Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-24T18:10:12.516Z Has data issue: false hasContentIssue false
  • English
  • Français

Self-perceived general health among community-dwelling Portuguese older adults: do men and women differ?

Published online by Cambridge University Press:  21 July 2020

Violeta Alarcão Open the ORCID record for Violeta Alarcão [Opens in a new window] ,
Joana Costa Open the ORCID record for Joana Costa [Opens in a new window] ,
Teresa Madeira Open the ORCID record for Teresa Madeira [Opens in a new window] ,
Catarina Peixoto-Plácido Open the ORCID record for Catarina Peixoto-Plácido [Opens in a new window] ,
Elisabete Fernandes Open the ORCID record for Elisabete Fernandes [Opens in a new window] ,
Nuno Sousa-Santos Open the ORCID record for Nuno Sousa-Santos [Opens in a new window] ,
Osvaldo Santos Open the ORCID record for Osvaldo Santos [Opens in a new window] ,
Paulo Jorge Nicola Open the ORCID record for Paulo Jorge Nicola [Opens in a new window] ,
Carla Lopes Open the ORCID record for Carla Lopes [Opens in a new window]  and
João Gorjão-Clara Open the ORCID record for João Gorjão-Clara [Opens in a new window]
Violeta Alarcão*
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Centro de Investigação e Estudos de Sociologia (CIES-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
Joana Costa
Affiliation:
Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Teresa Madeira
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Catarina Peixoto-Plácido
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Elisabete Fernandes
Affiliation:
Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Nuno Sousa-Santos
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Osvaldo Santos
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Paulo Jorge Nicola
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
Carla Lopes
Affiliation:
Faculdade de Medicina, Universidade do Porto, Porto, Portugal EPIUnit-ISPUP, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
João Gorjão-Clara
Affiliation:
Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Evidence on how gender intersects with relevant social constructs in later phases of life is scarce. This investigation examined gender inequalities in perceived health status (self-perceived general health; SPGH) by Portuguese elderly community-dwellers while considering psycho-social and socio-demographic determinants. This study used data from a representative sample of community-dwellers aged ≥65 years (N = 920), who were enrolled in the Portuguese Elderly Nutritional Status Surveillance System (PEN-3S) project. Associations between SPGH and socio-demographic and psycho-social variables, functionality and self-reported morbidity were tested; indirect effects of relevant predictors on SPGH were also tested using a bootstrap method. Gender inequalities in health were found: women significantly rated their health worse than men; overall, participants rated their health as fair. Education, functional status, depression symptoms and self-reported morbidity significantly predicted SPGH among women, whereas only the latter two were associated with SPGH among men. For both genders, depression was the strongest predictor of SPGH. Mediation analyses detected indirect effects of cognitive function and loneliness feelings on SPGH among older adults. Results herein provide insights on the predictive role of psycho-social variables on SPGH and support the need for considering the context when addressing the correlates of SPGH among Portuguese older adults. Altogether, these findings might support cost-effective interventions targeting the most vulnerable groups of the population to inequalities in health and its predictors.

Keywords

ageinggender inequalitieshealth inequalitiespsycho-social factorsself-perceived general healthsocio-economic factors
Type
Article
Information
Ageing & Society , Volume 42 , Issue 1 , January 2022 , pp. 223 - 245
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, KB, Sanders, S and Auth, EA (2004) Loneliness and depression in independent living retirement communities: risk and resilience factors. Aging and Mental Health 8, 475–485.10.1080/13607860410001725054CrossRefGoogle ScholarPubMed
Alarcão, V, Madeira, T, Peixoto-Plácido, C, Sousa-Santos, N, Fernandes, E, Nicola, P, Santos, O and Gorjão-Clara, J (2019) Gender differences in psychosocial determinants of self-perceived health among Portuguese older adults in nursing homes. Aging and Mental Health 23, 1049–1056.10.1080/13607863.2018.1471583CrossRefGoogle ScholarPubMed
Alves Apóstolo, JL, Loureiro, LMJ, dos Reis, IAC, da Silva, IALL, Cardoso, DFB and Sfetcu, R (2014) Contribution to the adaptation of the Geriatric Depression Scale-15 into Portuguese. Revista de Enfermagem Referência IV, 65–73.10.12707/RIV14033CrossRefGoogle Scholar
Araújo, F, Pais Ribeiro, J, Oliveira, A, Pinto, C and Martins, T (2008) Validação da escala de Lawton e Brody numa amostra de idosos não institucionalizados [Validation of the scale of Lawton and Brody in a sample of non-institutionalized elderly]. In Leal, I, Pais-Ribeiro, J, Silva, I and Marques, S (eds), Actas do 7 o Congresso Nacional de Psicologia da Saúde. Lisboa: ISPA, pp. 217–220.Google Scholar
Arber, S and Cooper, H (1999) Gender differences in health in later life: the new paradox? Social Science and Medicine 48, 61–76.10.1016/S0277-9536(98)00289-5CrossRefGoogle ScholarPubMed
Au, N and Johnston, DW (2014) Self-assessed health: what does it mean and what does it hide? Social Science and Medicine 121, 21–28.10.1016/j.socscimed.2014.10.007CrossRefGoogle ScholarPubMed
Baćak, V and Ólafsdóttir, S (2017) Gender and validity of self-rated health in nineteen European countries. Scandinavian Journal of Public Health 45, 647–653.10.1177/1403494817717405CrossRefGoogle ScholarPubMed
Beller, J and Wagner, A (2018) Disentangling loneliness: differential effects of subjective loneliness, network quality, network size, and living alone on physical, mental, and cognitive health. Journal of Aging and Health 30, 521–539.10.1177/0898264316685843CrossRefGoogle ScholarPubMed
Benyamini, Y, Blumstein, T, Lusky, A and Modan, B (2003) Gender differences in the self-rated health–mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival? The Gerontologist 43, 396–405.10.1093/geront/43.3.396CrossRefGoogle ScholarPubMed
Bryant, LL, Beck, A and Fairclough, DL (2000) Factors that contribute to positive perceived health in an older population. Journal of Aging and Health 12, 169–192.10.1177/089826430001200202CrossRefGoogle Scholar
Burke, KE, Schnittger, R, O'Dea, B, Buckley, V, Wherton, JP and Lawlor, BA (2012) Factors associated with perceived health in older adult Irish population. Aging and Mental Health 16, 288–295.10.1080/13607863.2011.628976CrossRefGoogle ScholarPubMed
Campos-Matos, I, Russo, G and Perelman, J (2016) Connecting the dots on health inequalities – a systematic review on the social determinants of health in Portugal. International Journal for Equity in Health 15, 26.10.1186/s12939-016-0314-zCrossRefGoogle ScholarPubMed
Carstensen, LL (1992) Social and emotional patterns in adulthood. Psychology and Aging 7, 331–338.10.1037/0882-7974.7.3.331CrossRefGoogle ScholarPubMed
Christensen, K, Doblhammer, G, Rau, R and Vaupel, JW (2009) Ageing populations: the challenges ahead. The Lancet 374, 1196–1208.10.1016/S0140-6736(09)61460-4CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J, Hazan, H, Lerman, Y and Shalom, V (2016) Correlates and predictors of loneliness in older-adults: a review of quantitative results informed by qualitative insights. International Psychogeriatrics 28, 557–576.10.1017/S1041610215001532CrossRefGoogle ScholarPubMed
Creavin, ST, Wisniewski, S, Noel-Storr, AH, Trevelyan, CM, Hampton, T, Rayment, D, Thom, VM, Nash, KJE, Elhamoui, H, Milligan, R, Patel, AS, Tsivos, DV, Wing, T, Phillips, E, Kellman, SM, Shackleton, HL, Singleton, GF, Neale, BE, Watton, ME and Cullum, S (2016) Mini-Mental State Examination (MMSE) for the detection of dementia in clinically unevaluated people aged 65 and over in community and primary care populations. Cochrane Database of Systematic Reviews.10.1002/14651858.CD011145.pub2CrossRefGoogle ScholarPubMed
da Silva, PA (2014) Individual and social determinants of self-rated health and well-being in the elderly population of Portugal. Cadernos de Saúde Pública 30, 2387–2400.10.1590/0102-311X00173813CrossRefGoogle Scholar
DeSalvo, K, Bloser, N, Reynolds, K, He, J and Muntner, P (2006) Mortality prediction with a single general self-rated health question. A meta-analysis. Journal of General Internal Medicine 21, 267–275.10.1111/j.1525-1497.2005.00291.xCrossRefGoogle ScholarPubMed
Dias, S, Gama, A and Martins, MO (2013) Health status and preventative behaviors of immigrants by gender and origin: a Portuguese cross-sectional study. Nursing and Health Sciences 15, 309–317.10.1111/nhs.12032CrossRefGoogle ScholarPubMed
Djernes, JK (2006) Prevalence and predictors of depression in populations of elderly: a review. Acta Psychiatrica Scandinavica 113, 372–387.10.1111/j.1600-0447.2006.00770.xCrossRefGoogle ScholarPubMed
Dowd, JB and Zajacova, A (2007) Does the predictive power of self-rated health for subsequent mortality risk vary by socioeconomic status in the US? International Journal of Epidemiology 36, 1214–1221.10.1093/ije/dym214CrossRefGoogle ScholarPubMed
Eikemo, TA, Huisman, M, Bambra, C and Kunst, AE (2008) Health inequalities according to educational level in different welfare regimes: a comparison of 23 European countries. Sociology of Health and Illness 30, 565–582.10.1111/j.1467-9566.2007.01073.xCrossRefGoogle ScholarPubMed
Ferraro, KF and Kelley-Moore, JA (2001) Self-rated health and mortality among black and white adults: examining the dynamic evaluation thesis. Journals of Gerontology: Psychological Sciences and Social Sciences 56B, S195–S205.10.1093/geronb/56.4.S195CrossRefGoogle Scholar
Ferreira-Valente, MA, Pais-Ribeiro, JL and Jensen, MP (2014) Associations between psychosocial factors and pain intensity, physical functioning, and psychological functioning in patients with chronic pain: a cross-cultural comparison. Clinical Journal of Pain 30, 713–723.10.1097/AJP.0000000000000027CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE and McHugh, PR (1975) Mini-mental state. Journal of Psychiatric Research 12, 189–198.10.1016/0022-3956(75)90026-6CrossRefGoogle ScholarPubMed
Gorman, BK and Read, JG (2006) Gender disparities in adult health: an examination of three measures of morbidity. Journal of Health and Social Behavior 47, 95–110.10.1177/002214650604700201CrossRefGoogle ScholarPubMed
Guerreiro, M, Silva, A, Botelho, M, Leitão, O, Castro Caldas, A and Garcia, C (1994) Adaptação à população portuguesa da tradução do ‘Mini Mental State Examination’ (MMSE). Revista Portuguesa de Neurologia 1, 9–10.Google Scholar
Hayes, A (2013) Introduction to Mediation, Moderation, and Conditional Process Analysis. New York, NY: Guilford.Google Scholar
Heller, DA, Ahern, FM, Pringle, KE and Brown, TV (2009) Among older adults, the responsiveness of self-rated health to changes in Charlson comorbidity was moderated by age and baseline comorbidity. Journal of Clinical Epidemiology 62, 177–187.10.1016/j.jclinepi.2008.05.009CrossRefGoogle ScholarPubMed
Hosseinpoor, AR, Stewart Williams, J, Amin, A, de Carvalho I, Araujo, Beard, J, Boerma, T, Kowal, P, Naidoo, N and Chatterji, S (2012) Social determinants of self-reported health in women and men: understanding the role of gender in population health. PLOS ONE 7, e34799.10.1371/journal.pone.0034799CrossRefGoogle ScholarPubMed
Huisman, M, van Lenthe, F and Mackenbach, J (2007) The predictive ability of self-assessed health for mortality in different educational groups. International Journal of Epidemiology 36, 1207–1213.10.1093/ije/dym095CrossRefGoogle ScholarPubMed
Huisman, M, Read, S, Towriss, CA, Deeg, DJH and Grundy, E (2013) Socioeconomic inequalities in mortality rates in old age in the World Health Organization Europe region. Epidemiologic Reviews 35, 84–97.10.1093/epirev/mxs010CrossRefGoogle ScholarPubMed
Idler, EL and Benyamini, Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behavior 38, 21–37.10.2307/2955359CrossRefGoogle ScholarPubMed
Idler, E and Cartwright, K (2018) What do we rate when we rate our health? Decomposing age-related contributions to self-rated health. Journal of Health and Social Behavior 59, 74–93.10.1177/0022146517750137CrossRefGoogle ScholarPubMed
Idler, EL and Kasl, S (1991) Health perceptions and survival: do global evaluations of health status really predict mortality? Journal of Gerontology 46, S55–S65.10.1093/geronj/46.2.S55CrossRefGoogle ScholarPubMed
Idler, E, Leventhal, H, McLaughlin, J and Leventhal, E (2004) In sickness but not in health: self-ratings, identity, and mortality. Journal of Health and Social Behavior 45, 336–356.10.1177/002214650404500307CrossRefGoogle Scholar
Jahn, DR and Cukrowicz, KC (2012) Self-rated health as a moderator of the relation between functional impairment and depressive symptoms in older adults. Aging & Mental Health 16, 281–287.10.1080/13607863.2011.598847CrossRefGoogle ScholarPubMed
Jylhä, M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science and Medicine 69, 307–316.10.1016/j.socscimed.2009.05.013CrossRefGoogle ScholarPubMed
Knäuper, B and Turner, PA (2003) Measuring health: improving the validity of health assessments. Quality of Life Research 12, 81–89.10.1023/A:1023589907955CrossRefGoogle ScholarPubMed
Lawton, MP and Brody, EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist 9, 179–186.10.1093/geront/9.3_Part_1.179CrossRefGoogle ScholarPubMed
Leão, T and Perelman, J (2018) Depression symptoms as mediators of inequalities in self- reported health: the case of Southern European elderly. Journal of Public Health 40, 756–763.10.1093/pubmed/fdx173CrossRefGoogle ScholarPubMed
Liang, J, Bennett, JM, Shaw, BA, Quiñones, AR, Ye, W, Xu, X and Ofstedal, MB (2008) Gender differences in functional status in middle and older age: are there any age variations? Journals of Gerontology: Psychological Sciences and Social Sciences 63B, S282–S292.10.1093/geronb/63.5.S282CrossRefGoogle Scholar
Lopes, C, Torres, D, Oliveira, A, Severo, M, Guiomar, S, Alarcão, V, Ramos, E, Rodrigues, S, Vilela, S, Oliveira, L, Mota, J, Teixeira, PJ, Nicola, PJ, Soares, S, Andersen, LF and IAN-AF Consortium (2018) National food, nutrition, and physical activity survey of the Portuguese general population (2015–2016): protocol for design and development. JMIR Research Protocols 7, e42.10.2196/resprot.8990CrossRefGoogle ScholarPubMed
Mackenbach, JP, Stirbu, I, Roskam, AJR, Schaap, MM, Menvielle, G, Leinsalu, M, Kunst, AE, Van Oyen, H, Demarest, S, Rychtarikova, J, Dzurova, D, Andersen, O, Ekholm, O, Judge, K, Tekkel, M, Prättäla, R, Martikainen, P, Desplanques, G, Jusot, F, Helmert, U, Kovacs, K, Marton, F, Layte, R, Costa, G, Vannoni, F, Villerusa, A, Kalediene, R, Klumbiene, J, Geurts, JJM, Dahl, E, Strand, BH, Wojtyniak, B, Santana, P, Madarasova Geckova, A, Artnik, B, Borrell, C, Esnaola, S, Regidor, E, Burström, B, Fritzell, J, Lundberg, O, Bopp, M and Glickman, M (2008) Socioeconomic inequalities in health in 22 European countries. New England Journal of Medicine 358, 2468–2481.10.1056/NEJMsa0707519CrossRefGoogle ScholarPubMed
Madeira, T, Peixoto-Plácido, C, Goulão, B, Mendonça, N, Alarcão, V, Santos, N, de Oliveira, RM, Yngve, A, Bye, A, Bergland, A, Lopes, C, Nicola, P, Santos, O and Clara, JG (2016) National survey of the Portuguese elderly nutritional status: study protocol. BMC Geriatrics 16, 139.10.1186/s12877-016-0299-xCrossRefGoogle ScholarPubMed
Malmusi, D, Vives, A, Benach, J and Borrell, C (2014) Gender inequalities in health: exploring the contribution of living conditions in the intersection of social class. Global Health Action 7, 1–9.10.3402/gha.v7.23189CrossRefGoogle ScholarPubMed
Martikainen, P, Bartley, M and Lahelma, E (2002) Psychosocial determinants of health in social epidemiology. International Journal of Epidemiology 31, 1091–1093.10.1093/ije/31.6.1091CrossRefGoogle ScholarPubMed
Mavaddat, N, Valderas, JM, Van Der Linde, R, Khaw, KT and Kinmonth, AL (2014) Association of self-rated health with multimorbidity, chronic disease and psychosocial factors in a large middle-aged and older cohort from general practice: a cross-sectional study. BMC Family Practice 15, 185.10.1186/s12875-014-0185-6CrossRefGoogle Scholar
Moor, I, Spallek, J and Richter, M (2017) Explaining socioeconomic inequalities in self-rated health: a systematic review of the relative contribution of material, psychosocial and behavioural factors. Journal of Epidemiology and Community Health 71, 565–575.10.1136/jech-2016-207589CrossRefGoogle ScholarPubMed
Orfila, F, Ferrer, M, Lamarca, R, Tebe, C, Domingo-Salvany, A and Alonso, J (2006) Gender differences in health-related quality of life among the elderly: the role of objective functional capacity and chronic conditions. Social Science and Medicine 63, 2367–2380.10.1016/j.socscimed.2006.06.017CrossRefGoogle ScholarPubMed
Palladino, R, Lee, JT, Ashworth, M, Triassi, M and Millett, C (2016) Associations between multimorbidity, healthcare utilisation and health status: evidence from 16 European countries. Age and Ageing 45, 431–435.10.1093/ageing/afw044CrossRefGoogle ScholarPubMed
Perelman, J, Chaves, P, Miguel, J, de Almeida, JC and Matias, MA (2018) Reforming the Portuguese mental health system: an incentive-based approach. International Journal of Mental Health Systems 12, 25.10.1186/s13033-018-0204-4CrossRefGoogle Scholar
Ploubidis, GB, Dale, C and Grundy, E (2012) Later life health in Europe: how important are country level influences? European Journal of Ageing 9, 5–13.10.1007/s10433-011-0215-3CrossRefGoogle ScholarPubMed
Pocinho, M, Farate, C and Dias, C (2010) Validação psicométrica da escala UCLA-Loneliness para idosos portugueses. Interações: Sociedade e Novas Modernidades 10, 18.Google Scholar
Preacher, KJ and Hayes, AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods 40, 879–891.10.3758/BRM.40.3.879CrossRefGoogle ScholarPubMed
Reher, DS (2011) Economic and social implications of the demographic transition. Population and Development Review 37, supplement 1, 11–33.10.1111/j.1728-4457.2011.00376.xCrossRefGoogle Scholar
Rodrigues, AM, Gregório, MJ, Sousa, RD, Dias, SS, Santos, MJ, Mendes, JM, Coelho, PS, Branco, JC and Canhão, H (2018) Challenges of ageing in Portugal: data from the EpiDoC Cohort. Acta Médica Portuguesa 31, 80–93.10.20344/amp.9817CrossRefGoogle ScholarPubMed
Schneider, G, Driesch, G, Kruse, A, Wachter, M, Nehen, H-G and Heuft, G (2004) What influences self-perception of health in the elderly? The role of objective health condition, subjective well-being and sense of coherence. Archives of Gerontology and Geriatrics 39, 227–237.10.1016/j.archger.2004.03.005CrossRefGoogle ScholarPubMed
Schütte, S, Chastang, J-F, Thirion, AP, Vermeylen, G and Niedhammer, I (2013) Social differences in self-reported health among men and women in 31 countries in Europe. Scandinavian Journal of Public Health 41, 51–57.10.1177/1403494812469854CrossRefGoogle ScholarPubMed
Schüz, B, Wurm, S, Schöllgen, I and Tesch-Römer, C (2011) What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults. Quality of Life Research 20, 1573–1580.10.1007/s11136-011-9909-4CrossRefGoogle ScholarPubMed
Stansfield, J and Bell, R (2019) Applying a psychosocial pathways model to improving mental health and reducing health inequalities: practical approaches. International Journal of Social Psychiatry 65, 107–113.10.1177/0020764018823816CrossRefGoogle ScholarPubMed
Taylor, HO, Taylor, RJ, Nguyen, AW and Chatters, L (2018) Social isolation, depression, and psychological distress among older adults. Journal of Aging and Health 30, 229–246.10.1177/0898264316673511CrossRefGoogle ScholarPubMed
Tissue, T (1972) Another look at self-rated health among the elderly. Journal of Gerontology 27, 91–94.10.1093/geronj/27.1.91CrossRefGoogle Scholar
Uccheddu, D, Gauthier, AH, Steverink, N and Emery, T (2019) Gender and socioeconomic inequalities in health at older ages across different European welfare clusters: evidence from SHARE data, 2004–2015. European Sociological Review 35, 346–362.10.1093/esr/jcz007CrossRefGoogle Scholar
Valtorta, N and Hanratty, B (2016) Loneliness, isolation and the health of older adults: do we need a new research agenda? Journal of the Royal Society of Medicine 105, 518–522.10.1258/jrsm.2012.120128CrossRefGoogle Scholar
von dem Knesebeck, O, Verde, PE and Dragano, N (2006) Education and health in 22 European countries. Social Science and Medicine 63, 1344–1351.10.1016/j.socscimed.2006.03.043CrossRefGoogle ScholarPubMed
World Health Organization (WHO) (2015) World Report on Ageing and Health. Geneva: WHO.Google Scholar
Zaidi, B and Morgan, SP (2017) The second demographic transition theory: a review and appraisal. Annual Review of Sociology 43, 473–492.10.1146/annurev-soc-060116-053442CrossRefGoogle Scholar
Zunzunegui, MV, Alvarado, BE, Guerra, R, Gómez, JF, Ylli, A, Guralnik, JM, Freeman, EE, Karna, G, Deshpande, N, Garcia, A, Kotecha, J, Philips, S, Curcio, CL, Freire, A and Qirjako, G (2015) The mobility gap between older men and women: the embodiment of gender. Archives of Gerontology and Geriatrics 61, 140–148.10.1016/j.archger.2015.06.005CrossRefGoogle ScholarPubMed