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Objectives: Using Interpolated Markov Chain software, we compare the length of life with and without depression among married individuals and widowers, and the related sex differences. Methods: We applied a multi-state life table approach to estimate depression-free life expectancy among recent cohorts of older married and widowed women and men in the United States, using data from the Health and Retirement Study over a 7-year period (2012–2018). Results: The study revealed that the difference in life expectancy between sexes widens in the context of widowhood. At age 50, the sex gap in depression-free life expectancy is 0.8 years among married people, whereas the gap almost doubles to 1.7 years among widowed people. Discussion: By quantifying disparities in the duration of life affected by depression between married and widowed women and men, policymakers could properly allocate resources specifically to address the mental health needs of these groups. [ABSTRACT FROM AUTHOR]

This work analyses the contribution of ages and causes of death to gender gap in life expectancy in 20 European and non-European countries between 1959 and 2015, using Functional Data Analysis. Data were retrieved from the WHO Mortality Database and from the Human Mortality Database. We propose a Functional Principal Component Analysis of the age profiles of cause-specific contributions, to identify the main components of the distribution of the age-specific contributions according to causes of death, and to summarize them with few components. Our findings show that the narrowing gender gap in life expectancy was mainly driven by decreasing differences in cardiovascular diseases. Additionally, the study reveals that the age cause contributions act almost entirely on only two dimensions: level (extent of the cause-specific contribution to the overall mortality gender gap) and age pattern (location of the curves across ages). Notably, in the last period, it is not the "quantum" of the cause-specific contributions that matters, but the "timing", i.e. location across the age spectrum. Moreover, our results show that in the most recent period the gender gap in life expectancy is affected by composition of the causes of death more than it was in previous periods. We emphasise that Functional Data Analysis could prove useful to deepen our understanding of complex demographic phenomena. [ABSTRACT FROM AUTHOR]

This study investigates the demographic characteristics and academic performances of foreign students with an Italian educational background in a cohort of 1st-year Bachelor students enrolled at Sapienza University of Rome, in the a.y. 2012/2013, comparing them to Italian and to International students. First, we employed a discrete-time competing risk hazard model to analyse differences in academic performances between Italian, foreign students with an Italian educational background and foreign students with a foreign educational background. Second, we applied regression trees to investigate final grades and the time-to-degree completion of Bachelor's degree holders. Results show differences in the academic performances of foreign students with an Italian educational background compared to Italian students. Policies are needed, these results suggest, that strengthen opportunities for students from a migrant background since high school. [ABSTRACT FROM AUTHOR]

Background: In Europe, one of the most consistent findings is that of migrant mortality advantage in high-income countries. Furthermore, the literature shows that economic shocks, which bring worse health outcomes, can severely affect the most disadvantaged individuals. We analyse differences and changes in all-cause mortality between Italians and migrants residing in Rome before, during, and in the aftermath of the Great Recession (2001-2015) by birth-cohort.Methods: The analysis is a longitudinal open cohort study. Mortality data come from the Register of the Causes of Death (58,637 deaths) and the population denominator (n = 2,454,410) comes from the Municipal Register of Rome. By comparing three time-periods (2001-2005, 2006-2010, and 2011-2015), we analyse all-cause mortality of Rome residents born, respectively, in the intervals 1937-1976, 1942-1981, 1947-1986 (aged 25-64 years at entry into observation). Computing birth-cohort-specific death rates and applying parametric survival models with age as the time-scale, we compare mortality differences between migrants and Italians by gender, area of origin, and time-period.Results: Overall, we find a lower risk of dying for migrants than Italians regardless of gender (Women: HR = 0.61, 95% CI 0.56-0.66; Men: HR = 0.49, 95% CI 0.45-0.53), and a lower death risk over time for the total population. Nevertheless, such a pattern changes according to gender and migrants' area of origin.Conclusion: Given the relevance of international migrations in Europe, studying migrants' health has proved increasingly important. The deterioration in migrant health and the gradual weakening of migrants' mortality advantage is likely to become a public health issue with important consequences for the healthcare system of all European countries. [ABSTRACT FROM AUTHOR]

BACKGROUND Gender and migrant status are important factors for health. A common finding is that women report poorer health than men and that migrants' health converges with nonmigrants' health as the duration of stay in the host country increases. However, little is known about whether gender differences in health persist within migrant groups and whether the migrant-native health convergence differs by gender, especially in the Italian context. OBJECTIVE This study aims to include the gender dimension in the analysis of the health differences between Italians and migrants by duration of stay, focusing on how gender interacts with duration of stay in determining migrants' health. METHODS We performed multivariate logistic regression on a sample of 70,154 residents in Italy aged 20-64, using the 2013 Italian Health Survey. We modelled the association between duration of stay and three health dimensions by gender and computed predicted probabilities to show the interaction effect of gender and duration of stay. RESULTS We found evidence of a migrant health advantage among recent migrant men and women that becomes weaker among long-term migrants. After a long duration of stay, differences in health between migrants and nonmigrants are slightly more pronounced among women than among men. [ABSTRACT FROM AUTHOR]

Besides health and socio-economic status, the social relationships maintained during elderly play an important role in shaping the living conditions at older ages. In this part of life, the family represents the major framework in which interpersonal relationships are experienced. With population ageing, the family increasingly ensures elderly care, especially where targeted public policies are lacking, and its protective effect on survival is foreseen. In this paper we investigate the complex role of family in mortality and contribute to the debate on the ideal living condition for elderly people, exploiting a nationwide integrated survey on private and collective households in France. Following a cohort of 16,263 individuals aged 55, we investigate the effect of family relations on survival. We question whether the lack of family care connected with the absence of active relationships with family members may be at least partly compensated by institutional settings. Estimates of life expectancy show that at the age of 60, people living in institutions live on average 10 years less that those living in private households, the gap decreasing with age. Cox proportional hazards models show a protective role of children on mortality. Having no children seems to be associated with a lower risk of death, but the effect is significant only for those declaring rare or no contacts with their children. Survival analysis also suggests that institutional living arrangement may be protective for the most fragile individuals, namely the severely disabled, isolated persons. [ABSTRACT FROM AUTHOR]

One of the key policy question for an ageing population is the identifications of the factors which influence health. Very recently, an increasing interest on social capital has developed and, surprisingly, not much is known for the European population. This study analyzes the effect of structural social capital on health (measured as self-perceived health) of the individuals aged 60 or more residing in European countries. The sample comes from the fourth wave of the survey on health and retirement in Europe. We use an instrumental variables approach in order to account for the reverse causality between social capital and health. We found that structural social capital exerts a positive effect preventing people to suffer of a poor self-perceived effect. Results are robust to different estimation methods. [ABSTRACT FROM AUTHOR]

There is increasing interest among researchers in the effects of social capital on the health of older adults. One of the key policy question for an ageing population concerns how do we identify the factors that influence health. Very recently, an increasing interest on social capital as a key determinant for health has developed and, surprisingly, not much is known for the European population. This paper analyzes the association between social capital and self-perceived health among older adults in Europe using a mixed effects logistic model. Social capital is considered in its two components-bonding and bridging-in order to understand if the relations inside or outside an individual inner circle have a different association with health. Our results give empirical support to the role of individual social capital in preventing a poor self-perceived health. This means that social capital, especially the bridging component of it, can be one of the key factors of ageing in good health and should be fostered by policy makers in order to give an answer to one of the most compelling challenge of our century: population ageing. [ABSTRACT FROM AUTHOR]

In this article we estimate health transition probabilities using longitudinal data collected in France for the survey on handicaps, disabilities and dependencies from 1998 to 2001. Life expectancies with and without disabilities are estimated using a Markov-based multi-state life table approach with two non-absorbing states: able to perform all activities of daily living (ADLs) and unable or in need of help to perform one or more ADLs, and the absorbing state of death. The loss of follow-up between the two waves induces biases in the probabilities estimates: mortality estimates were biased upwards; also the incidence of recovery and the onset of disability seemed to be biased. Since individuals were not missing completely at random, we correct this bias by estimating health status for drop-outs using a non parametric model. After imputation, we found that at the age of 70 disability-free life expectancy decreases by 0.5 years, whereas the total life expectancy increases by 1 year. The slope of the stable prevalence increases, but it remains lower than the slope of the cross sectional prevalence. The gender differences on life expectancy did not change significantly after imputation. Globally, there is no evidence of a general reduction in ADL disability, as defined in our study. The added value of the study is the reduction of the bias induced by sample attrition. [ABSTRACT FROM AUTHOR]

Background: The Emergency Department (ED) can be considered an indicator of accessibility and quality and can be influenced in period of economic downturns. In the last fifteen years, the number of migrants in Italy has doubled (from 2.4 million in 2005 to 5.2 in 2019, 4.1 and 8.7% of the total population, respectively). However, evidence about migrants' healthcare use is poor, and no studies focused on the ED utilisation rate during the Great Recession are available. This study aims to analyse trends in all-cause and cause-specific ED utilisation among migrants and Italians residing in Rome, Italy, before and after 2008.Methods: Longitudinal study based on data from the Municipal Register of Rome linked to the Emergency Department Register from 2005 to 2015. We analysed 2,184,467 individuals, aged 25-64 in each year. We applied a Hurdle model to estimate the propensity to use the ED and to model how often individuals accessed the ED.Results: Migrants were less likely to be ED users than Italians, except for Africans (RR = 1.46, 95%CI 1.40-1.52) and Latin Americans (RR = 1.04, 95%CI 1.00-1.08) who had higher all-cause utilisation rates than non-migrants. Compared to the pre-2008 period, in the post-2008 we found an increase in the likelihood of being an ED user (OR = 1.34, 95%CI 1.34-1.35), and a decrease in ED utilisation rates (RR = 0.96, 95%CI 0.96-0.97) for the whole population, with differences among migrant subgroups, regardless of cause.Conclusions: This study shows differences in the ED utilisation between migrants and Italians, and within the migrant population, during the Great Recession. The findings may reflect differentials in the health status, and barriers to access primary and secondary care among migrants. In this regard, health policies and cuts in health spending measures may have played a key role, and interventions to tackle health and access disparities should include policy measures addressing the underlying factors, adopting a Health in All Policies perspective. Further researches focusing on specific groups of migrants, and on the causes and diagnoses related to the ED utilisation, may help to explain the differences observed. [ABSTRACT FROM AUTHOR]