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Special Issue "Key Issues in Current Health Research: Ageing–Health–Equity"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: 31 December 2017

Special Issue Editors

Guest Editor
Prof. Dr. Ingrid Darmann-Finck

Institute for Public Health and Nursing Research (IPP), University of Bremen, Germany
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Guest Editor
Prof. Dr. Heinz Rothgang

SOCIUM – Research Center on Inequality and Social Policy University of Bremen, Germany
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Guest Editor
Prof. Dr. Hajo Zeeb

Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
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Special Issue Information

Dear Colleagues,

The Special Issue will bring together selected papers presented at the Conference "Key Issues in Current Health Research: Ageing–Health–Equity", in Bremen, 29–30 June, 2017, as well as other papers fitting the themes of this Special Issue.

Demographic change and the evolving demands on healthcare systems, especially the provision of healthcare and nursing care for a growing number of older people, are among the greatest social challenges of the next decades. The pursuit of health equity in ageing societies raises several questions: On the one hand, there are persisting health inequities related to a social gradient in health. On the other hand, as resources are limited, social challenges to healthcare and the healthcare system will always entail questions of distributive justice.

With the conference on Ageing, Health and Equity, the High Profile Research Area Health Sciences of the University of Bremen has established a forum for discussing these key challenges of healthcare in ageing societies. A common focus is on disparities in healthcare and equity requirements.

The conference focuses on four main topics that shall be reflected in the Special Issue:

  • Health–equity–health inequalities: This may comprise questions concerning concept for reducing health inequalities, international comparisons of health inequalities and analyses of the persistence of health inequalities.
  • Qualification requirements and training of healthcare professionals: The focus is on the analysis and international comparison of concepts and programmes to meet the growing demand for skilled workers for ageing populations.
  • Prevention–Healthy Ageing: Including determinants of healthy ageing, access to health services, evaluation of preventive interventions that may reinforce inequalities.
  • Ageing and Diversity: Requirements for health services: This includes questions of participatory approaches as well as the analysis of access barriers for specific groups of people such as the growing group of elderly migrants.

The four topics are linked by their common perspective on health equity issues.  The conference aims to analyze current developments, as well as possible solutions and action strategies. Papers are invited that focus on research obstacles, and how to overcome them, as well as new methodological concepts, technological developments and innovative solutions. Papers not related to the conference but fitting the scope are also welcome.

Prof. Dr. Hajo Zeeb
Prof. Dr. Heinz Rothgang
Prof. Dr. Ingrid Darmann-Finck
Guest editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Health Inequalities
  • Health Equity
  • Healthy Ageing
  • Ageing and Diversity
  • Distributive Justice
  • Health Disparities
  • Qualification requirements of healthcare professionals
  • Prevention
  • Access to Health Services
  • Diversity-sensitive health care provision

Published Papers (5 papers)

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Research

Open AccessFeature PaperArticle Cross-Cultural Adaptation of the Social Vulnerability Index for Use in the Dutch Context
Int. J. Environ. Res. Public Health 2017, 14(11), 1387; doi:10.3390/ijerph14111387
Received: 5 September 2017 / Revised: 30 October 2017 / Accepted: 10 November 2017 / Published: 14 November 2017
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Abstract
Being able to identify socially frail older adults is essential for designing interventions and policy and for the prediction of health outcomes, both on the level of individual older adults and of the population. The aim of the present study was to adapt
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Being able to identify socially frail older adults is essential for designing interventions and policy and for the prediction of health outcomes, both on the level of individual older adults and of the population. The aim of the present study was to adapt the Social Vulnerability Index (SVI) to the Dutch language and culture for those purposes. A systematic cross-cultural adaptation of the initial Social Vulnerability Index was performed following five steps: initial translation, synthesis of translations, back translation, a Delphi procedure, and a test for face validity and feasibility. The main result of this study is a face-valid 32 item Dutch version of the Social Vulnerability Index (SVI-D) that is feasible in health care and social care settings. The SVI-D is a useful index to measure social frailty in Dutch-language countries and offers a broad, holistic quantification of older people’s social circumstances related to the risk of adverse health outcomes. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
Open AccessFeature PaperArticle Changes in Sports Participation across Transition to Retirement: Modification by Migration Background and Acculturation Status
Int. J. Environ. Res. Public Health 2017, 14(11), 1356; doi:10.3390/ijerph14111356
Received: 23 September 2017 / Revised: 27 October 2017 / Accepted: 30 October 2017 / Published: 8 November 2017
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Abstract
While total physical activity decreases over the life course, sports and leisure-time physical activity (LTPA) have shown to increase after transition to retirement. This paper aimed to investigate whether this change in sports participation differs (1) between non-migrant persons (NMP) versus persons with
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While total physical activity decreases over the life course, sports and leisure-time physical activity (LTPA) have shown to increase after transition to retirement. This paper aimed to investigate whether this change in sports participation differs (1) between non-migrant persons (NMP) versus persons with a migrant background (PMB), and (2) by acculturation status. Data was drawn from 16 waves of the German Socio-Economic Panel Study (SOEP) including 2664 NMP and 569 PMB. PMB were grouped according to acculturation status (integrated, assimilated, marginalised, separated), assessed regarding three dimensions (language, social interaction and identification). We applied multilevel logistic regression models, adjusting for sex, retirement age, socioeconomic status, health status and body mass index. Our results show that (1) transition to retirement led to an increase in the sports participation of NMP during the first 5 years and the subsequent 5 years after retirement. Changes in sports participation were modified by migration status: In PMB sports participation increased to a lesser extent than in NMP. (2) While sports participation of integrated PMB was not significantly different from NMP in the preretirement phase, sports participation among integrated PMB increased less after retirement compared with NMP. Marginalized and assimilated PMB did not show consistent sports participation patterns before retirement, but seemingly increased their sports participation less than NMP over the retirement transition. Separated PMB had particularly low levels of sports participation. Considering that LTPA is a key factor for healthy ageing, the increasing gap in levels of sports participation after transition to retirement indicates the need for interventions targeting physical activity of the older migrant population. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Open AccessFeature PaperArticle Fairness and Eligibility to Long-Term Care: An Analysis of the Factors Driving Inequality and Inequity in the Use of Home Care for Older Europeans
Int. J. Environ. Res. Public Health 2017, 14(10), 1224; doi:10.3390/ijerph14101224
Received: 31 August 2017 / Revised: 22 September 2017 / Accepted: 2 October 2017 / Published: 14 October 2017
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Abstract
In contrast with the case of health care, distributional fairness of long-term care (LTC) services in Europe has received limited attention. Given the increased relevance of LTC in the social policy agenda it is timely to evaluate the evidence on inequality and horizontal
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In contrast with the case of health care, distributional fairness of long-term care (LTC) services in Europe has received limited attention. Given the increased relevance of LTC in the social policy agenda it is timely to evaluate the evidence on inequality and horizontal inequity by socio-economic status (SES) in the use of LTC and to identify the socio-economic factors that drive them. We address both aspects and reflect on the sensitivity of inequity estimates to adopting different definitions of legitimate drivers of care need. Using Survey of Health, Ageing and Retirement in Europe (SHARE)data collected in 2013, we analyse differences in home care utilization between community-dwelling Europeans in nine countries. We present concentration indexes and horizontal inequity indexes for each country and results from a decomposition analysis across income, care needs, household structures, education achievement and regional characteristics. We find pro-poor inequality in home care utilization but little evidence of inequity when accounting for differential care needs. Household characteristics are an important contributor to inequality, while education and geographic locations hold less explanatory power. We discuss the findings in light of the normative assumptions surrounding different definitions of need in LTC and the possible regressive implications of policies that make household structures an eligibility criterion to access services. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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Open AccessFeature PaperArticle The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study
Int. J. Environ. Res. Public Health 2017, 14(10), 1215; doi:10.3390/ijerph14101215
Received: 31 August 2017 / Revised: 27 September 2017 / Accepted: 5 October 2017 / Published: 11 October 2017
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Abstract
Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of
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Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
Open AccessFeature PaperArticle Socioeconomic Inequalities in Health and Perceived Unmet Needs for Healthcare among the Elderly in Germany
Int. J. Environ. Res. Public Health 2017, 14(10), 1127; doi:10.3390/ijerph14101127
Received: 17 July 2017 / Revised: 18 September 2017 / Accepted: 21 September 2017 / Published: 26 September 2017
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Abstract
Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived
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Research into health inequalities in the elderly population of Germany is relatively scarce. This study examines socioeconomic inequalities in health and perceived unmet needs for healthcare and explores the dynamics of health inequalities with age among elderly people in Germany. Data were derived from the Robert Koch Institute’s cross-sectional German Health Update study. The sample was restricted to participants aged 50–85 years (n = 11,811). Socioeconomic status (SES) was measured based on education, (former) occupation, and income. Odds ratios and prevalence differences were estimated using logistic regression and linear probability models, respectively. Our results show that self-reported health problems were more prevalent among men and women with lower SES. The extent of SES-related health inequalities decreased at older ages, predominantly among men. Although the prevalence of perceived unmet needs for healthcare was low overall, low SES was associated with higher perceptions of unmet needs in both sexes and for several kinds of health services. In conclusion, socioeconomic inequalities in health exist in a late working age and early retirement but may narrow at older ages, particularly among men. Socially disadvantaged elderly people perceive greater barriers to accessing healthcare services than those who are better off. Full article
(This article belongs to the Special Issue Key Issues in Current Health Research: Ageing–Health–Equity)
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