Скачать презентацию Old Sick and Alone Living arrangements health Скачать презентацию Old Sick and Alone Living arrangements health

906bebce754acadafaad5e7aa77593ea.ppt

  • Количество слайдов: 18

Old, Sick and Alone ? Living arrangements, health and wellbeing among older people RGS-IBG Old, Sick and Alone ? Living arrangements, health and wellbeing among older people RGS-IBG Annual International Conference London, 2006 Harriet Young and Emily Grundy London School of Hygiene and Tropical Medicine

Background Ø Demographic changes over the last century have led to older age structures Background Ø Demographic changes over the last century have led to older age structures throughout Europe. Ø Declines in the proportions of older people living with children and increases in proportions living alone.

Background What are the implications for health and well-being ? Research to date: l Background What are the implications for health and well-being ? Research to date: l Those living with spouse are the most healthy l l l Contradictory evidence for those not living with spouse: more healthy living with other relatives or living alone ? • Mor et al (1989), Grundy (2001) Selection effects Effects vary according to cultural and socioeconomic context

Research Objectives Ø Describe the magnitude of differences in living arrangements of those aged Research Objectives Ø Describe the magnitude of differences in living arrangements of those aged 60+ between regions of Europe Ø Analyse associations between living arrangements, health and happiness among older people l l For all countries together Examine variations between regions

Dataset: European Social Survey (ESS) Ø Two cross-sectional rounds of data – 2002 and Dataset: European Social Survey (ESS) Ø Two cross-sectional rounds of data – 2002 and 2004 Ø Using data from 18 countries – l l Excluded 5 countries with response rates below 50% (Italy, France, Czech, Lux, Switz) 3 additional countries (Ireland, Iceland, Israel) Ø Sample size 17, 208 people aged 60+

Country groupings Nordic West Sweden Norway Finland Denmark Germany Portugal Belgium Greece UK Spain Country groupings Nordic West Sweden Norway Finland Denmark Germany Portugal Belgium Greece UK Spain Austria Netherlands Poland Slovenia Slovakia Hungary Ukraine Estonia N=3621 N=5867 N=3863 Total population size=17, 208 South N=3857 East

Variables Ø Health and well-being: l l l Self-rated health Happiness scale (0 -10) Variables Ø Health and well-being: l l l Self-rated health Happiness scale (0 -10) Satisfaction with life (0 -10) Ø Other variables l l l Ø Living arrangements: MARRIED: l spouse only, l spouse and other, NOT MARRIED: l Children or others only, l Alone l l l Age Gender Region Marital status Socio-economic status Social contacts

Analysis Ø Carry out all analyses separately by gender Ø Descriptive analyses Ø Logistic Analysis Ø Carry out all analyses separately by gender Ø Descriptive analyses Ø Logistic regression with binary outcome objective): l l Ø Married: living with spouse and others versus spouse only; Non-married: living with non-spouse others versus living alone Logistic regression with ordinal outcome (2 nd objective) l l poor, fair, good health happiness scale (1 st

Results: Objective 1 Results: Objective 1

Table 1: Adjusted odds ratios from logistic regression of region on living arrangements for Table 1: Adjusted odds ratios from logistic regression of region on living arrangements for women, ESS * Married: Spouse + others v spouse only OR Not married: With others v alone OR Region (reference: Nordic) West 2. 4 *** 2. 9 *** South 9. 8 *** 26. 2 *** 13. 9 *** 34. 2 *** East * Model also controls for age, income, feelings about income, educational qualifications, health, and whether currently widowed for the non-married. ** p<0. 01 *** p<0. 001

Results: Objective 2 Results: Objective 2

Table 2: Adjusted odds ratios from ordinal logistic regression of living arrangements on health Table 2: Adjusted odds ratios from ordinal logistic regression of living arrangements on health and happiness for women, ESS* Self rated health OR (lower OR= less healthy) Happiness score OR (lower OR= less happy) Living arrangements (ref: spouse only) Spouse & other 0. 9 1. 0 Alone 0. 9 0. 5 *** Other only 1. 2 0. 9 * Model also controls for age, region, indicators of socio-economic status, indicators of social contacts, and whether currently widowed ** p<0. 01 *** p<0. 001

Table 3: Odds ratios from ordinal logistic regression of living arrangements & other factors Table 3: Odds ratios from ordinal logistic regression of living arrangements & other factors on health and happiness for non-married women, ESS* Self rated health OR (lower OR= less healthy) Happiness score OR (lower OR= less happy) Living arrangements (living with non-spouse other vv alone) All countries 1. 25 1. 7 *** * Model also controls for age, region, income, education, feelings about income, indicators of social contacts, whether currently widowed, & region for Europewide model ** p<0. 01 *** p<0. 001

Table 3: Odds ratios from ordinal logistic regression of living arrangements & other factors Table 3: Odds ratios from ordinal logistic regression of living arrangements & other factors on health and happiness for non-married women, ESS* Self rated health OR (lower OR= less healthy) Happiness score OR (lower OR= less happy) Living arrangements (living with non-spouse other vv alone) All countries 1. 25 1. 7 *** Nordic 1. 16 1. 2 West 1. 23 2. 1 *** South 1. 16 2. 0 ** East 1. 31 1. 4 By region: * Model also controls for age, region, income, education, feelings about income, indicators of social contacts, whether currently widowed, & region for Europewide model ** p<0. 01 *** p<0. 001

Limitations Ø Varying response rates for different countries may introduce bias. Ø Exclusion of Limitations Ø Varying response rates for different countries may introduce bias. Ø Exclusion of institutional population. Ø In the ESS there are no objective health measures. Only self-rated measures. Ø Cross-sectional analysis so unable to control for selection effects. Ø Small samples sizes in some analyses.

Conclusions Ø Region strongly associated with living arrangements after control for other factors. Ø Conclusions Ø Region strongly associated with living arrangements after control for other factors. Ø Regional gradient for self-rated health & happiness: (worst) East–South–West–Nordic (best) Ø HEALTH: No significant associations between living arrangements and health, except in Nordic region: living alone less healthy. Ø HAPPINESS: Women least likely to be happy living alone, significantly so for South and West.

Acknowledgements Ø This research is funded by the ‘Understanding Population Trends and Processes’ (UPTAP) Acknowledgements Ø This research is funded by the ‘Understanding Population Trends and Processes’ (UPTAP) programme of the ESRC. Ø If you would like more information, do get in touch: Harriet. [email protected] ac. uk THANK YOU