Determinants of socioeconomic inequalities in subjective well-being in later life: a cross-country comparison in England and the USA

PurposeIdentification of optimal predictors for different indicators of subjective well-being (SWB) in geriatric inpatients: (1) self-evaluated health status (SEH), (2) feeling of loneliness (FoL), and (3) severity of depression symptoms (SoDS). Investigation of the relationship between response categories of the SWB indicators and their predictors.MethodsThe data were collected retrospectively from hospital records. All 555 geriatric inpatients underwent a comprehensive geriatric assessment, including the Timed Up and Go (TUG) test. The Bayesian information criterion was applied in ordinal logistic regression models to identify optimal predictors of SEH, FoL, and SoDS among different objective factors.ResultsAfter controlling for high-stress situations in the recent past, motor slowness measured with the TUG test, and a level of education were jointly selected as the best predictors of all three SWB indicators. The speed of performing the TUG test improved SEH (OR = 2.08) and decreased both FoL (OR = 0.41) and SoDS (OR = 0.41). A higher level of education improved SEH (OR = 1.05) and alleviated both FoL (OR = 0.96) and SoDS (OR = 0.92). Additionally, a higher level of SEH was positively correlated with a lower BMI, improved instrumental activities of daily living (I-ADL), and higher hemoglobin level. FoL was reinforced by the level of comorbidity, and SoDS was increased by impaired basic ADL.ConclusionAlthough SWB in geriatric inpatients can be explained by objective comorbidities and disabilities, the good motor function (i.e., a TUG test outcome of less than about 20 s) and a higher level of education were the general predictors that exert an independent beneficial impact on all three SWB indicators.

This investigation examines the association of four measures of poverty (income-based, expenditure-based and asset-based poverty, and material deprivation) with life satisfaction. Perceived life satisfaction was measured among 1,410 older Chinese persons aged 65 and over. Besides life satisfaction and measures of poverty, the study assessed socio-demographic variables, financial strain, health indicators, and social and community resources. Those who faced expenditure-based poverty, material deprivation and asset-based poverty reported a significantly lower level of perceived life satisfaction, while the association between expenditure-based poverty and life satisfaction was found to be the strongest. Other factors that had an impact on life satisfaction included gender, education and marital status; financial strain; social support; the number of close family members and friends; self-rated health; functional capacity; perceived memory; pain; sleep quality; neighbourhood collective efficacy; and engagement in cultural and entertainment activities. From the theoretical perspective, the findings have strong implications for the understanding of the factors that shape the perception of quality of life in old age. Our results also have important policy implications for the official measurement of poverty, monitoring of the poverty situation and the development of anti-poverty measures to help older persons living in poverty to improve the quality of their lives.

ÖZET ABSTRACTAim/background: Loneliness occurs in all stages of life, and a major problem for most of the elderly. To determine the prevalence of loneliness and evaluate the effects of socio-demographic, health characteristics, life satisfaction, activities of daily living and instrumental activities of daily living among elderly people. Methods: This cross-sectional descriptive study was conducted with 160 participants in three regions of İzmir. Measures were included a demographic questionnaire, the UCLA Loneliness Scale, the Life Satisfaction Scale, the Katz Index of Activities of Daily Living and the Lawton and Brody's Instrumental Activities of Daily Living Index. Data were analysed via the independent t-test, Kruskal-Wallis test, ANOVA test, Pearson's correlation and multiple linear regression with stepwise analysis. Results: The loneliness rate was 46.9% among participants. A great difference existed between loneliness level and marital status, education level, place of residence, selfreported health, self-reported sleep quality, exercise and instrumental activities of daily living. Life satisfaction, activities of daily living and instrumental activities of daily living were negatively associated with loneliness. Conclusion: Elderly care services should be designed with a multidisciplinary approach, and nurses should especially assess loneliness in elderly with low levels of self-care capacity and reduced social contacts to develop appropriate nursing interventions.