Marshall Gillian L, Bryson William, Ronstant Ola, Canham Sarah
University of Washington, Social Work Program, 19000 Commerce Street, Tacoma, WA 98202, United States of America.
Clinical Faculty, Oregon Health and Sciences University, 3181 S.W. Sam Jackson Park Road, Portland, WA 97239, United States of America.
Prev Med Rep. 2019 Aug 1;16:100962. doi: 10.1016/j.pmedr.2019.100962. eCollection 2019 Dec.
To identify associations between modifiable risk factors (cigarette smoking, alcohol consumption, and obesity) and financial hardship (difficulty paying bills, food insecurity and medication need) among middle-aged and older Americans in a nationally representative sample.
This was a cross-sectional study of 8212 persons age 50 years and older who completed the core 2010 Health and Retirement Study survey and the psychosocial questionnaire. We ran separate multinomial logistic regressions to assess the association of three modifiable risk factors and three different financial hardship indicators.
Adjusting for all covariates, compared to men of normal weight, men who were obese had a 1.4 greater odds of difficulty paying their bills (95% CI: 1.08-1.76); former smokers had a 1.8 greater odds of being food insecure (95% CI: 1.05-2.95); current smokers were twice as likely to be food insecure (95% CI: 1.21-3.73); Compared to women who never smoked, current smokers had a 1.5 greater odds of having difficulty paying their bills (95% CI: 1.11-2.02); current smokers had a 1.8 greater odds of being food insecure (95% CI: 1.13-2.91); and women who were obese had a 1.5 greater odds of reducing medication due to cost (95% CI: 1.11, 2.02).
Our findings contribute to the literature on health behaviors and financial hardship by highlighting the cyclical nature between different indicators of socioeconomic status, modifiable risk factors, and poor health outcomes among middle-aged and older adults. Furthermore, findings highlight how modifiable risk factors may culminate in financial hardship in later life.
在一个具有全国代表性的样本中，确定美国中老年人中可改变的风险因素（吸烟、饮酒和肥胖）与经济困难（支付账单困难、粮食不安全和药物需求）之间的关联。
这是一项对8212名50岁及以上人群的横断面研究，这些人完成了2010年核心健康与退休研究调查以及心理社会调查问卷。我们进行了单独的多项逻辑回归分析，以评估三种可改变的风险因素与三种不同的经济困难指标之间的关联。
在对所有协变量进行调整后，与体重正常的男性相比，肥胖男性支付账单困难的几率高1.4倍（95%置信区间：1.08 - 1.76）； former smokers had a 1.8 greater odds of being food insecure (95% CI: 1.05 - 2.95); current smokers were twice as likely to be food insecure (95% CI: 1.21 - 3.73); 与从不吸烟的女性相比，目前吸烟者支付账单困难的几率高1.5倍（95%置信区间：1.11 - 2.02）；目前吸烟者粮食不安全的几率高1.8倍（95%置信区间：1.13 - 2.91）；肥胖女性因费用而减少用药的几率高1.5倍（95%置信区间：1.11, 2.02）。
我们的研究结果通过强调中年人和老年人社会经济地位的不同指标、可改变的风险因素和不良健康结果之间的循环性质，为有关健康行为和经济困难的文献做出了贡献。此外，研究结果突出了可改变的风险因素如何在晚年导致经济困难。
