Dumontet Magali, Henchoz Yves, Santos-Eggimann Brigitte
EconomiX, UPL, University Paris Nanterre, CNRS, Nanterre, France.
Department of epidemiology and health systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Eur J Public Health. 2024 Feb 5;34(1):7-13. doi: 10.1093/eurpub/ckad202.
A growing number of studies have underlined the relationship between socioeconomic status and health. Following that literature, we explore the causal effect of financial hardships on changes in health at older ages. Rather than traditional measures of socioeconomic variables, we study the role of financial hardships. The declarative measurement of financial hardships is particularly relevant for assessing the impact of short-term financial difficulties on health among older adults.
In this study, we use data from the Lausanne cohort 65+. Participants are community-dwelling older adults representative of the population aged 65-70 years in 2004 and living in Lausanne (Switzerland) (n = 1352). We use longitudinal annual data with 11 years of follow-up (2006-16) to estimate dynamic panel models on several indicators measuring older adults' health (self-rated health, number of medical conditions, depressive symptoms, difficulties with daily living activities).
We find evidence of causal effects of financial hardships on self-rated health (coef. = 0.059, P < 0.10) and on depressive symptoms (coef.=0.060, P < 0.05). On the other hand, we find no evidence of causality running from financial hardships to the number of medical conditions and the difficulties in daily living activities.
These results make a contribution to the literature where nearly all previous research on associations between financial hardship and health does not establish causal relationships. Our results support the need to integrate health policies that mitigate the potential adverse health effects of financial hardship for older adults.
越来越多的研究强调了社会经济地位与健康之间的关系。遵循该文献，我们探讨了经济困难对老年人健康变化的因果效应。我们研究的是经济困难的作用，而非社会经济变量的传统衡量指标。经济困难的声明性衡量对于评估短期经济困难对老年人健康的影响尤为重要。
在本研究中，我们使用来自洛桑65岁以上队列的数据。参与者是2004年居住在洛桑（瑞士）的65 - 70岁社区老年人（n = 1352）。我们使用具有11年随访（2006 - 2016年）的纵向年度数据，对衡量老年人健康的几个指标（自评健康、疾病数量、抑郁症状、日常生活活动困难）估计动态面板模型。
我们发现经济困难对自评健康（系数 = 0.059，P < 0.10）和抑郁症状（系数 = 0.060，P < 0.05）存在因果效应的证据。另一方面，我们没有发现经济困难与疾病数量和日常生活活动困难之间存在因果关系的证据。
这些结果为文献做出了贡献，因为之前几乎所有关于经济困难与健康之间关联的研究都没有建立因果关系。我们的结果支持有必要整合健康政策，以减轻经济困难对老年人潜在的不利健康影响。
