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Risk factors and health status among older adults in Europe: a socioeconomic analysis

Published online by Cambridge University Press:  19 August 2021

Aviad Tur-Sinai Open the ORCID record for Aviad Tur-Sinai [Opens in a new window]  and
Nir Becker Open the ORCID record for Nir Becker [Opens in a new window]
Aviad Tur-Sinai
Affiliation:
Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel University of Rochester Medical Center, School of Nursing, NY, USA
Nir Becker*
Affiliation:
Department of Economics and Management, Tel-Hai College, Upper Galilee, Israel
*
*Corresponding author. Email: nbecker@telhai.ac.il
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Abstract

The risk of developing a major non-communicable disease is critically affected by lifestyle choices. This study examined the consequences of factors that might predict a change in the self-rated health of older adults and aimed to assess their monetary costs. In particular, two predisposing risk factor moderators were studied: high blood pressure and high cholesterol. The effects of these on two serious adverse cardiovascular events – heart attack and stroke – were estimated. Using data from the Survey of Health, Aging and Retirement in Europe (SHARE) carried out in 2014, a two-stage procedure was applied as well as pairwise comparison. The results revealed the significant role of socioeconomic status in health outcomes. Behavioural risk factors were found to be significant predictors for heart attack and stroke. The findings support the claim that variables such as age, wealth and behavioural risk factors are additional predictors of a change in these two diseases. The monetary consequences can reach up to 12.8 thousand Euros for older adults per unit of predisposing risk factor. Since national health budgets are limited, health policies might be prioritized.

Keywords

Risk factorOlder adultsSHARE
Type
Research Article
Information
Journal of Biosocial Science , Volume 54 , Issue 5 , September 2022 , pp. 829 - 846
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Achdut, L, Tur-Sinai, A and Troitsky, R (2015) Transitions among states of labor force participation in the old age. European Journal of Ageing 12(1), 39–49.CrossRefGoogle Scholar
Adams, KF, Schatzkin, A and Harris, TB (2006) Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. New England Journal of Medicine 355, 763–778.CrossRefGoogle Scholar
Ahmed, MD, Hameed, IH and Abd-Ali, MQ (2017) Prospective and retrospective study of the acute heart attack cases in Marjan Hospital-Hillah City-Iraq. Research Journal of Pharmacy and Technology 10(10), 3408–3416.CrossRefGoogle Scholar
Antonanzas, F, Rodrigues-Ibeas, R, Barco, E, Ramirez, M and Pinillos, M (2008) Alcohol consumption in the EU: health economics and policy issues under a permanent debate. European Journal of Health Economics 9, 1–6.CrossRefGoogle Scholar
Bardage, C, Pluijm, SMF, Pedersen, NL, Deeg, DJH, Jylha, M, Noale, M et al. (2005) Self-rated health among older adults: a cross-national comparison. European Journal of Ageing 2, 149–158.CrossRefGoogle ScholarPubMed
Benjamin, EJ, Muntner, P, Alonso, A, Bittencourt, MS, Callaway, CW, Carson, AP et al. (2019) Heart disease and stroke Statistics-2019 update a report from the American Heart Association. Circulation 139(10), E56–E528.CrossRefGoogle ScholarPubMed
Bergmann, M, Kneip, T, De Luca, G and Scherpenzeel, A (2019) Survey Participation in the Survey of Health, Ageing and Retirement in Europe (SHARE), Wave 1–7. Munich Center for the Economics of Aging, Munich Google Scholar
Börsch-Supan, A, Brandt, M, Hunkler, C, Kneip, T, Korbmacher, J, Malter, F et al. (2013) Data resource profile: the Survey of Health, Ageing and Retirement in Europe (SHARE). International Journal of Epidemiology 42(4), 992–1001.CrossRefGoogle Scholar
Bós, AM and Bos, AJ (2007) The socioeconomic determinants of older people’s health in Brazil: the importance of marital status and income. Ageing and Society 27(3), 385–405.CrossRefGoogle Scholar
Braakmann, N (2011) The causal relationship between education, health and health related behaviour: evidence from a natural experiment in England. Journal of Health Economics 30(4), 753–763.CrossRefGoogle ScholarPubMed
Brunello, G, Fort, M, Schneeweis, N and Winter-Ebmer, R (2016) The causal effect of education on health: what is the role of health behaviors? Health Economics 25(3), 314–336.CrossRefGoogle ScholarPubMed
Calvert, JW (2011) Cardioprotective effects of nitrite during exercise. Cardiovascular Research 89(3), 499–506.CrossRefGoogle ScholarPubMed
Carmel, S and Tur-Sinai, A (2021) Cognitive decline among European retirees: impact of early retirement, nation-related and personal characteristics: a longitudinal study. Ageing & Society, doi: 10.1017/S0144686X21000064CrossRefGoogle Scholar
Chu, Hai-Jui, Chun-Hsien, Lin, Chih-Hao, Chen, Yi Ting, Hwang, Meng, Lee, Chung-Wei, Lee et al. (2020) Effect of blood pressure parameters on functional independence in patients with acute ischemic stroke in the first 6 hours after endovascular thrombectomy. Journal of Neurointerventional Surgery 12(10), 937–941.CrossRefGoogle ScholarPubMed
Davies, JM, Cillard, J, Friguet, B, Cadenas, E, Cadet, J, Cayce, R et al. (2017) The Oxygen Paradox, the French Paradox, and age-related diseases. GeroScience 39(5–6), 499–550.CrossRefGoogle ScholarPubMed
Doll, R, Peto, R, Boreham, J and Sutherland, I (2000) Smoking and dementia in male British doctors: prospective study. BMJ 320, 1097–1102.CrossRefGoogle ScholarPubMed
Donnan, GA, Fisher, M, Macleod, M and Davis, SM (2008) Stroke. The Lancet 371(9624), 1612–1623.CrossRefGoogle ScholarPubMed
Eurostat (2021) Your Key to European Statistics. Eurostat, European Commission. URL: https://ec.europa.eu/eurostat/data/database (accessed 8th July 2021).Google Scholar
Fattore, G, Torbica, A, Susi, A, Giovanni, A, Benelli, G, Gozzo, M and Toso, V (2012) The social and economic burden of stroke survivors in Italy: a prospective, incidence-based, multi-centre cost of illness study. BMC Neurology 12(1), 137.CrossRefGoogle ScholarPubMed
Gomes, IC, Santos, VR, Christofaro, DGD, Santos, LL and Júnior, IFF (2013) The most frequent cardiovascular risk factors in Brazilian aged 80 years or older. Journal of Applied Gerontology 32(4), 408–421.CrossRefGoogle ScholarPubMed
Humphreys, BR, McLeod, L and Ruseski, JE (2014) Physical activity and health outcomes: evidence from Canada. Health Economics 23(1), 33–54.CrossRefGoogle ScholarPubMed
Holme, I and Anderssen, SA (2015) Increases in physical activity is as important as smoking cessation for reduction in total mortality in elderly men: 12 years of follow-up of the Oslo II study. British Journal of Sports Medicine 49(11), 743–748.CrossRefGoogle ScholarPubMed
Horton, R (2015) Offline: the French paradox. The Lancet 385(9968), 590.CrossRefGoogle Scholar
Hung, HC, Joshipura, KJ and Jiang, R (2004) Fruit and vegetable intake and risk of major chronic disease. Journal of the National Cancer Institute 96, 1577–1584.CrossRefGoogle ScholarPubMed
Jang, SN, Choi, YJ and Kim, DH (2009) Association of socioeconomic status with successful ageing: differences in the components of successful ageing. Journal of Biosocial Science 41(2), 207.CrossRefGoogle ScholarPubMed
Katz, R, Lowenstein, A, Halperin, D and Tur-Sinai, A (2015) Generational solidarity in Europe and Israel. Canadian Journal of Aging/La Revue canadienne du vieillissement 34(3), 342–355.CrossRefGoogle ScholarPubMed
Kennedy, P (2008) A Guide to Econometrics, Sixth Edition. Wiley-Blackwell Press.Google Scholar
Kronish, IM, Lynch, AI, Oparil, S, Whittle, J, Davis, BR, Simpson, LM et al. (2016) The association between antihypertensive medication nonadherence and visit-to-visit variability of blood pressure: findings from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Hypertension 68(1), 39–45.CrossRefGoogle ScholarPubMed
Kunst, AE, Bos, V, Lahelma, E, Bartley, M, Lissau, I, Regitor, E et al. (2005) Trends in socioeconomic inequalities in mortality in self-assessed health in 10 European countries. International Journal of Epidemiology 34(2), 295–305.CrossRefGoogle Scholar
Laditka, SB and Laditka, JN (2001) Effects of improved morbidity rates on active life expectancy and eligibility for long-term care services. Journal of Applied Gerontology 20(1), 39–56.CrossRefGoogle Scholar
Leal, J, Luengo-Fernández, R, Gray, A, Petersen, S and Rayner, M (2006) Economic burden of cardiovascular diseases in the enlarged European Union. European Heart Journal 27(13), 1610–1619.CrossRefGoogle ScholarPubMed
Lee, S, Colditz, G, Berkman, L and Kawachi, I (2003) Caregiving to children and grandchildren and risk of coronary heart disease in women. American Journal of Public Health 93(11), 1939–1944.CrossRefGoogle ScholarPubMed
Lehto, S, Rönnemaa, T, Pyörälä, K and Laakso, M (2000) Cardiovascular risk factors clustering with endogenous hyperinsulinaemia predict death from coronary heart disease in patients with Type II diabetes. Diabetologia 42(2), 148–155.CrossRefGoogle Scholar
Leinonen, R, Heikkinen, E and Jylha, M (2001) Predictors of decline in self-assessments of health among older people – a 5-year longitudinal study. Social Science & Medicine 2(9), 1329–1341.CrossRefGoogle Scholar
Lesyuk, W, Kriza, C and Kolominsky-Rabas, P (2018) Cost-of-illness studies in heart failure: a systematic review 2004–2016. BMC Cardiovascular Disorders 18(1), 74.CrossRefGoogle ScholarPubMed
Lopez, AD, Mathers, CD, Ezzati, M, Jamison, DT and Murray, CJL (2006) Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. The Lancet 367, 1747–1757.CrossRefGoogle ScholarPubMed
Lowenstein, A, Katz, R and Tur-Sinai, A (2019) Intergenerational family relationships and successful aging. In Fernandez-Ballesteros, R, Robine, JM and Benetos, A (eds) The Cambridge Handbook of Successful Aging. Cambridge University Press, pp. 455–474.CrossRefGoogle Scholar
Luengo-Fernandez, R, Violato, M, Candio, P and Leal, J (2020) Economic burden of stroke across Europe: a population-based cost analysis. European Stroke Journal 5(1), 17–25.CrossRefGoogle ScholarPubMed
McPake, B and Hanson, K (2016) Managing the public–private mix to achieve universal health coverage. The Lancet 388(10044), 622–630.CrossRefGoogle ScholarPubMed
Mohammadnezhad, M, Tsourtos, G, Wilson, C, Ratcliffe, J and Ward, P (2015) “I have never experienced any problem with my health. So far, it hasn’t been harmful”: older Greek-Australian smokers’ views on smoking: a qualitative study. BMC Public Health 15(1), 304.CrossRefGoogle ScholarPubMed
Murray, M, King, C, Sorensen, C, Bunick, E and King, R (2018) Community awareness of stroke, hypertension and modifiable risk factors for cardiovascular disease in Nkonya-Wurupong, Ghana. Journal of Public Health in Africa 9(2), 783.Google ScholarPubMed
Okulicz-Kozaryn, A and Valente, RR (2019) Livability and subjective well-being across European cities. Applied Research in Quality of Life 14(1), 197–220.CrossRefGoogle Scholar
Olesen, J, Gustavsson, A, Svensson, M, Wittchen, HU, Jönsson, B, CDBE2010 Study Group et al. (2012) The economic cost of brain disorders in Europe. European Journal of Neurology 19(1), 155–162.Google ScholarPubMed
Pan, WH, Hung, YT, Shaw, NS, Lin, W, Lee, SD, Chiu, CF and Su, SC (2005) Elderly Nutrition and Health Survey in Taiwan (1999-2000): research design, methodology and content. Asia Pacific Journal of Clinical Nutrition 14(3), 203–210.Google ScholarPubMed
Pavlušová, M, Klimes, J, Špinar, J, Zeman, K, Jarkovský, J, Benešová, K et al. (2018) Chronic heart failure – impact of the condition on patients and the healthcare system in the Czech Republic. A retrospective cost-of-illness analysis. Cor et Vasa 60(3), e224–e233.CrossRefGoogle Scholar
Payne, KA, Huybrechts, KF, Caro, JJ, Green, TJC and Klittich, WS (2002) Long term cost-of-illness in stroke. Pharmacoeconomics 20(12), 813–825.CrossRefGoogle ScholarPubMed
Peralta, M, Ramos, M, Lipert, A, Martins, J and Marques, A (2018) Prevalence and trends of overweight and obesity in older adults from 10 European countries from 2005 to 2013. Scandinavian Journal of Public Health, 1403494818764810.Google ScholarPubMed
Roos, ET, Lahti, JM and Rahkonen, O (2018) Lifestyle and cancer – a joint pairwise association of lifestyle habits with subsequent cancer diagnosis. European Journal of Public Health 29(2), 340–345.CrossRefGoogle Scholar
Rudd, AG, Hoffman, A, Down, C, Pearson, M and Lowe, D (2007) Access to stroke care in England, Wales and Northern Ireland: the effect of age, gender and weekend admission. Age and Ageing 36(3), 247–255.CrossRefGoogle ScholarPubMed
Scarborough, P, Bhatnagar, P, Wickramasinghe, KK, Allender, S, Foster, C and Rayner, M (2011) The economic burden of ill health due to diet, physical inactivity, smoking, alcohol and obesity in the UK: an update to 2006–07 NHS costs. Journal of Public Health 33(4), 527–535.CrossRefGoogle ScholarPubMed
Schouten, B (2018) Statistical inference based on randomly generated auxiliary variables. Journal of the Royal Statistical Society: Series B (Statistical Methodology) 80(1), 33–56.CrossRefGoogle Scholar
Segel, JE (2006) Cost-of-illness studies – a primer. RTI-UNC Center of Excellence in Health Promotion Economics 1, 39.Google Scholar
Shafie, AA, Tan, YP and Ng, CH (2018) Systematic review of economic burden of heart failure. Heart Failure Reviews 23(1), 131–145.CrossRefGoogle ScholarPubMed
Sharma, A (2012) Health disparities in later life: a simultaneous equations analysis of utilization. Journal of Aging and Health 24(8), 1421–1448.CrossRefGoogle ScholarPubMed
Shiovitz-Ezra, S and Litwin, H (2015) Social network type and health among older Americans. In Nyqvist, F and Forsman, AK (eds) Social Capital as a Health Resource in Later Life: The Relevance of Context. Springer, Netherland, pp. 15–31.CrossRefGoogle Scholar
Shuldiner, J, Tur-Sinai, A and Bentur, N (2020) Musculoskeletal pain medication use in middle age and older adults in 15 European countries and Israel. Pain Management Nursing 21(2), 165–171.CrossRefGoogle ScholarPubMed
Silverstein, M, Tur-Sinai, A and Lewin-Epstein, N (2020) Intergenerational support of older adults by the ‘Mature’ sandwich generation: the relevance of national policy regimes. Theoretical Inquiries in Law 21(1), 55–76.CrossRefGoogle Scholar
Sohail, QZ, Chu, A, Rezai, MR, Donovan, LR, Ko, DT and Tu, JV (2015) The risk of ischemic heart disease and stroke among immigrant populations: a systematic review. Canadian Journal of Cardiology 31(9), 1160–1168.CrossRefGoogle ScholarPubMed
Sorkin, D, Rook, KS and Lu, JL (2002) Loneliness, lack of emotional support, lack of companionship, and the likelihood of having a heart condition in an elderly sample. Annual Behavioral Medicine 24, 290–298.CrossRefGoogle Scholar
Stenholm, S, Westerlund, H, Head, J, Hyde, M, Kawachi, I, Pentti, J and Vahtera, J (2015). Comorbidity and functional trajectories from midlife to old age: the Health and Retirement Study. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 70(3), 332–338.CrossRefGoogle ScholarPubMed
Tong, W, Lai, H, Yang, C, Ren, S, Dai, S and Lai, S (2005) Age, gender and metabolic syndrome-related coronary heart disease in US adults. International Journal of Cardiology 104(3), 288–291.CrossRefGoogle Scholar
Tsimbos, C (2010) An assessment of socioeconomic inequalities in health among elderly in Greece, Italy and Spain. International Journal of Public Health 55, 5–15.CrossRefGoogle Scholar
Tubeuf, S, Jusot, F and Bricard, D (2012). Mediating role of education and lifestyles in the relationship between early-life conditions and health: evidence from the 1958 British Cohort. Health Economics 21, 129–150.CrossRefGoogle ScholarPubMed
Tur-Sinai, A and Litwin, H (2015) Forgone visits to the doctor due to cost or lengthy waiting time among older adults in Europe. In Börsch-Supan, A et al. (eds) Ageing in Europe: Supporting Policies for an Inclusive Society. De Gruyter, Berlin, pp. 291–300.Google Scholar
Tur-Sinai, A, Shuldiner, J and Bentur, N (2019) Sociodemographic inequality in joint-pain medication use among community-dwelling older adults in Israel. Health & Social Care in the Community 27(5), 1167–1174.Google ScholarPubMed
Tur-Sinai, A and Soskolne, V (2020) Socioeconomic status and health behaviors as predictors of changes in self-rated health among older persons in Israel. Health and Social Care in the Community, doi: 10.1111/hsc.13205.Google ScholarPubMed
United Nations (2017) World Population Prospects: The 2017 Revision – Key Findings and Advance Tables. Population Division, United Nations Department of Economic and Social Affairs.Google Scholar
Verropoulou, G (2009) Key elements composing self-rated health in older adults: a comparative study of 11 European countries. European Journal of Aging 6, 213–226.CrossRefGoogle ScholarPubMed
von Humboldt, S, Leal, I and Pimenta, F (2014) Living well in later life: the influence of sense of coherence, and socio-demographic, lifestyle and health-related factors on older adults’ satisfaction with life. Applied Research in Quality of Life 9(3), 631–642.CrossRefGoogle Scholar
Wahrendorf, M, Knesebeck, OVD and Siegrist, J (2006) Social productivity and well-being of older people: baseline results from the SHARE study. European Journal of Aging 3, 67–73.CrossRefGoogle ScholarPubMed
Warburton, DER, Nicol, CW and Bredin, SSD (2006) Health benefits of physical activity: the evidence. Canadian Medical Association Journal 174, 801–809.CrossRefGoogle ScholarPubMed
Yi, SW, Shin, DH, Kim, H, Yi, JJ and Ohrr, H (2018) Total cholesterol and stroke mortality in middle-aged and elderly adults: a prospective cohort study. Atherosclerosis 270, 211–217.CrossRefGoogle ScholarPubMed