Is the Association Between Late Life Morbidity and Disability Attenuated Over Time? Exploring the Dynamic Equilibrium of Morbidity Hypothesis

Hossin, Muhammad Zakir; Östergren, Olof; Fors, Stefan

doi:10.1093/geronb/gbx067

Cited by 9 publications

(16 citation statements)

References 85 publications

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“…The onset of more burdensome symptoms is delayed in those who have already had diseases [30] and the function of vital organs get declined slowly over time [31]. The clinical improvement and healthier behavior, education, and better living environment reduce mortality rate, leading to the reduction of severity of the chronic disease, slowing its rate of progression, and minimizing the effects of severe health problems on mortality but increasing the prevalence of disease [32][33][34][35]. Thus, the number of people living with highlymorbid or severe-health conditions gets relatively constant over time, whereas, the prevalence of people with mild and moderate disability or non-lethal impairment increases [29,[36][37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?

Huang

Liao

et al. 2021

PLoS ONE

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Studies about medical care needs for home healthcare (HHC) previously focused on disease patterns but not gender and income differences. We used the Taiwan National Health Research Insurance Database from 1997 to 2013 to examine trends in medical care needs for patients who received HHC, and the gender and income gaps in medical care needs, which were represented by resource utilization groups (RUG). We aimed to clarify three questions: 1. Are women at a higher level of medical care needs for HHC than men, 2. Does income relate to medical care needs? 3. Is the interaction term (gender and income) related to the likelihood of medical care needs? Results showed that the highest level of medical care need in HHC was reducing whereas the basic levels of medical care need for HHC are climbing over time in Taiwan during 1998 and 2013. The percentages of women with income-dependent status in RUG1 to RUG4 are 26.43%, 26.24%, 30.68%, and 32.07%, respectively. Women were more likely to have higher medical care needs than men (RUG 3: odds ratio, OR = 1.17, 95% confidence interval, CI = 1.10–1.25; RUG4: OR = 1.13, 95% CI = 1.06–1.22) in multivariates regression test. Compared to the patients with the high-income status, patients with the income-dependent status were more likely to receive RUG3 (OR = 2.34, 95% CI = 1.77–3.09) and RUG4 (OR = 1.98, 95% CI = 1.44–2.71). The results are consistent with the perspectives of fundamental causes of disease and feminization of poverty theory, implying gender and income inequalities in medical care needs. Policymakers should increase public spending for delivering home-based integrated care resources, especially for women with lower income, to reduce the double burden of female poverty at the higher levels of medical care needs for HHC.

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Section: Discussionmentioning

confidence: 99%

Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?

Huang

Liao

et al. 2021

PLoS ONE

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“…We used the robust sandwich estimators of variance to correct the standard errors of the Poisson regression models which are known to produce wider CIs. Poisson regression as a viable alternative to logistic regression was previously demonstrated in the context of a binary outcome of common prevalence i.e., > 10% [ 41 , 42 ]. Because psychological distress was highly prevalent in our data (47%), we preferred the RRs over the odds ratios (OR) which would have inflated the relative risks.…”

Section: Methodsmentioning

confidence: 99%

Associations between family social circumstances and psychological distress among the university students of Bangladesh: To what extent do the lifestyle factors mediate?

et al. 2021

Self Cite

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Background While there is a growing body of empirical studies focusing on the social and behavioral predictors of psychological health, the mechanisms that may underlie the reported associations have not been adequately explored. This study aimed to examine the association of social and lifestyle factors with psychological distress, and the potential mediating role of the lifestyle factors in the estimated associations between social circumstances and psychological distress. Methods A total of 742 tertiary level students (53% females) from a range of socio-economic backgrounds and multiple educational institutions participated in this cross-sectional study. The 12-items General Health Questionnaire (GHQ-12) was utilized for measuring psychological distress. Data related to students’ socio-demographic characteristics, family social circumstances, and lifestyle factors were also collected. Modified Poisson regression analysis was used to estimate the risk ratios (RR) and their 95% confidence intervals (CI). Results The multivariable regression analysis suggests heightened risks of psychological distress associated with low parental Socio-Economic Position (SEP) (RR: 1.36; 95% CI: 1.07, 1.76), childhood poverty (RR: 1.31; 95% CI: 1.11, 1.55), and living away from the family (RR: 1.28; 95% CI: 1.07, 1.54). Among the lifestyle factors, past smoking, physical inactivity, inadequate fruit intake, and poor sleep quality were strongly associated with psychological distress and these associations persisted when the family social circumstances and lifestyle factors were mutually adjusted for. The lifestyle factors did not considerably mediate the estimated associations between family social circumstances and psychological distress. Conclusion The social and lifestyle factors operated independently to increase students’ risk of psychological distress. Accordingly, while promoting students’ healthy lifestyles may reduce the overall burden of psychological distress, any equity initiative aiming to minimize the social inequalities in psychological health should be targeted to improving the living conditions in early life.

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“…Finally, a third conjecture by Manton [11] proposes that, as a consequence of multiple advances, principally medical innovations, most diseases will be controlled at early stages of their progression thus reducing the average severity of chronic conditions and lead to a "dynamic equilibrium" with no systematic compression or expansion of morbidity [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, a number of studies find a combination of trends such as a decline of time spent with functional limitations occurring simultaneously with an increase in the duration of chronic diseases. Finally, there is also evidence for shifting landscapes over time in the same population, the result of a replacement of conditions that produce compression by those sustaining expansion or vice-versa [12].…”

Section: Introductionmentioning

confidence: 99%

Trends in Education-specific Differences in Disability-Free Life Expectancy in Spain, 2008-2017

Voigt¹,

Daza²,

Ordanovich³

et al. 2020

Preprint

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Background: There is mounting evidence for a recent increase of social disparities in chronicdisease prevalence and mortality. However, little is known about how these trends are reflected incombined measures of morbidity, disability and mortality.Method: We use two nationally representative surveys of the Spanish population for the years2008 to 2017 and standard measures of expected duration of disability and illness to assess timetrends and social disparities in mortality, morbidity and expected years lived in disability (DFLE)and with chronic illness (chrDFLE). We provide empirical evidence of shifting trends for thesemeasures. We then decompose these changes into contributions associated with disability, chronicillness and mortality. Finally, we estimate the size of education differentials in DFLE and chrDFLEand evaluate the magnitude and direction of changes of these differentials over time.Results: While the disability based indicator suggests a decrease of expected years withoutdisability for both men and women (expansion of morbidity), the morbidity based indicator showsan increase in time spend free of chronic disease for women but a slight decrease for men. Thedecrease in time spent without disability was observed for all education groups but is particularlymarked for those with low education.Conclusion: We find evidence of an expansion of morbidity in Spain between 2008 and 2017.The bulk of this development is related to increases in time spent with functional limitations overthis period. These patterns occur in conjuncture with growing social disparities in time spend withchronic illness or disability.

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Is the Association Between Late Life Morbidity and Disability Attenuated Over Time? Exploring the Dynamic Equilibrium of Morbidity Hypothesis

Abstract: In agreement with the dynamic equilibrium of morbidity hypothesis, this study concludes that the morbidity-disability associations among the Swedish older adults largely waned between 1992 and 2011.

Cited by 9 publications

References 85 publications

Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?

Medical care needs for patients receiving home healthcare in Taiwan: Do gender and income matter?

Associations between family social circumstances and psychological distress among the university students of Bangladesh: To what extent do the lifestyle factors mediate?

Trends in Education-specific Differences in Disability-Free Life Expectancy in Spain, 2008-2017

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