Romero K Renata Flores, Yang Yulin, Green Sharon H, Gutierrez Sirena, Meza Erika, Torres Jacqueline M
UC San Francisco.
UC Berkeley.
Res Sq. 2023 Mar 28:rs.3.rs-2719897. doi: 10.21203/rs.3.rs-2719897/v1.
Older adults' psychosocial outcomes during the COVID-19 pandemic have been inequitable by socio-economic status (SES). However, studies have focused solely on own SES, ignoring emerging evidence of the relationship between adult child SES and late-life health. We evaluated whether adult child educational attainment - a core marker of SES - is associated with older parents' psychosocial outcomes during the pandemic.
We used data from the Survey of Health, Aging, and Retirement in Europe (SHARE; 2004-2018) and the SHARE Corona Surveys (2020 and 2021). We included 15,553 respondents > 65 years who had pre-pandemic information on adult child educational attainment, self-reported mental health, and worsened mental health compared to the pre-pandemic period. We used generalized estimating equations adjusted for respondent and family-level characteristics, including respondents' own SES.
Older adults whose adult children averaged levels of educational attainment at or above (vs. below) their country-specific mean had a lower prevalence of nervousness (Prevalence Ratio [PR]: 0.95, 95% Confidence Interval [CI]: 0.91, 0.99), depression (PR: 0.96, 95% CI: 0.92, 1.00), and trouble sleeping (PR: 0.96, 95% CI: 0.92, 1.00) during the pandemic; associations with loneliness were null. Overall associations with worsened mental health as compared to the pre-pandemic period were null. Protective associations were stronger in countries experiencing "high" levels of COVID-19 intensity.
Adult child SES may be an important driver of inequities in older adults' mental health during the COVID-19 pandemic. Policies aimed at improving adult child SES may buffer the adverse psychosocial impacts of societal stressors.
在新冠疫情期间,老年人的社会心理状况因社会经济地位(SES)不同而存在不平等。然而,以往研究仅关注自身的社会经济地位,忽视了成年子女社会经济地位与老年人健康之间关系的新证据。我们评估了成年子女的教育程度(社会经济地位的核心指标)是否与疫情期间老年父母的社会心理状况相关。
我们使用了来自欧洲健康、老龄化与退休调查(SHARE;2004 - 2018年)以及SHARE新冠调查(2020年和2021年)的数据。我们纳入了15553名65岁以上的受访者,他们在疫情前就有关于成年子女教育程度、自我报告的心理健康状况以及与疫情前相比心理健康恶化情况的信息。我们使用广义估计方程,并对受访者和家庭层面的特征进行了调整,包括受访者自身的社会经济地位。
成年子女平均教育程度达到或高于(对比低于)其所在国家特定均值的老年人,在疫情期间出现紧张情绪(患病率比值[PR]:0.95,95%置信区间[CI]:0.91,0.99)、抑郁(PR:0.96,95%CI:0.92,1.00)和睡眠问题(PR:0.96,95%CI:0.92,1.00)的患病率较低;与孤独感的关联不显著。与疫情前相比,总体心理健康恶化的关联不显著。在新冠疫情强度处于“高”水平的国家,保护关联更强。
成年子女的社会经济地位可能是新冠疫情期间老年人心理健康不平等的一个重要驱动因素。旨在提高成年子女社会经济地位的政策可能会缓冲社会压力源对心理社会的不利影响。