Job loss and lower healthcare utilisation due to COVID-19 among older adults across 27 European countries

BACKGROUND: Older adults are at greater risk for becoming severely ill from COVID-19; however, the impact of the pandemic on their economic activity and non-COVID-19-related healthcare utilisation is not well understood. The aim of this study was to examine the prevalence and predictors of COVID-19-related unemployment and healthcare utilisation in a sample of older adults across 27 European countries. METHODS: We used data from the Survey of Health, Ageing and Retirement in Europe COVID-19 Survey, collected between June and August 2020. Participants (n=52 061) reported whether they lost a job, forwent medical treatment and whether their appointment was postponed due to COVID-19. Three-level models were estimated for each outcome to test the effects of individual, household and country-level characteristics. RESULTS: The mean prevalence of reported job loss, and forgone and postponed medical care was 19%, 12% and 26%, respectively. Job loss was associated with female sex, lower education and household income, and older age in women. For example, the OR of job loss, comparing primary versus tertiary (college) education, was 1.89 (95% CI 1.59 to 2.26). Forgone and postponed medical care was associated with older age in men, female sex and higher education. At the country level, postponed medical care was associated with more stringent governmental anti-COVID measures. CONCLUSION: Job loss and lower healthcare utilisation for non-COVID-19-related reasons were common among older adults and were associated with several sociodemographic characteristics. Job loss appeared to disproportionally affect already economically vulnerable individuals, raising concerns about the exacerbation of social inequalities

The explanation of educational disparities in adiposity by lifestyle, socioeconomic and mental health mediators: a multiple mediation model

BACKGROUND: The inverse association between education and obesity was previously found in numerous studies. This study aims to assess several possible mediators in the educational disparities in adiposity. We hypothesize the potential mediating role of lifestyle, socioeconomic, and mental health factors in the association between education and adiposity. METHODS: Cross-sectional population-based sample from Czechia included 2,154 25-64 years old subjects (54.6% women). Education was classified as high, middle, and low. Adiposity was assessed as a latent variable based on body fat percentage, BMI, waist circumference, and visceral fat. The mediation potential of unhealthy dietary behavior, alcohol intake, smoking, sedentary behaviors, income, stress, depression, and quality of life was assessed in age-adjusted sex-specific multiple mediation models. RESULTS: The negative direct effect of education on adiposity was statistically significant at 5% level of significance in both sexes. For men, the indirect effect was statistically significant via sedentary behavior (β = 0.041; 95% CI [0.025–0.062]) with a mediation ratio of 23.7%. In women, the indirect effect was statistically significant via dietary risk (β = −0.023, 95% CI [−0.037, −0.013]), alcohol intake (β = −0.006; 95% CI [−0.014, −0.001]), sedentary behavior (β = 0.012, 95% CI [0.004,0.023]), income (β = −0.022; 95% CI [−0.041, −0.004]), and mental health (β = −0.007; 95% CI [−0.019, −0.001]). The total mediation ratio in women was 30.5%. CONCLUSIONS: Sedentary behaviors had mediating role in the association between education and adiposity in both sexes, with more important role in men. In addition, unhealthy diet and lower income partially mediated the educational gradient in adiposity in women

Association Between Parental Supply of Alcohol and Later Adolescent Alcohol Use in a Highly Permissive Context

OBJECTIVE: Many children and adolescents get their first experience with alcohol in a family setting. Evidence suggests that parental supply of alcohol is a risk factor for drinking later in life. However, most of the previous studies have been conducted in Western countries. The Czech Republic has among the highest alcohol consumption per capita, including among adolescents, and providing their own children with sips of alcohol is widely considered by parents to be a good way to introduce children to safe drinking. This study examined whether the parental supply of alcohol is associated with later use among adolescents in an Eastern European alcohol-permissive context. METHOD: The sample included children (49% female) assessed at age 11 (n = 2,202) and age 15 (n = 1,279) from the European Longitudinal Study of Parents and Children (ELSPAC). The outcome was adolescent alcohol use at age 15, reported by adolescents and pediatricians. Predictors included different sources of alcohol (parents, family member, friend, own supply, or other sources) reported by adolescent at age 11. RESULTS: Parental supply of alcohol consistently emerged as a robust longitudinal predictor of adolescent alcohol use, with adjusted odds ratios of self-reported and pediatrician-reported frequent drinking at age 15 of 2.34 [1.19, 4.44] and 2.37 [1.02, 5.47], respectively. It also mediated the association between parental drinking and adolescent alcohol use. CONCLUSIONS: Parental supply of alcohol is an important risk factor for later adolescent alcohol use in the high alcohol-permissive population of the Czech Republic, suggesting that the association might not be context dependent