Family Survey Research Articles

The relationship between education level, retirement status, and civic engagement among older adults in Indonesia

The Indonesian population is aging very rapidly and as the number of old people increases, the number of retirees increases as well. Many scholars have argued the benefits of civic engagement in old age, but there is lack of empirical evidence of the factors associated with civic engagement in Indonesia. The aim of this study was to investigate the association between education levels, retirement status, and civic engagement among older adults in Indonesia. The study used data from the fifth wave of the Indonesia Family and Life Survey which was held in late 2014 and early 2015. The study included participants aged 56 years and older, the mandatory age for retirement in 2014 in Indonesia. Multiple regression was modelled for data analysis. The main results revealed that those who completed junior and senior high school and high education exhibited more civic engagement than those who completed only primary education. Moreover, the study found that those who were retired were less engaged in civic activities than those still in labor force. These relationships held true even after controlling for gender, age, marital status, personality traits, religiosity, and self-rated health variables. To strengthen democracy and growth, education needs to be re-emphasized and there is need for further investigation concerning retirement and civic engagement in Indonesia.

이혼 후 자녀와 비양육부모의 면접교섭에 양육부모의 동기 요인이 미치는 영향

This study examined whether child support payments, perceived compensation, cost of child rearing, and perceived potential support from former spouse, which are all factors related to custodial parent’s motivation to allow visitation, affect contact between children and non-custodial parents. The types of contact were divided into regular contact, irregular contact, and no contact. A comparison between single-father and single-mother families was conducted to see if motivation factors of custodial parents were different by gender of parents. Using the Living Status of Korean Single-Parent Families Survey, this study analyzed 1,913 divorced custodial parents through multi-nominal logit analysis. The motivation factors that influence regular contact were different by gender of parents. In single-mother families, child support payment was a significant motivation factor, while in single-father families, perceived potential support from former spouse was significant. These results suggest that an intervention strategy to increase visitations takes into account custodial parent’s motivation and gender difference.

Social Support and Family Functioning in Chinese Families of Children with Autism Spectrum Disorder.

Families caring for children with autism spectrum disorder (ASD) have reported poorer family functioning. Social support might strengthen family functioning, but limited research to date has focused on this association in China. This study conducted a cross-sectional survey of Chinese families that have children with ASD to examine the relationship between social support and family functioning. Caregivers of children with ASD from Sichuan province in China (N = 167) were surveyed concerning their perceived social support and family functioning. The Social Support Rating Scale was used to investigate caregivers’ perceived social support from three dimensions: subjective support, objective support, and the utilization of support. A Chinese version of the Family Adaptability and Cohesion Scale was used to investigate their perceptions of family cohesion and adaptability. The Pearson correlation coefficient and stepwise multiple regression were used for analyses. The results suggested that social support was positively related to family cohesion and adaptability. Of the three sub-domains of social support, both subjective support and the utilization of support were positively associated with family cohesion and adaptability. The study’s findings evidenced the importance of different types of social support and could be used to develop a targeted support service for families that have children with ASD to improve their family functioning and sustain the family unit.

Adapting to a New Normal After Severe Acute Brain Injury: An Observational Cohort Using a Sequential Explanatory Design.

Treatment decisions following severe acute brain injury need to consider patients' goals-of-care and long-term outcomes. Using family members as respondents, we aimed to assess patients' goals-of-care in the ICU and explore the impact of adaptation on survivors who did not reach the level of recovery initially considered acceptable. Prospective, observational, mixed-methods cohort study. Comprehensive stroke and level 1 trauma center in Pacific Northwest United States. Family members of patients with severe acute brain injury in an ICU for greater than 2 days and Glasgow Coma Scale score less than 12. At enrollment, we asked what level of physical and cognitive recovery the patient would find acceptable. At 6 months, we assessed level of recovery through family surveys and chart review. Families of patients whose outcome was below that considered acceptable were invited for semistructured interviews, examined with content analysis. For 184 patients, most family members set patients' minimally acceptable cognitive recovery at "able to think and communicate" or better (82%) and physical recovery at independence or better (66%). Among 170 patients with known 6-month outcome, 40% had died in hospital. Of 102 survivors, 33% were able to think and communicate, 13% were independent, and 10% died after discharge. Among survivors whose family member had set minimally acceptable cognitive function at "able to think and communicate," 64% survived below that level; for those with minimally acceptable physical function at independence, 80% survived below that. Qualitative analysis revealed two key themes: families struggled to adapt to a new, yet uncertain, normal and asked for support and guidance with ongoing treatment decisions. Six months after severe acute brain injury, most patients survived to a state their families initially thought would not be acceptable. Survivors and their families need more support and guidance as they adapt to a new normal and struggle with persistent uncertainty.

Transitions from Cohabitation to Marriage or Separation among the Birth Cohort of 1970–1984 in Lithuania

This paper aims to analyse the impact of demographic and social factors on first partnership in Lithuania – the duration of premarital cohabitation, the sustainability of such relationships, and the transition into marriage. The research is based on the 2019 Family and Inequality Survey of 1970–1984 birth cohorts. Data analysis shows that most young people began their first partnership as a cohabitation rather than marriage, and the average premarital time spent in a cohabitation increases within this cohort. Cohabitation eventually transitions into marriage, and five years after the start of cohabitation, almost all cohabitants marry, and only a small percentage of cohabitating unions dissolve. Based on Cox regression analysis, the level of education and finished studies, as well as pregnancy, are significant predictors of the transition from cohabitation to marriage. The results of the research show that three decades after the beginning of the spread of cohabitation in Lithuania, cohabitation competes with marriage, but it does not challenge the importance of marriage as an institution of childbearing and upbringing.

Association of Mobile Instant Messaging Chat Group Participation With Family Functioning and Well-Being: Population-Based Cross-sectional Study.

BackgroundConvenient and quality family communication improves family functioning and well-being. Using mobile instant messaging (IM) for family communication is increasingly popular, but its association with family functioning and family well-being has not been reported.ObjectiveThe aim of this study was to examine the association of the use of family IM chat groups with family functioning and well-being, and the mediating effect of family communication quality among Chinese adults in Hong Kong.MethodsWe analyzed data from the Family and Health Information Trend Survey (FHInTS), a territory-wide, probability-based telephone survey conducted in 2017. The quality of family communication, family functioning, and well-being was assessed using the Family Communication Scale; Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR) Scale; and Family Well-Being Scale (family heath, harmony, and happiness), respectively. Respondents also reported the number of family IM chat groups (0, 1, 2, ≥3), and numbers of IM messages received (<1, 1-2, 3-10, 11-20, >20) and sent (<1, 1-2, 3-10, 11-20, >20) daily. The frequency of family IM chat interaction (range 0-8) was calculated by combining the number of messages received from and sent to the family IM chat groups daily. Covariates included sociodemographic characteristics and the frequency of family face-to-face communication (often, sometimes, seldom, or never). Data were weighted by sex, age, and education of the general population. Adjusted β coefficients of family functioning and well-being in relation to having a family IM chat group, and numbers of messages received and sent were calculated. The mediation effects of family communication on these associations were assessed, controlling for the covariates.ResultsA random sample of 1638 Chinese adults (45.6% men; 78.1% aged 25 to 64 years) were interviewed (response rate: 74.4%). Female, younger age, being married or cohabiting, higher education, higher income, better family functioning, and well-being were associated with having at least one family IM chat group (all P<.01). Higher scores of family communication, family APGAR, and family well-being were associated with having more family IM chat groups and more messages received from and sent to family IM chat groups daily (all P for trend <.01). More frequent family IM chat interaction was associated with higher scores of family communication, family APGAR, and family well-being (β=.16-.83, all P for trend <.001). The associations of family IM chat interaction with family functioning and well-being were moderately (51.0%-59.6%) mediated by family communication.ConclusionsUse of a family IM chat group was associated with higher family functioning and well-being, and the association was partially mediated by family communication.

Religiosity and Life Satisfaction in Indonesia: Evidence from a Community Survey

There is a growing interest in the relationship between religiosity and subjective well-being in the literature. However, little evidence exists from Indonesia with a national scope. The aim of this study was to contribute to the literature by investigating the association between self-perceptions of religiosity and life satisfaction using nationally representative data from the Indonesia Family and Life Survey. Linear regression was used for data analysis with a sample of 27,150 individuals aged between 18 and 90. The main findings showed that those who were religious were more satisfied with their life than their counterparts, even after controlling for a set of confounding variables. It seems that religiosity provides people with well-being benefits which might lead to the good life.

Association between the type of provider and Cesarean section delivery in India: A socioeconomic analysis of the National Family Health Surveys 1999, 2006, 2016.

BackgroundPrevalence of Cesarean section (C-section) is unequally distributed. Since both extremely low and high levels of C-section can not only cause adverse birth outcomes but also impose a double burden of inefficiency within maternal health care, it is important to monitor the dynamics of key factors associated with the use of C-section.ObjectivesTo examine the association between type of provider and C-section in India in three-time points: 1999, 2006, and 2016, and also to assess whether this association differed across maternal education and wealth level.MethodsData were from three waves of cross-sectional and nationally representative Indian National Health Family Survey: Wave II (1999), III (2006), and IV (2016). Target population is women aged 15 and 49 who had an institutional delivery for the most recent live birth during the three or five years preceding the survey (depending on the survey round). Multivariate logistic regression models adjusting for state cluster effect were performed to determine the association between the type of providers and C-section. Differential association between the type of providers and C-section by maternal education and wealth level was examined by stratified analyses.ResultsThe prevalence of C-section among institutional delivery increased from 20.5% in 1999 to 24.8% in 2006 while it declined to 19.4% in 2016. The positive association between private providers and C-section became stronger over the study period (Odds Ratio (OR) = 1.39, 95% Confidence Interval (CI) 1.18–1.64 in 1999, OR = 3.71 95% CI 2.93–4.70 in 2016). The association was consistently significant across all states in 2016. The gap in C-section between public and private providers was greater among less-educated and poorer women. The ORs gradually increased from the poorest to the richest quintiles, and also from the least educated group (no formal education) to the most educated group (college graduate or above)ConclusionsOur results suggest that disparity in C-section between private and public providers has increased over the last 15 years and was higher in lower SES women. The behavior of providers needs to be closely monitored to ensure that C-section is performed only when medically justified.

Experiences of lockdown during the Covid-19 pandemic: descriptive findings from a survey of families in the Born in Bradford study.

Background: Lockdown measures implemented to contain the Covid-19 virus have increased health inequalities, with families from deprived and ethnically diverse backgrounds most likely to be adversely affected. This paper describes the experiences of families living in the multi-ethnic and deprived city of Bradford, England. Methods: A wave of survey data collection using a combination of email, text and phone with postal follow-up during the first Covid-19 UK lockdown (10th April to 30 th June 2020) with parents participating in two longitudinal studies. Cross tabulations explored variation by ethnicity and financial insecurity. Text from open questions was analysed using thematic analysis. Results: Of 7,652 families invited, 2,144 (28%) participated. The results presented are based on the 2,043 (95%) mothers' responses: 957 (47%) of whom were of Pakistani heritage, 715 (35%) White British and 356 (18%) other ethnicity 971 (46%) lived in the most deprived decile of material deprivation in England. and 738 (37%) were financially insecure. Many families lived in poor quality (N=574, 28%), overcrowded (N=364, 19%) housing. Food (N=396, 20%), employment (N=728, 37%) and housing (N=204, 10%) insecurities were common, particularly in those who were furloughed, self-employed not working or unemployed. Clinically important depression and anxiety were reported by 372 (19%) and 318 (16%) mothers. Ethnic minority and financially insecure families had a worse experience during the lockdown across all domains, with the exception of mental health which appeared worse in White British mothers. Open text responses corroborated these findings and highlighted high levels of anxiety and fear about Covid-19. Conclusions: There is a need for policy makers and commissioners to better support vulnerable families during and after the pandemic. Future work will use longitudinal data from before the pandemic, and from future surveys during the pandemic, to describe trajectories and the long-term consequences of the pandemic on vulnerable populations.

Profiles of Working Moms' Daily Time Use: Exploring Their Impact on Leisure.

This paper identified latent profiles depending on the patterns of daily time usage amongst working moms in Korea and tested their relations to family- and work-related characteristics. The consequent differences in the levels of leisure attributes were further investigated. Taking a holistic approach, latent profile analysis, one of the person-centered methods, was conducted using data drawn from the seventh year of the Korean Longitudinal Survey of Women and Families (KLoWF), with a sample of 1074 women. The results of this study indicate that three different subtypes of individuals emerged: a low-level care group (82.1%), a medium-level care group (13.8%), and a high-level care group (4.1%). The factors determining the classification for the profiles were the existence of preschool children, household income, gender role attitudes, and domestic help. Work-related factors proved to have no significant effect on time-use patterns. Profile membership was related to leisure attributes as perceived by working moms: the low-level care group reported the highest level of leisure time adequacy and leisure satisfaction, while the high-level care group presented the lowest level of sufficiency and satisfaction in their leisure time. Based on these findings, the article discusses the practical implications for enhancing the quality of life of working mothers.

Life satisfaction of multicultural married couples: Actor-Partner Interdependence Model analysis

We aimed to identify the actor and partner effects of health status, relationship satisfaction, and depression on the life satisfaction of married immigrant women and their husbands in South Korea. We used a cross-sectional design that included 2865 multicultural married couples with data from the 2015 national survey of multicultural families in Korea. We analyzed the data using path analyses within the Actor-Partner Interdependence Model (APIM) framework. Health status, depression, and relationship satisfaction had actor effects in both wives and husbands, while depression had no partner effects on either. Health status had partner effects only for wives, and relationship satisfaction had partner effects for both husbands and wives. Given that factors influencing life satisfaction differed in couples and since those with depression and poor health were more susceptible to lower life satisfaction, it is essential to introduce efforts to prevent depression and improve relationships considering differences of partner effects.

New records of Meschia pugnax (Heteroptera: Meschiidae) and stethoconus praefectus (Heteroptera: Miridae): predatory deraeocorinae plant bug associated with tingidae bugs, Pakistan

So far, little work has been done on the economically significant families of terrestrial heteroptera in Pakistan's Pothwar region. The taxonomy of the Pentatomidae family of the suborder Heteroptera was primarily the subject of previous work. In the present research, the author conducted surveys of different heteropteran families from different altitudes for the exploration of fauna. Meschia pugnax, a phytophagous species, belonging to newly recorded family Meschiidae and an obligatory predator, Stethoconus praefectus belonging to plant bug family Miridae have been recorded for the first time from Pakistan. Urentius hystricellus, pest of Brinjal crop, belonging to family Tingidae has been recorded as new country record. Meschia pugnax Distant and Stethoconus praefectus Distant were first recorded from the Pothwar area of Pakistan during the collection of terrestrial heteroptera. An obligatory predator, Stethoconus praefectus, is found to predate the species of lace bugs Urentius hystricellus Richter and Corythauma ayyari Drake. Lace bug species, Urentius hystricellus is reported as a new Pakistani record. Collected specimens have been sent to the Biosystematics Laboratory, Department of Entomology, PMAS-Arid Agriculture University, Rawalpindi. This paper has given the distribution of reported species along with body measurements and illustrations. A lot of work must be done to investigate the fauna of different heteropteran families, as the work done in previous years is scarce.

Experiences of lockdown during the Covid-19 pandemic: descriptive findings from a survey of families in the Born in Bradford study

Background: Lockdown measures implemented to contain the Covid-19 virus have increased health inequalities, with families from deprived and ethnically diverse backgrounds most likely to be adversely affected. This paper describes the experiences of families living in the multi-ethnic and deprived city of Bradford, England. Methods: A wave of survey data collection using a combination of email, text and phone with postal follow-up during the first Covid-19 UK lockdown (10th April to 30 th June 2020) with parents participating in two longitudinal studies. Cross tabulations explored variation by ethnicity and financial insecurity. Text from open questions was analysed using thematic analysis. Results: Of 7,652 families invited, 2,144 (28%) participated. The results presented are based on the 2,043 (95%) mothers’ responses: 957 (47%) of whom were of Pakistani heritage, 715 (35%) White British and 356 (18%) other ethnicity 971 (46%) lived in the most deprived decile of material deprivation in England. and 738 (37%) were financially insecure. Many families lived in poor quality (N=574, 28%), overcrowded (N=364, 19%) housing. Food (N=396, 20%), employment (N=728, 37%) and housing (N=204, 10%) insecurities were common, particularly in those who were furloughed, self-employed not working or unemployed. Clinically important depression and anxiety were reported by 372 (19%) and 318 (16%) mothers. Ethnic minority and financially insecure families had a worse experience during the lockdown across all domains, with the exception of mental health which appeared worse in White British mothers. Open text responses corroborated these findings and highlighted high levels of anxiety and fear about Covid-19. Conclusions: There is a need for policy makers and commissioners to better support vulnerable families during and after the pandemic. Future work will use longitudinal data from before the pandemic, and from future surveys during the pandemic, to describe trajectories and the long-term consequences of the pandemic on vulnerable populations.

Early childhood factors associated with obesity at age 8 in Vietnamese children: The Young Lives Cohort Study

BackgroundOver recent decades, Vietnam has experienced rapid economic growth, a nutrition transition from the traditional diet to highly-processed and calorie-dense foods and beverages, and an increasing prevalence of childhood overweight/obesity (ow/ob). The goal of this study is to describe the patterns of ow/ob in a longitudinal sample of Vietnamese children from ages 1 to 8, and the sociodemographic and behavioral factors associated with ow/ob at age 8.MethodsThis study is a secondary data analysis of a geographically-representative, longitudinal cohort of 1961 Vietnamese children from the Young Lives Cohort Study from 2002 to 2009. Thirty-one communities were selected with oversampling in rural communities, and children age 1 were recruited from each community using simple random sampling. Surveys of families and measurements of children were collected at child ages 1, 5, and 8. Our specified outcome measure was childhood ow/ob at age 8, defined by the World Health Organization’s thresholds for body-mass-index (BMI) for age Z-scores. Associations between early and concurrent socio-behavioral factors, childhood nutrition and physical activity variables were analyzed using STATA 15. Bivariate and multivariable analyses were completed utilizing logistic regression models.ResultsThe prevalence of ow/ob increased from 1.1% in both sexes at age 1 to 7% in females and 13% in males at age 8. Bivariate analyses show greater likelihood of ow/ob at age 8 was significantly associated with early life sociodemographic factors (at age 1), male sex (OR = 2.2, 1.6–3.1), higher wealth (OR = 1.1–1.4), and urban residence (OR = 4.3, 3–6). In adjusted analyses, ow/ob at age 8 was associated with early nutrition practices at age 5, including frequent consumption of powdered milk (OR = 2.8, 1.6–4.6), honey/sugar (OR = 2.7, 1.8–4.1), prepared restaurant/fast foods (OR = 4.6, 2.6–8.2), and packaged sweets (OR = 3.4, 2.3–4.9). In addition, breastfeeding for 6 months or longer was protective against obesity at age 8 (OR = 0.3, 0.1–0.9).ConclusionsWe found that increased consumption of powdered milk, honey/sugar, packaged sweets, and prepared restaurants/fast foods are associated with childhood ow/ob. In contrast, breastfeeding for 6 months or longer was protective against childhood ow/ob. These findings suggest that public health programs and campaigns aimed to prevent childhood ow/ob in Vietnam should target early feeding practices.

A novel compound heterozygous mutation in MYSM1 gene in a 1-month-old girl: a bone marrow failure syndrome 4 family survey and literature review

目的报道1例MYSM1基因复合杂合变异致骨髓衰竭综合征4型患儿临床表现及全外显子检测结果，同时报道其家系全外显子检测结果，为早期诊断此类骨髓衰竭综合征提供典型案例。方法报道1例1月龄骨髓衰竭综合征4型患儿临床诊断过程，并对患儿及其家系成员外周血DNA进行全外显子测序，使用BWA、GATK等软件对测序结果进行注释分析。结果本例1月龄骨髓衰竭综合征4型患儿，表现为全血细胞减少、多指畸形，影像学示非特异性脑白质改变及囊肿，淋巴细胞亚群分类示CD3−CD19+ B细胞降低。通过家系全外显子测序检测，鉴定患儿携带分别遗传自父母的MYSM1基因复合杂合性变异NM_001085487.2:c.1607_c.1611delAAGAG和c.1432C>T。家系验证证实先证者父亲携带的c.1432C>T突变来源于先证者祖父，先证者母亲携带的c.1607_c.1611delAAGAG突变来自于先证者外祖父，其他家系成员均不携带突变。结论本研究新发现MYSM1致病性变异c.1607_c.1611delAAGAG，国内外尚未见报道。本例为BMFS4的早期诊断提供了典型案例，并扩展了MYSM1基因致病性变异谱和表型谱。

The Association Between Ambient PM2.5 Exposure and Anemia Outcomes Among Children Under Five Years of Age in India.

The ecological analysis assessed average hemoglobin levels and anemia prevalence (hemoglobin < 11 g/dL considered anemic) by district using multiple linear regression models. The individual-level analysis assessed average individual hemoglobin level and anemia status (yes/no) using generalized linear mixed models to account for clustering by district. Ambient PM2.5 exposure data were derived from the Multiangle Imaging SpectroRadiometer (MISR) level 2 aerosol optical depth (AOD) data and averaged from birth date to date of interview. The district-level ecological analysis found that, for every 10 μg m-3 increase in ambient PM2.5 exposure, average anemia prevalence increased by 1.90% (95% CI = 1.43, 2.36) and average hemoglobin decreased by 0.07 g/dL (95% CI = 0.09, 0.05). At the individual level, for every 10 μg m-3 increase in ambient PM2.5 exposure, average hemoglobin decreased by 0.14 g/dL (95% CI = 0.12, 0.16). The odds ratio associated with a 10-μg m-3 increase in ambient PM2.5 exposure was 1.09 (95% CI = 1.06, 1.11). There was evidence of effect modification by wealth index, maternal anemia status, and child BMI. Our results suggest that ambient PM2.5 exposure could be linked to anemia in Indian children, although additional research on the underlying biologic mechanisms is needed. Future studies on this association should specifically consider interactions with dietary iron deficiency, maternal anemia status, and child BMI.Keywords: Anemia; Children; Ambient PM2.5 exposure; India; Association.

Beyond Prevalence: Annual Cumulative Incidence of Kidney Stones in the United States.

It is well documented that the prevalence of nephrolithiasis is increasing in adults in the United States over time. Approximately 11% of men and 7% of women have reported a lifetime history of nephrolithiasis in cross-sectional studies. However, the burden of acute management may be better assessed from annual cumulative incidence. This accounting of new stone occurrences, however, is not well described on a national scale. The Medical Expenditure Panel Survey is a set of large-scale health care utilization surveys of families, individuals, their health care providers and employers, with surveys administered every 6 months for the duration of each individual's 2-year panel. We queried the survey data of adult participants between 2005 and 2015, with analysis conducted with provided weights and strata to allow our findings to be representative of the civilian noninstitutionalized U.S. adult population. Those with diagnosed renal or ureteral calculi as noted by ICD-9 codes were included as our incident stone formers. In 2005, the mean age of stone formers was 45 years. Of stone formers 52.2% were male, 91% were White and 47.6% were in the Southern U.S. The incidence of stone occurrences was 0.6% (177/33,961 individuals, weighted to represent population of 1,923,322/296,185,002 individuals). By 2015, the mean age was 51.7 years, with 52% male, 83% White and 38.2% residing in the Southern U.S. Between 2005 and 2015, the overall incidence increased from 0.6% to 0.9% (p <0.001). Based on this large-scale, nationally representative analysis of adults in the United States, the estimated annual cumulative incidence of stone occurrence is approaching 1%. Moreover, this incidence appears to be increasing over time, rising from 0.6% in 2005 to 0.9% in 2015. These data may help to better anticipate the need for urological care for stone disease and direct resource distribution.

Informal Volunteering and Socialization Effects: Examining Modelling and Encouragement by Parents and Partner

Informal volunteering is seen as an important indicator of social relations and community life. We therefore investigate the impact of various socialization practices on informal volunteering, being small helping behaviours outside of organizations for people outside the household. From theoretical notions on socialization, we hypothesize that experiencing extensive prosocial socialization practices promotes informal volunteering. We examine socialization processes of both modelling and encouragement and consider two socializing agents: parents and partners. We test our expectations employing the sixth wave of the Family Survey Dutch Population (N = 2464) that included unique measures on socialization as well as informal volunteering and holds important control variables. Our results indicated that parental modelling, partner modelling and partner encouragement were all positively related to informal volunteering, but that parental encouragement was not significantly related to informal volunteering. Our paper, thus, underscores that socialization practices are relevant in nurturing social relations and community life.

Does smoking impact trust in physicians and satisfaction with the health system in China?

INTRODUCTIONTrust and satisfaction play vital roles in how smokers react to smoking cessation treatment delivered by physicians. This paper aims to ascertain whether smoking status and pack-years of smoking affect trust in physicians and satisfaction with the health system in China.METHODSThe current study used the ordered probit model to evaluate how smoking status affects trust in physicians and satisfaction with the health system in China. Data from the China Family Panel Studies (CFPS) 2018 were used for the analysis, and the final sample consisted of 29500 adults. The CFPS is a nationally representative, comprehensive, high-quality, biennial longitudinal survey of Chinese communities, families, and individuals. The survey was conducted in 25 provinces and their administrative equivalents. The population of 25 provinces represents 95% of the total population in Mainland China.RESULTSAccording to the ordered probit model, the results showed that current smokers were significantly negatively associated with trust in physicians, and more cigarette smoking was associated with decreased trust in physicians. Moreover, current smokers were also significantly negatively related to satisfaction with the health system.CONCLUSIONSThe present study found that current smokers would be more likely to rate trust in physicians lower, and less likely to rate greater satisfaction with the health system, than never smokers. These results may have important implications for regaining trust in physicians from smokers and supporting health-system reform for tobacco treatment.

Body mass index and mild cognitive impairment among rural older adults in China: the moderating roles of gender and age

BackgroundEvidence concerning the association between body mass index (BMI) and cognitive function among older people is inconsistent. This study aimed to investigate gender and age as moderators in association between BMI and mild cognitive impairment (MCI) among rural older adults.MethodsData were derived from the 2019 Health Service for Rural Elderly Families Survey in Shandong, China. In total, 3242 people aged 60 years and above were included in the analysis. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender and age, then further to explore the relationship between BMI and MCI.ResultsThere were 601 (18.5%) participants with MCI. Compared with normal BMI group, low BMI group had a higher risk of MCI among older people [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.26–3.44], women (aOR = 2.06, 95% CI: 1.35–3.12), or the older elderly aged ≥75 years old (aOR = 3.20, 95% CI: 1.34–7.45). This effect remained statistically significant among older women (aOR = 3.38, 95% CI: 1.69–6.73). Among older men, elevated BMI group had a higher risk of MCI (aOR = 2.32, 95% CI: 1.17–4.61) than normal BMI group.ConclusionsGender and age moderated the association between BMI and MCI among Chinese rural older adults. Older women with low BMI were more likely to have MCI, but older men with elevated BMI were more likely to have MCI. These findings suggest rural community managers strengthen the health management by grouping the weight of older people to prevent the risk of dementia.