Elderly Immigrants, Socio-economic Status and Health. An epidemiological study of cardiovascular risk factors, impaired mobility and self-reported health status.

Research output: ThesisDoctoral Thesis (compilation)

Abstract

Aims: To analyse the relationship between country of birth/ethnicity, socio-economic status (SES) and impaired mobility, impaired working capacity, cardiovascular disease (CVD) risk factors, health behaviours among those with CVD risk factors, self-reported health status, impaired instrumental activities of daily living (IADL) and all-cause mortality.

Methods: Two main data sources were used: the Swedish Survey of Living Conditions (in Swedish ULF) 1986–1993, people aged 55–74 years, and the Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994 in the USA, people aged 65–84. Logistic, linear and proportional hazard models were used in the statistical modelling.

Results: There was a strong relationship between being a foreign-born labour immigrant from Finland or Southern Europe or being a refugee from All Others (Eastern Europe, Asia, Africa and South and Central America), and impaired mobility and impaired working capacity. People with a low educational status had the highest odds ratios (ORs) for impaired mobility and impaired working capacity. Elderly foreign-born people ran an increased risk of engaging in no physical activity (men only), being a current smoker and/or having an increased body mass index (BMI) than Swedish-born people. Immigrants from Southern and Eastern Europe and Finland had increased risks of poor self- reported health status. Southern Europeans, people from All Others and Finns exhibited an increased risk of impaired IADL compared to those born in Sweden. However, country of birth was not associated with premature all-cause mortality. Black and Mexican American women had significantly higher prevalences of type II diabetes mellitus than White women. Black women were more likely to have abdominal obesity and hypertension and to be physically inactive than White women. Black men had significantly higher prevalences of hypertension and physical inactivity than White men. Among individuals with CVD risk factors, especially Mexican American women whose primary language was Spanish, health behaviours were in need of improvement.

Conclusion: Country of birth/ethnicity is a powerful predictor of poor health among elderly people even after adjustment for SES. Being non-acculturated (women only) seems to be associated with negative health behaviours. These findings, particularly a disadvantaged risk profile for CVD, argue for appropriate prevention programmes modified for the linguistic, cultural and medical needs of foreign-born people/ethnic minorities.

Details

Authors
  • Sonja Pudaric
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Public Health, Global Health, Social Medicine and Epidemiology

Keywords

  • stress, cardiovascular risk factors, IADL, impaired mobility/impaired working capacity, self-reported health, socio-economic status, country of birth/ethnicity, elderly people, discrimination, Socialmedicin, Social medicine, samhällsmedicin
Original languageEnglish
QualificationDoctor
Awarding Institution
Supervisors/Assistant supervisor
  • [unknown], [unknown], Supervisor, External person
Award date2002 Oct 3
Publisher
  • Sonja Pudaric, Department of Community Medicine, Malmö University Hospital, 205 02 Malmö,
Print ISBNs91-628-5354-6
Publication statusPublished - 2002
Publication categoryResearch

Bibliographic note

Defence details Date: 2002-10-03 Time: 10:15 Place: Malmö External reviewer(s) Name: Janlert, Urban Title: Professor Affiliation: Umeå --- Article: Pudaric S, Sundquist J and Johansson S-E. Impaired mobility and impairedworking capacity among foreign born people and native born Swedes. JEpidemiol Community Health 1998;52:34–40. Article: Pudaric S, Sundquist J and Johansson S-E. Major risk factors forcardiovascular disease in elderly migrants in Sweden. Ethn Health2000;5(2):137–150. Article: Sundquist J, Winkleby MA and Pudaric S. Cardiovascular disease risk factorsamong older Black, Mexican-American and White women and men:An analysis of NHANES III, 1988–1994. JAGS 2001;49:109–116. Article: Pudaric S, Sundquist J and Johansson S-E. Country of birth, instrumentalactivities of daily living, self-rated health and mortality: A Swedish population-based survey of people aged 55–74. (Accepted for publication in Soc SciMed).