Self-rated health disparities among disadvantaged older adults in ethnically diverse urban neighborhoods in a Middle Eastern country

Sibai, Abla Mehio; Rizk, Anthony; Chemaitelly, Hiam

doi:10.1080/13557858.2016.1244736

Cited by 9 publications

(5 citation statements)

References 52 publications

(78 reference statements)

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“…SRH is also used for cross-country comparisons [23,24,25,26,27,28,29] and policy development [30,31,32,33]. It is used as a reflection of health disparities and inequality [34,35,36,37]. SRH is also used to track the subjective health of individuals with index psychiatric or medical conditions [38].…”

Section: Introductionmentioning

confidence: 99%

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Assari

Smith

Bazargan

2019

IJERPH

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Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

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Section: Introductionmentioning

confidence: 99%

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Assari

Smith

Bazargan

2019

IJERPH

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“…Acknowledging the transformed role of women in bearing the economic burden of a family, the report equally highlighted women's increased marginalisation, where 'political oppression, extremism, widespread violence, and exploitation' compromised women's possibility of social participation (Syrian Center for Policy Research 2017, p. 6). We add our recommendations to existing ones to promote the use of social capital building approaches, such as community-driven development, job creation, and education as peace building blocks in post-conflict settings (Idres 2016;Sibai et al 2017). This is a topic that will require considerable further research, as post-conflict rebuilding becomes possible in urban Syria.…”

Section: Discussionmentioning

confidence: 99%

Women’s health and well-being in low-income formal and informal neighbourhoods on the eve of the armed conflict in Aleppo

Ahmad

Fouad

Zaman

et al. 2018

Int J Public Health

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Objectives To explore how married women living in low-income formal and informal neighbourhoods in Aleppo, Syria, perceived the effects of neighbourhood on their health and well-being, and the relevance of these findings to future urban rebuilding policies post-conflict. Methods Semi-structured interviews were undertaken with eighteen married women living in informal or socioeconomically disadvantaged formal neighbourhoods in Aleppo in 2011, a year before the armed conflict caused massive destruction in all these neighbourhoods. Results Our findings suggest that the experience of neighbourhood social characteristics is even more critical to women's sense of well-being than environmental conditions and physical infrastructure. Most prominent was the positive influence of social support on well-being. Conclusions The significance of this study lies, first, in its timing, before the widespread destruction of both formal and informal neighbourhoods in Aleppo and, second, and in its indication of the views of women who lived in marginalised communities on what neighbourhood characteristics mattered to them. Further research post-conflict needs to explore how decisions on urban rebuilding are made and their likely influence on health and well-being.

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“…Accessibility of patients from minority ethnic groups to healthcare services has been recognized as a challenge in many societies world-wide, and such inequality has been especially identified among the elderly population [2–4]. Walton & Anthony (2017) [5] found that while Latino, Black and Native American elderly individuals utilized less medical services than white peers, they expressed higher needs for utilization rates of medical services, even when other factors such as health needs, socio-economic levels or the medical systems’ features are accounted for.…”

Section: Ethnic Inequality Within the Elderly Population In Utilizingmentioning

confidence: 99%

Ethnic inequality within the elderly population in utilizing healthcare services

Adini

2019

Isr J Health Policy Res

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The accessibility of minority ethnic groups to healthcare services is challenging in many societies, most especially among the elderly population. Elderly individuals from minority groups have been found to have lower levels of utilizing healthcare services, including preventive care, intensive hospital care, advanced technological procedures and rehabilitation. Universal health coverage is incapable of addressing all of healthcare’s access inequities and there is a need to assess the overall outcomes, including mortality rates over time, functionality of discharged patients, quality of life and/or unplanned readmissions that may indicate low quality hospital discharge processes. There is a need to investigate the impact of perceived trust/distrust in the healthcare system of elderly patients from minority ethnicities on their willingness to consume medical services. To ensure equity in service provision, there is a need to examine whether medical providers, even unconsciously, prioritize vital services, such as rehabilitation services to populations that share similar social backgrounds. An essential measure is enhancement of health literacy at all levels, from the individual to policy-makers and strategic adoption of health literacy programs that encompass all ethnicities, considering their respective needs, norms and expectations. Ethnic equality in accessing medical services is crucial in view of the numerous migrants and asylum-seekers who look for refuge in varied societies globally. Such populations are perceived as faring worse in healthcare quality of care, and this highlights the need to adapt the healthcare systems to the varied health behaviors, contextual factors, language barriers, lower health literacy levels and limited access to timely care. Improving equity and access to medical care is dependent on enhanced health literacy; policies that consider diverse needs of majority and minority groups; and advanced research. Concurrent implementation of these measures will be well aligned with the global strive to promote the Sustainable Development Goals (SDGs).

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Self-rated health disparities among disadvantaged older adults in ethnically diverse urban neighborhoods in a Middle Eastern country

Cited by 9 publications

References 52 publications

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Women’s health and well-being in low-income formal and informal neighbourhoods on the eve of the armed conflict in Aleppo

Ethnic inequality within the elderly population in utilizing healthcare services

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