The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
Abstract
Objectives: By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands. Methods: From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity. Results: Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001). Conclusions: A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
참고문헌 (40)
- "Health impact assessment (HIA)"[URL]
- Fountoulakis KN, "Relationship of suicide rates to economic variables in Europe: 2000-2011", Br J Psychiatry, 205(6), pp.486~496 (2014)
- Chang SS, "Impact of 2008 global economic crisis on suicide: time trend study in 54 countries", BMJ, 347, pp.f5239~ (2013)
- 이상욱, "Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study", 예방의학회지, 49(3), pp.176~182 (2016), 대한예방의학회
- Fortes PA, "Economic crisis and counter-reform of universal health care systems: Spanish case", Rev Saude Publica, 49, pp.34~ (2015)
- Rachiotis G, "Medical supplies shortages and burnout among Greek health care workers during economic crisis: a pilot study", Int J Med Sci, 11(5), pp.442~447 (2014)
- Bruggink JW, "Changes between pre-crisis and crisis period in socioeconomic inequalities in health and stimulant use in Netherlands", Eur J Public Health, 26(5), pp.772~777 (2016)
- Marra M, "Health inequalities and nutrition in Italy during crisis times", Epidemiol Prev, 39(5-6), pp.322~331 (2015)
- Economou M, "Major depression in the era of economic crisis: a replication of a cross-sectional study across Greece", J Affect Disord, 145(3), pp.308~314 (2013)
- Evans RG, "Apocalypse no: population aging and the future of health care systems", Can J Aging, 20(S1), pp.160~191 (2001)
- Simou E, "Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: a systematic review", Health Policy, 115(2-3), pp.111~119 (2014)
- "Management of substance abuse"[URL]
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive summary of the Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)", JAMA, 285(19), pp.2486~2497 (2001)
- Papathanasiou G, "Reliability measures of the short International Physical Activity Questionnaire (IPAQ) in Greek young adults", Hellenic J Cardiol, 50(4), pp.283~294 (2009)
- Tyrovolas S, "Repeatability and validation of a short, semi-quantitative food frequency questionnaire designed for older adults living in Mediterranean areas: the MEDIS-FFQ", J Nutr Elder, 29(3), pp.311~324 (2010)
- Panagiotakos DB, "Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk", Nutr Metab Cardiovasc Dis, 16(8), pp.559~568 (2006)
- Fountoulakis KN, "The validation of the short form of the Geriatric Depression Scale (GDS) in Greece", Aging (Milano), 11(6), pp.367~372 (1999)
- "Gaining health: the European strategy for the prevention and control of noncommunicable diseases" (2006)[URL]
- Tyrovolas S, "Successful aging, dietary habits and health status of elderly individuals: a k-dimensional approach within the multi-national MEDIS study", Exp Gerontol, 60, pp.57~63 (2014)
- Tyrovolas S, "Factors associated with the prevalence of diabetes mellitus among elderly men and women living in Mediterranean islands: the MEDIS study", Rev Diabet Stud, 6(1), pp.54~63 (2009)
- Stavrianakos K, "Attempted suicide during the financial crisis in Athens", Psychiatriki, 25(2), pp.104~110 (2014)
- Benmarhnia T, "Impact of the economic crisis on the health of older persons in Spain: research clues based on an analysis of mortality. SESPAS report 2014", Gac Sanit, 28(Suppl 1), pp.137~141 (2014)
- Gutiérrez-Misis A, "Prevalence and incidence of hypertension in a population cohort of people aged 65 years or older in Spain", J Hypertens, 29(10), pp.1863~1870 (2011)
- Brinkman HJ, "High food prices and the global financial crisis have reduced access to nutritious food and worsened nutritional status and health", J Nutr, 140(1), pp.153S~161S (2010)
- Bonaccio M, "Decline of the Mediterranean diet at a time of economic crisis. Results from the Moli-sani study", Nutr Metab Cardiovasc Dis, 24(8), pp.853~860 (2014)
- Pereira M, "Trends in prevalence of diabetes mellitus and mean fasting glucose in Portugal (1987-2009): a systematic review", Public Health, 128(3), pp.214~221 (2014)
- Darmon N, "Food price policies improve diet quality while increasing socioeconomic inequalities in nutrition", Int J Behav Nutr Phys Act, 11, pp.66~ (2014)
- Conklin AI, "Social relationships and healthful dietary behaviour: evidence from over-50s in the EPIC cohort, UK", Soc Sci Med, 100, pp.167~175 (2014)
- Agardh E, "Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis", Int J Epidemiol, 40(3), pp.804~818 (2011)
- 서수라, "The Incidence of Stroke by Socioeconomic Status, Age, Sex, and Stroke Subtype: A Nationwide Study in Korea", 예방의학회지, 47(2), pp.104~112 (2014), 대한예방의학회
- Kollia N, "Exploring the association between low socioeconomic status and cardiovascular disease risk in healthy Greeks, in the years of financial crisis (2002-2012): the ATTICA study", Int J Cardiol, 223, pp.758~763 (2016)
- Gow AJ, "Social resources and cognitive ageing across 30 years: the Glostrup 1914 Cohort", Age Ageing, 45(4), pp.480~486 (2016)
- Sarah T. Stahl, "Living alone and depression: the modifying role of the perceived neighborhood environment", Aging & Mental Health, 21(10), pp.1065~1071 (2016), Informa UK Limited[DOI]
- McKenzie K, "Using an accumulation of deficits approach to measure frailty in a population of home care users with intellectual and developmental disabilities: an analytical descriptive study", BMC Geriatr, 15, pp.170~ (2015)
- "Older people also suffer because of the crisis" (2012)[URL]
- Sim F, "‘Back to the future’--from 2015 to 2016", Public Health, 129(12), pp.1551~1552 (2015)
- Edward J, "Friends in old age", Clin Soc Work J, 44(2), pp.198~203 (2016)
- Munné MI, "Alcohol and the economic crisis in Argentina: recent findings", Addiction, 100(12), pp.1790~1799 (2005)
- Trichopoulou A, "Traditional Mediterranean diet and longevity in the elderly: a review", Public Health Nutr, 7(7), pp.943~947 (2004)
- Skarupski KA, "Mediterranean diet and depressive symptoms among older adults over time", J Nutr Health Aging, 17(5), pp.441~445 (2013)