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Equity of Health and Health Care in Aging Societies

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 March 2020) | Viewed by 16090

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Special Issue Editors

Prof. Dr. Hui-Chuan Hsu

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Guest Editor

School of Public Health, Taipei Medical University
Interests: successful aging, active aging, gerontology, health policy, health promotion, long-term care
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Chyi-Huey Bai

E-Mail Website
Guest Editor

School of Public Health, Taipei Medical University
Interests: stroke, cardiovascular diseases, dementia, survey, epidemiology

Prof. Dr. Hsing Jasmine Chao

E-Mail Website
Guest Editor

School of Public Health, Taipei Medical University
Interests: air quality, exposures assessment, environmental and occupational health, bioaerosols

Special Issue Information

Dear Colleagues,

Due to the global trend of population aging, the needs of health promotion, health care, and long-term care for older adults have become challenging issues in aging societies. Issues of disparity in health, health care, and environmental health have been raised. Demographic and social determinants, such as age, sex, ethnicity, socioeconomic status, occupation, living area, and the development level of countries, are sources of income inequality. When healthy aging, successful aging, or active aging become the goal of an aging world, the inequality of health and health care needs to be solved. The purpose of this Special Issue is to highlight the issue of equity (or inequality) in health, health care, long-term care, environmental health, and quality of life in aging societies. We welcome manuscripts that discuss equity issues in health, risk factors to health, and use of health care for older adults and their families. We also encourage the study findings that can be translated to policy and/or practice suggestions, and thus research that can be applied to improving health and health care for aging societies.

Prof. Dr. Hui-Chuan Hsu
Prof. Dr. Chyi-Huey Bai
Prof. Dr. Hsing Jasmine Chao
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 submissions that pass pre-check are 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 2500 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

aging
health equity
health inequality
health disparity
health care
health services utilization
long-term care
older adults
socioeconomic status
social determinants

Published Papers (5 papers)

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Research

14 pages, 311 KiB

Open AccessArticle

The Burden of Caring: An Exploratory Study of the Older Persons Caring for Adult Children with AIDS-Related Illnesses in Rural Communities in South Africa

by Makhosazane Ntuli and Sphiwe Madiba

Int. J. Environ. Res. Public Health 2019, 16(17), 3162; https://doi.org/10.3390/ijerph16173162 - 30 Aug 2019

Cited by 7 | Viewed by 2232

Abstract

Since the start of the HIV and AIDS epidemic, very little research has been conducted on the older persons’ provision of HIV-related care to adult children. This is despite the fact that a large proportion of adults who die of AIDS-related illnesses stay with their elderly parents during the terminal stage of their illnesses. This paper explores how older persons in rural settings experience caring for their adult children with AIDS-related illnesses. In-depth interviews took place with older persons aged 60 years and above. The qualitative data analysis was informed by thematic approach to identify and report themes using inductive approach. The paper found that the older persons undertake the caring role without resources and support. As a result, they are burdened with having to care for adult children with AIDS-related illness. Fatigue arising from the hard work of physically caring for their sick adult children day and night adds to the physical burden on the older persons. Older persons will continue to carry the burden of caring for people with AIDS-related illnesses due to the increase in the number of new infections in South Africa. There is a need to involve them in HIV/AIDS programmes; their experience and wisdom would surely contribute positively and assist in addressing HIV prevention. Full article

(This article belongs to the Special Issue Equity of Health and Health Care in Aging Societies)

16 pages, 808 KiB

Open AccessArticle

Who Are the Beneficiaries of China’s New Rural Pension Scheme? Sons, Daughters, or Parents?

by Zhaohua Zhang, Yuxi Luo and Derrick Robinson

Int. J. Environ. Res. Public Health 2019, 16(17), 3159; https://doi.org/10.3390/ijerph16173159 - 29 Aug 2019

Cited by 6 | Viewed by 2652

Abstract

By applying a fuzzy regression discontinuity design, this study investigates whether sons, daughters, or parents are the beneficiaries of China’s New Rural Pension Scheme. Using data drawn from the China Health and Retirement Longitudinal Survey, our results indicate that pension income crowds out approximately 27.9% of the monetary support from adult sons and decreases the likelihood that adult sons live with their parents by 6.5%. However, we do not find a significant effect of pension income on the likelihood that adult daughters live with their parents. In regards to the well-being of parents, which is measured by consumption and health outcomes, the results show that pension income increases food and non-food consumption by 16.3 and 15.1%, respectively, and improves the psychological health of the elderly. Accounting for the different effects of pension income for those with different income levels, our results show that the New Rural Pension Scheme only has a significant effect on the poor elderly. Full article

(This article belongs to the Special Issue Equity of Health and Health Care in Aging Societies)

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18 pages, 375 KiB

Open AccessArticle

Social Determinants and Disparities in Active Aging Among Older Taiwanese

by Hui-Chuan Hsu, Jersey Liang, Dih-Ling Luh, Chen-Fen Chen and Ying-Wei Wang

Int. J. Environ. Res. Public Health 2019, 16(16), 3005; https://doi.org/10.3390/ijerph16163005 - 20 Aug 2019

Cited by 12 | Viewed by 4318

Abstract

This study assesses equity in active aging across social determinants among older Taiwanese. The data were collected from face-to-face interviews with adults aged 55 years or more in Taiwan in 2017 (n = 738). A total of 30 individual-level Taiwan active aging indicators were chosen, and the relationship between social determinants and active aging indicators were analyzed by logistic regression models. Women were more likely to participate in volunteering and other social groups and in lifelong learning activities, whereas men were more likely to be employed, to engage in physical activity, to feel safe from violence, and to use preventive care. Higher education was related to higher employment, social participation, independent living, lifelong learning, and a lower likelihood of poverty and severe cognitive impairment. Those living in rural areas were more likely to be employed, perform physical activity, feel physically safe, have better mental well-being, and have higher social respect and social integration ratings, whereas living in urban areas was related to greater access to medical care, owning assets, less severe cognitive impairment, greater likelihood of using information and communications technology, higher level of education, and higher access to convenient transportation. The significant disparities that exist in active aging may suggest inequality. Full article

(This article belongs to the Special Issue Equity of Health and Health Care in Aging Societies)

13 pages, 315 KiB

Open AccessArticle

by Shervin Assari, James Smith and Mohsen Bazargan

Int. J. Environ. Res. Public Health 2019, 16(9), 1522; https://doi.org/10.3390/ijerph16091522 - 29 Apr 2019

Cited by 13 | Viewed by 2969

Abstract

Background: The association between age and health-related quality of life (HRQoL) is still under debate. While some research shows older age is associated with better HRQoL, other studies show no or negative association between age and HRQoL. In addition, while the association between age and HRQoL may depend on race, ethnicity, gender, and their intersections, most previous research on this link has been performed in predominantly White Middle Class. Objective: To explore gender differences in the association between age and mental and physical HRQoL in a sample of economically disadvantaged African American (AA) older adults. Methods: This cross-sectional survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 economically disadvantaged AA older adults (age ≥ 55 years) were enrolled in this study, using non-random sampling. This includes 266 AA men and 474 AA women. The independent variable of interest was age. Dependent variables of interest were physical component scores (PCS) and mental component scores (MCS), two main summary scores of the HRQoL, measured using Short Form-12 (SF-12). Gender was the moderator. Socioeconomic status (educational attainment and financial difficulty) were covariates. Linear regression models were used to analyze the data. Results: AA women reported worse PCS; however, gender did not impact MCS. In the pooled sample, high age was associated with better PCS and MCS. In the pooled sample, a significant interaction was found between gender and age on PCS, suggesting a stronger effect of age on PCS for AA men than AA women. In gender-stratified models, older age was associated with better PCS for AA men but not AA women. Older age was similarly and positively associated with better MCS for AA men and women. Conclusions: There may be some gender differences in the implications of ageing for the physical HRQoL of AA older adults. It is unclear how old age may have a boosting effect on physical HRQoL for AA men but not AA women. Future research should test gender differences in the effect of age on physical health indicators such as chronic disease as well as cognitive processes involved in the evaluation of own’s health in AA men and women. Full article

(This article belongs to the Special Issue Equity of Health and Health Care in Aging Societies)

14 pages, 337 KiB

Open AccessArticle

Utility of Geriatric Syndrome Indicators for Predicting Subsequent Health Care Utilization in Older Adults in Taiwan

by Ching-Ju Chiu and Ya-Yun Cheng

Int. J. Environ. Res. Public Health 2019, 16(3), 456; https://doi.org/10.3390/ijerph16030456 - 04 Feb 2019

Cited by 9 | Viewed by 3275

Abstract

Background: The predictive utility of both individual and combined indicators of geriatric syndromes on subsequent emergency use and hospitalization is not clear. Methods: Nationally representative data on adults aged 65+ (N = 2345) (with 1148 male, 1197 female) in Taiwan were analyzed. The receiver operating characteristic (ROC) curve examined the diagnostic accuracy of the combined effects of geriatric syndromes on predicting health care utilization in three years. Negative binomial regressions identified the individual effect of each indicator with the control of sociodemographic and baseline health status. Results: The combined indicators of geriatric syndromes predicted future hospitalization of old-old (75+ yrs) diabetes patients, with area under the curve (AUC) = 0.709, 95% confidence interval (CI) = 0.635–0.782, and young-old patients (65–74 yrs) with mild cognitive impairment (AUC = 0.727, 95% CI = 0.610–0.845 for hospitalization and AUC = 0.770, 95% CI = 0.664–0.877 for emergency visits). As for individual indicators, while incontinence was the indicator having the most influence on hospitalization (incidence rate ratio (IRR) = 1.81, 95% CI = 1.21–2.72) and emergency visits (IRR = 1.78, 95% CI = 1.23–2.59) for general older adults (65+), and for old-old emergency visits, especially (IRR = 2.21, 95% CI = 1.39–3.49), falls was the most prominent indicator of hospitalization for young-old (65-74) adults (IRR = 1.61, 95% CI = 1.13–2.28). In addition, pain was another significant indicator for predicting future hospitalization of old-old diabetes patients (IRR = 1.61, 95% CI= 1.07–2.44). Conclusions: Combined indicators of geriatric syndromes effectively predict hospitalization in old-old (75+ yrs) diabetes patients and hospitalization and emergency visits in young-old (65–74 yrs) patients with cognitive impairment. Incontinence, falls, and pain were the most predictive independent geriatric assessment indicators. Full article

(This article belongs to the Special Issue Equity of Health and Health Care in Aging Societies)

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