The aim of the present study was to analyse the association between the occurrence of a major depressive episode among older adults and work status in low- and medium-income countries. A cross-sectional study was conducted with people 60 years of age and older from the six countries (Mexico, India, China, Russian Federation, Ghana and South Africa) included in the Study on Global Ageing and Adult Health (SAGE) and who participated in its first wave (2009–2010). The occurrence of a major depressive episode (MDE) over the previous 12 months was determined based on an adaptation of the ICD-10 diagnostic criteria. The association between current work status and the presence of an MDE was estimated using binary logistic regression models with country-level fixed effects, and interaction terms between the country and work status. Results showed the odds of presenting an MDE were lower for older adults who were retired with a pension than for those who were currently working, although this protective association was observed only for men in China (OR=0.23; CI 95%:0.08–0.70) and Ghana (OR=0.25; CI 95%:0.07–0.95) and for women in India (OR=0.05; CI 95%:0.01–0.51) and South Africa (OR=0.19; CI 95%:0.04–0.97). For women, being a homemaker also showed a protective association in South Africa (OR=0.09; CI95%:0.01–0.66) and Mexico (OR=0.32; CI95%:0.14–0.76). In the case of being retired without a pension, no significant association was found in any country. The previous indicates that retirement with pension has a protective association with MDE only for men in China and Ghana and women in India and South Africa. The heterogeneity of this association reflects cultural and socioeconomic differences between the analysed countries.
A growing body of literature shows that neighborhood characteristics influence older adults’ mental health. Therefore, the aim of this study was to examine the association between structural and social characteristics of the neighborhood, and depression in Mexican older adults. A longitudinal study was conducted based on waves 1 (2009–2010) and 2 (2014) of the Mexican sample from the Study on global AGEing and adult health (SAGE). A street-network buffer around each participant’s household was used to define neighborhood, so that built environment and social characteristics were assessed within it. Depression was ascertained by using an algorithm based on the Composite International Diagnostic Interview. In the analysis, multilevel logistic regression models were constructed separately for each built and social environments measurement, adjusted for socioeconomic, demographic and health-related covariates, and stratified by area of residence (urban versus rural). The results showed that a length of space between 15–45 meters restricted to vehicles was significantly associated with a lower risk of depression in older adults from the urban area (OR: 0.44; IC 95% 0.23–0.83) and the protective association appeared to be larger with increasing space with this restriction, although it lacked significance. Contrarily, the built environment measures were not predictive of depression in the rural setting. On the other hand, none of the variables from the social environment had a significant association, although safety appeared to behave as a risk factor in the overall (OR: 1.48; CI 95% 0.96–2.30; p = 0.08) and rural (OR: 3.44; CI 95% 0.95–12.45; p = 0.06) samples, as it reached marginal significance. Research about neighborhood effects on older adults’ mental health is an emergent field that has shown that depression might be treated not only from the individual-level, but also from the neighborhood-level. Additionally, further research is needed, especially in low- and middle-income countries, to help guide neighborhood policies.
Association between the employment status and the presence of depressive symptoms in men and women in MexicoAsociación entre el estatus de empleo y la presencia de síntomas depresivos en hombres y mujeres en México Associação entre situação laboral e presença de sintomas depressivos em homens e mulheres mexicanos AbstractThis study aims to estimate the relationship between employment status and depressive symptoms among Mexican adults, as well as to explore its differential effect by gender. Cross-sectional study of 36,516 adults between 20 and 59 years of age taken from the 2012 Mexican National Health and Nutrition Survey. Depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D), and the employment status was determined a week before the survey. Logistic regression models were stratified by gender and education level and adjusted by sociodemographic and health-related conditions to estimate the association between depressive symptoms and employment status. The prevalence of clinically depressive symptoms was 7.59% for men and 18.62% for women. In the case of men, those who were unemployed were more likely to present depressive symptoms (OR = 1.66; 95%CI: 1.08-2.55) than those who were working. For women, employment status is not associated with the presence of depressive symptoms, except in students (OR = 1.57; 95%CI: 1.02-2.43) compared with those who were working. In both genders, disability preventing one from working was associated with depressive symptoms. Although being employed has been reported to be associated with lower levels of psychiatric morbidity, the estimated effect is different for men and women. Occupational health policies should consider these conditions.
Background Colombia is currently the world’s main recipient country for Venezuelan migrants, and women represent a high proportion of them. This article presents the first report of a cohort of Venezuelan migrant women entering Colombia through Cúcuta and its metropolitan area. The study aimed to describe the health status and access to healthcare services among Venezuelan migrant women in Colombia with irregular migration status, and to analyze changes in those conditions at a one-month follow-up. Methods We carried out a longitudinal cohort study of Venezuelan migrant women, 18 to 45 years, who entered Colombia with an irregular migration status. Study participants were recruited in Cúcuta and its metropolitan area. At baseline, we administered a structured questionnaire including sociodemographic characteristics, migration history, health history, access to health services, sexual and reproductive health, practice of early detection of cervical cancer and breast cancer, food insecurity, and depressive symptoms. The women were again contacted by phone one month later, between March and July 2021, and a second questionnaire was applied. Results A total of 2,298 women were included in the baseline measurement and 56.4% could be contacted again at the one-month follow-up. At the baseline, 23.0% of the participants reported a self-perceived health problem or condition in the past month and 29.5% in the past 6 months, and 14.5% evaluated their health as fair or poor. A significant increase was found in the percentage of women who reported a self-perceived health problem during the past month (from 23.1% to 31.4%; p<0.01); as well as in the share who reported moderate, severe, or extreme difficulty working or performing daily chores (from 5.5% to 11.0%; p = 0.03) and who rated their health as fair (from 13.0% to 31.2%; p<0.01). Meanwhile, the percentage of women with depressive symptoms decreased from 80.5% to 71.2% (p<0.01). Conclusion This report presents initial information on the health status of Venezuelan migrant women in Colombia, and is a starting point for further longer longitudinal follow-ups to assess changes over time in health conditions.
Background: Colombia is currently the world main recipient country for Venezuelan migrants, and women represent a high proportion of them. This article presents the first report of a cohort of Venezuelan migrant women entering Colombia through Cucuta and its metropolitan area (the main land entry point to this country). The study aimed to describe the health status and access to healthcare services among Venezuelan migrant women in Colombia with irregular migration status, and to analyze changes in those conditions at a one-month follow-up. Methods: A longitudinal cohort study of Venezuelan migrant women, 18 to 45 years, who entered Colombia with an irregular migration status, was carried out in 2021. Study participants were recruited in temporary shelters, transit points, and migrant settlements in Cucuta and the metropolitan area. At baseline, we administered a structured questionnaire including sociodemographic characteristics, migration history, health history, access to health services, sexual and reproductive health, practice of early detection of cervical cancer and breast cancer, food insecurity, and depressive symptoms. The women were again contacted by phone one month later, between March and July 2021, and a second questionnaire was applied. Results: A total of 2,298 women were included in the baseline measurement and 56.4% could be contacted again at the one-month follow- up. A significant increase was found in the percentage of women who had a health problem during the past month (from 23.1% to 31.4%; p<0.01). Meanwhile, the percentage of women with depressive symptoms decreased from 80.5% to 71.2% (p<0.01). Conclusion: This report is a starting point for the longitudinal follow-up of the cohort, which will allow us to better understand how the health status of Venezuelan women changes during the migration flow in Colombia
Considering that the world population is rapidly aging and disability is a very frequent event in older adults, there is an increasing interest in studying their determinants, such as the neighborhood characteristics. Thus, this study aimed to explore the association between the social environment of the neighborhood and disability in older adults. A cohort study was assembled using waves 1 and 2 from the Study of Global Ageing and Adults Health (SAGE) in Mexico, which included adults with 55+ years old. Neighborhood characteristics - such as social participation, trust and safety - and individual covariates were measured only in wave 1 (baseline), while disability was measured in both waves to adjust for the score of wave 1. Multilevel negative binomial models with random intercepts at the municipality level were constructed for the disability score in wave 2, using each of the social environment variables as the main exposure and adjusting for the sociodemographic and health-related variables. Finally, interaction terms with sex, age, and socioeconomic quintiles were tested. Results showed that neighborhoods with a medium (IRR: 0.68; 95%CI: 0.53-0.87) or high (IRR: 0.67; 95%CI: 0.52-0.86) safety level were associated with a significant reduction in the disability score of adults older than 75 years, although there was no association between other characteristics of the social environment and disability in the general sample. Consequently, actions to improve safety in the neighborhoods should be carried out to help reduce the disability score in vulnerable older adults, especially in a context where safety is a critical issue, as in Mexico.
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