The prevalence of self-reported underuse of medications due to cost for the elderly: Results from seven European urban communities

Background: The aim of this study was to evaluate the prevalence of self-reported underuse of medications due to procurement costs amongst older persons from seven European urban communities. Methods: The data were collected in a cross-sectional study (“ABUEL, Elder abuse: A multinational prevalence survey”) in 2009. Randomly selected people aged 60–84 years (n = 4,467) from seven urban communities: Stuttgart (Germany), Athens (Greece), Ancona (Italy), Kaunas (Lithuania), Porto (Portugal), Granada (Spain) and Stockholm (Sweden) were interviewed. Response rate - 45.2 %. Ethical permission was received in each country. Results: The results indicate that 3.6 % (n = 162) of the respondents self-reported refraining from buying prescribed medications due to cost. The highest prevalence of this problem was identified in Lithuania (15.7 %, n = 99) and Portugal (4.3 %, n = 28). Other countries reported lower percentages of refraining from buying medications (Germany – 2.0 %, Italy – 1.6 %, Sweden – 1.0 %, Greece – 0.6 %, Spain – 0.3 %). Females refrained more often from buying medications than males (2.6 % vs. 4.4 %, p < 0.0001). The prevalence of this refraining tended to increase with economic hardship. Discussion: These differences between countries can be only partly described by the financing of health-care systems. In spite of the presence of cost reimbursement mechanisms, patients need to make co-payments (or in some cases to pay the full price) for prescribed medications. This indicates that the purchasing power of people in 10.1186/s12913-015-1089-4 the particular country can play a major role and be related with the economic situation in the country. Lithuania, which has reported the highest refrain rates, had the lowest gross domestic product (at the time of conducting this study) of all participating countries in the study. Conclusions: Refraining from buying the prescribed medications due to cost is a problem for women and men in respect to ageing people in Europe. Prevalence varies by country, sex, and economic hardship.The ABUEL was supported by the Executive Agency for Health and Consumers (EAHC) (Grant No., A/2007123) and participating institutions

Differences in reporting somatic complaints in elderly by education level

Aim: To evaluate the association between somatic complaints and education level among elders in selected European countries. Methods: Cross-sectional study among randomly selected community dwelling persons aged 60–84 years from seven cities in Europe: Ancona (Italy), Athens (Greece), Granada (Spain), Kaunas (Lithuania), Stuttgart (Germany), Porto (Portugal) and Stockholm (Sweden). Somatic complaints were measured with the 24-item version of the Giessen Complaint List (GBB-24). A regression analysis was done to investigate the association between education and somatic complaints. Results. The mean GBB-24 scale was 16.3±14.9. The most common complaints were pain in joints and limbs (29.6%), back-pain (24.1%), heaviness or tiredness in the legs (19.1%) and general tiredness (15.7%). Respondents with less than primary education reported higher levels of somatic symptoms compared to those with university degree. A regression analysis showed that higher education (OR=0.69) and being male (OR=0.48) were associated with a decreased risk for high levels of somatic complaints, and the opposite for older age (OR=1.03) and being single/divorced/window (OR=1.28). Conclusions: The results indicate that less educated elders are more likely to expressed somatic complaints

Divorce Trends in Seven Countries Over the Long Transition from State Socialism: 1981–2004

The collapse of communism was a defining geopolitical event of late-20th century Europe, with well-documented economic, social, and political implications. Yet there is a striking absence of research on how it influenced divorce. The objective of this study is to provide an exploratory analysis of trends in divorce over the long transition from communism—starting from the decline of the communist economy in the 1980s and ending with economic revival—in seven countries: Bulgaria, Estonia, Hungary, Lithuania, Poland, Romania, and Russia. We discuss how the transition could be expected to either increase or decrease divorce risks. We analyze retrospective micro-level data on first marriages from the Changing Life Course Regimes in Eastern Europe (CLiCR) dataset. Based on our event-history analyses, we find that divorce rates increased in each country at some stage during the long transition and these increases cannot be explained by compositional change of the marriages. However, no uniform pattern emerged in the timing and duration of the increase in divorce risk. This striking variation leads us to conclude that even the effect of major societal ruptures is contextually contingent

L'opinion publique et l'éducation sexuelle en URSS.

Bodrova V, Stankuniene V., Mytil A. L'opinion publique et l'éducation sexuelle en URSS.. In: Population, 47ᵉ année, n°1, 1992. pp. 204-211

Linked versus unlinked estimates of mortality and length of life by education and marital status: Evidence from the first record linkage study in Lithuania

Earlier studies have found large and increasing with time differences in mortality by education and marital status in post-Soviet countries. Their results are based on independent tabulations of population and deaths counts (unlinked data). The present study provides the first census-linked estimates of group-specific mortality and the first comparison between census-linked and unlinked mortality estimates for a post-Soviet country. The study is based on a data set linking 140,000 deaths occurring in 2001-2004 in Lithuania with the population census of 2001. The same socio-demographic information about the deceased is available from both the census and death records. Cross-tabulations and Poisson regressions are used to compare linked and unlinked data. Linked and unlinked estimates of life expectancies and mortality rate ratios are calculated with standard life table techniques and Poisson regressions. For the two socio-demographic variables under study, the values from the death records partly differ from those from the census records. The deviations are especially significant for education, with 72-73%, 66-67%, and 82-84% matching for higher education, secondary education, and lower education, respectively. For marital status, deviations are less frequent. For education and marital status, unlinked estimates tend to overstate mortality in disadvantaged groups and they understate mortality in advantaged groups. The differences in inter-group life expectancy and the mortality rate ratios thus are significantly overestimated in the unlinked data. Socio-demographic differences in mortality previously observed in Lithuania and possibly other post-Soviet countries are overestimated. The growth in inequalities over the 1990s is real but might be overstated. The results of this study confirm the existence of large and widening health inequalities but call for better data.Socio-economic inequalities Differential mortality Health Lithuania Baltic countries

Différences socioculturelles de mortalité en Lituanie : résultats d'un couplage des données de l'état civil et du recensement de 2001

Jusqu’à présent, dans les pays d’Europe centrale et orientale autrefois sous régime communiste, la mesure des différences sociales de mortalité s’est toujours heurtée à l’impossibilité de coupler des données de recensement à des données d’état civil pour éviter le biais classique causé par l’incohérence entre le statut individuel observé au recensement et celui déclaré au moment du décès à l’état civil. L’étude dont les résultats sont présentés ici est l’une des toutes premières jamais réalisées dans un pays issu du bloc soviétique sur la base d’un couplage des données individuelles d’état civil avec celles d’un recensement, en l’occurrence les décès de 2001-2004 avec le recensement de 2001. L’étude porte sur les différences de mortalité par cause parmi les personnes âgées de plus de 30 ans selon le niveau d’instruction, l’état matrimonial, le groupe ethnique et le milieu de résidence. De fait, les résultats obtenus sont différents de ceux qu’aurait donnés l’approche agrégée traditionnelle, mais confirment l’existence de très fortes inégalités. Les maladies infectieuses et les conséquences de l’alcoolisme s’avèrent particulièrement discriminantes

Sociocultural Mortality Differentials in Lithuania: Results Obtained by Matching Vital Records with the 2001 Census Data

When measuring social differences in mortality in the former socialist countries of central and eastern Europe, it has been impossible, until now, to link census data and vital records to avoid the classic problem of bias caused by inconsistency between the individual status recorded in the census and that reported at the time of death. The results presented here come from one of the first studies ever conducted in a former Soviet-bloc country based on linkage of individual vital records with census data, in this case deaths in 2001-2004 and the 2001 census. The study considers cause-specific mortality differentials among persons over age 30 by educational level, marital status, ethnicity and place of residence. The results differ from those that would have been obtained with the traditional aggregative approach but confirm the existence of sharp inequalities, notably for infectious diseases and the effects of alcoholism

A Turbulent political history and the legacy of state Socialism in the Baltic countries

This chapter provides a survey of the political, socio-economic and demographic development of the Baltic countries. It is meant to give readers a general understanding of the setting in which large urban housing estates were built from the 1960s to the 1980s. The chapter begins with an account of the history of the Baltic countries, including their emergence as independent nations, their incorporation into the USSR and their reappearance on the world map in 1991. The second section analyses the modernisation of the Baltic economies, the Soviet strategies for industrialisation and their impact on the housing sector. The Baltic region enjoyed somewhat higher living standards and exhibited greater openness to Western influences than other union republics, which made Estonia, Latvia and Lithuania attractive to economic migrants from other parts of the USSR. The analysis also shows that the Baltic countries experienced demographic modernisation earlier than other regions of the USSR. A high demand for labour is driven by Soviet strategies for economic development, and slow population growth in the host countries, particularly in Estonia and Latvia, contributed to the persistence of high levels of immigration throughout the post-war decades. Due to their large numbers, migrant workers significantly transformed the composition of the urban population in the Baltic countries. Through a combination of factors, including the housing allocation mechanism, immigrants gained privileged access to new accommodation, and they became over-represented in the housing estates. This development connects the future of the housing estates with the integration of immigrants who settled in the region during the Soviet era