Search

Highlights • This paper explores the effects of four dimensions of social exclusion on self-rated health and depression among older people in China. • Lower level of exclusion from social relationships was associated with less likely to report fair or poor SRH. • Lower level of subjective feelings of exclusion was associated with less likely to report fair or poor SRH. • Lower level of subjective feeling of exclusion was associated with less likely to report depression. • Lower level of exclusion from financial products was associated with less likely to report depression. Abstract Background It is well established that social exclusion is a key social determinant of health; however, such association between social exclusion and health outcomes among older people remain a relatively under-researched area. This paper explores the effects of four dimensions of social exclusion on self-rated health and depression among older people in China. Methods This paper includes 8038 individuals aged 60 and over from the first wave national multi-stage probability sample (2014) from the China Longitudinal Aging Social Survey (CLASS). Descriptive univariate information for individual variables and four dimensions of social exclusion are presented. Multinomial and binary logistic regression models are used to examine the associations between social exclusion and self-rated health and depression. Results Older people who were in the lower level of exclusion from social relationships or subjective feelings of exclusion were significantly less likely to report fair or poor self-rated health than people in the higher level of exclusion (lower level of exclusion from social activities was significantly associated with being less likely to report poor SRH only). Older people who were in the lower level of subjective feeling of exclusion or exclusion from financial products were significantly less likely to report depression. Conclusions Different dimensions of social exclusion have different effects on self-rated health and depression. Social policies need to reflect this and efforts of services could usefully be oriented to prevent multi-dimensions of social exclusion. Ultimately, such policies should have the potential to enhance the health of older people in China. [ABSTRACT FROM AUTHOR]

Background Chronic patients are frequent users of healthcare services and are prone to hospital admissions. In Valencia (Spain) the Valcronic programme aims to manage chronic patients through different levels of telemonitoring and telecare. This paper examines the impact of the Valcronic programme on self-perceived HRQOL in a one-year period and on perceptions of satisfaction and usefulness in a sample of older adults with chronic diseases. Methods The sample ( n = 74) was randomly selected from Valcronic users and was stratified considering different variables. HRQOL was assessed using the EQ-5D questionnaire at two points in time: before the beginning of the Valcronic programme and after a one-year follow-up. Satisfaction and usefulness were evaluated one year after users’ inclusion. Results The whole sample experienced improvement, although not significant, of its HRQOL; patients over 75 showed impairment. Patients with at least one problem in the EQ-5D dimensions decreased after one year (82.43% vs. 74.32%). Users’ perceptions of satisfaction and usefulness were highly positive. Conclusions Our sample benefited from the Valcronic programme, experiencing an improvement in their HRQOL, a decreased use of health resources or high satisfaction levels. Implications Further adjustments are needed to address a comprehensive response to the needs of the global population of reference. [ABSTRACT FROM AUTHOR]