Assessing the impact of caregiving for older parents on caregivers' health: Initial health status and trajectories of physical and mental health among midlife caregivers for parents and parents-in-law in Britain.

Assessing the impact of caregiving for older parents on caregivers' health is increasingly important in the context of population changes and curtailment of state provided services. This has been extensively studied but results are inconsistent, possibly reflecting a lack of attention to health-related selection into the caregiver role. We use data from a nationally representative UK longitudinal study to analyse differences in the health of people aged 40-69 at baseline by whether they were 'eligible' to provide parent care (with a living parent/parent-in-law) and by whether they subsequently assumed a caregiver role. We measured initial health status using a latent variable derived from three observer-recorded indicators as well as self-reported health. We analysed trajectories of physical and mental health over a seven-year follow-up for those providing intensive care (20+ hours per week) to a parent or parent-in-law, providers of lesser amounts of care, and non-caregivers. Outcomes were measured using the SF-12 indicators of mental and physical health. RESULTS: showed that those with a living parent or parent-in-law had better health than those lacking these relatives. However, among potential caregivers for a parent or parent-in-law, those assuming intensive caregiving had poorer initial health than non-caregivers or those who became providers of less intensive care. Fixed effects analyses of follow-up data showed that the mental health of intensive caregivers deteriorated. However, the physical health of intensive caregivers with low levels of education improved. RESULTS: show the importance of taking account of whether people are at risk of providing parental care and initial health status when assessing impacts of caregiving on health. They also indicate differential effects of caregiving on health depending on socio-demographic characteristics and reaffirm the need for greater supports for those providing substantial amounts of care to older parents.

Cared and uncared populations: understanding unmet care needs of older adults (65+) across different social care systems in Europe.

Population care needs are dynamic. They change throughout individuals' life courses and are related to the population structure. These needs are particularly demanding during population ageing and may vary depending on how societies cope with them. In this study, we explored the unmet social care needs of individuals in twelve European countries with different social care systems. We used data from the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to conduct a cross-sectional study of individuals aged 65 and over with care needs (n = 7136). Unmet care needs were measured from an absolute approach. We fitted binomial regression models to explain the relative importance of individuals' characteristics, health status and different social care systems on unmet needs. The absolute measure shows that 53.02% of the analytical sample faced unmet care needs as they reported limitations and did not receive help. The prevalence of unmet care needs is higher for men than women and for younger than older individuals. Furthermore, we found that individuals living in Mediterranean social care systems have the highest prevalence of these unmet needs. This analysis contributes to the ongoing debate about the challenges posed by ageing populations and their relationship with care.

Corrigendum: Gender Gap in Unhealthy Life Expectancy: The Role of Education Among Adults Aged 45.

[This corrects the article DOI: 10.3389/ijph.2022.1604946.].

Gender Gap in Unhealthy Life Expectancy: The Role of Education Among Adults Aged 45.

Objectives: This paper examines the gender gap in unhealthy life expectancy across education levels and age in Spain to understand the extent to which the gender paradox exists over education and across ages. Methods: Death registrations and vital status were taken from the Spanish Statistical Office, while the three health measures (chronic conditions, bad-self rated health and cognitive impairment) from the 2019 European Health Interview Survey. We used Sullivan's method to compute unhealthy life expectancy by education level. We computed the gender and the education ratios of the proportion of unhealthy life years in each health measure by education and age. Results: At almost all ages and all education levels, women significantly lived longer but in poorer health than men. Marked gender differences are seen across most age-groups, particularly among the low educated. We detected greater health inequalities by education level for women (confirming the gender paradox) and a health gradient due to aging and across the health measures charting the disablement process. Conclusion: The new education distribution might improve the unhealthy life expectancy and might reduce the gender gap in the number of years spent in poor health.

Macro-level factors explaining inequalities in expected years lived free of and with chronic conditions across Spanish regions and over time (2006-2019).

Life expectancy has long been associated with macro-level factors, including health expenditures, but little research has focused on the relationship with morbidity measures. This paper examines the relationship between the expected years lived free of and with chronic conditions (YLFCC and YLCC) at age 50 and macroeconomic and social factors including, for the first time, several indicators of public health expenditure. We calculate YLFCC and YLCC for Spanish regions using the Sullivan method over a long period of time (2006-2019). Spain is a good case study due to two reasons. First, its national health system is decentralized among regional administrations since 2002. Second, the financial crisis of 2008 led to public health cuts in 2010-2014 that each region handled differently. We use fixed-effects models to assess the relationship between changes in macro-level regional indicators (socioeconomic factors, healthcare resources, health behavior and public health expenditures) with YLFCC and YLCC across regions and over time. Results show that socioeconomic levels, public health expenditure, healthcare resources and health behaviors are associated with years lived free of and with chronic conditions when analyzing them independently. However, in the global model including all these dimensions only public health expenditure is associated with both YLFCC and YLCC for men and women, showing that a higher level of expenditures is correlated with more YLFCC and less YLCC. Therefore, regional authorities need to pay special attention to the level of investments on health services, as they are clearly associated with a better quality of living of the middle age and older population.

[Household structure of older persons in Latin America and the CaribbeanA estrutura de moradia de idosos na América Latina e no Caribe]. / La estructura de los hogares de las personas mayores en América Latina y el Caribe.

OBJECTIVE: Analyze cohabitation patterns in the population over 60 years of age living in private households in 23 countries in Latin America and the Caribbean. METHODS: Cross-sectional study based on the most recently available census microdata from the Integrated Public Use Microdata Series (IPUMS, International), corresponding mainly to the 2010 census. Average number of household members, age distribution, and family relationships were calculated and compared for each country and by sex. The average number of household members was compared, by country and by sex, in relation to level of schooling and marital status. RESULTS: The average number of people that older people live with differs between countries, ranging from two or less in countries such as Argentina, Puerto Rico, and Uruguay, to four or more in countries such as Honduras and Nicaragua. This difference depends on a greater or lesser presence of young adults, children, and other family members in the household. The number of household members declines with a higher level of schooling, except in Cuba and Puerto Rico, where no differences are observed. In general, older women live in households with fewer people than men, although this is not the case for unmarried or divorced people. CONCLUSIONS: In the Region, it is common for older persons to live with children and other family members. The differences between countries and by educational level show that the family plays an important role in social protection of the elderly in less developed countries and in the least educated groups.

OBJETIVO: Analisar os padrões de convivência da população de 60 anos ou mais que reside em moradias particulares em 23 países da América Latina e do Caribe. MÉTODOS: Estudo transversal realizado com base nos microdados censitários mais recentes disponíveis no Integrated Public Use Microdata Series (IPUMS)-International, na maior parte correspondente à etapa censitária de 2010. O número médio de coabitantes, sua distribuição por idade e as relações de parentesco estabelecidas entre eles foram calculados e comparados para cada país e por sexo. A média de coabitantes em função do nível de escolaridade e do estado civil foi comparada por país e por sexo. RESULTADOS: A média do número de pessoas com quem os idosos convivem difere entre países. Oscila entre 2 pessoas em países como Argentina, Porto Rico e Uruguai e 4 ou mais pessoas em países como Honduras e Nicarágua. Essa diferença resulta da maior ou menor presença de jovens, filhos e outros familiares em casa. Quanto maior o nível de escolaridade, menor o número de coabitantes, exceto em Cuba e em Porto Rico, onde não são observadas diferenças. Em geral, as mulheres idosas vivem em moradias com menos pessoas que os homens, embora não seja o caso das pessoas solteiras ou divorciadas. CONCLUSÕES: A convivência com filhos e outros familiares é habitual na Região. As diferenças entre países e por nível educacional mostram que a família desempenha um papel importante na proteção social da velhice nos países menos desenvolvidos e nos grupos menos escolarizados.

La estructura de los hogares de las personas mayores en América Latina y el Caribe

[RESUMEN]. Objetivo. Analizar las pautas de convivencia de la población de 60 años o más que reside en hogares priva-dos en 23 países de América Latina y el Caribe. Métodos. Estudio transversal realizado con base en los microdatos censales más recientes disponibles en Integrated Public Use Microdata Series (IPUMS)-International, la mayoría de ellos correspondientes a la ronda censal de 2010. Se calcularon y se compararon, para cada país y por sexo, el número medio de convivientes, su distribución por edad y las relaciones de parentesco que se establecen entre ellos. Se compararon, por país y por sexo, el promedio de convivientes en función del nivel de escolaridad y del estado civil. Resultados. El promedio del número de personas con las que convive la gente mayor difiere entre países. Oscila entre dos personas en países como Argentina, Puerto Rico y Uruguay, y cuatro o más personas en países como Honduras y Nicaragua. Esta diferencia resulta de la mayor o menor presencia de personas jóvenes, hijos y otros familiares en el hogar. El número de convivientes disminuye con el mayor nivel de escolaridad, salvo en Cuba y en Puerto Rico, donde no se observan diferencias. En general, las mujeres mayores viven en hogares con menos personas que los hombres, aunque no es el caso de las personas solteras o divorciadas. Conclusiones. La convivencia con hijos y otros familiares es habitual en la Región. Las diferencias entre países y por nivel educativo muestran que la familia juega un papel importante en la protección social de la vejez en los países menos desarrollados y en los grupos menos escolarizados.

[ABSTRACT]. Objective. Analyze cohabitation patterns in the population over 60 years of age living in private households in 23 countries in Latin America and the Caribbean. Methods. Cross-sectional study based on the most recently available census microdata from the Integrated Public Use Microdata Series (IPUMS, International), corresponding mainly to the 2010 census. Average number of household members, age distribution, and family relationships were calculated and compared for each country and by sex. The average number of household members was compared, by country and by sex, in relation to level of schooling and marital status. Results. The average number of people that older people live with differs between countries, ranging from two or less in countries such as Argentina, Puerto Rico, and Uruguay, to four or more in countries such as Honduras and Nicaragua. This difference depends on a greater or lesser presence of young adults, children, and other family members in the household. The number of household members declines with a higher level of schooling, except in Cuba and Puerto Rico, where no differences are observed. In general, older women live in households with fewer people than men, although this is not the case for unmarried or divorced people. Conclusions. In the Region, it is common for older persons to live with children and other family members. The differences between countries and by educational level show that the family plays an important role in social protection of the elderly in less developed countries and in the least educated groups.

[RESUMO]. Objetivo. Analisar os padrões de convivência da população de 60 anos ou mais que reside em moradias particulares em 23 países da América Latina e do Caribe. Métodos. Estudo transversal realizado com base nos microdados censitários mais recentes disponíveis no Integrated Public Use Microdata Series (IPUMS)-International, na maior parte correspondente à etapa cen-sitária de 2010. O número médio de coabitantes, sua distribuição por idade e as relações de parentesco estabelecidas entre eles foram calculados e comparados para cada país e por sexo. A média de coabitantes em função do nível de escolaridade e do estado civil foi comparada por país e por sexo. Resultados. A média do número de pessoas com quem os idosos convivem difere entre países. Oscila entre 2 pessoas em países como Argentina, Porto Rico e Uruguai e 4 ou mais pessoas em países como Honduras e Nicarágua. Essa diferença resulta da maior ou menor presença de jovens, filhos e outros familiares em casa. Quanto maior o nível de escolaridade, menor o número de coabitantes, exceto em Cuba e em Porto Rico, onde não são observadas diferenças. Em geral, as mulheres idosas vivem em moradias com menos pessoas que os homens, embora não seja o caso das pessoas solteiras ou divorciadas. Conclusões. A convivência com filhos e outros familiares é habitual na Região. As diferenças entre países e por nível educacional mostram que a família desempenha um papel importante na proteção social da velhice nos países menos desenvolvidos e nos grupos menos escolarizados.

Correction: Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.

[This corrects the article DOI: 10.1371/journal.pone.0240923.].

Trends in disease-free life expectancy at age 65 in Spain: Diverging patterns by sex, region and disease.

Life expectancy in Spain is among the highest in the world. Nevertheless, we do not know if improvements in health conditions at older ages have followed postponements of death. Previous studies in Spain show a stable trend in years lived in ill health in the past. In this paper we investigate changes between 2006, 2012 and 2017 in life expectancy with and without disease at age 65 in Spain and, for the first time, in Spanish regions, which have autonomous powers of health planning, public health and healthcare. Results show that, at the country level, disease-free life expectancy reduced between 2006 and 2017 in Spain. This was explained by an expansion of most diseases except for some cardiovascular and respiratory chronic conditions. However, at the regional level the evolution was different, especially regarding each disease and sex. First, regional differences reduced between 2006 and 2012 but largely widened in 2017, suggesting that not all regions had the same ability to recover after the 2008 financial crisis that caused government cuts to health services. Second, regional analysis also highlighted diverging trends by sex. While men experienced expansion of morbidity in most regions, women experienced a compression in about half of them, ending up with women showing higher disease-free life expectancies than men in 9 out of the 17 regions considered. This study, then, calls attention to the importance of focusing the analysis of health surveillance to more disaggregated levels, more in accordance with the level of health management, as regional trends showed heterogeneity in the prevalence of diseases and different progresses in the relationship between sexes.

Marital status, living arrangements, and mortality in middle and older age in Europe.

OBJECTIVES: We study the role of marital status and living arrangements in mortality among a 50+ population living in Europe by gender and welfare states. METHODS: Using data from waves 4, 5, and 6 of the Survey of Health Age and Retirement in Europe (n = 54,171), we implemented Cox proportional hazard models by gender and age groups (50-64 and 65-84). We estimated pooled models and separated models for two regions representing different welfare states (South-East and North-West). RESULTS: Among people aged 50-64, nonpartnered individuals (except never-married women) showed a higher mortality risk as compared with those partnered. Among the older population (65-84), divorce was associated with higher mortality among men, but not among women, and living with someone other than a partner was associated with higher mortality risk as compared to those partnered. In the South-East region living with a partner at ages 50-64 was associated with lower mortality. CONCLUSIONS: Partnership and residential status are complementary for understanding the role of family dimensions in mortality. The presence of a partner is mortality protective, especially among 50-64-year-old men in South-East Europe.

[Socioeconomic health inequalities in the Catalan population aged 50+ during the last economic crisis]. / Desigualdades socioeconómicas en salud en la población catalana mayor de 50 años durante la última crisis económica.

OBJECTIVE: The short- and medium-term consequences of the economic crisis since 2008 has become a cause of concern for population health. The study's objective was to analyse health inequalities according to the socioeconomic profile of the Catalan population aged 50 year and older. METHODS: Cross-sectional study using data from the Catalan Health Survey (ESCA) for the periods 2006 (N=6667), 2010-12 (N=4458) y 2013-15 (N=5469). The dependent variables were self-perceived health, mental health, medication intake and sedentary lifestyle and the independent variables: labour force activity status, educational level, health care coverage, household social class and household monthly income. On each dependent variable multivariate logistic analysis was conducted using Stata 14, adjusting for the remaining socioeconomic factors and other demographic variables, and estimating the average marginal effects for each socioeconomic category in the three observation moments. RESULTS: Between 2006 and 2013-15 the difference in the probability of having less than good self-perceived health among the population with or without double health coverage reduced from 0.06 to 0.04; between the most and least educated from 0.12 to 0.08; but did not reduce between workers and non-workers. The gap according to employment status, educational levels and income in the risk of poor mental health increased between 2006 and 2010-12 from 0.08 to 0.10, from 0.10 to 0.12 and from 0.10 to 0.13, although subsequently, inequality decreased. Difference in medication intake increased by employment status (from 0.07 to 0.10) and educational level (from -0.01 to 0.03) and in sedentary lifestyles between workers and non-workers (from 0, 05 to 0.06). Socioeconomic conditions had more impact on 50-64 year olds, especially women, while social inequality declined among men. CONCLUSIONS: Despite the crisis health generally improved, while socioeconomic health inequalities remained or reduced, barring few exceptions.

OBJETIVO: Las consecuencias a corto y medio plazo de la crisis económica desde 2008 han provocado una preocupación por la salud de la población. El objetivo del estudio fue conocer las desigualdades en salud en función del perfil socioeconómico de la población de 50 y más años en diferentes momentos de la crisis. METODOS: Estudio transversal utilizando datos de la Encuesta de Salud de Cataluña (ESCA) para los periodos 2006 (N=6667), 2010-12 (N=4458) y 2013-15 (N=5469). Las variables dependientes fueron salud autopercibida, salud mental, toma de medicamentos y sedentarismo, y las variables independientes: relación con la actividad, nivel de instrucción, cobertura sanitaria, clase social del hogar e ingresos mensuales del hogar. Para cada variable dependiente se realizó análisis logísticos multivariados mediante Stata 14 ajustados por el resto de factores socioeconómicos y otras variables demográficas y se estimaron los efectos marginales promedio para cada categoría socioeconómica en los tres momentos de observación. RESULTADOS: Entre 2006 y 2013-15 disminuyó la brecha en la probabilidad de no tener buena salud autopercibida de 0,06 a 0,04 en función de tener o no doble cobertura sanitaria y de 0,12 a 0,08 según el nivel educativo, pero se mantuvo estable entre trabajadores y no trabajadores. La brecha según actividad, niveles educativos e ingresos aumentó entre 2006 y 2010-12 en el riesgo de mala salud mental de 0,08 a 0,10, de 0,10 a 0,12 y de 0,10 a 0,13, respectivamente aunque posteriormente se redujo la desigualdad. La diferencia en la toma de medicamentos aumentó según actividad (de 0,07 a 0,10) y nivel educativo (de -0,01 a 0,03), así como en llevar una vida sedentaria entre personas que trabajaban y no trabajaban (de 0,05 a 0,06). El impacto del nivel socioeconómico fue mayor entre la población de 50-64 años, especialmente la femenina, mientras que los hombres presentaron una disminución de la desigualdad social. CONCLUSIONES: En general la salud mejoró a pesar de la crisis y la brecha de desigualdad social se mantuvo o redujo, salvo en contadas ocasiones.

Evolución del perfil de los cuidadores de personas de 65 y más años con discapacidad en la persistencia de un modelo de cuidado familiar / The changing profile of caregivers of persons aged 65 years and over with disabilities within a persisting family care model

Introducción. La creciente participación laboral femenina compromete el actual modelo de cuidado a los mayores. El objetivo es conocer la evolución del perfil sociodemográfico de los cuidadores informales de los mayores con discapacidad, la interacción entre empleo y cuidado y la opinión de la ciudadanía sobre la responsabilidad de ese cuidado. Material y métodos. Estudio transversal de las encuestas de ámbito nacional de discapacidad realizadas en 1999 (n=3.936) y en 2008 (n=5.257), la de salud de 2011-2012 (n=439) y la de familia y género de 2012 (n=1.359). Se analizaron mediante tablas de contingencia en función del sexo y la edad. Resultados. La mitad de los cuidadores estudiados son mujeres de 45 a 64 años. Entre 1999 y 2011-2012 se concentraron cada vez más en las edades 55 a 64, entre las que se dobló la participación laboral del 20% al 40%. El aumento de los cuidadores masculinos estuvo asociado al desempleo. El trabajo de cuidado repercutió negativamente en la vida laboral, con mayor impacto entre las mujeres y entre los cuidadores de mayores con discapacidad severa. Los menos proclives a que el cuidado a los mayores se fundamentara en la familia fueron las mujeres de 45 a 54 años activas (solo el 42%) o más instruidas (40%), frente al 60% de las inactivas y el 55% de las menos formadas. Conclusiones. Las mujeres activas e instruidas son menos proclives al cuidado fundamentado en la familia, pero lo asumen independientemente de su actividad, mientras que los varones lo hacen según su disponibilidad (AU)

Introduction. The increasing participation of women in the workforce may make it difficult to sustain the current model of elderly care. The aim of this article was to determine the changing sociodemographic profile of informal elderly caregivers with disabilities, the interaction between employment and care, and the view of the public on the responsibility of that care. Materials and methods. Cross-sectional analysis of secondary data from four national surveys were used: the disability surveys held in 1999 (N=3,936) and 2008 (N=5,257), the 2011-12 National Health Survey (N=439), and the Family and Gender survey of 2012 (N=1,359). They were analysed using contingency tables based on gender and age. Results. Half of the informal caregivers were women aged 45 to 64 years. Between 1999 and 2011-12 they became more concentrated in the 55-64 age-bracket, among whom participation in the workforce doubled from 20% to 40%. Increased care for men was associated with unemployment. Care work had a negative impact on working life, with greater impact among women and those who cared for elderly people with severe disabilities. Less likely to consider that elderly care provision should rest on family are 45-54 year-old economically active women (only 42%) or those who are more educated (40%), compared to 60% of economically inactive women and 55% of less educated women. Conclusions. Economically active and educated women are less inclined to family-based care, but assume it independently of their workforce participation, whereas males do so according to their availability (AU)

[The changing profile of caregivers of persons aged 65 years and over with disabilities within a persisting family care model]. / Evolución del perfil de los cuidadores de personas de 65 y más años con discapacidad en la persistencia de un modelo de cuidado familiar.

INTRODUCTION: The increasing participation of women in the workforce may make it difficult to sustain the current model of elderly care. The aim of this article was to determine the changing sociodemographic profile of informal elderly caregivers with disabilities, the interaction between employment and care, and the view of the public on the responsibility of that care. MATERIALS AND METHODS: Cross-sectional analysis of secondary data from four national surveys were used: the disability surveys held in 1999 (N=3,936) and 2008 (N=5,257), the 2011-12 National Health Survey (N=439), and the Family and Gender survey of 2012 (N=1,359). They were analysed using contingency tables based on gender and age. RESULTS: Half of the informal caregivers were women aged 45 to 64 years. Between 1999 and 2011-12 they became more concentrated in the 55-64 age-bracket, among whom participation in the workforce doubled from 20% to 40%. Increased care for men was associated with unemployment. Care work had a negative impact on working life, with greater impact among women and those who cared for elderly people with severe disabilities. Less likely to consider that elderly care provision should rest on family are 45-54 year-old economically active women (only 42%) or those who are more educated (40%), compared to 60% of economically inactive women and 55% of less educated women. CONCLUSIONS: Economically active and educated women are less inclined to family-based care, but assume it independently of their workforce participation, whereas males do so according to their availability.

Desigualdades socioeconómicas en salud en la población catalana mayor de 50 años durante la última crisis económica / Socioeconomic health inequalities in the Catalan population aged 50+ during the last economic crisis

Fundamentos: Las consecuencias a corto y medio plazo de la crisis económica desde 2008 han provocado una preocupación por la salud de la población. El objetivo del estudio fue conocer las desigualdades en salud en función del perfil socioeconómico de la población de 50 y más años en diferentes momentos de la crisis. Métodos: Estudio transversal utilizando datos de la Encuesta de Salud de Cataluña (ESCA) para los periodos 2006 (N=6731), 2010-12 (N=4466) y 2013-15 (N=5692). Las variables dependientes fueron salud autopercibida, salud mental, toma de medicamentos y sedentarismo, y las variables independientes: relación con la actividad, nivel de instrucción, cobertura sanitaria, clase social del hogar e ingresos mensuales del hogar. Para cada variable dependiente se realizó análisis logísticos multivariados mediante Stata 14 ajustados por el resto de factores socioeconómicos y otras variables demográficas y se estimaron los efectos marginales promedio para cada categoría socioeconómica en los tres momentos de observación. Resultados: Entre 2006 y 2013-15 disminuyó la brecha en la probabilidad de no tener buena salud autopercibida de 0,06 a 0,04 en función de tener o no doble cobertura sanitaria y de 0,12 a 0,08 según el nivel educativo, pero se mantuvo estable entre trabajadores y no trabajadores. La brecha según actividad, niveles educativos e ingresos aumentó entre 2006 y 2010-12 en el riesgo de mala salud mental de 0,08 a 0,10, de 0,10 a 0,12 y de 0,10 a 0,13, respectivamente aunque posteriormente se redujo la desigualdad. La diferencia en la toma de medicamentos aumentó según actividad (de 0,07 a 0,10) y nivel educativo (de -0,01 a 0,03), así como en llevar una vida sedentaria entre personas que trabajaban y no trabajaban (de 0,05 a 0,06). El impacto del nivel socioeconómico fue mayor entre la población de 50-64 años, especialmente la femenina, mientras que los hombres presentaron una disminución de la desigualdad social. Conclusiones: En general la salud mejoró a pesar de la crisis y la brecha de desigualdad social se mantuvo o redujo, salvo en contadas ocasiones

Background: The short- and medium-term consequences of the economic crisis since 2008 has become a cause of concern for population health. The study's objective was to analyse health inequalities according to the socioeconomic profile of the Catalan population aged 50 year and older. Methods: Cross-sectional study using data from the Catalan Health Survey (ESCA) for the periods 2006 (N=6731), 2010-12 (N=4466) y 2013-15 (N=5692). The dependent variables were self-perceived health, mental health, medication intake and sedentary lifestyle and the independent variables: labour force activity status, educational level, health care coverage, household social class and household monthly income. On each dependent variable multivariate logistic analysis was conducted using Stata 14, adjusting for the remaining socioeconomic factors and other demographic variables, and estimating the average marginal effects for each socioeconomic category in the three observation moments. Results: Between 2006 and 2013-15 the difference in the probability of having less than good self-perceived health among the population with or without double health coverage reduced from 0.06 to 0.04; between the most and least educated from 0.12 to 0.08; but did not reduce between workers and non-workers. The gap according to employment status, educational levels and income in the risk of poor mental health increased between 2006 and 2010-12 from 0.08 to 0.10, from 0.10 to 0.12 and from 0.10 to 0.13, although subsequently, inequality decreased. Difference in medication intake increased by employment status (from 0.07 to 0.10) and educational level (from -0.01 to 0.03) and in sedentary lifestyles between workers and non-workers (from 0, 05 to 0.06). Socioeconomic conditions had more impact on 50-64 year olds, especially women, while social inequality declined among men. Conclusions: Despite the crisis health generally improved, while socioeconomic health inequalities remained or reduced, barring few exceptions

Modelos de convivencia de las personas mayores en Cataluña. Impacto del deterioro de la salud en la independencia residencial / Living arrangements of elderly adults in Catalonia (Spain). The impact of health deterioration on residential independence

Objetivos. Identificar el efecto del deterioro del estado de salud en las situaciones de dependencia residencial. Material y métodos. Estudio transversal de los microdatos de la Encuesta de Salud de Cataluña (2006), que cuenta con una muestra de 3.566 mayores de 64 años. Mediante regresión logística bivariada y multivariada, se analizan factores sociodemográficos (sexo, edad, estado civil, nivel de estudios y tamaño del municipio) y de salud (salud percibida y grado de dependencia para las ABVD y AIVD) susceptibles de estar asociados a la dependencia residencial de los mayores. Resultados. El análisis multivariado muestra que los factores más discriminantes en las formas de convivencia y que más vulneran la independencia residencial de hombres y mujeres son la edad, el estado civil y el deterioro de la salud. Para los hombres, ser mayor de 79 años (OR>4), soltero o viudo (OR=6,4), y tener alguna dependencia en AIVD (OR>2,8) están asociados con la dependencia residencial. Mientras que para las mujeres, ser mayor de 79 años (OR>4), soltera (OR=6,8) o viuda (OR=11,8), y tener tres o más dependencias en AIVD (OR=2,7) están asociados con la dependencia residencial. Asimismo, el tamaño del municipio y el nivel de estudios (en este último caso sólo para los hombres), presentan valores significativos (p<0,05). Conclusión. A pesar de que el deterioro de la salud, y sobre todo la dependencia en las AIVD, inciden en la dependencia residencial, su influencia es menor que la de otras variables de carácter sociodemográfico, como son el estado civil o la edad. Además su influencia es mucho mayor entre los hombres que entre las mujeres, las cuales viven de manera independiente hasta que tienen muy limitada su vida cotidiana, mientras que ellos recurren más fácilmente a la dependencia residencial(AU)

Objectives. To identify the effect of health deterioration on residential dependency. Material and methods. We performed a cross-sectional analysis of the microdata from the Catalan Survey of Health (2006), which features a sample of 3566 individuals aged 65 and over. A set of socio-demographic (sex, age, marital status, educational level and municipality size), as well as health variables (self-rated health, BADL and IADL dependency) associated with residential dependency are analysed by bivariate and multivariate logistic regression. Results. Multivariate analysis shows that age, marital status and health are the variables that most affect living arrangements and cohabitation. Among men, being aged 80 or over (OR>4), being unmarried or widowed (OR=6.4) and having one or more IADL dependencies (OR>2.8) increases the risk of residential dependency. Whereas for women being aged 80 and over (OR>4), being unmarried (OR=6.8) or widowed (OR=11.8) and having three or more IADL dependencies (OR=2.7) is associated with residential dependency. Municipality size and the level of education (in the latter case only for men) are also significant determining factors (P<0.05). Conclusion. Although health deterioration, and especially IADL dependency, affects residential dependency, its impact is lower than that of socio-demographic variables, such as marital status or age. What is more, health has a greater influence on men than women, who live independently until they experience great difficulty in coping with their activities of daily living. On the other hand, men seem to fall more easily into residential dependency once they experience any IADL dependency(AU)

[Living arrangements of elderly adults in Catalonia (Spain). The impact of health deterioration on residential independence]. / Modelos de convivencia de las personas mayores en Cataluña. Impacto del deterioro de la salud en la independencia residencial.

OBJECTIVES: To identify the effect of health deterioration on residential dependency. MATERIAL AND METHODS: We performed a cross-sectional analysis of the microdata from the Catalan Survey of Health (2006), which features a sample of 3566 individuals aged 65 and over. A set of socio-demographic (sex, age, marital status, educational level and municipality size), as well as health variables (self-rated health, BADL and IADL dependency) associated with residential dependency are analysed by bivariate and multivariate logistic regression. RESULTS: Multivariate analysis shows that age, marital status and health are the variables that most affect living arrangements and cohabitation. Among men, being aged 80 or over (OR>4), being unmarried or widowed (OR=6.4) and having one or more IADL dependencies (OR>2.8) increases the risk of residential dependency. Whereas for women being aged 80 and over (OR>4), being unmarried (OR=6.8) or widowed (OR=11.8) and having three or more IADL dependencies (OR=2.7) is associated with residential dependency. Municipality size and the level of education (in the latter case only for men) are also significant determining factors (P<0.05). CONCLUSION: Although health deterioration, and especially IADL dependency, affects residential dependency, its impact is lower than that of socio-demographic variables, such as marital status or age. What is more, health has a greater influence on men than women, who live independently until they experience great difficulty in coping with their activities of daily living. On the other hand, men seem to fall more easily into residential dependency once they experience any IADL dependency.