Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

When does poor subjective financial position hurt the elderly? Testing the interaction with educational attainment using a national representative longitudinal survey

Authors: Christy Pu, Nicole Huang, Gao-Jun Tang, Yiing-Jenq Chou

Published in: BMC Public Health | Issue 1/2011

Login to get access

Abstract

Background

Several studies have demonstrated that perceived financial status has a significant impact on health status among the elderly. However, little is known about whether such a subjective perception interacts with objective socioeconomic status (SES) measures such as education that affect the individual's health.

Methods

This research used data from the Survey of Health and Living Status of the Middle Age and Elderly in Taiwan (SHLS) conducted by the Bureau of Health Promotion, Department of Health in Taiwan. Waves 1996, 1999 and 2003 were used. The sample consisted of 2,387 elderly persons. The interactive effects of self-rated satisfaction with financial position and educational attainment were estimated. Self-rated health (SRH), depressive symptom (measured by CES-D) and mortality were used to measure health outcomes.

Results

Significant interaction effect was found for depressive symptoms. Among those who were dissatisfied with their financial position, those who were illiterate had an odds ratio (OR) of 8.3 (95% CI 4.9 to 14.0) for having depressive symptoms compared with those who were very satisfied with their financial position. The corresponding OR for those with college or above was only 2.7 (95% CI 1.0 to 7.3). No significant interaction effect was found for SRH and mortality.

Conclusions

Although poor financial satisfaction was found to be related to poorer health, the strongest association for this effect was observed among those with low educational attainment, and this is especially true for depressive symptoms. Subjective financial status among the elderly should be explored in conjunction with traditional measures of SES.
Literature
1.
Wege N, Dragano N, Erbel R, Jockel KH, Moebus S, Stang A, et al: When does work stress hurt? Testing the interaction with socioeconomic position in the Heinz Nixdorf Recall Study. J Epidemiol Community Health. 2008, 62 (4): 338-41. 10.1136/jech.2007.062315.CrossRefPubMed
2.
Adler N: When one's main effect is another's error: material vs. psychosocial explanations of health disparities. A commentary on Macleod et al., "is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men". Soc Sci Med. 2005, 61 (9): 1916-1929. 10.1016/j.socscimed.2005.04.009. Soc Sci Med. 2006 Aug;63(4):846-50; discussion 51-7CrossRef
3.
Manuck SB, Phillips JE, Gianaros PJ, Flory JD, Muldoon MF: Subjective Socioeconomic Status and Presence of the Metabolic Syndrome in Midlife Community Volunteers. Psychosom Med. 2009
4.
Baron-Epel O, Kaplan G: Can subjective and objective socioeconomic status explain minority health disparities in Israel?. Soc Sci Med. 2009, 69 (10): 1460-7. 10.1016/j.socscimed.2009.08.028.CrossRefPubMed
5.
Suchday S, Chhabra R, Wylie-Rosett J, Almeida M: Subjective and objective measures of socioeconomic status: predictors of cardiovascular risk in college students in Mumbai, India. Ethn Dis. 2008, 18 (2 Suppl 2): S2-235-7. SpringPubMed
6.
Demakakos P, Nazroo J, Breeze E, Marmot M: Socioeconomic status and health: the role of subjective social status. Soc Sci Med. 2008, 67 (2): 330-40. 10.1016/j.socscimed.2008.03.038.CrossRefPubMed
7.
Ostrove JM, Adler NE, Kuppermann M, Washington AE: Objective and subjective assessments of socioeconomic status and their relationship to self-rated health in an ethnically diverse sample of pregnant women. Health Psychol. 2000, 19 (6): 613-8. 10.1037/0278-6133.19.6.613.CrossRefPubMed
8.
Singh-Manoux A, Adler NE, Marmot MG: Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med. 2003, 56 (6): 1321-33. 10.1016/S0277-9536(02)00131-4.CrossRefPubMed
9.
Adler NE, Ostrove JM: Socioeconomic status and health: what we know and what we don't. Ann N Y Acad Sci. 1999, 896: 3-15. 10.1111/j.1749-6632.1999.tb08101.x.CrossRefPubMed
10.
Adler NE, Epel ES, Castellazzo G, Ickovics JR: Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol. 2000, 19 (6): 586-92. 10.1037/0278-6133.19.6.586.CrossRefPubMed
11.
Kaplan GA, Pamuk ER, Lynch JW, Cohen RD, Balfour JL: Inequality in income and mortality in the United States: analysis of mortality and potential pathways. BMJ. 1996, 312 (7037): 999-1003.CrossRefPubMedPubMedCentral
12.
Diez-Roux AV, Nieto FJ, Muntaner C, Tyroler HA, Comstock GW, Shahar E, et al: Neighborhood environments and coronary heart disease: a multilevel analysis. Am J Epidemiol. 1997, 146 (1): 48-63.CrossRefPubMed
13.
Haan M, Kaplan GA, Camacho T: Poverty and health. Prospective evidence from the Alameda County Study. Am J Epidemiol. 1987, 125 (6): 989-98.PubMed
14.
Weden MM, Carpiano RM, Robert SA: Subjective and objective neighborhood characteristics and adult health. Soc Sci Med. 2008, 66 (6): 1256-70. 10.1016/j.socscimed.2007.11.041.CrossRefPubMed
15.
Wolff LS, Subramanian SV, Acevedo-Garcia D, Weber D, Kawachi I: Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample. Soc Sci Med. 2010, 70 (12): 2019-28. 10.1016/j.socscimed.2010.02.033.CrossRefPubMedPubMedCentral
16.
Marmot MG, Bosma H, Hemingway H, Brunner E, Stansfeld S: Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet. 1997, 350 (9073): 235-9. 10.1016/S0140-6736(97)04244-X.CrossRefPubMed
17.
Macleod J, Davey Smith G, Metcalfe C, Hart C: Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men. Soc Sci Med. 2005, 61 (9): 1916-29. 10.1016/j.socscimed.2005.04.009.CrossRefPubMed
18.
Szanton SL, Allen JK, Thorpe RJ, Seeman T, Bandeen-Roche K, Fried LP: Effect of financial strain on mortality in community-dwelling older women. J Gerontol B Psychol Sci Soc Sci. 2008, 63 (6): S369-74.CrossRefPubMedPubMedCentral
19.
Cantril H: The pattern of human concerns. 1965, New Brunswick, NJ: Rutgers University Press
20.
Veenstra G: Social status and health: absolute deprivation or relative comparison, or both?. Health Sociology Review. 2005, 14 (2): 121-34.CrossRef
21.
Butterworth P, Rodgers B, Windsor TD: Financial hardship, socio-economic position and depression: results from the PATH Through Life Survey. Soc Sci Med. 2009, 69 (2): 229-37. 10.1016/j.socscimed.2009.05.008.CrossRefPubMed
22.
Zimmerman FJ, Katon W: Socioeconomic status, depression disparities, and financial strain: what lies behind the income-depression relationship?. Health Econ. 2005, 14 (12): 1197-215. 10.1002/hec.1011.CrossRefPubMed
23.
Chou KL, Chi I: Financial strain and life satisfaction in Hong Kong elderly Chinese: moderating effect of life management strategies including selection, optimization, and compensation. Aging Ment Health. 2002, 6 (2): 172-7. 10.1080/13607860220126781.CrossRefPubMed
24.
Singh-Manoux A, Marmot MG, Adler NE: Does subjective social status predict health and change in health status better than objective status?. Psychosom Med. 2005, 67 (6): 855-61. 10.1097/01.psy.0000188434.52941.a0.CrossRefPubMed
25.
Laaksonen M, Rahkonen O, Martikainen P, Lahelma E: Socioeconomic position and self-rated health: the contribution of childhood socioeconomic circumstances, adult socioeconomic status, and material resources. Am J Public Health. 2005, 95 (8): 1403-9. 10.2105/AJPH.2004.047969.CrossRefPubMedPubMedCentral
26.
Parna K, Ringmets I: Comparison of socioeconomic differences in self-perceived health in Estonia and Finland. Scand J Public Health. 2010, 38 (2): 129-34. 10.1177/1403494809357259.CrossRefPubMed
27.
Wang JL, Schmitz N, Dewa C: Socioeconomic status and the risk of major depression: The Canadian National Populatoin Health Survey. J Epidemiol Community Health. 2009
28.
Mete C: Predictors of elderly mortality: health status, socioeconomic characteristics and social determinants of health. Health Econ. 2005, 14 (2): 135-48. 10.1002/hec.892.CrossRefPubMed
29.
Bassuk SS, Berkman LF, Amick BC: Socioeconomic status and mortality among the elderly: findings from four US communities. Am J Epidemiol. 2002, 155 (6): 520-33. 10.1093/aje/155.6.520.CrossRefPubMed
30.
Martelin T: Mortality by indicators of socioeconomic status among the Finnish elderly. Soc Sci Med. 1994, 38 (9): 1257-78. 10.1016/0277-9536(94)90190-2.CrossRefPubMed
31.
Chang CHA: The 1989 Survey of Health and Living Status in Taiwan: questionnaire and survey design. 1989, Ann Arbor, MI: Population Studies Center, University of Michigan.(Comparative study of the elderly in four Asian countries, research report no. 1)
32.
Monden CW, van Lenthe F, de Graaf ND, Kraaykamp G: Partner's and own education: does who you live with matter for self-assessed health, smoking and excessive alcohol consumption?. Soc Sci Med. 2003, 57 (10): 1901-12. 10.1016/S0277-9536(03)00055-8.CrossRefPubMed
33.
Lue BH, Chen LJ, Wu SC: Health, financial stresses, and life satisfaction affecting late-life depression among older adults: a nationwide, longitudinal survey in Taiwan. Arch Gerontol Geriatr. 2010, 50 (Suppl 1): S34-8. 10.1016/S0167-4943(10)70010-8.CrossRefPubMed
34.
Andresen EM, Malmgren JA, Carter WB, Patrick DL: Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994, 10 (2): 77-84.PubMed
35.
Melin R, Fugl-Meyer KS, Fugl-Meyer AR: Life satisfaction in 18- to 64-year-old Swedes: in relation to education, employment situation, health and physical activity. J Rehabil Med. 2003, 35 (2): 84-90. 10.1080/16501970306119.CrossRefPubMed
36.
Chandola T, Ferrie J, Sacker A, Marmot M: Social inequalities in self reported health in early old age: follow-up of prospective cohort study. BMJ. 2007, 334 (7601): 990-10.1136/bmj.39167.439792.55.CrossRefPubMedPubMedCentral
37.
Marmot MG, Shipley MJ: Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. BMJ. 1996, 313 (7066): 1177-80.CrossRefPubMedPubMedCentral
38.
Huisman M, Kunst AE, Mackenbach JP: Socioeconomic inequalities in morbidity among the elderly; a European overview. Soc Sci Med. 2003, 57 (5): 861-73. 10.1016/S0277-9536(02)00454-9.CrossRefPubMed
39.
House JS, Lepkowski JM, Kinney AM, Mero RP, Kessler RC, Herzog AR: The social stratification of aging and health. J Health Soc Behav. 1994, 35 (3): 213-34. 10.2307/2137277.CrossRefPubMed
Metadata
Title
When does poor subjective financial position hurt the elderly? Testing the interaction with educational attainment using a national representative longitudinal survey
Authors
Christy Pu
Nicole Huang
Gao-Jun Tang
Yiing-Jenq Chou
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-166

Other articles of this Issue 1/2011

BMC Public Health 1/2011 Go to the issue

Study protocol

The Healthy Toddlers Trial Protocol: An Intervention to Reduce Risk Factors for Childhood Obesity in Economically and Educationally Disadvantaged Populations

Research article

Increase in EPI vaccines coverage after implementation of intermittent preventive treatment of malaria in infant with Sulfadoxine -pyrimethamine in the district of Kolokani, Mali: Results from a cluster randomized control trial

Research article

An evaluation of factors associated with taking and responding positive to the tuberculin skin test in individuals with HIV/AIDS

Research article

Women in post-trafficking services in moldova: diagnostic interviews over two time periods to assess returning women's mental health

Research article

Occupational therapy and return to work: a systematic literature review

Research article

Polyunsaturated fatty acid intake and prevalence of eczema and rhinoconjunctivitis in Japanese children: The Ryukyus Child Health Study