Self-assessed Physical Health Research Articles

A longitudinal perspective to migrant health: Unpacking the immigrant health paradox in Germany

Previous research finds that recent immigrants are healthier than the native-born, while more established immigrants exhibit worse health, suggesting a process of unhealthy assimilation. However, previous literature is mostly based on cross-sectional data or on longitudinal analyses similarly failing to disentangle individual-level variation from between-individual confounding. Moreover, previous longitudinal studies are often limited in their study of different health outcomes (few and mostly subjective health), populations (sometimes only elderly individuals), time periods (short panels) and geographical contexts (mostly Australia, Canada and USA). We address these limitations by comparing the health trajectories of adult immigrants and natives in Germany over extended periods, using data from years 2002–2021 of the German Socio-Economic Panel (SOEP), and investigating a wide range of health outcomes, including self-assessed physical and mental health measures, diagnosed illnesses, and health behaviors. We employ a longitudinal approach that stratifies immigrants by age at arrival, and compares them to natives of the same age. This allows us to estimate both Hierarchical Linear Models and more rigorous Fixed Effects models to further address confounding. Cross-sectionally, we confirm previous literature's findings: recent immigrants are healthier than natives and established immigrants. Longitudinally, we find support for the unhealthy assimilation hypothesis concerning subjective health and mental health, but not for the others health indicators or behaviors. We interpret these findings as possible evidence of immigrants' reduced access to timely health care and emphasize the need for greater longitudinal research investigating migrant gaps in various health outcomes.

Research on the Evaluation and Enhancement Strategies of College Students’ Health Human Capital in “Healthy Hunan” under the Background of Big Data

Abstract This paper precisely explores the structure and characteristics of college students’ healthy human capital and its influencing factors. It aims to enhance students’ positive and healthy mindset and promote optimism in life and learning. A solid analytical framework is constructed by sorting out the ordered multicategorical logistic regression model and parameter estimation methods and the application steps of the propensity score matching model. College students from ten colleges and universities in Hunan Province were selected as research subjects, and a questionnaire was designed to assess their healthy human capital. The specific factors affecting college students’ healthy human capital accumulation were analyzed in depth through the probability density analysis of propensity score matching, standard support hypothesis testing, and the parallel line test and regression results of the ordered multicategorical regression model. The findings show that the curves of the experimental and control groups after propensity score matching almost overlap in the [0.2,0.4] interval, indicating the method’s validity. A more important finding is that the number of college students with poor self-assessed physical health is 8.063 times higher than that of college students with self-assessed mental health as good, which emphasizes the significant impact of mental health on healthy human capital. Therefore, to effectively improve the health human capital of college students, students, families and universities must form a linkage mechanism and work together to cultivate college students’ health awareness.

The Effectiveness of Health-Oriented Interventions and Health Promotion for Unemployed People-A Meta-Analysis.

Background: Unemployment is known to have negative effects on mental and physical health. Yet, the effectiveness of interventions aimed at improving the health of unemployed people is unclear. Methods: We conducted a random-effects meta-analysis of extant intervention studies with at least two measurement points and a control group. A literature search in PubMed, Scopus, and PsycINFO in December 2021 identified 34 eligible primary studies with 36 independent samples. Results: For mental health, the average meta-analytic effect sizes for the comparison of the intervention group and the control group were significant and of small size after the intervention, d = 0.22; 95% CI [0.08, 0.36], as well as at follow-up, d = 0.11; 95% CI [0.07, 0.16]. Effects on self-assessed physical health status were small and marginally significant (p = 0.10) after the intervention: d = 0.09; 95% CI [-0.02, 0.20], and insignificant at follow-up. However, when job search training was not part of the intervention program (i.e., all available resources were used solely for health promotion), the average effect size for physical health was significant after the intervention, d = 0.17; 95% CI [0.07, 0.27]. Furthermore, the effects of physical activity promotion were significant and of small-to-medium size after the intervention, leading to increased levels of activity, d = 0.30; 95% CI [0.13, 0.47]. Conclusions: Population-based health promotion programs are recommended because even measures with small effect sizes can actually improve the health of a large group of unemployed people.

Does medical insurance improve health? An empirical analysis from China.

Medical insurance is considered to be closely related to individual health status, while their relationship are left to be clarified. This article aims to examine the relationship between medical insurance and the health status of residents in China. The data is from a nationally representative sample of CGSS2015, and the estimation methods of ordered logit model, generalised ordered logit model and instrumental variable (IV) were used. Both public medical insurance (PMI) and commercial medical insurance (CMI) had a positive correlation with residents' self-assessed physical and mental health, while PMI was more statistically significant and substantively important than CMI. The basic results estimated with the generalised ordered logit model and IV model still remained robust. Further analysis found that medical insurance, whether public or commercial, had more or less weakened the importance of income to personal health, showing a substitute effect for income. PMI has been proven to help promote the physical and mental health of residents and moderate the importance of residents' income to health. Besides, CMI also plays a beneficial supplementary role in promoting residents' health.

Food Insecurity in Israeli Elderly is Associated with Sociodemographic Characteristics, Disability, and Depression: Policy Implications

BackgroundFood insecurity (FI) and poor health can turn into a vicious cycle with detrimental effects, especially in the elderly, however, few studies have examined the relationship between FI and health in this age group. ObjectivesWe investigated associations of FI with physical and mental health and health behaviors among community-dwelling elderly. MethodsWe used nationally representative, cross-sectional data from the 2014–2015 Israel National Health and Nutrition Survey of the Elderly (Rav Mabat Zahav) on FI, sociodemographic characteristics, noncommunicable diseases (NCDs), disability, self-assessed physical, oral, and mental health for 1006 individuals aged ≥65 y. ResultsFI affected 12.3% of all households with elderly and was significantly higher among late immigrants and Arabs. Bivariate associations of FI with the number of NCDs, depression, disability in all 6 domains (vision, hearing, mobility, self-care, remembering, communication), poor self-assessed physical and oral health, chewing and swallowing problems, feelings of loneliness, insufficient physical activity, and smoking were significant (P < 0.05). In a multivariable logistic regression controlling for population group, household size, age and sex, FI was significantly associated (P < 0.05) with lack of formal education (OR: 6.26; 95% CI: 1.66, 23.65), being in the lowest (OR: 23.56; 95% CI: 3.71, 149.76) or second-lowest (OR: 16.75; 95% CI: 2.68, 104.52) per capita household income quartile, having one (OR: 2.11; 95% CI: 1.05, 4.23) or several disabilities (OR: 4.04; 95% CI: 1.72, 9.45), and having ever been diagnosed with depression (OR: 3.34; 95% CI: 1.35, 8.28). ConclusionsFI is associated with physical and mental health problems, multiple disabilities, and loneliness among Israeli elderly. Providing income support could reduce FI, and subsidized congregate and home-delivered meal services could be expanded to meet the needs of elderly with disabilities and counter social isolation. Because low education, disability, and depression are particularly prevalent among the food insecure and vulnerable groups face language barriers, assistance with applications for these services should be increased.

Health promotion among unemployed people – meta-analytic evidence

Abstract Background It is well known that unemployment impairs health. However, less is known about health promotion among unemployed people and healthy coping strategies to deal with unemployment. Methods A random-effect meta-analysis was applied to statistically integrate quantitative controlled intervention studies among unemployed people. Results The meta-analysis included 34 eligible primary studies with 36 independent intervention samples. For mental health, the average meta-analytic effect sizes for the comparison of intervention group and comparison group was significant and of small size after the intervention d = 0.25; 95% CI [0.10, 0.39], and at follow-up, d = 0.13; 95% CI [0.04, 0.22]. For health behavior (measured as physical activity), the effects were also significant after the intervention, d = 0.30; 95% CI [0.12, 0.47] (no data available at follow-up). Effects on self-assessed physical health status were very small and not significant. However, when health improvement was the only goal of the respective intervention (in contrast to studies with multiple goals, e.g., health improvement plus re-employment), the effect on physical health was significant, too, d = 0.15; 95% CI [0.04, 0.25]. Moderator tests showed that intervention effects on mental health were significantly stronger when cognitive-behavioral methods were used (p &amp;lt; .05), while the use other kinds of stress-management techniques (p &amp;lt; .05), of methods to increase social support (p &amp;lt; .05), or of relaxation techniques (p &amp;lt; .07) did not improve the effectiveness of the intervention. Conclusions The present meta-analyses provided evidence that, on average, interventions aiming at improving unemployed people’s health do indeed improve participants’ health. Key messages • The present meta-analysis confirms that it is possible to promote unemployed people’ health. The moderator effects for type of intervention that were found here might be helpful for health promotion. • The inclusion of cognitive-behavioral methods, appears to be a successful approach for health-oriented interventions with unemployed people.

Analysing the Quality of Life of Older Adults: Heterogeneity, COVID-19 Lockdown, and Residential Stability.

This study aims to, first, investigate the quality of life (QOL) of older adults in Taiwan, from the perspective of heterogeneity and, second, clarify the social isolation affecting their QOL during the pandemic. Additionally, it explores the residential stability of older adults. Our empirical model, a Generalized Ordered Probit Model, uses secondary data from the 2019 Taiwan Social Change Survey for people aged 65 and above, with a total sampling size of 417. The results show that the self-assessed physical health of older adults is a significantly heterogeneous variable affecting their QOL, and has a varying impact on the probability of them being satisfied with their QOL. Results suggest that better financial plans and staying healthy are the main determinants of their QOL. Social isolation during the COVID-19 pandemic significantly hampered their QOL, which was not compensated by the use of the internet. Furthermore, older adults’ residential stability significantly influences their QOL. Family members and relevant social work units should contribute to in-person home care for older adults to reduce their social isolation, with a focus on improving their living environments and to ensure that they age in a safe and healthy place.

Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study.

Depression among university students and international university students is an increasing problem globally. This study aimed to clarify the differences on the conditions and determinants of the knowledge, preventive practices and depression of the Chinese international students and local Korean students in South Korea during the COVID-19 pandemic. An online cross-sectional questionnaire including general demographic characteristics, COVID-19-related knowledge, preventive practice, and the Patient Health Questionnaire (PHQ-9) was applied from March 23 to April 22, 2020. A total of 533 university students (171 Chinese international students and 362 local South Korean students) were included in the study. The majority of both Chinese international students and local South Korean students had a good comprehension of COVID-19. Chinese international students in South Korea showed better preventive practice than local Korean students, while the proportion of moderate to severe depression of Chinese international students was relatively higher (28.07%) than that of local Korean students (22.38%). Determinants of depression of Chinese international students in South Korea were information satisfaction, likelihood of survival after infection, symptoms of a cough and feelings of discrimination, while for local Korean students were gender, educational level, family, suspected symptoms, self-assessed physical health status, COVID-19 detection, population contact history and online sources of information. These results could be used as a reference for decreasing the depressive symptoms among the university students.

Perceived threat of COVID-19, self-assessment of physical health and mental resilience

ABSTRACT The coronavirus pandemic is a global health crisis and the biggest challenge of our time. The aim of the study was to compare the perceived threat of COVID-19, self-assessed physical health, and mental resilience among some social categories vulnerable to stress during the COVID-19 pandemic, such as 67 people diagnosed with mental disorders and healthy people (67 healthcare specialists, 67 professionals in the areas of economy, education, law or IT, and 67 athletes). Age advance (r (266) = −227, p < 001) and perception of COVID-19 as a bigger threat (r (266) = −270, p < 001) were related to worsened self-assessed physical health. Higher mental resilience was accompanied by better physical health (r (266) = .190, p = 002). The people with mental disabilities had the lowest level of mental resilience (p = 034) and self-assessed their physical health as the poorest (p = 040). The healthcare specialists perceived COVID-19 as a threat in the highest degree (p = 011). The results revealed some coping resources that may strengthen mental resilience and improve health status among different sub-groups of population.

Economic Hardship, Sleep, and Self-Rated Health

The Supplemental Nutrition Assistance Program (SNAP) distributes vouchers for grocery shopping to around 43 million individuals across the United States to counteract food insecurity. In this study, we take advantage of the random interview day assignment of the American Time Use Survey (ATUS) and the variation in voucher issuance dates across states to identify changes in self-rated health and sleep over the monthly SNAP payment cycle. We find that the economic hardship experienced at the end of the payout period causes a significant and sizable negative effect on self-assessed physical health and sleep quality. SNAP recipients were 18 percent more likely to report fair or poor physical health at the end of the payment cycle compared with the rest of the month. During this period of scarcity, recipients were also 50 percent more likely to report sleeplessness, with the number of minutes being sleepless more than doubling while total sleep duration remained unchanged. Drawing upon information on time use in the ATUS, we discuss evidence suggesting that higher levels of stress, changed eating patterns, and reduced sleep quality may be potential mechanisms of the adverse health effects. Our findings extend the literature on sleep quality as a mediator between low socioeconomic status and self-rated health in the short run.

Well-being, food habits, and lifestyle for longevity. Preliminary evidence from the sardinian centenarians and long-lived people of the Blue Zone

ABSTRACT Lifestyle, physical, and mental health impact successful aging. However, at present, extensive literature about the interplay among perceived mental and physical health, lifestyle, and food intake in long-lived people residing in areas of exceptional longevity is lacking. This study was mainly aimed at examining the relationships among self-assessed life satisfaction, physical health, lifestyle, and food intake in the last two decades of life. A further goal was to investigate the impact of age-related factors on the above variables. The recruitment was mainly conducted in the Sardinian Blue Zone, a well-documented area of exceptional longevity in Sardinia, an Italian Island located in the Mediterranean Sea. Twenty-nine octogenarians (Mage = 83.9 years, SD = 2.7) and 28 gender-matched long-lived (Mage = 97.6 years, SD = 7.9) community-dwellers took voluntarily part in the study. Each participant individually completed a battery of tasks assessing their global cognitive efficiency, life satisfaction, lifestyle, food intake, and perceived physical health. The results highlighted that life satisfaction was significantly associated with time spent on outdoor leisure activities (r = .314, p = .026), perceived physical health (r = .459, p = .001), and carbohydrate intake (r = .333, p = .021). Moreover, the octogenarians and long-lived groups reported similar levels of life satisfaction (t(56) = .573, p = .569, Cohen’s d = .164). In conclusion, healthy nutrition habits and a physically active lifestyle boosting mental and physical health are crucial for promoting optimal aging.

Exploring impact on eating behaviour, exercise and well-being during COVID-19 restrictions in the Netherlands

Many studies address the effect of the COVID-19 restrictions on food consumption and health, focusing on one or two measurements. Whether or not any effects are permanent or change over a longer period of restrictions has not been assessed in such studies. This study presented a survey containing questions on food consumption, exercise and self-assessed physical and mental health, repeatedly for six times over a 20-week period (July to November 2020) to a representative sample of 258 Dutch consumers. The majority of consumers reported no change in food consumption compared to before the COVID-19 restrictions, two smaller groups report a change to a more, or a less, healthy choice. This trend appears stable over the course of the measurements. The ‘healthy changers’ seem to couple a healthy and more diverse diet to healthy exercise habits, in contrast to the ‘unhealthy changers’. No change was observed in self-assessed physical health over the measurements. Overall a decline in time spent exercising showed, as well as a decline in self-assessed mental health.Clearly a lockdown situation affects food choice, exercise habits and (self-assessed) mental health. The fact that habits are able to suddenly change, for better or for worse, and that a decrease in mental health was reported, suggests that such insights need to be further explored to help individual consumers retain a healthy diet and lifestyle, and governments devise effective public health recommendations.

An Indigenous food sovereignty initiative is positively associated with well-being and cultural connectedness in a survey of Syilx Okanagan adults in British Columbia, Canada

BackgroundFor the Syilx Okanagan Nation in Canada, salmon has vital nutritional, cultural, and spiritual significance. Yet, the Okanagan Sockeye salmon population came to near extinction, resulting in a drastic decline in salmon consumption from high historical levels. Thus, restoring and protecting salmon is crucial to Syilx well-being and way of life. A Syilx-led food sovereignty initiative re-established the Okanagan Sockeye salmon population, which has resulted in a rise in fish harvesting. The aim of this study was to assess whether engaging with this initiative was associated with health, well-being, and cultural connectedness (i.e., degree to which one is integrated in their culture) among Syilx adults. Eating Okanagan Sockeye salmon was conceptualized as a proxy for engaging with this Indigenous food sovereignty initiative.Methods265 Syilx adults completed a survey including a traditional food frequency questionnaire and questions on health status (e.g., BMI, self-assessed physical health), well-being (e.g., life satisfaction, stress levels), and cultural connectedness (e.g., sense of belonging, importance of cultural practices). Participants were divided into 3 groups based on their wild salmon eating during the year prior to the survey: (1) adults who ate Okanagan Sockeye salmon, (2) adults who ate salmon but did not usually know the species of the salmon they ate, or who solely ate salmon that were not Okanagan Sockeye; and (3) adults who did not eat any salmon.ResultsA statistically significant gradient was observed for enhanced well-being and cultural connectedness, with individuals in group 1 having better indicators than those in group 2, and adults in groups 1 and 2 having better indicators than adults in group 3. No differences were observed in physical health outcomes between the three groups.ConclusionFindings suggest that the initiative to re-establish Okanagan Sockeye salmon in the Okanagan River system may have led to better well-being and cultural connectedness among Syilx adults. This study highlights the importance of Indigenous food sovereignty as a way to enhance well-being and cultural connectedness among First Nations in Canada. Findings also reinforce the importance of assessing health and well-being in a wholistic way in Indigenous health research.

Reporting biases in self-assessed physical and cognitive health status of older Europeans.

This paper explores which demographic characteristics substantially bias self-reported physical and cognitive health status of older Europeans. The analysis utilises micro-data for 19 European countries from the Survey of Health, Ageing and Retirement in Europe to compare performance-tested outcomes of mobility and memory with their self-reported equivalents. Relative importance analysis based on multinomial logistic regressions shows that the bias in self-reported health is mostly due to reporting heterogeneities between countries and age groups, whereas gender contributes little to the discrepancy. Concordance of mobility and cognition measures is highly related; however, differences in reporting behaviour due to education and cultural background have a larger impact on self-assessed memory than on self-assessed mobility. Southern as well as Central and Eastern Europeans are much more likely to misreport their physical and cognitive abilities than Northern and Western Europeans. Overall, our results suggest that comparisons of self-reported health between countries and age groups are prone to significant biases, whereas comparisons between genders are credible for most European countries. These findings are crucial given that self-assessed data are often the only information available to researchers and policymakers when asking health-related questions.

QUALITY OF LIFE IN RENAL TRANSPLANT RECIPIENTS

THE AIM. To assess quality of life (QOL) in kidney transplant recipients (KTR) using the Kidney Disease Quality of Life Short Form (KDQOL-SFTM) questionnaire which includes specific for renal replacement therapy questions, and to compare QOL of KTR and hemodialysis (HD) patients.PATIENTS AND METHODS. 41 KTR and 142 HD patients were included in the study. The KDQOL-SF questionnaire was used for QOL evaluation.RESULTS. Compared with HD patients, KTR scored higher on the majority of self-assessed physical health parameters (Physical Functioning, Pain, General Health, Physical Component Summary). Significant differences were observed for two of the five scales representing psychosocial component of QOL – Vitality and Social Functioning. Overall health rating was also higher in KTR. These patients were frustrated by the burden of kidney disease and its limiting impact on daily activities to a lesser degree. The frequency of patients’ complaints decreased. 39% of HD patients reported being bothered by itchy skin, among KTR – only 8%. Soreness in muscles bothered 44% of HD patients and 22% of KTR, numbness in hands or feet – 33% of HD patients and 13% of KTR. Limited ability to travel was bothersome for 75% of HD patients and 42% of KTR. 38% of KTR, and 29% of HD patients were employed.CONCLUSION. As far as we know, the presented study is the first in our country to report about QOL in KTR where QOL was measured using a questionnaire containing items specific for renal replacement therapy. It was shown that KTR scored higher than HD patients on the majority of KDQOL-SF scales.

Psychosocial determinants of depression in the community of the elderly with cardiovascular disease

The co-morbidity of cardiovascular disease (CVD) and depression is quite frequent in old people, and some potential biological and behavioural mechanisms linking them have been reported. Yet the impact of psychosocial factors on depression in the elderly with CVD remains unclear. This study aimed to analyze the psychosocial determinants of depression in the elderly with CVD. Using the Geriatric Mental Status–Automated Geriatric Examination for Computer Assisted Taxonomy, a community-based household survey was performed in 2,199 elderly people from the Anhui cohort third-wave survey from 2007 to 2009 and an extended study in Hubei from 2010 to 2011. Multiple logistic regression analyses were employed to assess the influence of psychosocial factors on depression. Among them, the prevalence of depression was 4.77%. Three factors were associated with depression in elderly in the community: self-assessed physical health status, anything else severely upsetting and unpleasantness with relatives, friends, or neighbors. In particular, associations of psychosocial factors with depression were more evident in individuals with CVD. This study confirms several psychosocial determinants of depression and the impact of CVD on the associations among the elderly, which provides some clues for interventional strategies of late-life depression.

L’influence des conditions de travail passées sur la santé et la consommation de médicaments auto-déclarées des retraités

The Impact of PastWorking Conditions on Retirees’ Self-Assessed Health and Medication Use. This article aims to measure the net effect of physical and psychosocialworking conditions, throughout their entire professional career, on retirees’ self-assessed physical and mental health, and drug consumption. Based on the French Health and Career Path (Santé et Itinéraire Professionnel) survey, we control our regressions for socioeconomic characteristics, employment, career path, past individual characteristics on entering the labour market, and past health status. Our results highlight the negative role of exposure to detrimentalworking conditions on retirees’ physical and mental health, evidencing a clear relationship between physical constraints and physical health on the one hand, and between psychosocial risk factors and mental health (including drug consumption) on the other hand. These findings underline the long-term effect of difficult working conditions on health status, even after retirement.

Assessment of cumulative health risk in the World Trade Center general responder cohort.

Multiple comorbidities have been reported among rescue/recovery workers responding to the 9/11/2001 WTC disaster. In this study, we developed an index that quantifies the cumulative physiological burden of comorbidities and predicts life expectancy in this cohort. A machine learning approach (gradient boosting) was used to model the relationship between mortality and several clinical parameters (laboratory test results, blood pressure, pulmonary function measures). This model was used to construct a risk index, which was validated by assessing its association with a number of health outcomes within the WTC general responder cohort. The risk index showed significant associations with mortality, self-assessed physical health, and onset of multiple chronic conditions, particularly COPD, hypertension, asthma, and sleep apnea. As an aggregate of several clinical parameters, this index serves as a cumulative measure of physiological dysregulation and could be utilized as a prognostic indicator of life expectancy and morbidity risk.

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OBJECTIVES/SPECIFIC AIMS: To explore associations among bio-psychosocial factors predictive of overall physical and mental health status as assessed using the SF-12 Health Survey. METHODS/STUDY POPULATION: Community-dwelling, male and female elders with peripheral arterial disease (PAD) were administered an assessment battery to identify factors associated with self-assessed physical and mental health status using the SF-12 Health Survey. The battery included an assessment of pain, depressive symptoms, perceived social support, perceived psychological stress, physical function, as well as selected demographic variables. RESULTS/ANTICIPATED RESULTS: Preliminary linear regression analyses have identified several factors predictive of physical and mental health status including depressive symptoms, pain, perceived stress, and physical function. A more in-depth examination using path analysis is anticipated to reveal important mediational associations, wherein physical function is a strong mediator between bio-psychosocial factors and overall physical and mental health status. DISCUSSION/SIGNIFICANCE OF IMPACT: Aging is often associated with a reduction in physical and mental well-being, frequently exacerbated by the development and progression of chronic disease. PAD is a common chronic condition that places significant burden on the older patient and their family. Identifying and developing a more in-depth understanding of the factors that impact health status in PAD is an important and timely objective. We anticipate that our findings will inform development of more targeted and effective intervention strategies we can employ to improve the quality of life among elders struggling to manage PAD.

Retirement saving and mental health in China.

The Chinese population is aging rapidly while both the pension system is underdeveloped and the traditional family care arrangement is in retreat. This article's objective is to assess the relationship between concerns over retirement saving sufficiency and the mental health status of middle-aged and older Chinese adults, and identify the socioeconomic and demographic profile of those with insufficient retirement savings. A survey from about 2000 respondents collected information on self-assessed physical and mental health status based on the EQ-5D-5L framework, self-assessed longevity, retirement plans and financial preparedness and socioeconomic status. Multivariate ordered logistic regressions are used to identify the relationship between mental health status, financial preparedness for retirement and self-assessed longevity, as well as socioeconomic factors associated with mental health status and financial preparedness for retirement respectively. It is found that 59% of the respondents thought that they have not saved, or will not be able to save enough for their retirement. For these people, the odds of having less anxiety or depression are 0.36 (95% CIs: 0.16-0.43) times lower than those who are financially prepared. Having more external sources of financial assistance including family and governments, did not help ease mental distress. Rural people are half as likely to be financially prepared for retirement, regardless of whether they remain in rural areas or migrate to cities. Health promotion strategies should consider the role for financial planning in improving mental health.