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Restrictive federal and state immigration policies create conditions of employment exclusion that may negatively influence the health of immigrants. In particular, these policy effects are reflected in labor market and workplace experiences that determine the types of work and employment opportunities that immigrants are able to access and pursue. This study examines the relationship between both cumulative and individual measures of employment exclusion and self-rated health and psychological distress among Asian and Latino immigrants in California, and whether this relationship is modified by legal status. We used data from the Research on Immigrant Health and State Policy (RIGHTS) study (n = 2010). We used both multivariable logistic regression and linear regression models for our analyses. For cumulative models, labor market exclusion was associated with poor health (OR = 1.21, 95% CI: 1.01, 1.46). Workplace exclusion was also associated with poor self-rated health (OR = 1.45, 95% CI: 1.15, 1.82) and increased psychological distress (β = 0.69, 95% CI: 0.31, 1.07). For individual measures of employment exclusion, settling for a job - a labor market exclusion - and working in a dangerous job and experiencing wage theft - workplace exclusions - were associated with poor health and increased psychological distress. There was no evidence that the association between employment exclusions and health varied by legal status. These findings demonstrate that the combined effect of employment exclusions is detrimental to immigrant health. To improve population health, public health researchers should continue to interrogate the policy conditions at the federal, state, and local level that exclude immigrants from employment opportunities and workplace protections.

Social participation is crucial for enhancing senior's well-being and promoting their integration into society. Using nationwide data investigated in China, this study explored the association between self-reported visual impairment, health level, and social participation among Chinese middle-aged old adults. It has been found that (a) the probability and frequency of social participation among middle-aged and older adults with self-reported vision loss were significantly lower than those without vision problems; (b) self-reported vision loss was negatively associated with self-rated health and mental health status, and both were positively associated with social participation; and (c) self-rated health and mental health played a mediating role between vision loss and social participation. The findings suggest that under the framework of active aging, universal vision screening programs and rehabilitation plans for the older adults with visual impairment are exceedingly significant to promote their participation in social activities, thereby enhancing their quality of life. [ABSTRACT FROM AUTHOR]

Adults aged 65+ are at highest risk for severe COVID-19 outcomes, and prior to the distribution of vaccines in the U.S., were strongly advised to quarantine at home to reduce risk of infection. This study examines how COVID-19 restrictions impacted various dementia risk factors and social determinants of health among older adults. Data came from the Systematic Multi-Domain Alzheimers Risk Reduction Trial, a randomized controlled trial of a multi-domain intervention in higher-risk older adults (aged 70-89). A questionnaire was administered to participants (n = 156; 90.7% response rate) between May 2020 and March 2021. The data show a significant decline in social activity, physical activity, and mood among respondents. Compared to living with others, living alone was associated with worsened physical activity, diet, and subjective memory/thinking, adjusted for sex and age. These results suggest that the COVID-19 pandemic exacerbated several risk factors for dementia in older adults, particularly in those living alone.

INTRODUCTION: Childhood circumstances impact senior health, prompting the introduction of machine learning methods to assess their individual and collective contributions to senior health. METHODS: Using health and retirement study (HRS) and China Health and Retirement Longitudinal Study (CHARLS), we analyzed 2,434 American and 5,612 Chinese participants aged 60 and above. Conditional inference trees and forests were employed to estimate the influence of childhood circumstances on self-rated health (SRH). RESULTS: The conventional method estimated higher inequality of opportunity (IOP) values in both China (0.039, accounting for 22.67% of the total Gini coefficient 0.172) and the US (0.067, accounting for 35.08% of the total Gini coefficient 0.191). In contrast, the conditional inference tree yielded lower estimates (China: 0.022, accounting for 12.79% of 0.172; US: 0.044, accounting for 23.04% of 0.191), as did the forest (China: 0.035, accounting for 20.35% of 0.172; US: 0.054, accounting for 28.27% of 0.191). Childhood health, financial status, and regional differences were key determinants of senior health. The conditional inference forest consistently outperformed others in predictive accuracy, as demonstrated by lower out-of-sample mean squared error (MSE). DISCUSSION: The findings emphasize the need for early-life interventions to promote health equity in aging populations. Machine learning showcases the potential in identifying contributing factors.

Child maltreatment seriously affects children's psychological and social well-being, as well as their physical health. The study aimed to explore the impact of violence experienced by children on their self-rated health. It also examined whether this effect is mediated by parent–child conversations and whether it varies based on the child's gender. The study was based on the Child Victim Survey of 2013 (FSD2943) in Finland. Mediation and moderation models were tested. According to the analyses, violence experienced by a child at the hands of their parents weakened the parent–child relationship, which, in turn, negatively impacted the child's self-rated health. Further, the higher the frequency of experienced violence, the more negative are the health consequences. However, girls had stronger negative health consequences as a result of low frequency of violence than boys. Social workers should pay particular attention to the dynamics within the family when assessing the possibility of child maltreatment. [ABSTRACT FROM AUTHOR]

To examine the role of work in the bereavement process, we focused on health changes among widowed adults. We analyzed a sample of 518 adults (aged 52–95) from the Korean Retirement and Income Study (2011–2019) who experienced spousal loss during the study period. The widowed participants provided data on their employment status and perceived health at both pre-loss and post-loss. Widowed participants reported worse physical and mental health after the bereavement, but the significant health deterioration was not observed among employed participants. Adjusting for pre-loss health status and other covariates, employed widow(er)s showed a smaller decrease in physical and mental health, compared to their counterparts. The effect of employment on physical health changes was more pronounced for economically vulnerable widow(er)s. Work might serve as a restoring coping strategy for widowed individuals; economic benefits from the job may also contribute to their health and well-being. [ABSTRACT FROM AUTHOR]

The benefits of tea consumption as a special diet for health and life satisfaction have attracted considerable attention; however, it is not clear whether the effect of tea consumption on self‐rated health (SRH) and self‐rated life satisfaction (SRL) is equal among all types of tea, and it is unclear whether these associations are impacted by gender and age in older adults. This study aimed to examine the associations between tea consumption, SRH and SRL in older adults and to explore the role of gender and age. Participants aged 65–105 (N = 78,345) were interviewed in the years 2002, 2005, 2008, 2011, 2014 and 2018 in the Chinese Longitudinal Healthy Longevity Study (CLHLS). Generalized estimation equations (GEE) with the identity link function were adopted to estimate the cross‐sectional associations of tea consumption with SRH and SRL. GEE with the logic link function were used to explore the longitudinal associations of tea consumption with SRH decline and SRL decline. Drinking tea at present, especially scented tea, was significantly associated with better SRH and SRL for older adults. Male participants benefited more from tea consumption than females, and the protective effect of green tea consumption on improving SRH and SRL in males was evident. Older adults aged 90–105 with current tea consumption daily had better SRH and reduced risk of SRL decline. [ABSTRACT FROM AUTHOR]

The association between self-rated health (SRH) and the development of atrial fibrillation (AF) in the general population remains underexplored. We reviewed the data of 9,895 participants in the Ansung–Ansan cohort study, a community-based Korean study. SRH was categorised as 'poor', 'fair', or 'good'. A newly developed AF was identified through biennial electrocardiography examinations and/or a self-reported history of physician-determined diagnoses. Over a median follow-up of 11 years, 149 patients (1.5%) developed AF. Compared with the 'good' group, the 'poor' group exhibited a higher risk of incident AF (adjusted hazard ratio, 1.85; 95% confidence interval, 1.19–2.87). Old age, female sex, lower educational level, smoking, cardiovascular diseases (hypertension, diabetes mellitus, and coronary artery disease), and inflammation were associated with 'poor' SRH. Along with SRH, age, male sex, urban residence, hypertension, and myocardial infarction were also associated with a higher risk of incidental AF. The combined model, which included conventional risk factors and SRH, demonstrated a marginally improved performance in predicting incident AF (concordance index: 0.704 vs. 0.714, P = 0.058). Poor SRH is independently associated with the development of AF in Korean adults. However, it plays a limited role in AF surveillance when combined with conventional AF risk factors. [ABSTRACT FROM AUTHOR]

Informal caregivers of older adults usually suffer from loneliness, which makes them vulnerable to reduced health outcomes. This study attempted to explore whether internet usage mitigates the effects of loneliness on subjective health among informal caregivers of older adults. A sample of 1089 informal caregivers (mean age = 58.0 ± 15.7 years, 60.3% females) providing unpaid cares for older adults in the United States were investigated. Their loneliness, subjective health, and utilization of caregiving-related online resources were measured. Descriptive statistics and correlation analyses were conducted to summarize the sample’s characteristics and determine the relationships among the study variables, respectively. Finally, a multivariate regression analysis with an interaction term was performed to test the moderating effect of internet usage. Results indicated that loneliness was significantly negatively associated with subjective health. Furthermore, after controlling for demographic and caregiving-related factors, the moderating effect of internet usage on the link between loneliness and subjective health was significant, namely, the negative association between loneliness and subjective health was less pronounced at higher levels of internet usage. Hence, in addition to alleviating loneliness, providing caregiving-related online services and promoting positive utilization of resources on the internet may be potential intervention targets to improve informal caregivers’ health. [ABSTRACT FROM AUTHOR]

The Greater Fifth Ward (GFW) is a Northeast Houston, Texas, neighborhood with a legacy of industrial contamination and a confirmed cancer cluster. To understand self-rated health in the GFW, community-based participatory research (CBPR), was used to promote the inclusion of all partners. CBPR involves the community during each stage of the research process from design to research dissemination. A complete census was conducted, and 114 surveys were obtained in the environmental justice (EJ) community from July to November 2021. EJ communities shoulder an unfair burden of environmental exposures, pollution, and poor built environments. Mental and physical health were measured using the validated 12-item Short Form Health Survey (SF-12v2). We posited that the Black or African American (Black/AA) community would have lower mental composite scores (MCS) and physical composite scores (PCS) compared to the nation and their White counterparts. The MCS and PCS were calculated and compared against the national mean. Overall, participants had higher MCS and lower PCS than the national mean. Black/AA males and females had lower MCS compared to their White counterparts. White females had the lowest PCS among all respondents, significantly lower than the national average. MCS was lower among those who lived in the neighborhood longer. Burdens from pollution may impact residents' health and perceived health. Targeted interventions or programs that improve mental or physical health would benefit this community and other inequitably burdened neighborhoods. [ABSTRACT FROM AUTHOR]

Self-rated health is a common assessment used in epidemiological research and an independent predictor of morbidity and mortality. We investigate if a single measure of self-rated health in late adolescence predict mortality between 46 and 70 years of age. This study was based on 47 286 Swedish men that conscribed 1969–1970 at age 18–20 and that were still alive in 1997. Self-rated health and data on potential explanatory factors (psychological factors, health status markers and health behaviors) were collected at conscription. Adult socioeconomic position in 1990 was derived from registries. Death and cause of death (cancer, cardiovascular disease, violent and alcohol abuse related disorders) were derived from the Causes of Death Register between 1997 and 2019. Conscripts that rated their health as fair or poor/very poor had significantly higher hazard of all-cause mortality than conscript that rated their health as very good (HRfair = 1.27, 95%CI:1.18–1.37 and HRpoor = 1.25, 95%CI:1.11–1.41) and disease-specific mortality. Adjusting for all explanatory factors attenuated the risk estimates by 9–100%. In conclusion, poor self-rated health reported in late adolescence predicts all-cause and disease-specific mortality between the ages of 46 and 70 years. Psychological factors and health behaviors measured at conscription may serve as potential explanatory factors underlying the predictive ability of self-rated health in late adolescence. [ABSTRACT FROM AUTHOR]

Background: We investigated the predictors of poor SRH in a representative sample of Lithuanian mainstream school students in grades 7–8. We also checked for gender differences in the associations between SRH and depressive symptoms and other predictors. Methods: A total of 2104 7th–8th-grade students participated (response rate 73.95%) and were asked about depressive symptoms, psychosomatic health complaints, negative acts at school, feeling at school, family stress and violence, sense of coherence, self-esteem, and lifestyle. We used a hierarchical regression analysis including a variety of self-rated health predictors. Results: Boys scored significantly higher on physical activity and smoking, whereas girls scored significantly higher on SRH, depressive symptoms, psychosomatic health complaints, and family stress and violence, though the significance was lost in the hierarchical regression. Depressive symptoms were the strongest predictor of poor SRH (standardized β = 0.309, p < 0.001), though other investigated predictors were also significant but had lower effect sizes. Strong evidence was found supporting the buffering role of sense of coherence in the relationship between depressive symptoms and SRH (standardized β = −0.266, p < 0.001). Conclusions: We can conclude that the magnitude of the relationship between depressive symptoms and self-rated health is dependent on the levels of sense of coherence. We did not find gender differences in those associations. As poor SRH is easy to determine, especially with a one-item question, the cases of poorly rated health should be detected early and corrected by interventions in order to prevent poor health outcomes in the future. [ABSTRACT FROM AUTHOR]

Self-confidence is an attribute of the individual that enables one to have a positive or realistic view of themselves or the situations in which they exist. Investigations have shown that people with high self-confidence may have better general health. Based on our knowledge, no study has been conducted on the relationship between self-confidence and students' health status so far in Iran. Therefore, this study aimed to investigate the relationship between Self-rated health and self-confidence among students of Tehran University of Medical Sciences. This cross-sectional study was performed on 600 students of different faculties at Tehran University of Medical Sciences. To measure self-confidence, the validated personal evaluation inventory (PEI) questionnaire and demographic characteristics questionnaire, suitable for Iranian medical students was used. To measure students' Self-rated health as a dependent variable of the study, a standard question was used. Statistical analysis was performed using multivariable logistic regression. Of the 600 students who participated in the study, 322 (53.67%) were female and 278 (46.33%) were male. The overall mean score of students' self-confidence was 66.71% (standard deviation = 10.42). In terms of Self-rated health, most participants reported good status (69.54% in females and 65.51% in males). The results showed the probability of having good health was associated with the rising of mean scores of self-confidence. It is recommended to educational policymakers to consider general and mental health and personal relationships as factors related to self-confidence and perform the necessary interventions needed to increase the level of self-confidence among students. [ABSTRACT FROM AUTHOR]

Awareness of racial health care inequities is one prerequisite to eliminating them. Although extant research has described awareness of racial health care inequities in the United States, the health impacts of such awareness on communities that are most impacted by these inequities remains unknown. Therefore, we examined associations between awareness of Black–White racial health care inequities and self-rated health for Black and White adults in the United States. We used survey data from non-Hispanic Black and White participants (N = 6,449) who responded to the national American Health Values Survey (2015–2016) to test associations between awareness of Black–White inequities in health care and self-rated health. Accurate awareness of health care inequities was associated with 47% higher odds of poorer self-rated health for Black individuals. Inaccurate awareness was associated with 36% higher odds of poorer self-rated health for White individuals. Accurate awareness may be adaptive, yet place an additional burden on Black individuals. Inaccurate awareness may harm White individuals' health. Health care system changes and alleviation of racism-related stress may be preventive supports for the health of Black individuals. Accurate awareness should be a goal for White individuals, not only to prevent health risks, but to also facilitate structural change for racial equity. Public Policy Relevance Statement: Increasing accurate awareness of health care inequities for White Americans must be priority to engender equitable policies and should be framed as crucial for their own health. In the meantime, we must acknowledge Black Americans' psychosocial burden of knowing that they face health care discrimination and explicitly support and prioritize their health. [ABSTRACT FROM AUTHOR]

Introduction: Given the known female disadvantage in physical and mental health, this study aimed to investigate sex differences in self-rated health (SRH) among older adults, considering the longitudinal course by age, birth cohort, and educational level. Methods: Data from birth cohort 1911–1937 with baseline age 55–81 years (n = 3,107) and birth cohort 1938–1947 with baseline age 55–65 years (n = 1,002) from the Longitudinal Aging Study Amsterdam (LASA) were used. Mixed model analyses were used to examine sex differences in SRH (RAND General Health Perception Questionnaire [RAND-GHPQ], range 0–16) over the age course, testing for effect modification by the birth cohort and educational level (low, middle, high). Results: For both sexes, a decline in SRH was seen with increasing age. Over the age course, there was no significant sex difference in SRH within the older (1911–1937) birth cohort (0.13 lower score on SRH for women compared to men, 95% CI: −0.35 to 0.09) and only a small sex difference in the more recent (1938–1947) birth cohort (0.35 lower score on SRH for women compared to men [95% CI: −0.69 to −0.02], p = 0.04). There was no significant cohort difference in the size of the sex difference (p = 0.279). Those with a higher level of education reported a higher SRH, but between educational levels, there was no significant difference in the size of the sex difference in SRH. Discussion: In this study, no relevant sex difference in SRH over the age course was observed among older adults. Future research on SRH trajectories by sex during aging should take health-related, cognitive, psychosocial, and behavioral factors into account. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the impact of informal care on the health of older adults, providing data to inform the development of informal care systems and social support policies for long‐term care services in developing countries. Methods: Based on data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study employed the Propensity Score Matching (PSM) method to empirically analyze the effects of informal care on older adults' self‐rated health, depression, and anxiety. Results: A total of 4790 older adults were included in the study sample, with 3194 receiving informal care and 1596 not receiving informal care. The results indicated that older adults who received informal care reported better self‐rated health and had lower depression and anxiety scores compared to those who did not receive informal care. Among different groups, the positive effects of informal care on physical and mental health were more significant for very old adults, rural residents, and those without a spouse. Informal care had a greater positive impact on the physical health of women and the mental health of men. Conclusion: Government agencies should promote effective coordination between informal and formal care through financial support, awareness campaigns, and policy incentives. This will help to accelerate the improvement of the long‐term care system and effectively meet the long‐term care needs of older adults. [ABSTRACT FROM AUTHOR]

• Self-rated health has direct or indirect effects on depressive symptoms in older adults. • Social participation and spouse health are mediating factors. • Gender, drinking, visual function, diet, quality of life, and economic level have significant moderating effects in the model. This study investigates the relationship between self-rated health, social participation, spouse health, and depressive symptoms in older adults. It also analyzed the moderating effects of gender, drinking, visual function, diet, quality of life, and economic level on the model. We analyzed data from 5119 participants aged 60 and above, from the CLHLS. We used a partial least squares structural equation model to explore the correlation between self-rated health, spouse health, social participation, and depressive symptoms. Self-rated health was significantly correlated with spouse health, social participation, and depressive symptoms (P < 0.001). Social participation (β=-0.034) and spouse health (β=-0.029) were mediators of self-rated health to depressive symptoms. In addition, gender, drinking, visual function, diet, quality of life, and economic level were mediated factors. This study provides evidence that self-rated health has direct or indirect associations with depressive symptoms in older people, with social participation and spouse health playing a crucial mediating role. [ABSTRACT FROM AUTHOR]

Background: Understanding the self-rated health of industrially disabled individuals is an important variable that significantly affects their quality of life, satisfaction, and return to work after an industrial accident. Since the health of people with industrial disabilities is affected by various environments and variables, interventions and policies that are suitable for their characteristics are needed. Objectives: This study aimed to identify changes in self-rated health among industrially disabled individuals, distinguish between different latent classes, and verify predictive factors for each latent class. Methods: Four time-point datasets from the 2018–2021 panel study of Korean workers' compensation insurance were used. Using the latent growth curve model, an overall trajectory of self-rated health of industrially disabled individuals was confirmed, and the number and characteristics of different trajectories were identified using the latent class growth model. Multinomial logistic regression analysis was used to identify the predictive factors for each class. Results: Four classes of self-rated health trajectories were identified: low-decreasing (21.7%), moderate-increasing (15.7%), high-decreasing (56.1%), and low-stable (6.5%) classes. A multinomial logistic regression analysis revealed that significant determinants (age, capacity, type of industrial accident, grade of disability, mental activity, outdoor activity, and social relationships) were different for each latent class. Capacity level affected all potential class classifications. Conclusions: To improve the self-rated health of industrially disabled individuals, it is necessary to develop an appropriate strategy that considers the characteristics of the latent class. [ABSTRACT FROM AUTHOR]

This study addresses the impact of urban parks on the self-rated health of office workers under 40, a demographic experiencing significant increases in depressive symptoms during the pandemic. This study in Baise City, China, aims to fill this gap by exploring the relationships between landscape quality, leisure time spent in parks, place attachment, and self-rated health among 411 office workers aged 18 to 40. Structural equation modeling was used to assess these relationships, and multigroup analysis (MGA) in SmartPLS evaluated differences between subgroups. The findings reveal a strong link between urban park landscape quality and leisure time spent in parks, place attachment, and self-rated health. Although the old-fashioned park showed lower overall performance in the study variables compared to the modern park, it had a stronger relationship between landscape quality and place attachment. Leisure time spent in parks did not directly impact self-rated health but was mediated by place attachment. MGA results indicated that while leisure time in parks positively affected self-rated health for single participants, it had a negative effect for married participants. These results underscore the importance of tailoring urban park design and management to accommodate the varying needs of different demographics. This research provides new insights into enhancing office workers' self-rated health through environmental design and supports the objectives of the Healthy China strategy and Sustainable Development Goal 11. [ABSTRACT FROM AUTHOR]

BackgroundPositive childhood experiences (PCEs) are supportive relationships and environments associated with improved health when aggregated into composite scores. Adverse childhood experiences (ACEs), a reciprocal measure to PCEs, are associated with worse health in aggregate scores and when disaggregated into measures of specific ACE types (hereafter domains). Understanding the associations between specific PCE domains and health, while accounting for ACEs, may direct investigations and intervention planning to foster PCE exposure.MethodsWe analyzed data from the nationally representative United States longitudinal Panel Study of Income Dynamics. Five PCE domains were examined: (i) peer support and healthy school climate, (ii) neighborhood safety, (iii) neighborhood support, and nurturing relationships with (iv) maternal and (v) paternal figures. Survey weighted logistic regression models tested associations between each PCE domain measure and adult general health rating, controlling for demographic covariates and nine ACE exposures: physical, emotional, or sexual abuse/assault; emotional neglect; witnessing intimate partner violence or household substance use; having a parent with mental illness; any parental separation or divorce; and/or having a deceased or estranged parent. Secondary outcomes included adult functional status and mental and physical health diagnoses. We also tested for statistical interactions between PCE domain and ACE score measures.ResultsThe sample included 7105 adults. Higher scores for the "peer support and healthy school climate" and "neighborhood safety" domain measures showed the most protective relationships with the adverse health conditions tested, most notably for mental illness. The relationship between PCE domain measures and health outcomes was attenuated, but not statistically moderated by ACE exposure.ConclusionExperiencing childhood peer support, a healthy school climate, and neighborhood safety were especially protective against multiple adult health conditions, including for ACE exposed individuals. Interventions that promote PCEs may yield population health gains.

Abstract The association between self-rated health (SRH) and the development of atrial fibrillation (AF) in the general population remains underexplored. We reviewed the data of 9,895 participants in the Ansung–Ansan cohort study, a community-based Korean study. SRH was categorised as ‘poor’, ‘fair’, or ‘good’. A newly developed AF was identified through biennial electrocardiography examinations and/or a self-reported history of physician-determined diagnoses. Over a median follow-up of 11 years, 149 patients (1.5%) developed AF. Compared with the ‘good’ group, the ‘poor’ group exhibited a higher risk of incident AF (adjusted hazard ratio, 1.85; 95% confidence interval, 1.19–2.87). Old age, female sex, lower educational level, smoking, cardiovascular diseases (hypertension, diabetes mellitus, and coronary artery disease), and inflammation were associated with ‘poor’ SRH. Along with SRH, age, male sex, urban residence, hypertension, and myocardial infarction were also associated with a higher risk of incidental AF. The combined model, which included conventional risk factors and SRH, demonstrated a marginally improved performance in predicting incident AF (concordance index: 0.704 vs. 0.714, P = 0.058). Poor SRH is independently associated with the development of AF in Korean adults. However, it plays a limited role in AF surveillance when combined with conventional AF risk factors.

Abstract Objectives South Africa was the worst affected country in Africa by the COVID-19 pandemic and it is important to interrogate the attitude of the populace towards the pandemic for future interventions. Therefore, this study examined effects of mass media messages, susceptibility to COVID-19 and self-rated health on the attitudes of South Africans towards the COVID-19 pandemic. Methods Data was from the National Income Dynamics Study – Coronavirus Rapid Mobile Survey (NIDS-CRAM) of 2021 which is a nationally representative panel survey of about 7,000 South African individuals in all the nine provinces. Analyses of data were through descriptive statistics, chi square test and logistic regression models. Results The results showed that 61.28% of the resondents did not take COVID-19 test while 91.09% of them engaged in behavioral changes such as social distancing and wearing of face masks. In addition, 74.27% of the respondents had access to mass media information, 70.44% believed they have good physical health while 32.43% felt they were not susceptible to COVID-19. The chi-square results of attitude towards COVID-19 showed significant differences in access to mass media messages on COVID-19, race, and province of residence. Furthermore, respondents who had access to mass media information on COVID-19 (OR = 1.469; p = 0.001) and respondents who believed that they were susceptible to COVID-19 infection (OR = 1.443; p = 0.001) were significantly associated with increased likelihood of engagement in behavioral changes to avoid the COVID-19. Conclusion These findings therefore emphasize the need for increased awareness and sensitization of the people about the susceptibility and adverse effects of diseases to ensure that they adopt the appropriate attitudes that will safeguard them from such diseases outbreak.

Abstract The Greater Fifth Ward (GFW) is a Northeast Houston, Texas, neighborhood with a legacy of industrial contamination and a confirmed cancer cluster. To understand self-rated health in the GFW, community-based participatory research (CBPR), was used to promote the inclusion of all partners. CBPR involves the community during each stage of the research process from design to research dissemination. A complete census was conducted, and 114 surveys were obtained in the environmental justice (EJ) community from July to November 2021. EJ communities shoulder an unfair burden of environmental exposures, pollution, and poor built environments. Mental and physical health were measured using the validated 12-item Short Form Health Survey (SF-12v2). We posited that the Black or African American (Black/AA) community would have lower mental composite scores (MCS) and physical composite scores (PCS) compared to the nation and their White counterparts. The MCS and PCS were calculated and compared against the national mean. Overall, participants had higher MCS and lower PCS than the national mean. Black/AA males and females had lower MCS compared to their White counterparts. White females had the lowest PCS among all respondents, significantly lower than the national average. MCS was lower among those who lived in the neighborhood longer. Burdens from pollution may impact residents’ health and perceived health. Targeted interventions or programs that improve mental or physical health would benefit this community and other inequitably burdened neighborhoods.

Abstract Self-rated health is a common assessment used in epidemiological research and an independent predictor of morbidity and mortality. We investigate if a single measure of self-rated health in late adolescence predict mortality between 46 and 70 years of age. This study was based on 47 286 Swedish men that conscribed 1969–1970 at age 18–20 and that were still alive in 1997. Self-rated health and data on potential explanatory factors (psychological factors, health status markers and health behaviors) were collected at conscription. Adult socioeconomic position in 1990 was derived from registries. Death and cause of death (cancer, cardiovascular disease, violent and alcohol abuse related disorders) were derived from the Causes of Death Register between 1997 and 2019. Conscripts that rated their health as fair or poor/very poor had significantly higher hazard of all-cause mortality than conscript that rated their health as very good (HRfair = 1.27, 95%CI:1.18–1.37 and HRpoor = 1.25, 95%CI:1.11–1.41) and disease-specific mortality. Adjusting for all explanatory factors attenuated the risk estimates by 9–100%. In conclusion, poor self-rated health reported in late adolescence predicts all-cause and disease-specific mortality between the ages of 46 and 70 years. Psychological factors and health behaviors measured at conscription may serve as potential explanatory factors underlying the predictive ability of self-rated health in late adolescence.

Maomin Jiang,1,&ast; Yisong Yao,2,&ast; Xiaoqian Xia,3,&ast; Yang Kong,4 Nan Zhang5 1School of Public Affairs, Xiamen University, Xiamen, Fujiang, People’s Republic of China; 2School of The Fourth Clinical Medical College, Qingdao University, Yantai, Shangdong, People’s Republic of China; 3Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK; 4School of Health Management, Binzhou Medical University, Yantai, Shangdong, People’s Republic of China; 5Physical Education Department, Shandong Technology and Business University, Yantai, Shangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Nan Zhang, Email zhangnansd@126.comBackground: This study aims to investigate the relationship between older adults’ perceived community services for the elderly (PCSE), life satisfaction (LS), and self-rated health (SRH).Methods: Data from four rounds of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018 were used. A total of 2454 older adults were obtained. Unconditional Least Squares (ULS) was used to measure PCSE, LS, and SRH growth trajectories without covariates. Finally, a mediating latent growth model was constructed using Mplus 8.3 to examine the mediating role of LS in the relationship between PCSE and SRH after adjusting for some demographic characteristics.Results: The results from the ULS method indicate that the intercepts and slopes for PCSE and LS are significantly negatively correlated (β1 = − 0.629, β2 = − 0.579, p < 0.001). Additionally, there is a significant positive correlation between the intercept and slope of health levels (β = 0.774, p < 0.001). Using a parallel growth model, significant regression coefficients were found between the intercept of PCSE and the intercepts of SRH and LS (β1 = − 0.335, β2 = 0.378, p < 0.01). Similarly, the regression coefficients between the slope of PCSE and the slopes of SRH and LS were also significant (β1 = − 0.532, β2 = 0.344, p < 0.01). Furthermore, the regression coefficient between the intercept of LS and the intercept of SRH was significant (β = 0.415, p < 0.001). The regression coefficient between the slope of LS and the slope of SRH was also found to be significant (β = 0.729, p < 0.001).Conclusion: It is essential to ensure adequate supply and accessibility of community services for older adults. LS especially is, and should be a promising target for assessing the quality of life and utilization of PCSE supply.Keywords: perceived community services for elderly, life satisfaction, Self-rated health, Latent growth model, older adults

BACKGROUND: US housing policy places a high priority on homeownership, providing large homeowner subsidies that are justified in part by homeownerships purported health benefits. However, studies conducted before, during, and immediately after the 2007-2010 foreclosure crisis found that while homeownership is associated with better health-related outcomes for White households, that association is weaker or non-existent for African-American and Latinx households. It is not known whether those associations persist in the period since the foreclosure crisis changed the US homeownership landscape. OBJECTIVE: To examine the relationship between homeownership and health and whether that relationship differs by race/ethnicity in the period since the foreclosure crisis. DESIGN: We conducted a cross-sectional analysis of 8 waves (2011-2018) of the California Health Interview Survey (n = 143,854, response rate 42.3 to 47.5%). PARTICIPANTS: We included all US citizen respondents ages 18 and older. MAIN MEASURES: The primary predictor variable was housing tenure (homeownership or renting). The primary outcomes were self-rated health, psychological distress, number of health conditions, and delays in receiving necessary medical care and/or medications. KEY RESULTS: Compared to renting, homeownership is associated with lower rates of reporting fair or poor health (OR = 0.86, P

Objectives: The prevalence of the co-occurrence of depressive and anxious symptoms (CO) and their influence on perceived overall health were not clear in community dwelling Chinese older adults. The aims of the study were to investigate the prevalence of CO and to explore its influence on self-rated health (SRH). Method: This study included 12301 individuals aged ≥65 years from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a nationally representative survey of older adults in mainland China. Participants received face-to-face interviews and assessments of depressive symptoms and anxious symptoms via 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) and 7-item Generalized Anxiety Disorder Questionnaire (GAD-7), respectively. SRH was measured by self-reported. A logistic regression model was used to examine the association between CO and SRH after adjusting for confounding variables. Results: The average age was 83.4 (SD: 11.0) years and there were 6576 (53.5%) females. The age- and sex-standardized prevalence of depressive symptoms only (DSO) was 38.6%, anxious symptoms only (ASO) was 1.5%, and CO was 10.8%. Compared with those without depressive and anxious symptoms, the older adults with DSO or ASO were more likely to have significant influence on SRH. And particularly, CO was likely to produce the greatest decrement in the level of SRH. Conclusion: CO was not rare in Chinese older adults nationwide. The older adults having CO had increased risk for lower level of SRH than having DSO or ASO. More attention should be given to CO among the older adults. [ABSTRACT FROM AUTHOR]

Self-rated health (SRH) is a subjective indicator of overall health based on a single questionnaire item. Previous evidence found that it is a strong predictor of mortality, although the underlying mechanism is poorly understood. Epigenetic age is an objective, emerging biomarker of health, estimated using DNA methylation data at hundreds of sites across the genome. This study aimed to assess the overlap and interaction between SRH and epigenetic ageing in predicting mortality risk. We used DNA methylation data from 1059 participants in the Melbourne Collaborative Cohort Study (mean age: 69 years) to calculate three age-adjusted measures of epigenetic ageing: GrimAge, PhenoAge, and DunedinPACE. SRH was assessed using a five-category questionnaire item ("excellent, very good, good, fair, poor"). Cox models were used to assess the associations of SRH, epigenetic ageing, and their interaction, with all-cause mortality over up to 17 years of follow-up (Ndeaths = 345). The association of SRH with mortality per category increase was HR = 1.29; 95%CI: 1.14–1.46. The association was slightly attenuated after adjusting for all three epigenetic ageing measures (HR = 1.25, 95%CI: 1.10–1.41). A strong gradient was observed in the association of GrimAge (Pinteraction = 0.006) and DunedinPACE (Pinteraction = 0.002) with mortality across worsening SRH strata. For example, the association between DunedinPACE and mortality in participants with "excellent" SRH was HR = 1.02, 95%CI: 0.73–1.43 and for "fair/poor" HR = 1.72, 95%CI: 1.35–2.20. SRH and epigenetic ageing were synergistic risk factors of mortality in our study. These findings suggest that consideration of subjective and objective factors may improve general health assessment, which has implications for the ongoing development of molecular markers of ageing. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the impact of on-demand versus continuous prescribing of proton pump inhibitors (PPIs) on symptom burden and health-related quality of life in patients with gastroesophageal reflux disease (GERD) presenting to primary care. Methods: Thirty-six primary care centres across Europe enrolled adult GERD patients from electronic health records. Participants were randomised to on-demand or continuous PPI prescriptions and were followed for 8 weeks. PPI intake, symptom burden, and quality of life were compared between the two groups using mixed-effect regression analyses. Spearman's correlation was used to assess the association between changes in PPI dose and patient-reported outcomes. Results: A total of 488 patients (median age 51years, 58% women) completed the initial visit, with 360 attending the follow-up visit. There was no significant difference in PPI use between the continuous and on-demand prescription groups (b=.57, 95%CI:0.40-1.53), although PPI use increased in both groups (b=1.33, 95%CI:0.65-2.01). Advice on prescribing strategy did not significantly affect patient-reported outcomes. Both symptom burden (Reflux Disease Questionnaire, b=-0.61, 95%CI:-0.73 - -0.49) and quality of life (12-item Short Form Survey physical score b=3.31, 95%CI:2.17-4.45) improved from baseline to follow-up in both groups. Increased PPI intake correlated with reduced reflux symptoms (n=347, ρ=-0.12, p=0.02) and improved quality of life (n=217, ρ=0.16, p=0.02). Conclusion: In real-world settings, both continuous and on-demand PPI prescriptions resulted in similar increases in PPI consumption with no difference in treatment effects. Achieving an adequate PPI dose to alleviate reflux symptom burden improves quality of life in GERD patients. EudraCT number 2014-001314-25. [ABSTRACT FROM AUTHOR]

Abstract Background Health-related quality of life (HRQOL) in cancer patients has attracted increasing attention, which may be associated with self-rated health (SRH), anxiety, and depression. However, limited studies have focused on the mediating role of anxiety and depression in the relationship between SRH and HRQOL among cancer patients. Therefore, this study aims to explore the serial multiple mediating effects of anxiety and depression between SRH and HRQOL in cancer patients. Methods This cross-sectional study investigated a total of 565 hospitalized cancer patients in Anhui province in China from November 2020 to October 2021. SRH was assessed using a single-item measure, anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D, three-level version). Socio-demographic and clinical characteristics were analyzed using descriptive statistics. The relationships between SRH, anxiety, depression, and HRQOL were evaluated by Pearson correlation analysis. The serial multiple mediation of anxiety and depression was assessed by SPSS PROCESS macro. Results SRH, anxiety, depression and HRQOL were significantly correlated(P

Abstract Objective Self-rated health (SRH) has been documented as an important predictor of quality of life among the elderly and its risk factors are vision-specific among elderly males. The aim of this study was to clarify vision-specific risk factors to SRH among elderly females without dementia in Chinese urban areas. Methods From March to November 2012, 2147 elderly women in Liaoning Province of China were selected using a stratified sampling method. After cognitive screening, 1956 participants without dementia were finally enrolled. A questionnaire including SRH, visual ability and factors including demographic characteristics, physical conditions, lifestyle factors, social psychological status and social activities were analyzed. Multivariate logistic regression was used to clarify the association of SRH with risk factors, while stepwise multivariate logistic regression was used to examine the vision-specific associations with SRH. Results The mean age was 73.6 ± 5.82 (mean ± SD). The percentages of good SRH in good and impaired visual ability groups were 36.2% and 24.4%, respectively. Most characteristics between elderly females with different visual abilities were significantly different. Visual ability had interactions with physical conditions, lifestyle factors and social activities to affect SRH. Among elderly females with good visual ability, depressive symptoms, rather than chronic disease had the strongest association with good SRH followed by marital status, regular diet, going out alone to distant places, taking a walk, smoking and alcohol consumption. In the impaired visual ability group, going out alone to distant places had the strongest association with good SRH followed by chronic disease, filial piety, taking a walk, participating in entertainment, ethnicity, quality of sleep, worrying about falling and alcohol consumption. Conclusions Good SRH status was at a low level especially among elderly females with impaired visual ability and the risk factors differed between elderly females with different visual abilities. Social psychological status was crucial for SRH among elderly females with good visual ability whereas physical conditions were prominent for impaired visual ability group.

Abstract Objectives To assess the influence of loneliness on the healthy life expectancy of older adults in China and its gender disparities across different health indicators, in order to provide insights for enhancing the health status and subjective well-being of the older population. Method We conducted a cohort analysis using four waves of weighted samples (2008, 2011, 2014, and 2018) from the Chinese Longitudinal Healthy Longevity Survey, encompassing 15,507 respondents aged 65–99. Physical and subjective health were assessed through activity of daily living (ADL) and self-rated health (SRH), respectively. Utilizing loneliness status as a time-variant variable, we employed the multi-state interpolated Markov Chain to explore the associations between loneliness and age-specific life expectancy (LE), healthy life expectancy (HLE), and the proportion of healthy life expectancy in life expectancy (HLE/LE). Results Compared to the non-lonely population, both LE and HLE were lower among lonely individuals. Regarding gender differences, the HLE/LE for females in the lonely population was consistently lower than that for males. The impact of loneliness on the health of older adults varied by measurement indicators and gender. Specifically, based on ADL results, the decline in HLE/LE was greater for females, with a decline of 53.6% for lonely females compared to 51.7% for non-lonely females between the ages of 65 and 99. For males, the decline was 51.4% for lonely males and 51.5% for non-lonely males. According to SRH, the gender difference in the decline of HLE/LE due to loneliness was less apparent. For males, the change in HLE/LE for non-lonely individuals was 3.4%, compared to 4.2% for lonely individuals, whereas for females, the change was 3.7% for non-lonely individuals and 4.4% for lonely individuals. Conclusion Loneliness exerts varied effects on health across different measurement indicators and gender demographics. Targeted health promotion interventions are imperative to mitigate these negative impacts, particularly emphasizing the enhancement of subjective well-being and physical functioning, especially among older adult females.

Abstract The rapid development of digital technology has radically changed people’s lives. Simultaneously, as the population is rapidly aging, academic research is focusing on the use of Internet technology to improve middle-aged and older people’s health, particularly owing to the popularity of mobile networks, which has further increased the population’s accessibility to the Internet. However, related studies have not yet reached a consensus. Herein, empirical analysis of the influence of mobile Internet use on the subjective health and chronic disease status of individuals in their Middle Ages and above was conducted utilizing ordered logit, propensity score matching (PSM), and ordered probit models with data from the 2020 China Health and Retirement Longitudinal Study. The study aimed to provide a theoretical basis and reference for exploring technological advances to empower the development of a healthy Chinese population and to advance the process of healthy aging. The health of middle-aged and older adults mobile Internet users was greatly improved, according to our findings. Further, the use of mobile Internet by these persons resulted in improvements to both their self-assessed health and the state of their chronic diseases. As per the findings of the heterogeneity analysis, the impact of mobile Internet use was shown to be more pronounced on the well-being of middle-aged persons aged 45–60 years compared to those aged ≥ 60 years. Further, the endogeneity test revealed that the PSM model could better eliminate bias in sample selection. The results suggest that the estimates are more robust after eliminating endogeneity, and that failure to disentangle sample selectivity bias would overestimate not only the facilitating effect of mobile Internet use on the self-assessed health impacts of middle-aged and older adults, but also the ameliorating effect of mobile Internet use on the chronic diseases of middle-aged and older adults. The results of the mechanistic analysis suggest that social engagement is an important mediating mechanism between mobile Internet use and the health of middle-aged and older adults. This implies that mobile Internet use increases opportunities for social participation among middle-aged and older adults, thereby improving their health.

Abstract Background Successful ageing is the term often used for depicting exceptional ageing and can be measured with multidimensional models including physical, psychological and social wellbeing. The aim of this study was to test multidimensional successful ageing models to investigate whether these models can predict successful ageing, and which individual subcomponents included in the models are most significantly associated with successful ageing. Methods Successful ageing was defined as the ability to live at home without daily care at the age of 84 years or over. Data on the participants’ physical, psychological and social wellbeing were gathered at baseline and the follow-up period was 20 years. Four successful ageing models were constructed. Backward stepwise logistic regression analysis was used to identify the individual subcomponents of the models which best predicted successful ageing. Results All successful ageing models were able to predict ageing successfully after the 20-year follow-up period. After the backward stepwise logistic regression analysis, three individual subcomponents of four models remained statistically significant and were included in the new model: having no heart disease, having good self-rated health and feeling useful. As a model, using only these three subcomponents, the association with successful ageing was similar to using the full models. Conclusions Multidimensional successful ageing models were able to predict successful ageing after a 20-year follow-up period. However, according to the backward stepwise logistic regression analysis, the three subcomponents (absence of heart disease, good self-rated health and feeling useful) significantly associated with successful ageing performed as well as the multidimensional successful ageing models in predicting ageing successfully.

Background: Self-rated health is a simple measure that may identify individuals who are at a higher risk for hospitalization or death. Objective: To quantify the association between a single measure of self-rated health and future risk of recurrent hospitalizations or death. Participants: Atherosclerosis Risk in Communities (ARIC) study, a community-based prospective cohort study of middle-aged men and women with follow-up beginning from 1987 to 1989. Main Measures: We quantified the associations between initial self-rated health with risk of recurrent hospitalizations and of death using a recurrent events survival model that allowed for dependency between the rates of hospitalization and hazards of death, adjusted for demographic and clinical factors. Key Results: Of the 14,937 ARIC cohort individuals with available self-rated health and covariate information, 34% of individuals reported "excellent" health, 47% "good," 16% "fair," and 3% "poor" at study baseline. After a median follow-up of 27.7 years, 1955 (39%), 3569 (51%), 1626 (67%), and 402 (83%) individuals with "excellent," "good," "fair," and "poor" health, respectively, had died. After adjusting for demographic factors and medical history, a less favorable self-rated health status was associated with increased rates of hospitalization and death. As compared to those reporting "excellent" health, adults with "good," "fair," and "poor" health had 1.22 (1.07 to 1.40), 2.01 (1.63 to 2.47), and 3.13 (2.39 to 4.09) times the rate of hospitalizations, respectively. The hazards of death also increased with worsening categories of self-rated health, with "good," "fair," and "poor" health individuals experiencing 1.30 (1.12 to 1.51), 2.15 (1.71 to 2.69), and 3.40 (2.54 to 4.56) times the hazard of death compared to "excellent," respectively. Conclusions: Even after adjusting for demographic and clinical factors, having a less favorable response on a single measure of self-rated health taken in middle age is a potent marker of future hospitalizations and death. [ABSTRACT FROM AUTHOR]

Background: Self‐rated health (SRH), a measure of self‐reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. Methods: We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. Results: We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = −1.261 (Wald chi‐square test, χ2 = 22.097, df = 1, p <.05). Conclusions: As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL. [ABSTRACT FROM AUTHOR]

Background: Health complications from diabetes place major strain on individuals, financially and emotionally. The onset and severity of these complications are largely driven by patients' behaviors, making psychosocial factors that influence behaviors key targets for interventions. One promising factor is sense of purpose or the degree to which a person believes their life has direction. Method: The current study investigated whether sense of purpose predicts self-rated health, cardiovascular disease, and smoking status among adults with diabetes concurrently and prospectively. Moreover, it tested whether these associations held across multiple samples and cultures. Coordinated analysis using 12 datasets cross-sectionally and eight longitudinally (total N = 7277) estimated the degree to which sense of purpose is associated with subjective health, smoking status, and cardiovascular disease among adults with diabetes. Coordinated analysis allows for greater generalizability of results across cultures, time periods, and measurement instruments. Datasets were included if they concurrently included a measure of sense of purpose and diabetes status and at least one health measure: self-rated health, current smoking status, or heart condition status. Results: Sense of purpose was associated with higher self-rated health, smoking status, and cardiovascular disease cross-sectionally and self-rated health prospectively. Purpose was unassociated with changes in health over time. Conclusion: These results highlight the relationship of a key individual difference, sense of purpose, to the behaviors and outcomes of adults with diabetes. While more research is needed to determine the boundaries of this relationship, it seems sense of purpose may be considered in the future as a potential target for intervention. [ABSTRACT FROM AUTHOR]

The current study aims to examine predictors of subjective health, including its relation with happiness, at the individual and family levels. For this purpose, we analyzed data collected from spouses representing each family (9,634 families, N = 19,268). A multilevel analysis was conducted to examine both individual- and family-level variables associated with subjective health evaluations. Individual-level variables were gender, age, education, employment, presence of chronic illness, smoking, alcohol use, and individual happiness. Family-level variables were socioeconomic status, number of children, household size, length of the marriage (in a year), presence of an elderly person who needs care in the household, presence of a disabled person who needs care in the household, and family happiness. The results showed that subjective health is enhanced by being man, younger, employed, highly educated, free from chronic illness, and experiencing greater levels of happiness at the individual level. In addition, poorer subjective health is associated with caring for an elderly or disabled family member and having a higher number of children in the household at the family level. However, individuals had better subjective health at the family level when socioeconomic status was higher, greater family happiness, and greater household size existed. The current study is important since research that simultaneously considers individual- and family-level happiness has been scarce in the literature. Thus, the findings would enhance the current understanding of the link between happiness and health. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 2022, many universities transitioned from virtual learning back to in-person teaching. Significant changes in working conditions, along with COVID-19-related anxiety during the pandemic, might impact the well-being of lecturers. OBJECTIVE: This study aims to assess the perceived stress, self-rated physical and occupational health of Vietnamese lecturers in 2022 compared to the pre-pandemic levels, and to identify their associating factors. METHOD: This is a cross-sectional study conducted in May–June 2022 through an online survey questionnaire. A sample of 425 university lecturers were included. Participants' stress levels were assessed using the Perceived Stress Scale. Participants were asked to compare their current physical and occupational health with before the pandemic. Explanatory variables included (1) COVID-19 exposure; and (2) perceptions of changes in working environment due to the pandemic. Multivariable ordinal least squared regression analyses were used to estimate the coefficient and 95% confidence intervals for the associations between COVID-19 exposure variables, work conditions, and each outcome. RESULTS: Our findings indicated that over 60% of participants experienced moderate stress, while nearly half reported worsened physical and occupational health during the pandemic. Gender, age, perceptions of workload, workplace safety, COVID-19 infection, and incentive programs were significant factors associated with higher stress levels and worse self-rated health. CONCLUSION: To ensure occupational safety and support lecturers as they return to in-person classes, it is crucial to provide appropriate psychological and health support services. [ABSTRACT FROM AUTHOR]

Objective: Self-rated health (SRH) has been documented as an important predictor of quality of life among the elderly and its risk factors are vision-specific among elderly males. The aim of this study was to clarify vision-specific risk factors to SRH among elderly females without dementia in Chinese urban areas. Methods: From March to November 2012, 2147 elderly women in Liaoning Province of China were selected using a stratified sampling method. After cognitive screening, 1956 participants without dementia were finally enrolled. A questionnaire including SRH, visual ability and factors including demographic characteristics, physical conditions, lifestyle factors, social psychological status and social activities were analyzed. Multivariate logistic regression was used to clarify the association of SRH with risk factors, while stepwise multivariate logistic regression was used to examine the vision-specific associations with SRH. Results: The mean age was 73.6 ± 5.82 (mean ± SD). The percentages of good SRH in good and impaired visual ability groups were 36.2% and 24.4%, respectively. Most characteristics between elderly females with different visual abilities were significantly different. Visual ability had interactions with physical conditions, lifestyle factors and social activities to affect SRH. Among elderly females with good visual ability, depressive symptoms, rather than chronic disease had the strongest association with good SRH followed by marital status, regular diet, going out alone to distant places, taking a walk, smoking and alcohol consumption. In the impaired visual ability group, going out alone to distant places had the strongest association with good SRH followed by chronic disease, filial piety, taking a walk, participating in entertainment, ethnicity, quality of sleep, worrying about falling and alcohol consumption. Conclusions: Good SRH status was at a low level especially among elderly females with impaired visual ability and the risk factors differed between elderly females with different visual abilities. Social psychological status was crucial for SRH among elderly females with good visual ability whereas physical conditions were prominent for impaired visual ability group. [ABSTRACT FROM AUTHOR]

To move beyond the focus on individual types of support, we examined the overall reciprocity of support between older adults and their adult children. Drawing on the theory of esteem enhancement, we hypothesized that the under benefited older adults, defined as older adults whose support provided is larger than support received in intergenerational relationships, may have better health conditions than those with a more or less balanced exchange of support. To test the hypothesis, we examined the relationship between the reciprocity of intergenerational support and self-rated health (SRH) among older adults in China. We also investigated the moderating role of gender in this relationship. Using data collected from 832 older adults in Wuhan, China, we found that compared to those with a balanced level of reciprocal support in the intergenerational relationship, older adults who were under benefited from the intergenerational support had better SRH. This finding is in line with the esteem enhancement theory. We also found that gender moderated the association between the reciprocity of intergenerational support and SRH. Specifically, older women who under benefit from the support had better SRH than older women with a balanced level of reciprocal support. In contrast, older men who under benefit from the support had worse SRH than older men with a balanced level of reciprocal support. This finding highlights the necessity of constructing social psychological frameworks that are attuned to gender variations for a more comprehensive comprehension of health and health-related behaviors among older adults in China. Plain language summary: We looked at how older adults and their adult children give and receive support from each other, instead of just focusing on one type of support. We thought that older adults who give more support than they receive might have better health. To test this, we asked 832 older adults in China about the support they gave and received, and how they rated their health. We found that older adults who gave more support than they received had better health than those with an equal exchange of support. Women who gave more support than they received also had better health, but men who gave more support than they received had worse health. This shows that we need to pay attention to differences between men and women when thinking about older adults' health. We should also consider how older adults and their grown children support each other when we plan programs to promote health in older adults. [ABSTRACT FROM AUTHOR]

Background: To date, most studies examining the prevalence and determinants of depression among individuals aged 80 and over have used geographically limited samples that are not generalisable to the wider population. Thus, our aim was to identify the prevalence and the factors associated with probable depression among the oldest old in Germany based on nationally representative data. Methods: Data were taken from the nationally representative 'Old Age in Germany (D80+)' study (n = 8386; November 2020 to April 2021) covering both community‐dwelling and institutionalised individuals aged 80 and over. The Short Form of the Depression in Old Age Scale was used to quantify probable depression. Results: Probable depression was found in 40.7% (95% CI: 39.5% to 42.0%) of the sample; 31.3% were men (95% CI: 29.7% to 32.9%) and 46.6% women (95% CI: 44.9% to 48.3%). The odds of probable depression were positively associated with being female (odds ratio (OR): 1.55, 95% CI: 1.30 to 1.84), being divorced (compared to being married, OR: 1.33, 95% CI: 1.01 to 1.76), being widowed (OR: 1.14, 95% CI: 1.00 to 1.30), having a low education (e.g., medium education compared to low education, OR: 0.86, 95% CI: 0.74 to 0.99), living in an institutionalised setting (OR: 2.36, 95% CI: 1.84 to 3.02), living in East Germany (OR: 1.21, 95% CI, 1.05 to 1.39), not having German citizenship (German citizenship compared to other citizenship, OR: 0.55, 95% CI: 0.31 to 0.95), poor self‐rated health (OR: 0.31, 95% CI: 0.28 to 0.34), and the number of chronic conditions (OR: 1.12, 95% CI: 1.09 to 1.14). Conclusion: About four out of 10 individuals aged 80 and over in Germany had probable depression, underlining the importance of this challenge. Knowledge of specific risk factors for this age group may assist in addressing older adults at risk of probable depression. [ABSTRACT FROM AUTHOR]

Purpose: Patients on oral anticancer agent (OAA) therapies have the autonomy to manage their cancer treatments in home settings. However, patients may not have adequate knowledge, confidence, or ability to effectively manage OAA-related consequences, which can significantly impact their treatment and health outcomes. This study aims to identify the associations between medication beliefs, patient activation, and self-rated health (SRH) among oncology patients taking OAAs and explore the potential mediation effects of patient activation on the relationship between medication beliefs and SRH. Methods: A secondary data analysis was conducted on cross-sectional data from 114 patients who were diagnosed with breast, colorectal, lung, or prostate cancer. Patients completed a self-reported survey including items of SRH, Beliefs about Medicines Questionnaire (BMQ), and Patient Activation Measure (PAM-13). Descriptive statistics, bivariate correlation, hierarchical multiple linear regression, and mediation analysis were conducted. Results: The results indicate that patients taking OAAs have ambivalent attitudes toward medication. Both medication necessity (r = − 0.27) and concerns (r = − 0.21) were negatively associated with SRH, while patient activation was positively associated with SRH (r = 0.38). Patient activation had a negative association with medication concerns (r = − 0.36) and fully mediated the relationship between medication concerns and SRH in patients taking OAAs (indirect effect = − 0.154, 95% confidence interval, − 0.276 to − 0.060). Conclusion: The findings highlight the significance of activating patients to better understand and manage their OAAs. It is crucial for oncology professionals to provide multifaceted interventions to promote patient activation with an effort to mitigate the negative impact of medication beliefs on patient-perceived health outcomes. [ABSTRACT FROM AUTHOR]

Objective To investigate the self-rated health status and influencing factors of inter-provincial elderly floating population in China. Methods Using 2018 data from the National Dynamic Monitoring Survey of Health and Family Planning among the Floating Population, we selected inter-provincial migrants aged 60 years and older. Self-assessed health status was the dependent variable. Social demographic characteristics, mobility features, and health literacy were considered as independent variables. Descriptive analysis characterized the basic demographics and self-assessed health status of the inter-provincial elderly floating population. Binary logistic regression was performed to investigate factors affecting self-rated health. Results Among 2 682 inter-provincial elderly migrants, 50.9% rated their health as good, 35.0% as fair, and 24.1% as poor. The prevalence of those who were unhealthy but capable of self-care was 68.4%, while 91.3% of those unhealthy reported being unable to care for themselves. Regression analysis indicated that long-term settlement intention (OR=0.361, 95%CI: 0.227-0.574), migrating to central regions (OR=0.562, 95%CI: 0.393-0.806), and frequent mobility (OR=0.433, 95%CI: 0.325-0.577) were associated with lower self-rated health. Conclusion The self-rated health status of China’s inter-provincial elderly floating population is generally positive, reflecting widespread health education. However, utilization of health records and family doctor services remains low. Awareness and participation in basic public health services among the elderly floating population are inadequate. [ABSTRACT FROM AUTHOR]

Subjective health ratings are associated with dementia risk such that those who rate their health more poorly have increased risk for dementia. The genetic and environmental mechanisms underlying this association are unclear, as prior research cannot rule out whether the association is due to genetic confounds. The current study addresses this gap in two samples of twins, one from Sweden (N = 548) and one from Denmark (N = 4,373). Using genetically-informed, bivariate regression models, we assessed whether additive genetic effects explained the association between subjective health and dementia risk as indexed by a latent variable proxy measure. Age at intake, sex, education, depressive symptomatology, and follow-up time between subjective health and dementia risk assessments were included as covariates. Results indicate that genetic variance and other sources of confounding accounted for the majority of the effect of subjective health ratings on dementia risk. After adjusting for genetic confounding and other covariates, a small correlation was observed between subjective health and latent dementia risk in the Danish sample (rE = −.09, p <.05). The results provide further support for the genetic association between subjective health and dementia risk, and also suggest that subjective ratings of health measures may be useful for predicting dementia risk. [ABSTRACT FROM AUTHOR]

Objective To investigate the impact of audio-visual impairments on subjective well-being (SWB), and whether the depressive tendency mediate the association between them. Methods The China Health and Retirement Longitudinal Survey (CHARLS) conducted a questionnaire survey on people aged 45 and above, using multi-stage sampling at the county (district)-village (residential)-householdindividual level. In the county (district)-village (residential) level sampling, proportional probability sampling (PPS) was used according to population scale. This study was based on CHARLS data from 2018, and the inclusion criteria were (1) age ≥ 60 years old； (2) having a complete self-reported visual and hearing condition； (3) at least one of the three subjective well-being indicators of life satisfaction, subjective life expectancy, and self-rated health status should be included. Likert five-component scale was used in CHARLS to measure the subjective well-being of the elderly, and the Center for Epidemiology Studies Depression Scale-10 (CESD-10) was used to measure the depressive mood of the elderly. We used multiple regression to explore the association between vision and hearing impairment with depressive tendency and subjective well-being; and explored possible mediating effects through a mediation model. Two-side P values<0.05 were considered statistically significant. Results Finally, 7 620 people who met the standards were included. Individuals with audio-visual impairments had significantly higher levels of depression and lower levels of all three SWB measurements (all P values< 0.05). Single vision impairment (SVI), single hearing impairment (SHI) and double sensory impairment (DSI) were associated with more depression tendencies, lower self-rated health (SRH), and subjective life expectancy (SLE). SVI and DSI were associated with lower life satisfaction. Depressive tendency partially mediated the association of DSI with LS and the associations of SVI, SHI, and DSI with SLE and SRH. Conclusion Audio-visual impairments are independently associated with lower SWB status among the elderly in China, and depressive tendency plays a mediating role in these observed associations. [ABSTRACT FROM AUTHOR]

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The rapid development of digital technology has radically changed people's lives. Simultaneously, as the population is rapidly aging, academic research is focusing on the use of Internet technology to improve middle-aged and older people's health, particularly owing to the popularity of mobile networks, which has further increased the population's accessibility to the Internet. However, related studies have not yet reached a consensus. Herein, empirical analysis of the influence of mobile Internet use on the subjective health and chronic disease status of individuals in their Middle Ages and above was conducted utilizing ordered logit, propensity score matching (PSM), and ordered probit models with data from the 2020 China Health and Retirement Longitudinal Study. The study aimed to provide a theoretical basis and reference for exploring technological advances to empower the development of a healthy Chinese population and to advance the process of healthy aging. The health of middle-aged and older adults mobile Internet users was greatly improved, according to our findings. Further, the use of mobile Internet by these persons resulted in improvements to both their self-assessed health and the state of their chronic diseases. As per the findings of the heterogeneity analysis, the impact of mobile Internet use was shown to be more pronounced on the well-being of middle-aged persons aged 45–60 years compared to those aged ≥ 60 years. Further, the endogeneity test revealed that the PSM model could better eliminate bias in sample selection. The results suggest that the estimates are more robust after eliminating endogeneity, and that failure to disentangle sample selectivity bias would overestimate not only the facilitating effect of mobile Internet use on the self-assessed health impacts of middle-aged and older adults, but also the ameliorating effect of mobile Internet use on the chronic diseases of middle-aged and older adults. The results of the mechanistic analysis suggest that social engagement is an important mediating mechanism between mobile Internet use and the health of middle-aged and older adults. This implies that mobile Internet use increases opportunities for social participation among middle-aged and older adults, thereby improving their health. [ABSTRACT FROM AUTHOR]

Although time use is one of people's most important resources, there are social forces and inequalities that shape how time is used. The aim of this research is to examine gender differences in time use from adolescence to old age and to analyze the association of such use with sociodemographic characteristics and with women's and men's health and well-being. A cross-sectional study was conducted with a sample of 5700 women (54.2%) and men (45.8%) from the Spanish general population, aged 14 to 85 years. Participants were assessed using five self-reported measures of time use, health, mental symptoms, psychological well-being, life satisfaction, social support, and masculine/instrumental and feminine/expressive traits. The results showed that although there were important differences in life cycle stage and occupation, women spent more time than men on housework, childcare, and caring for sick relatives, while men spent more time than women on enjoying activities and exercise. More time spent on housework was associated with worse health and well-being for women and more exercise with better health and well-being for both genders. It is concluded that gender is relevant to time use and the impact of different uses of time on health and well-being. [ABSTRACT FROM AUTHOR]