Socioeconomic position and subjective health and well-being among older people in Europe

Poorer people are more likely to have a poorer health. Socioeconomic inequality in health extends worldwide and remains persistent in Europe despite increases in wealth, educational attainment, proportions of working in non-manual jobs, and expenditure on health services. All age groups are affected. We reviewed the evidence on health inequalities in Europe, focusing on older people, a group which is growing fast and is vulnerable to adverse socioeconomic circumstances

Predictors for early introduction of solid food among Danish mothers and infants: an observational study

Background Early introduction of complementary feeding may interfere with breastfeeding and the infant’s self-controlled appetite resulting in increased growth. The aim of the present study was to investigate predictors for early introduction of solid food. Methods In an observational study Danish mothers filled in a self-administered questionnaire approximately six months after birth. The questionnaire included questions about factors related to the infant, the mother, attachment and feeding known to influence time for introduction of solid food. The study population consisted of 4503 infants. Data were analysed using ordered logistic regression models. Outcome variable was time for introduction to solid food. Results Almost all of the included infants 4386 (97%) initiated breastfeeding. At weeks 16, 17–25, 25+, 330 infants (7%); 2923 (65%); and 1250 (28%), respectively had been introduced to solid food. Full breastfeeding at five weeks was the most influential predictor for later introduction of solid food (OR = 2.52 CI: 1.93-3.28). Among infant factors male gender, increased gestational age at birth, and higher birth weight were found to be statistically significant predictors. Among maternal factors, lower maternal age, higher BMI, and being primipara were significant predictors, and among attachment factors mother’s reported perception of the infant as being temperamental, and not recognising early infant cues of hunger were significant predictors for earlier introduction of solid food. Supplementary analyses of interactions between the predictors showed that the association of maternal perceived infant temperament on early introduction was restricted to primiparae, that the mother’s pre-pregnancy BMI had no impact if the infant was fully breastfed at week five, and that birth weight was only associated if the mother had reported early uncertainty in recognising infant’s cues of hunger. Conclusions Breastfeeding was the single most powerful indicator for preventing early introduction to solid food. Modifiable predictors pointed to the importance of supporting breastfeeding and educating primipara and mothers with low birth weight infants to be able to read and respond to their infants’ cues to prevent early introduction to solid food

Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review

Objectives: Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe. Method: Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and IBSS. We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population based samples of older people in Europe and published 1995-2013. Results: A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances. Conclusion: The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors

Data sources on the older population in Europe: comparison of the generations and gender survey (GGS) and the survey of health, ageing and retirement in Europe (SHARE)

The Survey of Health, Ageing and Retirement in Europe (SHARE) and the Generations and Gender Survey (GGS) are two widely used European longitudinal surveys with data on sociodemographic and health topics, but their comparability has not been systematically investigated. We compared SHARE and GGS data for 50-80 year olds in seven European countries (Belgium, Estonia, France, Germany, Hungary, the Netherlands and Poland) to assess data quality and the potential for joint analyses. The results showed that information on, and distributions by, age, gender, marriage and fertility patterns were broadly similar in both sources. For some countries distributions by educational level varied between the two sources even though both reported using the International Standard Classification of Education, which may reflect variations in the timings of surveys. The wording of health questions and their placement in the questionnaire sometimes differed between the surveys. This may account to some extent for differences between them in estimates of the prevalence of poor health. We investigated what effect these variations might have on analyses of health inequalities by undertaking multivariable analysis of associations between education and marital status and two health indicators

The role of intention and self-efficacy on the association between breastfeeding of first and second child, a Danish cohort study

Abstract Background The impact of parity on breastfeeding duration may be explained by physiological as well as psychosocial factors. The aim in the present study was to investigate the mediating influence of intention and self-efficacy on the association between the breastfeeding duration of the first and the following child. Methods A 5-year Danish cohort study with data from online questionnaires was used. Data came from 1162 women, who participated in the “Ready for child” trial in 2006–7 and gave birth to their second child within 5 years in 2011–3. Analysis included multiple regression models with exclusive/any breastfeeding duration of first child as the exposure variables, intention and self-efficacy measured as mediators, and exclusive/any breastfeeding duration of the second child as the outcome variables. Results Duration of exclusive breastfeeding of the first child was significantly associated with exclusive breastfeeding duration of the second child (p <  0.001) and with the self-reported intention and self-efficacy in the ability to breastfeed the second child (p <  0.001). The exclusive breastfeeding period was slightly longer for the second child. Self-efficacy and intention mediated the association between breastfeeding duration in the first and second child. Together the two factors explained 48% of the association in exclusive breastfeeding and 27% of the association in any breastfeeding between the first and second child. Conclusion Due to a reinforcing effect of intention and self-efficacy, breastfeeding support should focus on helping the first time mothers to succeed as well as to identify the second time mother with low self-efficacy and additional need for support

Data sources on the older population in Europe: Comparison of the Generations and Gender Survey (GGS) and the Survey of Health, Ageing and Retirement in Europe (SHARE)

ISBN: 9782733210680. This research was funded by a European Research Council Advanced Grant (FAMHEALTH) awarded to Professor Emily Grundy, under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ ERC, reference number 324055. GGS data were obtained from the Generations and Gender Programme Data Archive and were created by the organizations and individuals listed under each respective country name at http://www.ggp-i.org/online-data-analysis.html. This paper uses data from SHARE Wave 4 release 1.1.1, as of March 28th 2013 (DOI: 10.6103/SHARE.w4.111) and SHARE Waves 1 and 2 release 2.6.0, as of November 29th 2013 (DOI: 10.6103/SHARE.w1.260 and 10.6103/SHARE.w2.260). The SHARE data collection has been primarily funded by the European Commission through the 5th Framework Programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life), through the 6th Framework Programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5- CT-2005-028857, and SHARELIFE, CIT4-CT-2006-028812) and through the 7th Framework Programme (SHARE-PREP, N° 211909, SHARE-LEAP, N° 227822 and SHARE M4, N° 261982). Additional funding from the U.S. National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11 and OGHA 04-064) and the German Ministry of Education and Research as well as from various national sources is gratefully acknowledged (see www.share-project.org for a full list of funding institutions).he Survey of Health, Ageing and Retirement in Europe (SHARE) and the Generations and Gender Survey (GGS) are two widely used European longitudinal surveys with data on socio-demographic and health topics, but their comparability has not been systematically investigated. We compared SHARE and GGS data for 50-80 year olds in seven European countries (Belgium, Estonia, France, Germany, Hungary, the Netherlands and Poland) to assess data quality and the potential for joint analyses. The results showed that information on age, gender, marriage and fertility patterns and the corresponding distributions were broadly similar in both sources. For some countries, distributions by educational level varied between the two sources even though both reported using the same International Standard Classification of Education, which may reflect variations in the timings of surveys. The differences also observed for estimates of the prevalence of poor health might come from the wording of health questions and their placement in the questionnaire that sometimes differed between the surveys. We investigated what effect these variations might have on analyses of health inequalities by undertaking multivariable analysis of associations between education and marital status and two standard health indicators: self-reported health (SHR) and long-standing illness (LSI).Publisher PDFPeer reviewe

Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review Socio-economic position and subjective health and well-being among older people in Europe: a systematic narrative review

Objectives: Previous studies of older European populations have established that disability and morbidity vary with indicators of socio-economic position (SEP). We undertook a systematic narrative review of the literature to ascertain to what extent there is evidence of similar inequalities in the subjective health and well-being of older people in Europe. Method: Relevant original research articles were searched for using Medline, Global Health, Embase, Social Policy and Practice, Cinahl, Web of Science and International Bibliography of the Social Sciences (IBSS). We included studies of SEP and indicators of subjective health and well-being (self-rated health; life satisfaction; quality of life) conducted since 1991 using population-based samples of older people in Europe and published 1995À2013. Results: A total of 71 studies were identified. Poorer SEP was associated with poorer subjective health and well-being. Associations varied somewhat depending on the SEP measure and subjective health and well-being outcome used. Associations were weaker when social support and health-related behaviours were adjusted for suggesting that these factors mediate the relationship between SEP and subjective health and well-being. Associations tended to be weaker in the oldest age groups. The patterns of associations by gender were not consistent and tended to diminish after adjusting for indicators of health and life circumstances. Conclusion: The results of this systematic narrative review of the literature demonstrate the importance of social influences on later life subjective health and well-being and indicate areas which need further investigation, such as more studies from Eastern Europe, more longitudinal studies and more research on the role of mediating factors