Influence of Social Determinants of Health on the Quality of Life of Older Adults in Europe: A Sex Analysis-Reference-Cited by-同舟云学术

Influence of Social Determinants of Health on the Quality of Life of Older Adults in Europe: A Sex Analysis

Published:2023-10-10 Issue: Volume: Page:
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Author:

Llorens-Ortega Rafael¹,Bertran-Noguer Carmen²,Juvinyà-Canals Dolors²,Garre-Olmo Josep²,Bosch-Farré Cristina²

Affiliation:

1. Autonomous University of Barcelona

2. University of Girona

Abstract

Abstract Introduction: The global aging population poses challenges for society such as health inequalities among older persons and between genders. Objectives: To determine how Social Determinants of Health (SDH) influence the quality of life (QoL) of individuals over 50 years old in various European countries, taking a gender perspective in a longitudinal study. Materials and methods: Sample of 11,493 individuals from 13 European countries from Waves 5 (2013), 6 (2015), and 7 (2017) of the SHARE study. Instruments: CASP-12 (QoL), EURO-D (depression), SDH: gender, age, educational level, socioeconomic status, ethnicity, place of residence, and European region. Sociodemographic and clinical variables. Statistical analysis: Bivariate and multivariate mixed linear models. Results: The bivariate analysis showed higher economic hardship and lower education in women compared to men. The CASP-12 score was higher in men than in women. In the multivariate analysis, the variables associated with lower QoL scores among men and women from Wave 5 to Wave 7 were: (β:-0.196, 95% CI: -0.345; -0.047) vs (β:0.038, 95% CI: -0.122; 0.197); economic hardship; and the European region between South and North (β: 2.709, 95% CI: 2.403; 3.015) vs men (β: 2.224, 95% CI: 1.896; 2.551). Conclusions: The main SDH associated with poorer QoL were female gender, advanced age, economic hardship, educational level, and geographic location within Europe. Depression in women and in Southern Europe were associated with a decrease in QoL scores.

Publisher

Research Square Platform LLC

Reference59 articles.

1. Discussion.

2. QoL among people aged 50 years and older in 13 European countries from a sex perspective. This study was conducted before the COVID-19 pandemic. The results revealed significant differences in the evolution of QoL between men and women during follow-up;This study investigated SDHs

3. [30], our findings support evidence that women experienced a significant decline in their QoL compared to men over time, more significantly in the Southern European region;Consistent with the findings of previous research using the SHARE cohort

4. Our findings suggest that not facing economic difficulties has a protective effect on the evolution of QoL. This statement is supported by a study by Niedzwiedz [31] in 2014, which demonstrated a significant association between lifelong socioeconomic position and life satisfaction in early old age and revealed differences in this association between countries with different welfare systems. In our study, economic hardships were also related to lower QoL scores, especially in Southern and Eastern European countries during the follow-up period, and this effect was more evident among women. This finding is consistent with that of previous research, such as that of Conde-Sala in 2017 [32], suggesting that QoL is related to social welfare regimes. These regimes are more limited in Eastern and Southern European countries compared to Nordic and continental countries and have a protective effect on the evolution of QoL, especially among women [33]. We also found that being native to the country where the interview took place was a protective factor in the evolution of quality of life for women, in line with previous studies that found that migrant women experience triple discrimination based on ethnicity, sex, and class [34] that have significant implications for their QoL [35], which is not the case for men.

5. In this study. we observed that lower levels of education were correlated with worse QoL, especially in Southern European countries and among women. These results are consistent with those of other studies, such as that by Rivas [36] in 2011, which found an association between lower education levels and worse perceived QoL. The southern region had a higher prevalence of depression among older women, which was directly related to lower QoL, in line with the findings of a meta-analysis conducted by Zhao in 2012 [37].