moderate-to-high adherence to the Mediterranean diet (>8 points), while 71% of the participants declared that they had moderate physical activity. Almost half of the volunteers had a good self-perception of health (49.9%). Regarding lifestyle index, population LS7 showed a fair cardiovascular health status (7.9 ± 1.7), as well as moderate quality of life by MEDLIFE (9.3 ± 2.6) and MHL scores (2.4 ± 0.8). In addition, five metabotype models were developed based on 26 variables: Westernized Millennial (28.6%), healthy (25.1%), active Mediterranean (16.5%), dysmetabolic/pre-morbid (11.5%), and metabolically vulnerable/pro-morbid (18.3%). Conclusions: The support of tools related to precision nutrition and lifestyle integrates well-being characteristics and contributes to reducing the impact of unhealthy lifestyle habits with practical implications for primary care. Combining lifestyle, metabolic, and quality of life traits will facilitate personalized precision interventions and the implementation of targeted public health policies.

Sociodemographic and Temporal Differences in Menthol Cigarette Use Among US Adults Who Smoke, 1999-2018.

Monitoring menthol cigarette use allows for identification of potential health disparities. We examined sociodemographic and temporal differences in menthol cigarette use among US adults who smoke. We analyzed data from the 1999-2018 National Health and Nutrition Examination Survey for adults aged 20 years or older who smoke (N = 11,431) using binary logistic regression. Among US adults who smoke, 28.8% used menthol cigarettes. After adjusting for age, sex, race and ethnicity, education, income-to-poverty ratio, and health status, the prevalence of menthol use among adults who smoke increased on average by 3.8% (95% CI, 2.7%-4.9%) annually. Non-Hispanic Black adults had the highest average prevalence of menthol cigarette use, 73.0% (95% CI, 70.9%-75.2%), and Mexican American adults had higher average annual increase in menthol cigarette use, 7.1% (95% CI, 4.0%-10.3%). Adults with fair or poor health status had a 4.3% annual increase in menthol cigarette use (95% CI, 2.5%-6.1%). The adjusted prevalence ratios of menthol cigarette use were 1.61 (95% CI, 1.39-1.83) for adults aged 20-29 years compared with those aged 65 years or older, 1.41 (95% CI, 1.32-1.49) for female adults compared with male adults, and 1.17 (95% CI, 1.07-1.27) for high school graduates or higher compared with those with no high school diploma. Non-Hispanic Black adults who smoke had the highest prevalence of menthol cigarette use among all racial and ethnic groups; the prevalence of menthol cigarette use among adults who smoke increased especially among Mexican American adults, younger adults, and adults who reported fair to poor health status.

Abstract 825: Adverse childhood experiences and history of depression among cancer survivors

Abstract Introduction: Adverse Childhood Experiences (ACEs) are stressful life events that are associated with an increased risk of depression. Depression is experienced by 25% of cancer survivors in the US. While previous studies have examined the associations between ACEs and depression in the general population, studies on cancer survivors are lacking. We aimed to examine the predictors of depression with a primary focus on ACEs among cancer survivors. Methods: Using a cross-sectional data from the 2020 Behavioral Risk Factor Surveillance System for 19,241 cancer survivors aged 18 and above, we categorized ACEs based on severity. The ACE categories (zero, one, two-three, ≥four) included questions assessing exposure to eight types of ACEs before age 18 years. The outcome is self-reported history of depression diagnosis (yes/no). Weighted multivariable logistic regression models estimated odds of depression by ACEs as the primary variable and covariates were age, gender, smoking status, income, education, marital status, body mass index, health status and race. Results: In this sample of cancer survivors, 41%, 22%, 21% and 16% reported having experienced zero, one, two-three, and &amp;gt;4 ACEs respectively. Personal history of depression was reported by 21% of survey respondents. In the adjusted model, survivors with 1 ACE (aOR: 1.6, 95% CI. 1.2- 2.0), 2-3 ACEs (aOR: 1.7, 95% CI. 1.3- 2.1), or &amp;gt;=4 ACES (aOR: 4.4, 95% CI. 3.4- 5.7) had higher odds of depression compared with those with zero ACEs. Additional notable predictors of higher odds of depression are younger age, 18-39 (aOR: 2.7, 95% CI. 1.8- 4.0), middle age, 40-64 (aOR: 1.6, 95% CI. 1.3- 1.9) compared with those aged 65 and older; females (aOR: 2.1, 95% CI. 1.7- 2.5) compared with males; obese respondents (aOR: 1.5, 95% CI. 1.2- 1.9) compared with respondents with normal body mass index; current smokers (aOR: 1.5, 95% CI. 1.2- 2.0) compared with respondents who never smoked; and poor or fair health status (aOR: 3.2, 95% CI. 2.6- 3.9) compared with respondents with excellent/good health status. Conclusion: Adult cancer survivors who experience ACEs as children represent an important targeted prevention group to reduce risk of depression. Variation by age, obesity, female gender, current smoking status, and poor health associated factors that may reduce the risk of depression warrants additional studies regarding potential for identification of resilient factors; and this may inform future selective prevention strategies, as well as identify a pathway between ACE and depression among cancer survivors. Citation Format: Oluwole Adeyemi Babatunde, Vince Collucielli, Melanie S. Jefferson, Swann Arp Adams, Chanita Hughes Halbert, Jessica Obeysekare, Frank Clark, Anusuiya Nagar, Nosayaba Osazuwa-Peters, Eric Adjei Boakye. Adverse childhood experiences and history of depression among cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 825.

A latent profile analysis of doctors' joy in work at public hospitals.

When doctors' work stress increases, their joy in work decreases, severely affecting the quality of care and threatening patient safety. Analysis of the latent categories of joy in work of doctors in public hospitals and the differences in the characteristics of each category can help uncover hidden messages that enhance doctors' joy in work. Questionnaires were administered to 426 doctors working in public hospitals using the general information questionnaire and the public hospital doctor's joy in work evaluation scale. Upon identifying their potential categories using latent profile analysis, chi-square test, and multinomial logistic regression were performed to analyze the differences in the characteristics of each category. The 426 public hospital doctors could be divided into three potential categories: "low joy in work" (11.27%), "medium joy in work" (59.86%), and "high joy in work" (28.87%). Most of the doctors did not have much joy in work, with 71.13% of them having "low to medium joy in work." Doctors who work in secondary or tertiary hospitals, have a personnel agency or contract, and are older than 45 years are more likely to belong to the "low joy in work" category. Some of the protective factors are having an average monthly income (RMB) of 10,001-15,000 yuan and having a fair or good self-rated health status. There are obvious classification characteristics of doctors' level of joy in work. Hospital managers can take commensurate actions to improve their joy in work, thereby improving patient safety and the quality of medical services.

Racial and ethnic disparities in self-reported general and mental health status among colorectal cancer survivors: impact of sociodemographic factors and implications for mortality—a SEER-CAHPS study

PurposePatient-reported outcomes are recognized as strong predictors of cancer prognosis. This study examines racial and ethnic differences in self-reported general health status (GHS) and mental health status (MHS) among patients with colorectal cancer (CRC).MethodsA retrospective analysis of Medicare beneficiaries between 1998 and 2011 with non-distant CRC who underwent curative resection and completed a Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey within 6–36 months of CRC diagnosis. Analysis included a stepwise logistic regression to examine the relationship between race and ethnicity and fair or poor health status, and a proportional hazards model to determine the mortality risk associated with fair or poor health status.ResultsOf 1867 patients, Non-Hispanic Black (OR 1.56, 95% CI 1.06–2.28) and Hispanic (OR 1.48, 95% CI 1.04–2.11) patients had higher unadjusted odds for fair or poor GHS compared to Non-Hispanic White patients, also Hispanic patients had higher unadjusted odds for fair or poor MHS (OR 1.92, 95% CI 1.23–3.01). These relationships persisted after adjusting for clinical factors but were attenuated after subsequently adjusting for sociodemographic factors. Compared to those reporting good to excellent health status, patients reporting fair or poor GHS or MHS had an increased mortality risk (OR 1.52, 95% CI 1.31–1.76 and OR 1.63, 95% CI 1.34–1.99, respectively).ConclusionRacial and ethnic differences in GHS and MHS reported after CRC diagnosis are mainly driven by sociodemographic factors and reflect a higher risk of mortality. Identifying unmet biopsychosocial needs is necessary to promote equitable care.

The impact of dentition status and barriers to dental care services on perceived oral health of medicare beneficiaries.

To examine the association among barriers to dental care services, dentition groups, and self-reported oral health status for Medicare beneficiaries. We used data from the 2017 to 2018 National Health and Nutrition Examination Survey (NHANES), which included participants aged ≥65 years who were enrolled in Medicare and had completed the oral health exam. We created a dentition group variable using the detailed dental examination data to account for the presence of natural, replaced, removable, or missing teeth. Through bivariate and logistic analyses, we explored the relationship between barriers to receiving dental care services, dentition groups, and reported oral and general health statuses, along with other control variables. For the total Medicare population as well as in the four subgroup analyses, we showed that those with barriers to dental care services were more likely to report fair or poor oral health status. Those who were edentulous, had complete dentures, or had less than a full mouth of teeth had greater barriers and worse oral and general health than did those with all-natural teeth. Among those who reported fair or poor general health, those with less than a full mouth of teeth showed similar levels of barriers to dental care services and worse perceived oral health than did those without any teeth. Helping the 65 years and older population retain their teeth in good condition will improve their overall health. Investment in oral hygiene and health for the current and future Medicare populations could improve their overall health.

A comparison of quality of life between older adults living in high and low altitude areas.

High altitude is known to have a significant impact on human physiology and health, therefore, understanding its relationship with quality of life is an important research area. This study compared the quality of life (QOL) in older adults living in high and low altitude areas, and examined the independent correlates of QOL in those living in a high altitude area. Older adults living in three public nursing homes in Xining (high altitude area) and one public nursing home in Guangzhou (low altitude area) were recruited. The WHOQOL-BREF was used to measure the QOL. 644 older adults (male: 39.1%) were included, with 207 living in high altitude and 437 living in low altitude areas. After controlling for the covariates, older adults living in the high altitude area had higher QOL in terms of physical (P = 0.035) and social domains (P = 0.002), but had lower QOL in psychological (P = 0.009) domain compared to their counterparts living in the low altitude area. For older adults living in the high altitude area, smoking status was associated with higher social QOL (P = 0.021), good financial status was associated with higher physical QOL (P = 0.035), and fair or good health status was associated with higher physical (p < 0.001) and psychological QOL (P = 0.046), while more severe depressive symptoms were associated with lower QOL. Appropriate interventions and support to improve depressive symptoms and both financial and health status should be developed for older adults living in high altitude areas to improve their QOL.

Morbidity profile and physical health status of orphans and vulnerable children in selected orphanages in Ibadan, Nigeria

Background: Orphans and vulnerable children (OVC) are prone to poor health outcomes when compared to other children in society. Aims: This study assessed the morbidity profile and physical health status of OVC in orphanages. Methods: A descriptive cross-sectional design was employed and multistage sampling technique was used to select 384 OVC from the orphanages. A structured questionnaire was used to collect data on morbidity profile while a head-to-toe assessment checklist and the body mass index (BMI) were used to assess their physical health status. Analysis was done using descriptive and inferential statistics at a significant level of 0.05. Results: Results showed that the most prevalent health problems experienced by OVC were headaches, respiratory infections, and malaria. The study further revealed that 44.8%, 29.9% and 25.3% of respondents had respectively fair, poor and good physical health. Conclusions: A substantial proportion of OVC have a fair and poor physical health status and the majority are underweight.

Baseline Health Status and its Association With Subsequent Cardiovascular Events in Patients With Atrial Fibrillation

BackgroundClinical practice guidelines recommend optimizing the health status of patients with atrial fibrillation (AF) as a primary treatment goal. Whether disease-specific health status is associated with subsequent clinical events is unknown. ObjectivesThe aim of this study was to investigate the association between health status and subsequent clinical events among patients with AF. MethodsUsing a prospective cohort study of patients with new-onset AF referred to 11 hospitals (n = 3,313, 68.4% men, mean age 67.8 ± 11.6 years), data were extracted from 3,296 patients (99.4%) who completed the disease-specific Atrial Fibrillation Effects on Quality-of-Life (AFEQT) questionnaire between 2012 and 2018. Factors associated with baseline AFEQT overall summary (OS) score and associations between major adverse cardiovascular or neurologic events (MACNE; a composite of all-cause death, stroke, or new-onset heart failure hospitalization) over 2 years were investigated. ResultsOverall, 517 participants (15.6%) had poor to fair health status (AFEQT OS <60), and 1,035 (31.2%) had fair to good health status (AFEQT OS 60 to <80) at baseline. Female sex, younger age, family history of AF, higher baseline heart rate, paroxysmal AF, initial visit to the emergency department, and history of heart failure were associated with lower AFEQT OS scores. Of those, 226 participants (6.8%) experienced MACNE; restricted cubic spline analysis with adjustment for factors associated with baseline AFEQT score showed a nonlinear increase in the risk for MACNE with AFEQT OS score <80. The strongest associations were observed for baseline AFEQT daily activity scores (for AFEQT daily activity score of <80 vs ≥80, HR: 1.65; 95% CI: 1.21-2.25). ConclusionsDiminished health status in patients with AF is common and is independently associated with subsequent adverse cardiovascular events.

Mental wellbeing of frontline health workers post-pandemic: lessons learned and a way forward.

To assess the state of mental wellbeing among medical and dental frontline health workers as the COVID-19 pandemic transitions to an endemic phase and to determine what employer-provided intervention strategies these workers perceive as effective and desirable to improve their mental wellbeing. An anonymous online survey distributed to frontline health workers in a hospitalist program of a tertiary care medical center and a university dental school in Minnesota in September 2022. The survey contained validated tools to measure depression severity, levels of perceived stress, and mental health status as well as questions to determine effective strategies to improve emotional wellbeing among these health workers. Data was evaluated on an aggregate level as well as stratified by level (e.g., physician, staff) and field (e.g., medicine, dentistry). On average, all groups of health workers suffered from moderate to moderately severe depression, had a much higher perceived stress level than average, and had a fair mental health status. There were no significant differences in depression severity, stress level, or mental health status among physicians, dentists, medical staff, and dental staff. The majority of the respondents perceived adjusted work hours, rewards and incentives, and teamwork as the most effective and desirable strategies to improve their mental wellbeing. The current mental wellbeing of frontline health workers is poor. Many are dissatisfied with healthcare and consider leaving the industry. To improve their employees' mental wellbeing, healthcare employers might want to consider adjusted work hours, rewards, and teamwork as these intervention strategies are perceived as most effective and desirable by the intended recipients.

Perceived Life Expectancy Among Dialysis Recipients: A Scoping Review

Greater prognostic understanding is associated with higher quality care at the end of life. We undertook a scoping review to explore how long dialysis recipients expect to live. Scoping Review. People with kidney failure over 18 years old. Studies were identified by searching Medline, Embase, APA PsycINFO, HMIC, and ProQuest database for terms related to "life expectancy", "self-estimated", and "end stage kidney disease". Search strategies reported 349 unique, potentially eligible studies, with 8 studies meeting the inclusion criteria after screening. Significant mismatches between dialysis recipients and their health care provider's estimations of prognosis were reported, with patients predicting significantly higher life expectancies than health care professionals and almost no agreement between patient and nephrologist's estimates of 1-year survival. Documented cognitive impairment did not affect 1-year or 5-year prognosis estimates, nor did gender, age, time on dialysis, or discussing perceived life expectancy. Dialysis recipients who thought they were on the transplant list or who self-identified as African American reported higher perceived life expectancy, whereas people who were 75 years or older, or with fair or poor self-reported health status reported a lower perceived life expectancy. Those with a lower perceived life expectancy preferred care focusing on relieving pain and discomfort, whereas people who thought they had a higher chance of survival were significantly more likely to prefer life-extending care. There is a marked paucity of research in this area, with most studies conducted in North American cohorts. Optimistic patient prognostic expectations persist in dialysis recipients. Given the effects of perceived life expectancy on treatment choices and subsequent quality of life, it is important that transparent discussions regarding prognosis are conducted with people receiving dialysis and their families. Understanding illness severity and prognosis allows people to make decisions and prioritize areas of their lives that are important to them. We undertook a scoping review to explore how long dialysis recipients expect to live. We found significant mismatches between the perceived life expectancy of people treated with dialysis and their health care providers. Perceived life expectancy influenced treatment choices; thus, those who thought they would die sooner prioritized care focusing on relieving pain and discomfort. Those who thought they had a higher chance of survival were more likely to prefer life-extending care (with potential effects on quality of life). It is important to have frank discussions about prognosis with people receiving dialysis, to empower individuals and help them make informed decisions about their care.

Influence of cognitive function and social support on health-related quality of life of elderly men in partial medically underserved rural areas: A cross-sectional study

Purpose: This study aimed to identify factors influencing the health-related quality of life of elderly men in partial medically underserved rural areas. Methods: The subjects included 182 elderly men aged 65 or older living in the jurisdictions of the Health Care Centers in G, I, and J Myeon, which were medically underserved rural areas in Gongju City, South Korea. Data were collected on October 31 to November 1, 2020, and were analyzed with descriptive statistics, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical linear regression. Results: The subjects’ scored mean 24.20±3.29 points out of 30 in cognitive functions and mean 17.08±9.40 out of 60 in social support. The influential factors included three chronic diseases (β=-.50, p&lt;.001), two chronic diseases (β=-.30, p&lt;.001), one chronic disease (β=-.21, p&lt;.001); fair subjective health status (β=.24, p&lt;.001); good subjective health status (β=.25, p&lt;.001); cognitive functions (β=.17, p=.004); aged 80 or older (β=-.16, p=.006); and brushing teeth three times per day or more (β=.14, p=.009) with an explanatory power of 53.8%. Conclusion: It is necessary to develop chronic disease management and cognitive function enhancement programs to identify factors influencing the health-related quality of life of elderly men in partial medically underserved rural areas and thus improve their health-related quality of life.

Early life factors associated with the experiences of pain in later life: evidence from a population based study in India

BackgroundThe influence of early life factors is becoming increasingly apparent as studies investigate how experiences, resources, and constraints in childhood affect health and well-being later in life. The present study contributes to this literature by examining the association between several early life factors and self-reported pain among older adults in India.MethodsData come from the 2017-18 wave 1 of the Longitudinal Ageing Study of India (LASI). The sample size includes 28,050 older adults aged 60 and above (13,509 men and 14,541 women). Pain is a self-reported, dichotomous measure where participants responded to whether they were often troubled with pain and whether this experience interfered with their ability to carry out daily household chores. Early life factors, which are retrospective accounts of experiences, included the respondent’s position in birth order, their health status, school absenteeism, being bedridden, family socioeconomic status (SES), and their parent’s experience with chronic disease. Logistic regression analysis is employed to examine the unadjusted and adjusted average marginal effects (AME) of selected domains of early life factors associated with the probability of experiencing pain.Results22.8% of men and 32.3% of women reported pain that interfered with daily activities. Pain was higher among men (AME: 0.01, confidence interval (CI): 0.01–0.03) and women (AME: 0.02, CI: 0.01–0.04) with third or fourth birth order compared to counterparts with first birth order. Both men (AME: -0.02, CI: -0.04–0.01) and women (AME: -0.07, CI: -0.09 - -0.04) having a fair childhood health status reported a lower probability of pain. The probability of pain was higher among both men (AME: 0.03, CI: 0.01–0.07) and women (AME: 0.07, CI: 0.03–0.13) who were bedridden due to sickness in their childhood. Similarly, the pain likelihood was higher among men who missed school for more than a month due to health problems (AME: 0.04, CI: -0.01-0.09). Men and women with poor financial condition in their childhood reported (AME: 0.04, CI: 0.01–0.07) a higher probability of experiencing pain relative to their peers who reported a more financially advantaged early life.ConclusionsFindings of the present study add to the empirical literature on the association between early life factors and later life health and well-being. They also are pertinent to health care providers and practitioners working in pain management, as this knowledge better positions them to identify older adults most susceptible to pain. Moreover, findings of our study underscore that the interventions to ensure health and well-being in later life must start far earlier in the life course.

Factors associated with the incidence and the expenditure of self-medication among middle-aged and older adults in China: A cross-sectional study.

With the accelerated ageing of population and the growing prevalence of various chronic diseases in China, self-medication plays an increasingly important role in complementing the health care system due to its convenience and economy. This study aimed to investigate the incidence of self-medication and the amount of self-medication expenditure among middle-aged and older adults in China, and to explore factors associated with them. A total of 10,841 respondents aged 45 years and older from the China Health and Retirement Longitudinal Study (CHARLS) wave 4 which conducted in 2018 were included as the sample of this study. The two-part model was adopted to identify the association between the incidence of self-medication and the amount of self-medication expenditure and specific factors, respectively. The incidence of self-medication among Chinese middle-aged and older adults was 62.30%, and the average total and out-of-pocket (OOP) pharmaceutical expenditure of self-medication of the self-medicated individuals were 290.50 and 264.38 Chinese yuan (CNY) respectively. Participants who took traditional Chinese medicine (TCM), self-reported fair, and poor health status, suffered from one and multiple chronic diseases had strongly higher incidence of self-medication. Older age and multiple chronic diseases were strongly associated with higher expenditure of self-medication. Those who took TCM had more self-medication expenditure, while those who drank alcohol had less. Our study demonstrated the great prevalence of self-medication among middle-aged and older adults in China and the large pharmaceutical expenditure that come with it, especially in the high-risk groups of self-medication identified in this paper. These findings enhanced our understanding of self-medication behaviors among Chinese middle-aged and older adults and may contribute to the formulation of targeted public health policy.

Mental Health and Quality of Life During the COVID-19 Pandemic Among Local Residents in San Isidro, Bohol

The COVID-19 pandemic is a global pandemic that affects the mental health and quality of life of many people. This study aimed to determine the mental health and quality of life during the COVID-19 pandemic among residents in San Isidro, Bohol, as of Calendar Year 2022, and the study’s findings will serve as the basis for the formulation of the proposed intervention program. The study used the quantitative descriptive survey method of research utilizing survey questionnaires that measured residents' profiles, mental health, and quality of life. The resident’s profile questionnaire measures the age, sex, civil status, highest educational attainment, and employment status. To measure the residents' mental health, the study used the stress-allied queries designed by Meo et al., the COVID-19 worry scale designed by Oli Ahmed, and the WHO Quality of Life Scale to measure the quality of life. The study found that the respondents possessed a fair mental health status, and their quality of life was interpreted as good. There was a significant degree of relationship between the mental health status and the respondents’ quality of life. It implies that the mental health status of the residents during the COVID-19 pandemic also affects the respondents’ quality of life.