Apicella, G. and E. De Giorgi (2022): Gender attitudes toward longevity and retirement planning: theory and evidence.In: Corazza, M., Perna, C., Pizzi, C., Sibillo, M. (eds) Mathematical and Statistical Methods for Actuarial Sciences and Finance. MAF 2022.: 19-24. DOI: 10.1007/978-3-030-99638-3_4.
Abstract. This paper fosters discussion about the gender pension gap. We propose a research framework in financial economics, centered on the role of gender in longevity risk perception. Our approach is essentially made by three steps, aiming at the: (i) identification of drivers of subjective longevity assessment (e.g., biases), (ii) the measurement of the economic significance of longevity (mis)-perception in relation to saving and investment behaviors, (iii) the design of strategies to help women understand the opportunities behind long-term planning for retirement.
Chouzouris, M., A. Lyberaki and P. Tinios (2022): Are attitudes to financial risk reflected in precautional measures during the COVID-19 pandemic? A European study of individuals aged 50+. In: Lau, E. and A. J. Makin et al. Economics and Finance Readings, 57-67. Singapore: Springer.
Abstract. The COVID-19 pandemic led governments to take action to ensure public health by introducing emergency Non-Pharmaceutical Interventions (NPIs), such as social distancing, movement restrictions, and lock downs. People were encouraged to adopt preventive behaviors (wear face mask, keep social distance) as steps to minimize personal risk but also to limit the spread of the virus. In this study, we investigate the relationship between individuals’ propensity to take precautional measures against COVID-19 pandemic and their risk attitude profile toward financial risk as ascertained by pre-pandemic survey information. We use cross-sectional data from the 8th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to derive a measure for financial risk preference. The panel nature of the SHARE COVID-19 dataset allows us to relate these findings to precautionary behaviors against the pandemic, drawn from a telephone survey on the SHARE panel in July 2020. These include wearing a mask, limiting in-person contacts, keeping distance to others, washing hands, and using disinfectant. Risk attitude profiles were associated with precautionary behavior, with higher effect recorded in keeping social distance and wearing face mask. The study also probes the influence of important cofactors such as gender, age, and cognitive ability.
Koroleva, S., S. Sniķere, A. Aleksandrovs, I. Reine, A. Ivanovs and I. Gehtmane-Hofmane (2021): The Mental Health of the Elderly Population throughout the COVID-19 Pandemic in Latvia: The Role of Social and Support Networks.In: The 8th International Multidisciplinary Research Conference Society. Health. Welfare. (Rīga, 24 – 26 March 2021): Abstracts, 179. Riga: Riga Stradiņš University.
Abstract: Ageing is often accompanied by a decreased frequency and range of social contacts, and an increase in loneliness. During the Covid-19 pandemic, the social distancing requirement also reduced the social contacts of the elderly and their limited opportunities to receive social support. The aim of the study is to assess the role of social contacts and support in the changes in psycho-emotional states of the elderly. The analysis is based on Latvian data derived from The Survey of Health, Ageing and Retirement in Europe (SHARE)Wave 8 (n=1207), SHARE Covid-19 questionnaire. Indices of social isolation were constructed based on the self-reported measurements of social contacts, mutual support and assistance. Logistic regression models were calculated with dependent variables defined as experienced socio-emotional disturbances to identify the impact of social isolation on mental health during the crisis. Among respondents aged 50+, almost a one-fifth have felt the impact of the Covid-19 crisis on their mental health. A significantly higher proportion of those who have experienced problems in the past are single people and those vulnerable to social isolation: three times more people had experienced anxiety in the past month, twice as many people had experienced sadness, anxiety, and sleep disorders were present in 44% of this group. Reduced social contacts and limited availability of social support in times of crisis can become a factor in increased social exclusion and mental health deterioration. Therefore it is important to continue providing social support and assistance during the Covid-19 pandemic, involving volunteers to reduce loneliness among the elderly, as well as isolation and the associated deterioration of their mental health, and to implement strategic communication at the national level to reduce anxiety among seniors.VPP-COVID-2020/1-0011 “Impact of COVID-19 on health care system and public health in Latvia; ways in preparing health sector for future epidemics”.
Mieriņa, I. and I. Reine(2021): Why did they need to come now? COVID-19 Crisis Strains Relationships with Returning and Visiting Compatriots. In: SOCIETY. INTEGRATION. EDUCATION. Proceedings of the 15th International Scientific Conference (May 28th-29th) VI, 160-171. Rezekne: Rezekne Academy of Technologies. DOI: 10.17770/sie2021vol6.6266.
Abstract: One of the first areas severely hit by the Covid-19 pandemic was international travel. In March/April, with commercial flights coming to a near halt, the governments were struggling to help their stranded citizens to return home. Extra flights and ferry trips were organised, and the opportunity to return was used by many emigrants worried about the uncertainty and the possible future development of the pandemic. This paper containing both data collected through survey and in-depth interviews with people aged 50+ in Latvia, is the first to explore the reactions of the society to repatriation policy implemented by the government of Latvia, and to explore how the Covid-19 situation has affected the attitudes towards return migrants in general. Importantly, it demonstrates how education moderates these attitudes. The results show that most of the population consider returning migrants as a significant source of infections, and many had doubts if they follow self-isolation and other rules responsibly. Those with the higher education were in general more supportive of the repatriation policy demonstrating the importance of education and explaining difficult decisions in order to reduce tension and fear.
Rajevska, O., A. Reine and D. Baltmane (2021): Impact of the First Wave of COVID-19 on the Employment of Older People in Latvia, the Baltic States and Europe.In: The 8th International Multidisciplinary Research Conference Society. Health. Welfare. (Rīga, 24 – 26 March 2021): Abstracts, 13. Riga: Riga Stradiņš University.
Abstract: The objective of the study was to examine changes in the employment of older people brought about by the first wave coronavirus pandemic in Latvia in comparison with other European countries. The study is based on the SHARE Wave 8 COVID-19 Survey conducted in June-August 2020 in 26 European countries and Israel via computer-assisted telephone interviews. Questions examined how people aged 50 years and older coped with socioeconomic and health-related impact of COVID-19. The methods of descriptive statistics were applied in order to compare the influence of the first coronavirus wave on employment in older age groups in Latvia and across Europe. In Latvia, 6% of employed or self-employed aged 50+ experienced unemployment, laid off or business closed during the first wave of COVID-19, which is one of the lowest rates among all participating countries. The strongest impact was suffered by older workers in France (39%), Greece (36%) and Cyprus (35%). 75% of Latvians continued to work at their usual work place. Meanwhile 10% of participants in Latvia started to work from home; and 9% combined working from home and at the usual work place. Most of the employed experienced neither a reduced nor increased number of working hours. Participation of older age groups in labour market is comparatively high in Latvia and other Baltic States and the COVID-19 (at least, its first wave) had relatively mild impact on it. The branches with traditionally high share of workers aged 50+ (education, healthcare, agriculture, administrative services) were least affected by lockdown measures. Although the prevalence of remote work from home in Latvia was lower than the European average, this issue requires more regulation as the existing legislation lacks provisions on remote work and does not therefore ensure protection of workers' rights and health.
Reine, I., A. Ivanovs, S. Sniķere, I. Mieriņa, I. Gehtmane-Hofmane and I. Koroļeva(2021): Overcoming Social Isolation with Digital Technologies among Ageing Populations during Covid-19.In: SOCIETY. INTEGRATION. EDUCATION. Proceedings of the 15th International Scientific Conference (May 28th-29th) IV, 171-178. Rezekne: Rezekne Academy of Technologies. DOI: 10.17770/sie2021vol4.6356.
Abstract: During Covid-19 social isolation has become more common worldwide, however, some groups, especially elderly people, might have experienced dramatically limited communication due to the lack of skills and access to digital technologies. In this paper, we examined if education was associated with the use of digital technologies to maintain contacts with a family, friends, other social networks and services. The survey was conducted in June-August 2020 by doing 1089 computer-assisted telephone interviews. The questions examined how people aged 50 years and older coped with socioeconomic and health-related impact of COVID-19. We used logistic regression analysis to study the association between the use of digital technologies and the level of education by gender and age. The higher the education was, the more it strongly associated with the use of digital technologies (OR 5.85; 95% CI 3.78-9.03). As expected, age was a strong explanatory factor, however, we did not find consistent age and gender differences. Among those who used digital technologies, analyses showed that overcoming social isolation was related to the education level. The conclusion of the study is that education has inevitable impact on the use of digital technologies and social contacts, however high education level is not crucial for the acquisition of information. It seems that digital technologies are important tools to prevent social isolation and are related to education that includes digital access and competencies.
Reine, I., A. Ivanovs and S. Tomsone (2021): Access to Healthcare during COVID-19 among Ageing Population in LatviaThe 8th International Multidisciplinary Research Conference Society. Health. Welfare. (Rīga, 24 – 26 March 2021): Abstracts, 3. Riga: Riga Stradiņš University.
Abstract: Medical staff has worked tirelessly throughout the COVID-19 pandemic to test and treat coronavirus patients. However, the focus on the virus has caused huge disruption to healthcare services resulting in delayed treatment for patients with other serious conditions. Additionally, the reasons for forgoing or abstaining healthcare could also be related to individual decisions. We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE), where the respondents 50 years and older of the Wave 8, were asked to answer, among other, questions on delayed, postponed or denied healthcare services during the first wave of Covid-19 pandemic in Latvia. The study is based on 195 483 valid weighted cases. Pearson’s chi-squared test was performed to assess the association between the variables. Preliminary results show that 14% of the respondents forwent medical treatment. General practitioner or specialist/dentist check-ups were forgone (both 9%) or postponed more commonly (16% respectively 11%). Appointment was denied to 7% of the respondents. We found significant gender differences (p < 0.001), but they varied depending on the type of treatment and reason for not receiving it. During the first wave of Covid-19 in Latvia, there were few older people that chose themselves or were forced to abstain planned medical treatment or operations, as well as rehabilitation and physiotherapy. However, it is not clear how limited access to the healthcare for other reasons has affected health of ageing population and remains to be studied. The study was performed within the project/agreement No. 184.108.40.206/VIAA/3/19/540 'Challenges of ageing in the Baltic Sea region'.
Zorrilla-Muñoz, V., M. Agulló-Tomás, M. Forjaz, E. Fernandez, C. Rodriguez-Blazquez, A. Ayala and G. Fernandez-Mayoralas(2021): Technology, Gender and COVID-19. Analysis of Perceived Health in Adults and Older People. In: Gao, Q. and J. Zhou. Human Aspects of IT for the Aged Population. Supporting Everyday Life Activities. HCII 2021. Lecture Notes in Computer Science vol 12787, 363-379. Cham: Springer.
Abstract: This chapter aims to know the psychosocial impact and social behaviours and related to the perception of technological needs in adults and older persons with diseases, health problems and/or sensory or motor disabilities. This work delves into this reality from a gender, inclusive and, at the same time, technological, biotechnological and/or virtual device approach. This goal includes two secondary objectives: 1) To know the health conditions that affect the adult and older people, whether they suffer from chronic diseases and health problems. In this way, it will be possible to understand if there are specific conditions in which the adult and older persons have felt especially sensitive during the pandemic outbreak in Spain. 2) To understand the needs of older people with sensory or motor disabilities before the pandemic and how this connects with the looking forward to an activity after COVID-19. One conclusion is that new emerging technologies are essential in aspects such as safety, hygiene and other social factors that help to improve autonomy and independence - such as canes and support devices in functional disability type EGARA - of older persons during and after the pandemic times. In addition to the needs of adults and the older persons prior to the pandemic, especially in older women, there are others that require research from a more inclusive and gender perspective.
Angelova, M.(2021): Factors Affecting the Active Life of People Aged 50 and Over in Europe Before and During the Pandemic.Revista Inclusiones 8: 62-90.
Abstract: This prospective longitudinal cohort study aims to identify the factors affecting the active life of people aged 50 and over in Europe and point risk factors for inactivity both in ordinary working scenarios and during the pandemic. Comparative analyses of Wave 7 and Wave 8 of Survey of Health, Ageing and Retirement in Europe are used to assess the association between different factors and active life at baseline and follow-up. The target population comprises 29971 adults aged ≥50 years, included in both waves. Binary logistic regression models are estimated for both waves to examine the association between active life and different socio-economic, health and psychological aspects. Modification of baseline model for Wave 8 is used to show whether social contacts and digital networks affect active life. A multivariate analysis shows that being a man, unemployed or permanently sick, aged over 80, depressed, low educated, with low income, low extraversion, openness and agreeableness, high neuroticism, living in a rural area or small town are independent risk factors for inactiveness in ordinary working scenarios. During the pandemic there is a significant positive relationship between inactiveness and risk factors like age over 80, unemployment, illness, depression, lack of social and electronic contacts. On the other hand, predictors like gender man, partnership, high income and stress related to Covid-19 decrease the probability older people to be inactive. Most important factor associated with active life in both cases is the country of residence. Thеse findings provide evidence of change in the behavior of older people in Europe because of the global pandemic. Findings show a need to generation support in critical situations such as the one created by the Covid-19 pandemic.
Arnault, L., F. Jusot and T. Renaud(2021): Economic Vulnerability and Unmet Healthcare Needs among the Population Aged 50 + years During the COVID-19 Pandemic in Europe.European Journal of Ageing. DOI: 10.1007/s10433-021-00645-3.
Abstract: This study investigated the effect of economic vulnerability on unmet needs during the first wave of the coronavirus disease 2019 (COVID-19) epidemic in Europe among adults aged 50 years and older using data from the regular administration of the Survey of Health, Ageing and Retirement in Europe (SHARE) and the specific telephone survey administered regarding COVID-19 (SHARE Corona Survey). It addressed three main research questions: Did people who were in difficult economic situations before the epidemic face more barriers to accessing healthcare than others? If so, to what extent can these discrepancies be attributed to initial differences in health status, use of care, income or education between vulnerable individuals and non-vulnerable individuals or to differential effects of the pandemic on these groups? Did the effect of economic vulnerability with regard to unmet needs during the pandemic differ across countries? Unmet healthcare needs are characterised by three types of behaviours likely to be induced by the pandemic: forgoing care for fear of contracting COVID-19, having pre-scheduled care postponed and being unable to obtain medical appointments or treatments when needed. Our results substantiate the existence of significant differences in accessing healthcare during the pandemic according to economic vulnerability and of cumulative effects of economic and medical vulnerabilities: the impact of economic vulnerability is notably stronger among those who were in poor health before the outbreak and thus the oldest individuals. The cross-country comparison highlighted heterogeneous effects of economic vulnerability on forgoing care and having care postponed among countries, which are not comparable to the initial cross-country differences in social inequalities in access to healthcare.
Atzendorf, J. and S. Gruber(2021): Depression and Loneliness of Older Adults in Europe and Israel after the First Wave of Covid-19.. European Journal of Ageing. DOI: 10.1007/s10433-021-00640-8.
Abstract: Epidemic control measures that aim to introduce social distancing help to decelerate the spread of the COVID-19 pandemic. However, their consequences in terms of mental well-being might be negative, especially for older adults. While existing studies mainly focus on the time during the first lockdown, we look at the weeks afterward in order to measure the medium-term consequences of the first wave of the pandemic. Using data from the SHARE Corona Survey, we include retired respondents aged 60 and above from 25 European countries plus Israel. Combining SHARE data with macro-data from the Oxford COVID-19 Government Response Tracker allows us to include macro-indicators at the country level, namely the number of deaths per 100,000 and the number of days with stringent epidemic control measures, in addition to individual characteristics. The findings show that both macro-indicators are influential for increased feelings of sadness/depression, but that individual factors are crucial for explaining increased feelings of loneliness in the time after the first lockdown. Models with interaction terms reveal that the included macro-indicators have negative well-being consequences, particularly for the oldest survey participants. Additionally, the results reveal that especially those living alone had a higher risk for increased loneliness in the time after the first COVID-19 wave.
Bergmann, M., A. Bethmann, T.-V. Hannemann and A. Schumacher (2022): Who are the unvaccinated? Determinants of SARSCoV-2 vaccinations among older adults across Europe. easy_social_sciences Mixed 1: 1-11. DOI: 10.15464/easy.2022.01.
Abstract. With the arrival of effective COVID-19 vaccines, the fight against the ongoing global pandemic entered a new stage. The question shifted towards how to vaccinate as many people as quickly as possible. Understanding the reasons people choose to get vaccinated or not is integral in informing immunization campaigns. But who are the unvaccinated? This is determined by using cross-national data from the Survey of Health, Ageing and Retirement in Europe (SHARE). We investigate the interrelation of the (un)willingness to be vaccinated with social and health aspects as well as the economic situation of our sample of adults in Europe, aged 50 and above. We find that respondents’ economic situation as well as diagnosed physical illnesses and education show the strongest relation to vaccination hesitancy. Our results provide a comprehensive picture of influential factors of older adults’ vaccination behaviour that can advance the success of the immunisation campaigns in Europe.
Bergmann, M. and M. Wagner (2021): The Impact of COVID-19 on Informal Caregiving and Care Receiving Across Europe During the First Phase of the Pandemic. Frontiers in Public Health 9. DOI: 10.3389/fpubh.2021.673874
Abstract: Purpose: We analyzed the effects of COVID-19 as well as its accompanying epidemiological control measures on health-related outcomes (physical and mental health) and unmet care needs of both caregivers and care recipients across Europe and Israel by taking into account country differences. Methods: We applied comparisons of adjusted predictions, controlling for a large set of relevant respondent characteristics, to investigate changes in the physical and mental health of caregivers and care recipients due to COVID-19. Furthermore, multilevel regression models were used to analyze the effect of individual and contextual indicators on the probability of reporting difficulties in receiving care. For the analyses, we used data from 26 countries with 51,983 respondents over 50 years based on the eighth wave of the Survey of Health, Aging and Retirement in Europe (SHARE), which had to be suspended in March 2020, and the SHARE Corona Survey fielded from June to August 2020. Results: During the first phase of the pandemic in spring/summer 2020, the frequency of providing personal care to parents increased in almost all European countries, while care to children, in turn, decreased. Parental caregivers who increased the frequency of providing personal care reported significantly more mental health strains, that is, feeling sad/depressed and anxious/nervous more often since the outbreak of the pandemic. With respect to receiving care, about one out of five care recipients had difficulty in obtaining adequate care from outside the household during the pandemic. The perception of unmet care needs was significantly associated with country differences regarding the duration of the stay-at-home orders. In contrast, the number of confirmed deaths did not have a significant effect on perceiving difficulties related to receiving care. Conclusions: Our findings show the extent of the burden to which caregivers and care recipients were exposed with respect to the unintended consequences of COVID-19-related epidemiological control measures. There is a great need within this population for interventions, which effectively reduce the burden as well as the symptoms of anxiety or depression for caregivers as well as care recipients. This should be recognized by (health) policymakers and social organizations.
Bertoni, M., M. Celidoni, C. Dal Bianco and G. Weber (2021): How did European retirees respond to the COVID-19 pandemic? Economics Letters 203. DOI: 10.1016/j.econlet.2021.109853.
Abstract: We investigate the role of retirement on the adoption of preventive behaviours and on mental health during the first wave of the pandemic. We address the endogeneity of the timing of retirement using variation in early retirement and old-age pension eligibility. We find that those who retired earlier responded to the pandemic by limiting their mobility more, and by adopting stricter preventive behaviours in public. These limitations affected the mental health of singles in retirement.
Bíró, A., R. Branyiczki and P. Elek. (2021): Time Patterns of Precautionary Health Behaviours during an Easing Phase of the COVID-19 Pandemic in Europe. European Journal of Ageing. DOI: 10.1007/s10433-021-00636-4.
Abstract: Using data from the COVID-19 questionnaire of the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate the time patterns of precautionary health behaviours of individuals aged 50 years and above during the summer of 2020, an easing phase of the COVID-19 pandemic in Europe. We also examine how these health behaviours differ by the presence of chronic conditions such as hypertension, high cholesterol level, heart disease, diabetes or chronic bronchitis, which can be considered as risk factors for COVID-19. Our results suggest that while on average, people became less precautious during the analysed time period, this is less so for those who are at higher risk. We also document large regional differences in precautionary health behaviours and show that higher-risk individuals are on average more cautious in all regions. We conclude that people adjusted their health behaviours in line with the generally understood risk of the COVID-19 disease. At the same time, our results also point out divergences in the level of willingness to take different precautionary steps.
Bogdanova, B. and Z. Vladimirov(2021): Cross-sectional differences in the Level of Depression since the COVID-19 Outbreak: A Study on SHARE Data.Revista Inclusiones 8: 22-43.
Abstract: Depression is one of the most prevailing mental health problems nowadays and researchers expect it to deepen especially in most developed countries due to constantly aging population. At the same time the COVID-19 pandemic has led to overwhelming levels of distress by imposing severe restrictions on everyday activities of the world population. This situation inevitably created many stressful life events, and together with distancing measures, employment and financial insecurity, represent a massive mental health crisis. Moreover, according to SHARE data the changes in level of depression differ across Europe and while some countries such as Denmark and Slovenia exhibit comparatively low percentage of people stating that they feel sadder or depressed since the outbreak, other countries such as Portugal and Italy exhibit higher values of these indicators. Our paper aims to study the cross-sectional differences in the level of depression in the light of the additional risks that emerged since the COVID-19 outbreak for people in Europe and Israel. We base our analysis on the COVID-19 release of wave 8 of the SHARE project and we consider all the countries included in this wave. Based on extensive literature review we identify a set of variables associated with additional risks for the mental health since the outbreak. Then we apply factor analysis and extract risk factors that appeared due to the pandemic situation. As a next step we conduct K-means clustering over the identified factors so as to define distinct groups of respondents in terms of the effects caused by the pandemic situation and the lockdown measures. We profile each group by analyzing additional data for gender and age as well as changes in the level of depression. Last but not least, we summarize the proportion of respondents belonging to each cluster thus shedding light to the observed cross-sectional differences.
Brugiavini, A., R. E. Buia and I. Simonetti(2021): Occupation and Working Outcomes during the Coronavirus Pandemic. European Journal of Ageing. DOI: 10.1007/s10433-021-00651-5.
Abstract: Using data from the first wave of the SHARE COVID-19 Survey and additional information collected from the previous waves of SHARE (Survey of Health Ageing and Retirement in Europe), we explore the effects of job characteristics on two outcomes: (i) the probability of work interruptions and (ii) the length of such interruptions during the first phase of the Coronavirus Pandemic. In order to assess the relationship between job features and labour market outcomes, we define two indexes proxying the pre-COVID-19 technical remote work feasibility as well as the level of social interaction with other people while working. Moreover, we use an indicator that classifies ISCO-08 3-digit job titles based on the essential nature of the good or service provided. We find that job characteristics have been major determinants of the probability of undergoing work interruptions and their duration. In addition, we show that women have been negatively affected by the Pandemic to a much larger extent than men, suggesting the relevance of the intrinsic characteristics of jobs they are mainly involved in, and the role of gender selection into specific activities. Not only females were more likely to have undergone work interruptions but they also exhibited larger probabilities of longer work breaks. A similar impact is seen for self-employed and less-educated workers.
Chłoń-Domińczak, A. and D. Holzer-Żelażewska(2021): Economic Stress of People 50 + in European Countries in the Covid-19 Pandemic–Do Country Policies Matter?. European Journal of Ageing. DOI:10.1007/s10433-021-00662-2.
Abstract: The Covid-19 pandemic caused lockdown of economies, which in turn led to the worsening of the economic situation of many households. During the first wave of the Covid-19 pandemic governments undertook various measures to support economies and societies, including jobs protection along with financial support provision to people who suffered financial loss during the economic crisis. We analyse the economic situation of older Europeans, depending on their socio-economic status as well as country of residence characteristics, including economic and labour market changes during the first phase of the pandemic, the strictness of government policies but also the country development level using the Human Development Index. We use the results of the Survey of Health, Ageing, and Retirement in Europe (SHARE), including the SHARE Corona Telephone Survey, which was conducted during the first wave of the Covid-19 pandemic. Our results indicate that individual characteristics have a higher impact on individual economic stress, compared to country characteristics. However, country’s response to the consequences of the Covid-19 pandemic, but also the overall level of development influences the economic situation and ability to cope with the economic risks people aged 50 and over face. People in more developed countries have smaller difficulties in making ends meet, while the economic crisis and more stringent policies reduce chances to receive financial support and increase economic risks.
Clark, A., C. d’Ambrosio, I. Onur and R. Zhu(2021): COVID-19 Compliance Behaviors of Older People: The Role of Cognitive and Non-Cognitive Skills.Economics Letters. DOI: 10.1016/j.econlet.2021.110158.
Abstract: This paper examines the empirical relationship between individuals’ cognitive and non-cognitive abilities and COVID-19 compliance behaviors using cross-country data from the Survey of Health, Ageing and Retirement in Europe (SHARE). We find that both cognitive and non-cognitive skills predict responsible health behaviors during the COVID-19 crisis. Episodic memory is the most important cognitive skill, while conscientiousness and neuroticism are the most significant personality traits. There is also some evidence of a role for an internal locus of control in compliance.
Cohn-Schwartz, E., A. Vitman-Schorr and R. Khalaila (2021): Physical Distancing is Related to Fewer Electronic and In-person Contacts and to Increased Loneliness during the COVID-19 Pandemic among Older Europeans.Quality of Life Research. DOI: 10.1007/s11136-021-02949-4.
Abstract: Purpose. During the COVID-19 pandemic older adults are asked to maintain physical distancing, which can be linked to loneliness. While older people are encouraged to use electronic communication to stay socially connected, it remains an open question whether electronic contacts are related to lower loneliness during the pandemic. This study examined the associations of physical distancing during the pandemic with loneliness and the role of in-person and electronic contacts with children and non-kin as explaining these associations across European regions. Methods. The study used data from Survey of Health, Ageing and Retirement in Europe (SHARE), collected during the COVID-19 pandemic in 2020. Mediation and moderation analyses tested the direct and indirect associations between physical distancing, contact frequency and loneliness, as well as the differences across European regions. Results. The results indicate that adults who reported higher frequency of physical distancing also felt lonelier during the pandemic. This association was partly explained by social contacts—those who practiced physical distancing maintained less in-person contact with children and non-kin and less electronic contact with non-kin, which were related to feeling lonelier. Adults in Southern European countries felt lonelier and reported more frequent contacts. The moderation analyses showed that the link between physical distancing and loneliness was found in the northern region, but not in the southern and eastern regions of Europe. Conclusion. This study can indicate that attention should be paid to adults who may struggle to maintain social contacts in light of physical distancing guidelines.
Delerue Matos, A., A. Fonseca de Paiva, C. Cunha and G. Voss (2021): Precautionary Behaviours of Individuals with Multimorbidity during the COVID-19 Pandemic. European Journal of Ageing. DOI: 10.1007/s10433-021-00632-8.
Abstract: : Studies show that older individuals with multimorbidity are more susceptible to develop a more severe case of COVID-19 when infected by the virus. These individuals are more likely to be admitted to Intensive Care Units and to die from COVID-19-related conditions than younger individuals or those without multimorbidity. This research aimed to assess whether there are differences in terms of precautionary behaviours between individuals aged 50 + with multimorbidity and their counterparts without multimorbidity residing in 25 European countries plus Israel. We used data from the SHARE-COVID19 questionnaire on the socio-demographic and economic characteristics, multimorbidity, and precautionary behaviours of individuals. SHARE wave 8 and 7 databases were also used to fully identify individuals with multimorbidity. Our results showed that individuals with multimorbidity were more likely to exhibit precautionary behaviours than their counterparts without multimorbidity when gender, age, education, financial distress and countries were included as controls. Additionally, we found that women, more educated individuals and those experiencing more financial distress adopt more protective behaviours than their counterparts. Our results also indicate that the prevalence of precautionary behaviours is higher in Spain and Italy and lower in Denmark, Finland and Sweden. To guarantee the adoption of preventive actions against COVID-19, public health messaging and actions must continue to be disseminated among middle and older aged persons with multimorbidity, and more awareness campaigns should be targeted at men and less educated individuals but also at persons experiencing less financial distress, particularly in countries where people engaged in fewer precautionary behaviours.
García-Prado, A., P. González and Y. Rebollo-Sanz(2022): Lockdown Strictness and Mental Health Effects among Older Populations in Europe.Economics & Human Biology. DOI: 10.1016/j.ehb.2022.101116.
Abstract: This paper investigates whether lockdown policies aggravated mental health problems of older populations (50 and over) in Europe during the first COVID-19 wave. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE COVID-19 questionnaire) and from the Oxford COVID-19 Government Response Tracker for 17 countries, we estimate the causal effect of lockdown policies on mental health by combining cross-country variability in the strictness of the policies with cross-individual variability in face-to-face contacts prior to the pandemic. We find that lockdown policies worsened insomnia, anxiety, and depression by 5, 7.2 and 5.1 percentage points, respectively. This effect was stronger for women and those aged between 50 and 65. Interestingly, lockdown policies notably damaged the mental health of healthy populations. We close with a discussion of lockdown policies targeted at individuals above 65 and/or with pre-existing conditions.
González Rodríguez, I., M. Pascual Sáez and D. Cantarero Prieto (2022): Have health inequalities increased during the COVID-19 pandemic? Evidence from recent years for older European Union citizens. Environmental Research and Public Health 19(13), 7812. DOI: 10.3390/ijerph19137812.
Abstract. Reducing inequality is one of the current challenges that most societies are facing. Our aim was to analyze the evolution of inequalities in self-assessed health among older Europeans in a time period spanning the 2008 economic crisis and the COVID-19 health crisis. We used data from Waves 2, 4 and 8 of the Survey of Health, Ageing and Retirement in Europe. We used inequality indices that accept ordinal variables. Our empirical results suggest that average inequality declines over time. Gender significantly influences the results. Some of the countries with the highest level of inequality are Denmark and Sweden, and some with the lowest are Estonia and the Netherlands. Our results may be of interest for the development of public policies to reduce inequalities. Special attention should be paid to vulnerable groups, such as the elderly.
González-Touya, M., A. Stoyanova and R. Urbanos-Garrido (2021): COVID-19 and Unmet Healthcare Needs of Older People: Did Inequity Arise in Europe? International Journal of Environmental Research and Public Health 18(17). DOI: 10.3390/ijerph18179177
Abstract: Background: The disruption in healthcare provision due to the COVID-19 pandemic forced many non-urgent medical treatments and appointments to be postponed or denied, which is expected to have huge impact on non-acute health conditions, especially in vulnerable populations such as older people. Attention should be paid to equity issues related to unmet needs during the pandemic. Methods: We calculated concentration indices to identify income-related inequalities and horizontal inequity in unmet needs due to postponed and denied healthcare in people over 50 during COVID-19, using data from the Survey on Health, Ageing and Retirement in Europe (SHARE). Results: Very few countries show significant income-related inequalities in postponed, rescheduled or denied treatments and medical appointments, usually favouring the rich. Only Estonia, Italy and Romania show a significant horizontal inequity (HI) in postponed healthcare, which apparently favours the poor. Significant pro-rich inequity in denied healthcare is found in Italy, Poland and Greece. Conclusions: Although important income-related horizontal inequity in unmet needs of European older adults during the early waves of the COVID-19 pandemic is not evident for most countries, some of them have to carefully monitor barriers to healthcare access. Delays in diagnosis and treatments may ultimately translate into adverse health outcomes, reduced quality of life and, even, widen socio-economic health inequalities among older people.
Halivni, L. R., D. Christiani and S. Bramli-Grinberg(2021): O-439. The Complex Association of Perceived Workplace Safety, Work Environment, and National Factors with the Mental Health of Aging Workers in Europe during the COVID-19 Pandemic. Occupational and Environmental Medicine 78:A2. DOI: 10.1136/OEM-2021-EPI.4.
Abstract: Introduction. The widespread COVID-19 contagion in workplaces has created a new workplace hazard, albeit investigated mainly among health care workers. Work-environment factors are related to workplace infection risks and individual vulnerability factors, like older age, predispose workers to severe illness. The stress and anxiety associated with the concerns regarding workplace safety and COVID-19 repercussions are jeopardizing aging workers’ mental health (MH). Objectives. We aimed at investigating the individual and macro-level factors associated with declines in the MH of aging workers from different industry sectors. We hypothesize that higher perceived workplace safety is crucial in protecting their MH and mediates the work-environment influences. Methods. Using the Health, Ageing and Retirement in Europe (SHARE) data from COVID-19 survey (summer 2020) from 27 countries in Europe and Israel and additional data collected from pre-pandemic waves, we performed multi-level and mediation analyses to characterize work-environment, safety perception, socio-demographic, clinical, and national-level factors associated with MH among workers aged 50–70. Results. Multi-level analyses demonstrated that 24% of the aging workers experience MH declines characterized by East-West geographical European gradient associated with disease burden. The perceived workplace safety, which is low among 10% of the workers, is the strongest predictor- explaining 30% of their MH status and mediates the effects of work-environment aspects, such as workplace contagion risk. Being a woman, having financial difficulties, a higher vulnerability index (comorbidities and age>60), pre-existing mental morbidity, and the national high burden of COVID-19 are associated with declines in MH, whereas exclusively working on-site is protective. Conclusion. Evaluating workplace conditions and screening vulnerable sub-groups among the aging workers who are more prone to MH declines are imperative. Workplace interventions, integrated with individual targeted approaches to reduce the influence of work-environment factors on infection risks and mental distress, hence elevating workplace safety perception, are recommended.
Heidinger, T. and L. Richter (2022): Examining the Impact of COVID-19 Experiences on Reported Psychological Burden Increase in Older Persons: The Effects of Illness Severity and Social Proximity. Frontiers in Psychology. DOI: 10.3389/fpsyg.2022.884729.
Abstract. Previous findings have provided indications that experience of COVID-19 illness of self and other affect mental health unfavorably. However, prior studies do not satisfactorily differentiate according to severity of COVID-19 illness or social proximity, which are both hypothesized to be relevant factors for increased psychological burden. This study provides an in-depth examination of the impact of Covid-19 experience of self and other on mental health, considering illness severity as well as proximity to the infected person (self, close and distant network). It used data on an older population (50+ years) from 28 European countries (n > 40 000 persons) surveyed in summer of 2021 using the Survey of Health and Retirement in Europe (SHARE). Aside from bivariate analyses, a logistic regression model was computed to test the effects of illness severity by personal proximity over and above other stressors of life in the pandemic. Severity of illness was shown to be a contributor to psychological burden increase with the strongest effects among persons who reported own illness experiences or experiences in the close network. Regression analysis confirmed the impact of severe Covid-19 experience in self, close and distant relations. Moreover, even a less severe course impacted burden unfavorably when experienced in the own person and more distant relations. These results prove troubling. Psychological burden is impacted by infection, with experiences in self or close persons being strongest, while even ‘lighter' experiences in the distant network also have an unfavorable effect, emphasizing the need to gain control of the present pandemic.
Koch, M. and S. Park(2021): Do Government Responses Impact the Relationship between Age, Gender and Psychological Distress during the COVID-19 Pandemic? A Comparison across 27 European Countries.Social Science & Medicine. DOI: 10.1016/j.socscimed.2021.114583.
Abstract: Rationale. Governments around the world have developed a range of responses to deal with the COVID-19 pandemic, including containment and closure, health system and economic policies. Despite their ubiquity, little is known regarding how government policies interact with age and gender to predict individual-level psychological outcomes. Objective. This study examines how three types of national-level government responses to the COVID-19 pandemic moderate the relationship between age and psychological distress as well as gender and psychological distress. Method. We use a multilevel model to assess how government policies moderate the relationship between age as well as gender and psychological distress. Individual-level data are based on the SHARE COVID-19 Survey (n = 51,467 from 27 countries). Government policies are assessed using data from the Oxford COVID-19 Government Response Tracker. Results. Results show that containment and closure policies increase psychological distress more for women compared to men. Health system policies increase psychological distress more for women compared to men and more for older individuals compared to younger individuals. Economic policies do not interact with age or gender to predict psychological distress. Conclusions. While containment and closure policies and health system policies interact with age and gender to predict psychological distress, their overall effect is comparably modest.
König, R. and A. Seifert (2022): Digitally savvy at the home office: Computer skills of older workers during the COVID-19 pandemic across Europe. Frontiers in Sociology 7(858052). DOI: 10.3389/fsoc.2022.858052.
Abstract. Digital skills can be a valuable resource in work life, especially in such times as the current COVID-19 pandemic, during which working from home has become new reality. Although increasing numbers of older employees (aged 50 years and above) are using digital technologies to work remotely, many of these older adults still have generally lower digital skills. Whether the pandemic will be a push factor for the acquisition of computer skills in late working life remains unclear. This study investigated the explanatory factors of the computer skills gained by older workers who were working from home during the COVID-19 pandemic, using representative data for 28 countries from the Survey of Health, Aging and Retirement in Europe (SHARE). The analysis of the survey responses of 11,042 employed persons aged 50 years and older revealed that, 13% worked only at home due to the pandemic, while 15% said they worked at home and in their usual workplace. The descriptives indicate that full-time homeworking is more of an option among those with tertiary education and who already have some computer skills. Of the older employees who worked only at home, 36% reported an improvement in their computer skills, whereas of the older workers who worked at home and at their usual workplaces, only 29% reported such an improvement. Our results based on logistic regressions suggest that significantly more women, younger employees, respondents with tertiary educational qualifications, and those whose work was not affected by unemployment or even business closure acquired new computer skills, regardless of whether they were working permanently or only partly from home. The study underlines the importance of investigating the possible digital skills gained from the home office situation resulting from the pandemic.
Ksinan Jiskrova, G., M. Bobák, H. Pikhart and A. Ksinan(2021): Job Loss and Lower Healthcare Utilisation due to COVID-19 among Older Adults across 27 European Countries. Journal of Epidemiology & Community Health 75:1078-1083. DOI: 10.1136/jech-2021-216715.
Abstract: Background. Older adults are at greater risk for becoming severely ill from COVID-19; however, the impact of the pandemic on their economic activity and non-COVID-19-related healthcare utilisation is not well understood. The aim of this study was to examine the prevalence and predictors of COVID-19-related unemployment and healthcare utilisation in a sample of older adults across 27 European countries. Methods. We used data from the Survey of Health, Ageing and Retirement in Europe COVID-19 Survey, collected between June and August 2020. Participants (n=52 061) reported whether they lost a job, forwent medical treatment and whether their appointment was postponed due to COVID-19. Three-level models were estimated for each outcome to test the effects of individual, household and country-level characteristics. Results. The mean prevalence of reported job loss, and forgone and postponed medical care was 19%, 12% and 26%, respectively. Job loss was associated with female sex, lower education and household income, and older age in women. For example, the OR of job loss, comparing primary versus tertiary (college) education, was 1.89 (95% CI 1.59 to 2.26). Forgone and postponed medical care was associated with older age in men, female sex and higher education. At the country level, postponed medical care was associated with more stringent governmental anti-COVID measures. Conclusion. Job loss and lower healthcare utilisation for non-COVID-19-related reasons were common among older adults and were associated with several sociodemographic characteristics. Job loss appeared to disproportionally affect already economically vulnerable individuals, raising concerns about the exacerbation of social inequalities.
Litwin, H. and M. Levinsky (2021): Network-exposure Severity and Self-protective Behaviors: The Case of COVID-19.Innovation in Aging 5(2). DOI: 10.1093/geroni/igab015.
Abstract: Background and Objectives. To clarify whether awareness of the extent and severity of exposure to the coronavirus disease 2019 (COVID-19) virus in the social networks of older adults is related to the engagement by the latter in self-protective behaviors. The inquiry is guided by the Health Belief Model and by concepts from the domain of social networks. Research Design and Methods. Data from the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, including the SHARE COVID-19 Survey executed in the summer of 2020. The study sample numbered 33,053 persons aged 50 and older in 25 countries. We regressed a logged count of self-protective behaviors on network-exposure severity, controlling for sociodemographic background, country, personality traits, and self-exposure severity. Age and network-exposure interaction terms were examined, as were "close-family" and "other" network ties. Results. Network-exposure severity was positively associated with the extent of engagement in self-protective behaviors among older adults, but mainly among the oldest group, aged 70 and older. Awareness of exposure severity in "close-family" and "other" networks were similarly associated with self-protection. Respondents from countries with the lowest rates of COVID-19 infection at the time (Latvia, Finland, and Denmark) engaged in fewer self-protective behaviors, while those from countries with high infection rates (Spain, Italy, and Portugal), self-protected to a greater degree. Discussion and Implications. The study findings point to the role of the social network, even if indirect, in promoting self-protective behaviors among the oldest segment of society. Policymakers should collaborate with the social networks of older adults in order to promote the adoption of self-protective behaviors. Such intervention might help to reduce the threat of infection among the most vulnerable age group.
Litwin, H. and M. Levinsky (2021): Social Networks and Mental Health Change in Older Adults After the Covid-19 Outbreak. Aging & Mental Health (online first). DOI: 10.1080/13607863.2021.1902468.
Abstract: Objectives. This article examines the influence of social networks on selected aspects of mental health following the outbreak of the coronavirus. Method. We linked data from a post outbreak telephone survey in 2020 by the Survey of Health, Ageing and Retirement in Europe, with baseline data from SHARE Wave 6 (2016) (n = 33,485). Two mental health measures (depression and anxiety) were regressed on social network variables relevant to the Covid-19 crisis (frequency of face-to-face contact and frequency of contact through electronic means), controlling for confounders. Interactions of age group and social networks were considered. Baseline mental health was controlled, focusing the analysis on post-outbreak mental health change. Results. Face-to-face network contact significantly reduced negative mental health changes while electronic contact significantly increased them. The age interactions were insignificant. Country differences were observed. Conclusion. The findings suggest that face-to-face social networks can moderate the negative impact of the COVID-19 pandemic on important aspects of mental health.
Lourenço, Ó., C. Quintal, L. Moura-Ramos and M. Antunes (2022): The impact of the COVID-19 pandemic on the Unmet healthcare needs in people aged over 50 in Portugal. Acta Médica Portuguesa. DOI: 10.20344/amp.15970.
Abstract: Introduction: The COVID-19 pandemic led to the cancellation of healthcare appointments and to lower demand, which generated unmet healthcare needs. The aim of this study was to evaluate their prevalence and distribution in Portugal. Material and Methods: Data came from the ‘Survey of Health, Ageing and Retirement in Europe’. Between June and August 2020, 1118 Portuguese individuals aged 50 or over were inquired about unmet healthcare needs due to: i) fear of getting infected; ii) cancellation by the doctor/healthcare services; iii) unsuccessful consultation request. The analysis of the prevalence of unmet needs was complemented by the calculation of the concentration indices as a function of the variables: income, education and health status. Results: About 60% of respondents reported at least one unmet need, which was almost twice the European average. Motive ii) cancellation by the doctor/healthcare services was the most frequent. The prevalence of unmet needs differed depending on income level and health status. The indices evidence the concentration of unmet needs in individuals with the worst health status, although for the reason fear of infection the concentration occurred in those with higher levels of income and education. Conclusion: Our study showed a high prevalence of unmet needs and their concentration in individuals with worse health status. Given the association between unmet needs and the subsequent deterioration of health, these results should raise concerns about the near future. Keywords: COVID-19; Health Care Quality, Access, and Evaluation; Needs Assessment; Socioeconomic Inequalities.
Luchetti, M., T. Ledermann, D. Aschwanden, J. Nikitin, P. S. O’Súilleabháin, Y. Stephan, A. Terracciano and A. R. Sutin (2022): Actor and partner effect of loneliness on episodic memory and verbal fluency: A dyadic multilevel analysis of romantic couples across 28 countries. The Journals of Gerontology Series B, gbac086. DOI: 10.1093/geronb/gbac086.
Abstract. Objectives: There is evidence that loneliness is detrimental for cognitive health. Most studies, however, do not consider the association between loneliness and cognition in the context of close relationships, such as a spouse or romantic partner. This study examines loneliness, experienced by both the individual and their romantic partner, and cognitive performance. Methods: Data were from 24,689 opposite-sex couples (49,378 participants) from 28 countries in the Survey of Health, Ageing and Retirement in Europe. Each couple participant reported on loneliness and completed memory and verbal fluency tasks. A multilevel sex-stratified analysis was used to account for the nested data structure and evaluate actor and partner effects of loneliness on cognitive performance for male and female partners. Results: Consistent with the literature, there were small actor effects of loneliness on memory and verbal fluency for both males and females: A person’s own loneliness was associated negatively with their cognitive performance on both tasks. There were also small partner effects: A person with a partner who was lonely tended to have worse cognitive performance above and beyond their own loneliness. Actor and partners effects were similar for male and female partners, replicated in most countries, and generally held controlling for age, education, household size, and disease burden. For memory, loneliness effects were slightly stronger among older participants. Discussion: Both the experience of loneliness and loneliness of a partner have a negative association with cognitive health.
Maltagliati, S., S. Sieber, P. Sarrazin, S. Cullati, A. Chalabaev, G. P. Millet, M. P. Boisgontier and B. Cheval (2021): Muscle Strength Explains the Protective Effect of Physical Activity against COVID-19 Hospitalization among Adults aged 50 Years and Older. Journal of Sports Sciences. DOI: 10.1080/02640414.2021.1964721.
Abstract: Physical activity has been proposed as a protective factor for COVID-19 hospitalisation. However, the mechanisms underlying this association are unclear. We examined the association between physical activity and COVID-19 hospitalisation and whether this relationship was explained by risk factors (chronic conditions, weak muscle strength). We used data from adults over 50 years from the Survey of Health, Ageing and Retirement in Europe. The outcome was self-reported hospitalisation due to COVID-19, before August 2020. The main exposure was physical activity, self-reported between 2004 and 2017. Among the 3139 participants included (69.3 ± 8.5 years, 1763 women), 266 were tested positive for COVID-19, 66 were hospitalised. Logistic regression models showed that individuals who engaged in physical activity more than once a week had lower odds of COVID-19 hospitalisation than individuals who hardly ever or never engaged in physical activity (odds ratios = 0.41, 95% confidence interval = 0.22–0.74, p = .004). This association between physical activity and COVID-19 hospitalisation was explained by muscle strength, but not by other risk factors. These findings suggest that, after 50 years, engaging in physical activity is associated with lower odds of COVID-19 hospitalisation. This protective effect of physical activity may be explained by muscle strength.
Markova, E., G. Yordanova and E. Tosheva (2021): Mental Health Risk Alerts and Loneliness during the Pandemic: A Comparative Insight from Three Balkan Countries. Revista Inclusiones 8: 91-112.
Abstract: The aim of this paper is to explore the country-specific causes of mental health risk alerts (MHRA) and loneliness during the pandemic among populations aged 60+ in three Balkan countries: Bulgaria, Romania and Greece. Persons 60+ years of age are a high-risk group from a health (infection severity) and social (physical distance, self-isolation) perspective due to Covid-19. The lockdown measures in force differ between countries and have highlighted the importance of intensive social contacts and family support. Lack of social contact, anxiety and loneliness increase the risks for mental health, and analysis reveals interesting comparative insights. Restriction of physical contact and fear of infection intensify feelings of anxiety and loneliness, but there is insufficient empirical evidence on how these factors affect the 60+ age group in the three Balkan countries. The analysis is based on the SHARE Corona survey, with pre-selection of panel members 60+ years of age. Anxiety, depression, and loneliness also depend on social networks. In addition, low socioeconomic status is associated with a higher risk of mental disorders, especially during the outbreak, due to general economic uncertainty. There are peculiarities across the countries in terms of sociodemographic characteristics of the 60+ population, as well as self-assessment of household economic status since the beginning of the pandemic. The degree of MHRA and loneliness varies between countries and corresponds to the severity of the anti-epidemic measures introduced. Participation in social networks during the pandemic also varies between countries and various sociodemographic groups. The results of the logistics models support the hypothesis that factors influencing the increased MHRA and loneliness are country-specific. The outbreak and its influence on the population must be analysed within a specific national context. Anti-epidemic measures and the severity of the pandemic differ between countries, and MHRA and loneliness depend on national and cultural specifics.
Meier, C., S. Vilpert, G. Domenico Borasio, J. Maurer and R. J. Jox (2022): Perceptions and knowledge regarding medical situations at the end of life among older adults in Switzerland. Journal of Palliative Medicine. DOI: 10.1089/jpm.2022.0057.
Abstract. Background: Perceptions and knowledge regarding end-of-life health and health care can influence individuals' advance care planning, such as the completion and content of advance directives. Objectives: To assess older adults' perceptions of medical end-of-life situations in Switzerland along with their accuracy and corresponding associations with sociodemographic characteristics. Design: This is an observational study. Setting/study subjects: A nationally representative sample of adults aged 58 years and older who participated in wave 8 (2019/2020) of the Swiss part of the Survey of Health, Ageing, and Retirement in Europe (cooperation rate: 94.3%). Measurements: Subjective likelihood of 11 end-of-life situations on a 4-point scale: very unlikely (0–25%), rather unlikely (26%–50%), rather likely (51%–75%), and very likely (76%–100%). Results: Older adults' perceptions of end-of-life medical situations in Switzerland were rather heterogeneous and often inaccurate. Study subjects overestimated the success of cardiopulmonary resuscitation, the utility of a fourth-line chemotherapy, of hospital admission for pneumonia for patients with advanced dementia, and for artificial nutrition and hydration in the dying phase, while underestimating the effectiveness of pain management in this situation. Less than 28% of older adults correctly assessed the likelihood of dying in a nursing home, hospital, or at home, respectively. Inaccurate views were more frequent in men (p < 0.01) and individuals with financial difficulties (p < 0.05), whereas adults aged 75+ years (p < 0.01) and respondents from the German-speaking part of Switzerland (p < 0.01) had more accurate perceptions. Conclusions: The wide variation and low accuracy of end-of-life perceptions suggest considerable scope for communication interventions about the reality of end-of-life health and health care in Switzerland.
Mendez-Lopez, A., D. Stuckler, M. McKee, J. Semenza and J. Lazarus(2021): The Mental Health Crisis during the COVID-19 Pandemic in Older Adults and the Role of Physical Distancing Interventions and Social Protection Measures in 26 European Countries.SSM - Population Health 17. DOI: 10.1016/j.ssmph.2021.101017.
Abstract: Background. The COVID-19 pandemic and associated policy responses, such as physical distancing interventions, pose risks to mental health that could be mitigated by social support systems. We examine associations between changes in mental health in the population aged 50 years and older in Europe and stringency of pandemic responses and social protection. Methods. We analysed data from the Survey of Health, Ageing and Retirement in Europe: n = 50,278 individuals aged 50 years and older in 26 European countries between June and August 2020. Linear multivariable regression models were used to evaluate potential risk factors for deterioration in self-reported mental health and investigate whether social protection systems mitigate it. Results. Across the European Union, 28.1% (95% CI:27.1–29.2) of participants reported worsening mental health since the beginning of the pandemic, ranging from 16.1% in Slovakia to 54.8% in Portugal. Factors associated with increased risk of deterioration included: being female (12.7 percentage points (ppt), 95%CI:9.2–16.2); experiencing unmet healthcare needs during the pandemic (14.6 ppt, 95%CI:11.2–18.1); job loss during the pandemic (6.2 ppt, 95%CI:1.1–11.8); and financial hardship (5.1 ppt, 95%CI:2.9–7.2). Greater stringency of physical distancing measures in countries was associated with worsening mental health (0.2 ppt per each one point increase on a stringency index, 95% CI:0.09–0.4); however, country-level pre-pandemic expenditures on various social protection packages was associated with decreased probability of worsening mental health (−1.3 ppt, 95%CI: 0.3 to −2.3 per €1,000 increase in health care expenditures per capita and, among the unemployed, −3.8 ppt, 95%CI: 1.6 to −2.4 per €100 increase in unemployment expenditure per capita). Conclusions. The COVID-19 pandemic has been associated with substantial mental health deterioration exhibiting social inequalities. Adverse mental health has been exacerbated by policy responses to the pandemic regulating physical distancing, but social protection expenditure might have helped mitigate the impact. Strengthening social protection systems might render the mental health of the population more resilient to the consequences of crises such as the COVID-19 pandemic.
Mendoza-Jiménez, M.-J., T.-V. Hannemann and J. Atzendorf(2021): Behavioral Risk Factors and Adherence to Preventive Measures: Evidence from the Early Stages of the COVID-19 Pandemic. Frontiers in Public Health 9. DOI: 10.3389/fpubh.2021.674597.
Abstract: : Behavioral risk factors, such as smoking, excessive alcohol consumption, physical inactivity, obesity, and unhealthy food intake are added risk factors for severe outcomes of COVID-19 infections. Preventive measures to avoid infections are therefore particularly important for individuals engaging in behavioral risk factors. We seek to determine whether behavioral risk factors (BRFs) play a significant role in the adherence to preventive COVID-19 measures in a population aged 50 and above. The SHARE wave 8 (Survey of Health, Ageing and Retirement in Europe) and SHARE COVID-19 Survey served as the database, resulting in an analytical sample of 17,588 respondents from 23 European countries plus Israel. Of these 36.04% engaged in at least one BRF and 16.68% engaged in 3 or more BRFs. Multilevel logistic regressions revealed that engagement in one BRF was significantly associated with less adherence to hygiene preventive measures, i.e., hand-sanitizing, hand-washing and covering coughs and sneezes (OR: 0.86; 95% CI: 0.78; 0.94), as was engagement in two BRFs (OR: 0.85; 95% CI: 0.74; 0.97) and three or more BRFs (OR: 0.72; 95% CI: 0.59; 0.88). No such association was found between engagement in BRFs and adherences to social isolation preventive measures, i.e., avoiding meeting more than five people, visiting others or going shopping, or regulated preventive measures, i.e., wearing a mask and keeping physical distance. The found association was also stronger when three or more BRFs were engaged in (1 vs. 3 BRFs: χ 2 = 3.43, p = 0.06; 2 vs. 3 BRFs: χ 2 = 6.05; p = 0.01). The study gives insight into the protective behavior of a population with inherent vulnerability during a global health emergency. It lays the foundation for follow-up research about the evolution of adherence to preventive measures as the pandemic progresses and about long-term behavioral changes. In addition, it can aide efforts in increasing preventive compliance by raising awareness of the added risk behavioral risk factors pose.
Mikelsone, M. and I. Reine(2021): Prognostic Factors of Self-rated Health Deterioration during Covid-19 in the Baltic States. European Journal of Public Health. DOI: 10.1093/eurpub/ckab165.109.
Abstract: Background. In order to implement the necessary measures to prevent the consequences of the Covid-19 pandemics, long-term assessment of health status is needed. The objective of the study - to determine the prognostic factors of self-rated health deterioration during the first wave of Covid-19 pandemics. Methods. The study was based on a sample of individuals from wave 7, wave 8 and Covid-19 add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) in the period from 2017 till 2020. The sample size was 4429 respondents - Latvia: 649, Lithuania: 1083, Estonia: 2697. Descriptive statistics as well as univariate and multivariate binary logistic regression was performed, including health determinants, demographics and factors associated with Covid-19. Results. Based on univariate binary logistic regression analysis, the main predictors for deterioration of self-rated health (unadjusted OR; 95%CI) were: age 80+ years (reference group 50-59 years) for Estonia (3.03; 2.93-3.14), diagnosed with major condition since Covid-19 for Latvia (15.45; 15.14-15.77) and Estonia (6.75; 6.57-6.94), fair or poor health since Covid-19 for Lithuania (4.92; 4.86-4.99), loneliness since Covid-19 for Lithuania (5.03; 4.94-5.12), limited in activities due to health condition for Latvia (4.53; 4.42-4.64), depression since Covid-19 for Lithuania (3.78-3.71-3.85), limited in activities due to age for Latvia (3.01; 2.95-3.08), nervousness since Covid-19 for Lithuania (2.08; 2.04-2.12). All predictors were statistically significant for all three Baltic countries. Conclusions. The results in all three Baltic States indicated a similar trend that, taking into account the influence of other factors, the most important predictive factors were related to health and demographic indicators. Only one factor related to the first wave of Covid-19 (in Latvia - nervousness since Covid-19, in Lithuania and Estonia - less or no direct contact with children since Covid-19) predicts deterioration in health.
Mikucka, M. and R. Antczak (2022): Covid-19 Protective Behaviour Depends on an Interplay of National Policies and Individual Vulnerability: A Cross-Sectional Study of Older Adults in 27 European Countries. SocArXiv Paper. DOI: 10.31235/osf.io/tfb7r.
Abstract: Objectives: To date, little is known on how policies and individual vulnerability affected the prevalence of protective behaviour. The objective of this study is to examine the effect of policies and individual vulnerability on the prevalence of protective behaviours. Design Data on the individual behaviour in 27 countries come from the “Corona Survey” module of the Survey of Health, Ageing and Retirement in Europe, collected in summer 2020. We considered: (a) never leaving home, (b) never going for a walk, (c) always wearing a face mask in a public space, and (d) never participating in social meetings. Data on policies from the “Our World in Data” database included: (1) stay-at-home restrictions, (2) face coverings policies, and (3) gatherings’ restrictions. We used the statistical method of multilevel regression. Participants Nationally representative sample of older adults (50 years and over); N=52,061 respondents (58% of women). Results: The prevalence of protective behaviours and strictness of policies differed across countries, showing heterogeneity of responses to Covid-19. Stricter policies correlated with a higher prevalence of protective behaviour, but only for two out of four behaviours: stay-at-home policies correlated with avoiding walks, and stricter face-covering policy correlated with always wearing a mask. Vulnerable groups (older people and those in worse health) were more likely to use the protective measures. For social meetings and walks, stricter policies distributed the burden of protective behaviours more equally between more and less vulnerable groups. Conclusions: Stricter policies not only increased the propensity of protective behaviour but also reduced social differences in protective behaviours. Our results suggest that visible and not-limiting behaviours responded to policies, whereas less visible and more limiting behaviours reflected individual vulnerability.
Netov, N. and D. Tisheva(2021): An Intuitionistic Fuzzy Approach for COVID-19 Survey Analytics. Revista Inclusiones 8: 140-14.
Abstract: In 2020 there were numerous studies on the impact of COVID-19 on the human body. In this paper we target to analyze the results from a sociologic survey over a very big group of responders whose answers comprise a big data set. We suggest an approach for analysis based on a simple acquisition of intuitionistic fuzzy sets where intuitionistic fuzzy degrees are assigned on the dimensions health, socio-economic status, social and family relations in the context of COVID-19 for the purposes of data analysis and visualization. The intuitionistic fuzzy sets of assessments are based on the classical Atanasov’s intuitionistic fuzzy set theory and the subsequent analyses use an approach for comparison between such sets based on Intuitionistic Fuzzy norms and distances. We apply the suggested approach on a real big dataset, obtained from the Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 8. COVID-19 Survey 1. Release version: 0.0.1. beta. SHARE-ERIC. Data set. DOI: 10.6103/SHARE.w8cabeta.001 (Börsch-Supan, A. 2020). As a result, EU countries are classified into several groups that segment the database in terms of health, socio-economic status, social and family relationships in the context of COVID-19. The methodology we offer is broad enough to be extended to other research or disciplines.
Novais, F., C. Cordeiro, P. Câmara Pestana, B. Côrte-Real, T. Reynolds Sousa, A. Delerue Matos and D. Telles-Correia (2021): O Impacto da COVID-19 na População Idosa em Portugal: Resultados do Survey of Health, Ageing and Retirement (SHARE). (The Impact of COVID-19 in Older People in Portugal: Results from the Survey of Health, Ageing and Retirement (SHARE). Acta Médica Portuguesa 34(11): 761-766. DOI: 10.20344/amp.16209.
Abstract: Introduction. In March 2020, the World Health Organization declared COVID-19 as a pandemic, and Portugal reported its initial cases. In this study, we aimed to determine the impact of COVID-19 on Portuguese individuals aged over 60 years old. Material and Methods. We performed a cross-sectional study using data from the Survey of Health, Ageing and Retirement in Europe (SHARE 8: COVID-19 Survey). We selected a sample of 1080 non institutional Portuguese individuals aged ≥ 60 years. Results. The study sample consisted of 605 (56%) women and 475 (44%) men, with a mean age of 70 ± 9.1 years. In total, 80% of the participants experienced higher levels of anxiety, 73% felt more depressed and 30% experienced additional sleep problems compared to the period before the pandemic. Interestingly, there were no statistically significant differences between the sexes or the two selected age groups (60 - 74 and over 75 years old) regarding the incidence of these changes. Only 23%, of those that were interviewed maintained their walking routines. In addition, only 8% of the participants continued visiting family members as frequently as before. While 8% of the participants were refused some form of medical treatment, 56% claimed that they experienced healthcare delays. However, only 15% of the participants reported that their health status worsened during the pandemic. Discussion. The pandemic has had a significant impact on Portuguese individuals aged ≥ 60 years; which is in agreement with the findings of previous international studies. It changed the participants’ routines and increased their anxiety and depression levels. Despite the deterioration of healthcare services, most participants did not experience worsening of their health status. Conclusion. In conclusion, a COVID-19 pandemic had a significant impact on the elderly population, particularly regarding their mental health.
Paccagnella, O. and B. Pongiglione (2022): Depression Deterioration of Older Adults during the First Wave of the COVID-19 Outbreak in Europe.Social Science & Medicine 299(14828). DOI: 10.1016/j.socscimed.2022.114828.
Abstract: Rationale. Determining who is particularly vulnerable to mental health deterioration during the COVID-19 pandemic is essential when designing and targeting interventions to mitigate the adverse psychological impacts of the outbreak. Older people have appeared to be less exposed to mental health deterioration compared with younger individuals, but most exposed to the risk of severe illness and death from the virus, as well as less equipped to use technologies for coping with lockdown measures. Objective. Amongst the old population, we aim at determining how depressive symptoms have changed during the first wave of the COVID-19 pandemic and identifying individual risk factors associated with changes in reporting depression. We are particularly interested in exploring the role of pre-existing mental health problems and evaluating gender differences. Method. Data come from the Survey of Health, Ageing and Retirement in Europe, in particular from the first COVID-19 survey administered in summer 2020. Logistic models are estimated and Average Marginal Effects computed to take the degree of individual unobserved heterogeneity into account comparing point estimates across samples. Multiple Imputation (implemented through Multivariate Imputation by Chained Equations) is used to replace missing data. Statistical power of the effect sizes is estimated by a simulation approach. Results. Pre-existing mental health problems, a diagnosis of affective/emotional disorders, a recent diagnosis of a major illness, and (only for men) job loss during the first wave of the outbreak are the most important risk factors. Statistical differences between genders emerge, with women experiencing higher levels of depression and greater worsening of mental health than men. Conclusions. To identify people at greater risk of depression deterioration during an outbreak it is very important to consider their pre-existing mental and general health, distinguishing severity level. On population level, it is also crucial to evaluate depression disorders separately by gender.
Rachaniotis, N. P., T. K. Dasaklis, F. Fotopoulos and P. Tinios (2021): A Two-Phase Stochastic Dynamic Model for COVID-19 Mid-Term Policy Recommendations in Greece: A Pathway towards Mass Vaccination. International Journal of Environmental Research and Public Health 18(5). DOI: 10.3390/ijerph18052497.
Abstract: From 7 November 2020, Greece adopted a second nationwide lockdown policy to mitigate the transmission of SARS-CoV-2 (the first took place from 23 March to 4 May 2020), just as the second wave of COVID-19 was advancing, as did other European countries. To secure the full benefits of mass vaccination, which started in early January 2021, it is of utmost importance to complement it with mid-term non-pharmaceutical interventions (NPIs). The objective was to minimize human losses and to limit social and economic costs. In this paper a two-phase stochastic dynamic network compartmental model (a pre-vaccination SEIR until 15 February 2021 and a post-vaccination SVEIR from 15 February 2021 to 30 June 2021) is developed. Three scenarios are assessed for the first phase: (a) A baseline scenario, which lifts the national lockdown and all NPIs in January 2021; (b) a “semi-lockdown” scenario with school opening, partial retail sector operation, universal mask wearing, and social distancing/teleworking in January 2021; and (c) a “rolling lockdown” scenario combining a partial lifting of measures in January 2021 followed by a third nationwide lockdown in February 2021. In the second phase three scenarios with different vaccination rates are assessed. Publicly available data along with some first results of the SHARE COVID-19 survey conducted in Greece are used as input. The results regarding the first phase indicate that the “semi-lockdown” scenario clearly outperforms the third lockdown scenario (5.7% less expected fatalities); the second phase is extremely sensitive on the availability of sufficient vaccine supplies and high vaccination rates.
Reine, I. (2021): Factors Predicting Loneliness among Ageing Populations in the Baltic States during Covid-19. European Journal of Public Health 31(3). DOI: 10.1093/eurpub/ckab165.110.
Abstract: During Covid-19 social isolation has become more common worldwide, and elderly people might have experienced dramatically limited communication. The study was based on a sample of individuals aged 50+ from wave 7, wave 8 and Covid-19 add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) between 2017-2020. The sample size consisted of 4429 respondents from Latvia, Estonia and Lithuania. In order to assess the effects of factors associated with the first wave of Covid-19 predicting an increase in the intensity of loneliness symptoms, a multivariate binary logistic regression was used, including several health determinants in the model. The results indicated that in Latvia, the main predictive factors for the increase in the intensity of loneliness, by the adjustment for other factors, were increased nervousness (OR 44.39; 95%CI 41.06-48.00) and interrupted or reduced contact with children (OR 1.82; 95%CI 1.76-1.88). In Lithuania, the main predictors for the increase in the intensity of loneliness were high levels of nervousness (OR 6.80; 95%CI 6.56-7.04), deterioration of health (OR 2.51; 95%CI 2.44-2.59) and limited daily activity due to health conditions (OR 2.11; 95%CI 2.05-2.18). In Estonia, the most relevant predictive factors for the increase in the intensity of loneliness were financial difficulties (OR 5.65; 95%CI 4.76-6.71), interrupted or reduced contact with parents (OR 5.42; 95%CI 4.38-6.71), increased nervousness (OR 4.15; 95%CI 3.50-4.92) and limited daily activity due to health (adjusted OR 7.75; 95%CI 6.60-9.11). A relationship between an increase in the intensity of loneliness was mainly related to increased nervousness during the first wave of Covid-19 in all Baltic states. However, reduced or interrupted social contacts and health related factors were also found to be important predictors for loneliness. The study was performed within the project No. 220.127.116.11/VIAA/3/19/540 ‘Challenges of ageing in the Baltic Sea region'.
Richter, L. and T. Heidinger(2021): Hitting Close to Home: The Effect of COVID-19 Illness in the Social Environment on Psychological Burden in Older Adults. Frontiers in Psychology 12: 1-9. DOI: 10.3389/fpsyg.2021.737787.
Abstract: This study examines the impact of COVID-19 experience of infection in the individual’s social environment on psychological burden controlling for a broad range of factors using data on an older population (50+ years). Based on the empirical evidence of preexisting studies, it is hypothesized that psychological burden will increase concurrent to the severity of COVID-19 experience (tested positive, hospitalized, and death) independent of the other stressors resulting from the pandemic, such as a subjective sense of uncertainty or financial burden. Data of the Survey of Health, Aging and Retirement in EUROPE, and a European cross-national panel study were used to examine this hypothesis. Besides Chi2 test and Spearman’s rho, a logistic regression model was constructed to test the hypothesized model. The study confirms that there is significantly higher risk for psychological burden by heightened COVID-19 severity in the social environment independent of multiple also significantly influential variables depicting stressors to everyday life of older people during the pandemic. The results point to the importance of multiple factors (social, financial, health, and sociodemographic) which have significantly affected the psychological condition of the individual during the past year. Conclusively, the results illustrate the dilemma that infection and illness in the social circle, as well as countermeasures (social distancing), have negative consequences for our mental health.
Scheel-Hincke, L., L. Ahrenfeldt and K. Andersen-Ranberg(2021): Sex Differences in Activity and Health Changes following COVID-19 in Europe - Results from the SHARE COVID-19 Survey. European Journal of Public Health. DOI: 10.1093/eurpub/ckab096.
Abstract: While a female advantage in the overall survival from the Coronavirus Disease 2019 (COVID-19) has been demonstrated, potential sex differences in health changes is not investigated. In a sample of 21,395 men and 29,139 women aged 50+ from the SHARE COVID-19 Survey, we investigated sex differences in social activities, self-rated health, and mental health following the COVID-19 outbreak. We found considerable sex differences in all European regions with women experiencing larger negative changes across all social activities and health measures than men lending support for the male-female health survival paradox.
Settels, J. and A. Leist (2022): The role of country-level availability and generosity of healthcare services, and old-age ageism for missed healthcare during the COVID-19 pandemic control measures in Europe. Journal of Ageing and Health. DOI: 10.1177/08982643221087097.
Abstract. Objectives: The effects of the COVID-19 outbreak on non-COVID-19-related healthcare need further investigation. Methods: Using the Survey of Health, Ageing and Retirement in Europe’s COVID-19 module (2020) (N = 57,025), country-level data from the European Social Survey (2008) and OECD (2020), and logistic regressions, this study examines predictors of older Europeans’ forgone, postponed, and denied healthcare during the pandemic. Results: Country-level availability of physicians, healthcare systems’ generosity, and beliefs that older persons burden healthcare systems all increased forgone healthcare. Healthcare system generosity increased postponed and denied healthcare. Greater medical resources decreased denied healthcare. Furthermore, missed healthcare varied by individual-level gender (higher rates among women), age, education, and health. Discussion: This study reveals predictors of missed healthcare during the pandemic. To decrease unintended health consequences of a pandemic, both individual-level determinants, such as gender and health, and contextual-level determinants, such as healthcare systems’ characteristics, should be considered in research and practice.
Skałacka, K. and G. Pajestka (2021): Digital or In-Person: The Relationship between Mode of Interpersonal Communication during the COVID-19 Pandemic and Mental Health in Older Adults from 27 Countries. Journal of Family Nursing (online first). DOI: 10.1177/10748407211031980.
Abstract: Social distancing has limited the spread of the coronavirus (COVID-19), but also changed communication patterns. However, studies of how mental health in older adults relates to the usage of different modes of interpersonal communication are sparse. The aim of this study was to analyze how COVID-19-related changes in the frequencies of using different modes of communication (digital or in-person) have influenced mental health in older adults from 27 countries. Our study was based on part of Wave 8 of the SHARE data set, which focused on the living situation of older adults during the pandemic. Findings suggest that in-person communication benefited mental health in people aged ≥60 years more than digital communication. The older the person, the less beneficial digital communication was for their mental health, especially during interactions with their children. Our findings are useful for researchers and practitioners interested in technologically meditated interventions.
Smolić, Š. (2022): Some Aspects of the Lives of Older Europeans During the COVID-19 Pandemic: SHARE Corona Survey Findings [in Croatian]. Migracijske i etničke teme 37(2).
Abstract. The COVID-19 pandemic, which began its global spread in early 2020, has significantly changed the lives of people in almost every corner of the world. Today, almost two years later, long-term and unplanned effects of this, mainly health crisis may be observed, especially on the lives of the elderly. The elderly have also proven to be the most affected by the epidemic as the highest absolute and relative numbers of deaths from the disease have been recorded among them. The initial wave of the pandemic was marked by a dramatic health crisis and delayed responses of governments to prevent the spread of the pandemic, for example, in Belgium, Italy or Spain, and by strict measures to prevent the transmission of the infection in the other EU Member States; the Czech Republic, Slovakia or Croatia. It could be said that, among EU members, former socialist states were more successful in controlling the first wave of the pandemic, managing to protect the most vulnerable groups of the population, especially the elderly. Unfortunately, by the end of 2020, the uncontrolled spread of the pandemic in those countries had pushed their health systems to the limit of endurance, while the number of deaths reached unprecedented levels, accompanied by extremely high excess mortality. In addition, the COVID-19 vaccine did not arrive in time to contain the spread of the pandemic in early 2021. Due to a lack of response to voluntary vaccination, mainly during the summer of 2021, many countries entered the so-called fourth wave of the pandemic. To reveal how the pandemic has changed the lives of older Europeans the SHARE Corona Survey was launched in 26 EU Member States, Switzerland and Israel in mid-2020. It was conducted in two stages via a short telephone survey (lasting 25–30 minutes). The first SHARE Corona Survey collected data from approximately 57,000 respondents aged 50 and over. In mid-2021, about 47,000 respondents who had been surveyed at the first stage of SHARE Corona were re-surveyed at the second stage. This paper examines the effects of the pandemic on health, health behaviour, unmet health needs, and loneliness in a sample of 52,649 people aged 50 and over. During the first wave of the pandemic, the highest self-rated health deterioration occurred in Lithuania, Portugal and Belgium. Portugal and Luxembourg recorded high numbers of cancellations of scheduled medical examinations and treatments, while the fewest cancellations were observed in Romania and Bulgaria. Among people aged 50+, those in Luxembourg and the Czech Republic avoided seeking health care the most due to fear of coronavirus infection. On the other hand, almost every fifth person aged 50+ in Greece, Italy and Belgium has reported an increased sense of loneliness. It was also established that in post-socialist EU Member States, the Czech Republic, Hungary, Slovenia, Estonia, Bulgaria and Latvia, the prevalence of deteriorating health during the first wave of the pandemic was lower by one to five percentage points compared to the so-called old Europe countries (χ2 (1, N = 52,649) = 16.9 p <0.001). At the same time, in Bulgaria, the Czech Republic, Estonia, Croatia, Latvia, Hungary, Romania and Slovakia, the prevalence of delayed examinations was lower by two to 26 percentage points compared to the other EU Member States and Switzerland (averaging 21% vs. 26%; (χ2 (1, N = 52,649) = 44.4 p <0.001). In post-socialist countries, people over the age of fifty were statistically significantly less likely to refrain from using healthcare services due to fear of coronavirus infection compared to other so-called old Europe countries (averaging 10% vs. 13%; χ2 (1, N = 52,649) = 114.3 p <0.001). The prevalence of increasing loneliness was significantly lower in post-socialist countries, averaging 8% versus 13%, in so-called old Europe countries (χ2 (1, N = 52,649) = 554.4 p <0.001). Policymakers, primarily in the field of health care and social welfare, should strive to create measures targeting social groups that are particularly vulnerable and have become even more vulnerable due to the pandemic. Such an approach, such as targeted measures for the most vulnerable, could reduce growing health and social inequalities among the 50+ generations.
Smolić, Š., I. Čipin and P. Međimurec (2021): Access to Healthcare for People Aged 50+ in Europe during the COVID-19 Outbreak. European Journal of Ageing (online first). DOI: 10.1007/s10433-021-00631-9.
Abstract: This paper combines SHARE Corona Survey and SHARE Wave 7 data for 25 European countries and Israel (N = 40,919) with institutional and epidemic-related country characteristics to investigate healthcare access for Europeans aged 50+ during the outbreak of COVID-19. We use a micro–macro approach to examine whether and to what extent barriers to accessing healthcare measured by reported unmet healthcare needs vary within and between countries. We consider various aspects of barriers and distinguish among: (1) respondents who forewent medical treatment because they were afraid of becoming infected with the Coronavirus; (2) respondents who had pre-scheduled medical appointments postponed by health providers due to the outbreak; and (3) respondents who tried to arrange a medical appointment but were denied one. Limited access to healthcare during the initial outbreak was more common for the occupationally active, women, the more educated and those living in urban areas. A bad economic situation, poor overall health and higher healthcare utilisation were robust predictors of unmet healthcare. People aged 50+ in countries of ‘Old’ Europe, countries with higher universal health coverage and stricter containment and closure policies were more likely to have medical services postponed. Policymakers should address the healthcare needs of older people with chronic health conditions and a poor socio-economic status who were made more vulnerable by this pandemic. In the aftermath of the health crisis, public health systems might experience a great revival in healthcare demand, a challenge that should be mitigated by careful planning and provision of healthcare services.
Spitzer, S., M. Shaikh and D. Weber(2022): Older Europeans’ Health Perception and their Adaptive Behavior during the COVID-19 Pandemic.European Journal of Public Health. DOI: 10.1093/eurpub/ckab221.
Abstract: Background. Although older adults are more vulnerable to the COVID-19 virus, a significant proportion of them do not follow recommended guidelines concerning preventive actions during the ongoing pandemic. This paper analyses the role of biased health beliefs for adaptive health behaviour such as reduced mobility, protection in public spaces, and hygiene measures, for the population aged 50 and older in 13 European countries. Methods. Health perception is measured based on the difference between self-reported health and physical performance tests for over 24,000 individuals included in the most recent Survey of Health, Ageing and Retirement in Europe. Logistic regressions are employed to explore how over- and underestimating health are related to preventive behaviours. Results. Results suggest that older adults who underestimate their health are more likely to show adaptive behaviour related to mobility reductions. In particular, they are more likely to stay at home, shop less, and go for walks less often. By contrast, overestimating health is not significantly associated with reduced mobility. Protective behaviour in public spaces and adopting hygiene measures do not vary systematically between health perception groups. Conclusion. As health beliefs appear relevant for the adoption of preventive health behaviours related to mobility, they have serious consequences for the health and well-being of older Europeans. While adaptive behaviour helps to contain the virus, exaggerated mobility reduction in those who underestimate their health might be contributing to the already high social isolation and loneliness of older adults during the ongoing pandemic.
Styrc, M.(2021): COVID-19 Preventive Behaviours among Population 50+ in Poland.Studia Demograficzne 180(2). DOI: 10.33119/SD.2021.2.4.
Abstract: : In order to reduce the spread of the SARS-COVID pandemic a set of measures was recommended to reduce the spread of disease and protect individual health. In this article we analyse what factors are associated with utilisation of preventive measures: washing hands, using disinfectant and covering cough among the population of men and women aged 50+. Using Survey of Health, Ageing and Retirement data we estimate logistic regression models for the increased utilisation of each of the preventive behaviours on demographic, socio-economic and psychological characteristics. The results indicate that the likelihood of taking health precautions depends on age, education, level of conscientiousness, and staying isolated. For men it also matters whether they live with a partner. We discuss what the findings mean for managing preventive behaviours.
Tavares, A. I.(2022): Older Europeans’ Experience of Unmet Health Care during the COVID-19 Pandemic (First Wave). BMC Health Services Research 22(182). DOI: 10.1186/s12913-022-07563-9.
Abstract: Background. During the COVID-19 pandemic the utilization of health services has changed. People were living in a very different social, economic and epidemiological context. Unmet health care is expected to happen. The purposes of this work are i) to compare the differences between unmet care across countries, ii) to find the main factors which are associated with unmet health care, which includes giving up and postponing medical care, as well as denial of medical care provision by the health services, and iii) to determine if health systems’ characteristics and government decisions on lockdown were related to unmet care. Methods. We have used the most recent dataset collected by the SHARE-COVID Survey during the summer of 2020. These data cover all EU countries and are applied to people over 50. We have estimated a set of logistic regressions to explain unmet health care. Results. The results indicate that women, people who are slightly younger, with higher education and income, who find it hard to make ends meet each month, and people with poorer health were more likely to experience unmet health care. We also found that in health systems with high out-of-pocket payments people are more likely to give up health care while in countries with previous high levels of unmet health needs this likelihood was the opposite; people in countries with a high number of beds per capita and with a Beveridge-type health system were reporting less postponement of health care. Conclusion. Some policy measures may be suggested such as social and economic measures to mitigate loss of income, expansion of the points and forms of access to health care to improve utilisation.
Tavares, A. I.(2021): Working More and Less Hours, Profiling Old European Workers during First Wave of COVID-19 Pandemic, Evidence from SHARE Data.MPRA Paper No. 111263. Munich Personal Repec Archive. Munich.
Abstract: This study contributes to the discussion about the impact of the COVID-19 pandemic on the working hours and on the workplace by older workers, aged between 55 and 64. Our aim is to find the factors associated with working more and less hours during the first wave of the pandemic among older workers in Europe. We use data collected by SHARE Corona Survey during the summer of 2020. We estimate two logistic regressions on working more and less hours using a set of individual controls, workplace and a country lockdown control. Our findings show that male workers are less likely to work more hours; older workers are more likely to work less hours; more educated workers work more hours and not less; people with difficulty to meet ends are more often working less hours; worsening of health during the pandemic is associated with working more hours; working home or both home and usual work place are correlated with working more and working less hours. The contribution of this work comes from additional knowledge about the profile of older workers and their changed hours of work during a first wave of COVID-19 in Europe.
Tomás , J. M., Z. Torres, A. Oliver, S. Enrique and I. Fernández (2022): Psychometric properties of the EURO-D scale of depressive symptomatology: Evidence from SHARE wave 8. Journal of Affective Disorders 313: 49-55. DOI: 10.1016/j.jad.2022.06.079.
Abstract. Background: The EURO-D is a short scale to measure symptoms of depression, very used in large population surveys. Although there are numerous validation studies, its psychometric properties remain unclear. The two-factor structure (Affective Suffering and Lack of Motivation) is replicated in several studies but with different item compositions, and none reported reliability indices for both factors. For that reason, the aim of this study is to examine the factorial validity of the scale, the reliability of the dimensions, the gender differential item functioning (DIF), and the nomological validity. Methods: 46,317 participants aged 50 and over (M = 71.33), from which 57.4 % were females, in Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE) were included. Instruments: EURO-D, R-UCLA, Self-perceived health index, and indicator of taking drugs for anxiety or depression. Factor Analyses, DIF, Reliability Index and Spearman correlations were estimated. Results: Factor analysis identified a bifactor structure: a general factor of Depression and two specific factors of Affective Suffering and Lack of Motivation, which reliabilities were 0.83, 0.83 and 0.79 respectively. No relevant DIF item by gender was found, but higher scores were found in women in all factors. Both factors had positive relations with loneliness, taking drugs and self-perceived health. Limitations: this study has a cross-sectional design; future research may consider the longitudinal stability of the scale. Conclusions: EURO-D shows adequate psychometric properties when a general factor of depression and two specific factors are considered. Women have higher scores on all dimensions.
Tosheva, E., G. Yordanova and E. Markova (2021): Before and During the Outbreak: Prerequisites for the High COVID-19 Mortality Rate in Bulgaria. Empirical Insights from SHARE DataRevista Inclusiones 8: 44-61.
Abstract: The first wave of Covid-19 (March-June 2020) did not hit Bulgaria to the same extent as it did other countries in Europe (Italy, Spain, Belgium, United Kingdom). The severe second wave of the pandemic in Bulgaria was in November-December 2020, with a third wave in March-April 2021, but Bulgaria had the second highest case mortality rate in Europe. The aim of this article is to analyse the empirical insights into the health expectancy and self-rated health of Bulgarians aged 50+ before and during the outbreak, which need to be taken into account as one of the important factors contributing to the high mortality rate of Covid-19. The analysis is based on SHARE wave 7 and the SHARE corona survey, conducted in July-August 2020. The data analysis results indicate that a significant share of Bulgarians aged 50 and over suffer from conditions considered high-risk for Covid19. A steady tendency to overestimate personal health can be observed even before the pandemic. The general health attitudes of elderly Bulgarians have not changed much. The overestimation of personal health, despite the presence of more than 2 chronic conditions, regular medication, combined with non-attendance of preventive examinations, dangerous habits and physical immobility increase the risk of acute viral diseases. The deteriorating health status of the elderly in Bulgaria appears to be a strategic risk factor in the case of an epidemic, which is confirmed by the Covid-19 crisis outcomes. In spite of the problems in the Bulgarian health system as a whole, personal attitudes towards health should be prioritized by public measures and policies, along with promoting an improvement in health culture, physical activity and preventive medical examinations.
Tur-Sinai, A., N. Bentur and G. Lamura (2022): Perceived deterioration in health status among older adults in Europe and Israel following the first wave of the COVID-19 pandemic. European Journal of Ageing. DOI: 10.1007/s10433-022-00705-2.
Abstract. The COVID-19 pandemic has created challenges in providing medical care for people with health conditions other than COVID-19. The study aims to assess the prevalence of older adults’ reportage of decline in health relative to pre-pandemic and to identify its determinants. The study is based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data collected during the pandemic. It comprised 51,778 people in twenty-seven European countries and Israel. Participants were asked about changes in their health status relative to pre-pandemic. Bivariate analysis and logistic regression were used to identify factors associated with worsening of health. Nine percent of people (average age 70 years) reported a worsening of health relative to pre-pandemic. A logistic regression revealed a significant relation of the probability of a downturn in health to forgoing, postponing, or being denied an appointment for medical care. Multiple chronic illnesses, developing COVID-19, having at least one form of psychosocial distress, higher age, and lower economic capacity were also found significantly related to the probability of a decline in health. Older adults’ comprehensive health needs must be addressed even when healthcare services are under strain due to pandemic outbreaks. Policymakers should attend to the healthcare needs of people whose vulnerability to the pandemic is amplified by chronic health conditions and low socioeconomic status. Public healthcare systems may experience a massive rebound of demand for health care, a challenge that should be mitigated by delivery of healthcare services and the provision of the financial resources that they need.
Tur-Sinai, A., N. Bentur, P. Fabbietti and G. Lamura (2021): Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries. Sustainability 13(13). DOI: 10.3390/su13137277
Abstract: The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.
Vaculíková, J. and M. Hanková (2021): Risk Factors Affecting Mental Health During the Early Stages Of The Covid-19 Pandemic In High-Risk 50+ Population In The Czech Republic. Journal of Gerontological Social Work. DOI: 10.1080/01634372.2021.1939219.
Abstract: This study deals with key factors affecting mental health during the COVID-19 pandemic. The results are based on the longitudinal representative 50+ population-based multi-country panel study Survey of Health, Aging and Retirement in Europe (SHARE) in which representative samples of individuals in European countries plus Israel were collected. The goal is to turn the challenges of aging into opportunities as well as provide valid and reliable data for evidence-based policies. A total of 2,631 participants were interviewed by telephone in the Czech Republic during the initial stages of the COVID-19 outbreak in 2020. After a descriptive analysis showed that participants complied well with most preventative and protective COVID-19 measures, subsequent modeling using logistic regression analysis and a decision tree algorithm identified key determinants that have contributed to an understanding of variation in declared feelings of depression. We found that nervousness, previously unexperienced trouble with sleep, and self-rated health status before the COVID-19 outbreak and gender remained significant predictors of depression, from which statistically significant different categories concerning the percentage of depression could be formed. These identified potential risk factors should be considered in planning further supportive strategies for high-risk 50+ population.
Van Winkle, Z., E. Ferragina and E. Recchi(2021): The Unexpected Decline in Feelings of Depression among Adults Ages 50 and Older in 11 European Countries amid the COVID-19 Pandemic. Socius: Sociological Research for a Dynamic World 7: 1-11. DOI: 10.1177/23780231211032741.
Abstract: Findings on the mental health impact of the first wave of the coronavirus disease 2019 (COVID-19) pandemic in Europe are mixed and lack a comparative and longitudinal perspective. The authors used the Survey of Health, Ageing, and Retirement in Europe and fixed-effects regressions to estimate within-individual change in the probability to report feelings of depression between 2005 and 2017 and directly following the first wave of the COVID-19 pandemic in 11 European countries for adults ages 50 and older. The authors found an unprecedented decline in feelings of depression between 2017 and 2020 in all countries that was larger than any previous observed change. The probability to report feelings of depression decreased by 14.5 percentage points on average, ranging from 7 to 19 percentage points in Spain and Switzerland, respectively. Moreover, there were no systematic within-country differences by socioeconomic characteristics, chronic health conditions, virus exposure, or change in activities. These findings challenge conventional wisdom about the mental health impact of the COVID-19 pandemic.
Vergauwen, J., K. Delaruelle, P. Dykstra, P. Bracke and D. Mortelmans(2021): The COVID-19 Pandemic and Changes in the Level of Contact between Older Parents and their non-coresident Children: A European study. Journal of Family Research: 1–26. DOI: 10.20377/jfr-695.
Abstract: Objective: The present study aims to investigate changes in the frequency of parent-child contact among Europeans aged 65 years and over within the context of the COVID-19 pandemic, while recognizing heterogeneity within the group of older adults. Background: Physical distancing measures have been implemented worldwide to curb the spread of the COVID-19 pandemic. Although this policy has proven to be effective in flattening the curve, it undoubtedly posed a serious challenge to intergenerational relations. Experts hinted that physical distancing measures may have reduced older adults’ level of contact with their non-coresident children. However, empirical evidence is lacking. Method: Data from the SHARE COVID-19 questionnaire and previous SHARE waves for 26,077 individuals from 26 European countries and Israel were used and analyzed using multilevel multinomial logistic regression analysis. Results: The analysis revealed that older adults’ level of intergenerational contact remained stable or even increased – rather than decreased – during the COVID-19 pandemic. Despite the overall positive outcome, some subgroups (i.e., older men, residents of nursing homes, less educated older adults and older adults living in countries with less stringent COVID-19 measures) were more likely to report reduced intergenerational contact. Conclusion: Although variation was observed among older adults, the pandemic generally did not pose a threat to their level of intergenerational contact with non-coresident children.
Voss, G., A. F. Paiva and A. Delerue Matos(2021): A Study of the Association between the Stringency of Covid-19 Government Measures and Depression in Older Adults across Europe and Israel. International Journal of Environmental Research and Public Health 18(15). DOI: 10.3390/ijerph18158017.
Abstract: The COVID-19 pandemic is having major adverse consequences for the mental health of individuals worldwide. Alongside the direct impact of the virus on individuals, government responses to tackling its spread, such as quarantine, lockdown, and physical distancing measures, have been found to have a profound impact on mental health. This is manifested in an increased prevalence of anxiety, depression, and sleep disturbances. As older adults are more vulnerable and severely affected by the pandemic, they may be at increased psychological risk when seeking to protect themselves from COVID-19. Methods: Our study aims to quantify the association between the stringency of measures and increased feelings of sadness/depression in a sample of 31,819 Europeans and Israelis aged 65 and above. We hypothesize that more stringent measures make it more likely that individuals will report increased feelings of sadness or depression. Conclusions: We found that more stringent measures across countries in Europe and Israel affect the mental health of older individuals. The prevalence of increased feelings of sadness/depression was higher in Southern European countries, where the measures were more stringent. We therefore recommend paying particular attention to the possible effects of pandemic control measures on the mental health of older people.
Wang, H., A. Verdery, R. Margolis and E. Smith-Greenaway (2021): Bereavement from COVID-19, Gender, and Reports of Depression among Older Adults in Europe. The Journals of Gerontology: Series B. DOI: 10.1093/geronb/gbab132.
Abstract: Objectives. The COVID-19 pandemic has left older adults around the world bereaved by the sudden death of relatives and friends. We examine if COVID-19 bereavement corresponds with older adults’ reporting depression in 27 countries, and test for variation by gender and country context. Methods. We analyze SHARE COVID-19 data collected between June-August 2020 from N=51,383 older adults (age 50–104) living in 27 countries, of whom 1,363 reported the death of a relative or friend from COVID-19. We estimate pooled-multilevel logit regression models to examine if COVID-19 bereavement was associated with self-reported depression and worsening depression, and we test whether national COVID-19 mortality rates moderate these assocations. Results. COVID-19 bereavement is associated with significantly higher probabilities of both reporting depression and reporting worsened depression among older adults. Net of one’s own personal loss, living in a country with the highest COVID-19 mortality rate is associated with women’s reports of worsened depression but not men’s. However, the country’s COVID-19 mortality rate does not moderate associations between COVID-19 bereavement and depression. Discussion. COVID-19 deaths have lingering mental health implications for surviving older adults. Even as the collective toll of the crisis is apparent, bereaved older adults are in particular need of mental health support.
Wang, H., E. Smith-Greenaway, S. Bauldry, R. Margolis and A. M. Verdery (2022): Mourning in a pandemic: The differential impact of widowhood on mental health during COVID-19. The Journals of Gerontology Series B, gbac085. DOI: 10.1093/geronb/gbac085.
Abstract. Objectives: The death of a spouse is an established predictor of mental health decline that foreshadows worsening physical health and elevated mortality. The millions widowed by COVID-19 worldwide may experience even worse health outcomes than comparable pre-pandemic widows given the particularities of dying, mourning, and grieving during a pandemic defined by protracted social isolation, economic precarity, and general uncertainty. If COVID-19 pandemic bereavement is more strongly associated with mental health challenges than pre-pandemic bereavement, the large new cohort of COVID-19 widow(er)s may be at substantial risk of downstream health problems long after the pandemic abates. Methods: We pooled population-based Survey of Health, Ageing and Retirement in Europe data from 27 countries for two distinct periods: (1) pre-pandemic (Wave 8, fielded October 2019 to March 2020; N = 46,266) and (2) early-pandemic (COVID Supplement, fielded June to August 2020; N = 55,796). The analysis used a difference-in-difference design to assess whether a spouse dying from COVID-19 presents unique mental health risks (self-reported depression, loneliness, and trouble sleeping), compared to pre-pandemic recent spousal deaths. Results: We find strong associations between recent spousal death and poor mental health before and during the pandemic. However, our difference-in-difference estimates indicate those whose spouses died of COVID-19 have higher risks of self-reported depression and loneliness, but not trouble sleeping, than expected based on pre-pandemic associations. Discussion: These results highlight that the millions of COVID-19 widow(er)s face extreme mental health risks, eclipsing those experienced by surviving spouses pre-pandemic, furthering concerns about the pandemic's lasting impacts on health.
Wels, J. and N. Hamarat(2021): A shift in women’s health? Older workers’ self-reported health and employment settings during the COVID-19 pandemic.European Journal of Public Health, ckab204, DOI: 10.1093/eurpub/ckab204.
Abstract: The first wave of COVID-19 has had a massive impact on work arrangements settings in many European countries with potential effects on health that are likely to vary across gender. Focusing on the workforce aged 50 and over in 27 European countries using data from SHARE wave 8 (N = 11,221), the study applies a generalized logit mixed-effects model to assess the relationship between negative and positive change in self-reported health since the start of the pandemic and change in employment settings using an interaction effect between gender and employment arrangements to distinguish their specific association by gender after controlling for socio-economic covariates and multicollinearity. Female respondents have higher probabilities to declare a positive health when working fully or partially from home or when temporarily and permanently unemployed. However, introducing the main effect of gender exacerbates discrepancies and such benefits fade away. Differences across countries do not significantly change the estimates. The benefits of work arrangements to improve women’s health during the first wave of COVID-19 have not compensated the negative effect of gender discrepancies exacerbated by the pandemic to the extent that employment arrangements have no role, or just a negative impact, in modulating them.
Yordanova, V.(2021): COVID-19 Pandemic: A Study on the Relationship between Social Distancing and Mental Health Status among People Aged 50 and Older in Europe.Revista Inclusiones 8: 113-139.
Abstract: Background. Many procedures and regulations have been implemented by the policymakers to control the Covid-19 pandemic expand and establish a health-oriented environment. Objectives. This paper addresses the relationship between mental health and social distance restrictions taken by the government during the Covid-19 pandemic among people aged 50 years and older in Europe. Methods. For the research are used data from the SHARE Covid-19 dataset Wave-8. The response variable is mental health measured by the level of depression and stress in a time of pandemic. The explanatory variables included in our research examine the behavior of people and the frequency of their social contacts since the Covid-19 outbreak. For our exploration, we apply logistic regression to test significance of the variables related to social distancing among all countries. Results: Social distancing measures taken by the government have an impact on the human well-being. In many of the respondents is observed a change in their behavior and outdoor activities. Reduced level in shopping, going for a walk and people gathering are part of the social policy proposed by health experts. As a result, an increased level of stress, depression and sleep disorder is observed. People who worsened their health at that time have strong correlation among the levels of stress and depression. On other hand, mental health status is examined as better to ones keeping physical contacts. Conclusion: The consequences of the epidemic lockdown measures of Covid-19, affects negatively on social life and mental health of people. A need of more flexible pandemic measures might be considered, in term of prevention and protection of the human well-being.
Zhang, P. and S. Chen (2022): Association between workplace and mental health and its mechanisms during COVID-19 pandemic: A cross-sectional, population-based, multi-country study. Journal of Affective Disorders 310: 116-122. DOI: 10.1016/j.jad.2022.05.038.
Abstract. Background. The COVID-19 pandemic worsens populations' mental health. However, little is known about the COVID-19-related mental health among remote workers. Methods. We retrieved data from survey of Health, Ageing and Retirement in Europe, covering 27 countries. Eligible people were those employed. The main outcome is the mental disorder, covering four aspects: depression, anxiety, sleep disorder, and loneliness. Country-specific weighted mixed models were fitted to estimate the association of workplaces with mental health, controlled for age, gender, education level, living alone, making ends meets, working hours, closing to suspected or confirmed COVID-19 cases, received anti-virus protection, social contact, disability, and chronic disease. Moderate analyses were conducted to explore possible mechanisms. Results.11,197 participants were included, among them 29.3% suffered at least one worse mental disorder. After controlling for covariates, compared with those who worked at the usual workplace, those who worked at home only or part of the time did not associate with worse mental disorders (p-value ≥0.1395), and those who worked at neither the usual workplace nor home had a 55% higher likelihood of suffering from worse mental disorders (OR = 1.55, 95%CI 1.03–2.36). The mediation analyses identified three indirect pathways by which workplaces influence mental health, including making ends meets, social contact, and receiving anti-virus protection. Detailed results on subtypes of mental disorders were also provided. Limitations. All assessments were self-reported, resulting in a risk of method bias. Conclusions. During the COVID-19 pandemic, working at other places, neither at the usual workplace nor home, worsened mental health. Evidence provided in this study will contribute to more nuanced and practical public health policy strategy making.
Airaksinen, J., K. Komulainen, M. Jokela and K. Gluschkoff (2021): Big Five Personality Traits and COVID-19 Precautionary Behaviors among Older Adults in Europe. PsyArXiv Preprints. DOI: 10.31234/osf.io/rvbjf.
Abstract: Objectives: Taking precaution against COVID-19 is important particularly among older adults who have a greater risk for severe illness if infected. We examined whether Big Five personality traits are associated with COVID-19 precautionary behaviors among older adults in Europe. Method: We used data from the Survey of Health, Aging and Retirement in Europe (N=34 801). Personality was self-reported in 2017 using the BFI-10 inventory. COVID-19 precautionary behaviors – wearing a mask, limiting social contacts, and keeping distance to others – were assessed in the summer of 2020 through self-reports. Associations between personality and precautionary behaviors were examined with multilevel random-intercept logistic regression models. The models were adjusted for age, gender, educational attainment, and country of residence. Results: Higher conscientiousness, neuroticism, and openness were associated with a greater likelihood of wearing a face mask. Higher neuroticism was associated with a greater likelihood of limiting social contacts, and higher agreeableness with a lower likelihood of limiting social contacts. Higher conscientiousness was associated with a greater likelihood of keeping distance to others. The associations between personality and practicing precautionary behaviors were relatively weak. Discussion: Among older adults, taking COVID-19 precautionary behaviors was most consistently related to higher conscientiousness and neuroticism, suggesting that precautionary behaviors may be motivated by multiple psychological differences.
Arnault, L., F. Jusot and T. Renaud (2021): Social Inequalities in Access to Healthcare among the Population Aged 50+ years During the COVID-19 Pandemic in Europe. SHARE Working Paper Series 58-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3289765.
Abstract: This study investigated social inequalities in access to healthcare during the first wave of the coronavirus disease 2019 (COVID-19) epidemic in Europe among adults aged 50 years and older, using data from the regular administration of the Survey of Health, Ageing and Retirement in Europe (SHARE) and the specific telephone survey administered regarding COVID-19 (SHARE Corona Survey). It addressed three main research questions: did people who were in difficult economic situations before the epidemic face more barriers to access healthcare than others? If so, to what extent can these discrepancies be attributed to initial differences in health status and the use of care between social groups or to differential effects of the pandemic on these groups? Did social inequalities with regard to unmet needs during the pandemic differ across countries? Unmet healthcare needs are characterised by three types of behaviours likely to be induced by the pandemic: forgoing care for fear of contracting COVID-19, having pre-scheduled care postponed, and being unable to obtain medical appointments or treatments when needed. Our results substantiate the existence of social inequalities in accessing healthcare during the pandemic and of cumulative effects of economic and medical vulnerabilities: the impact of economic vulnerability is notably stronger among those who were in poor health before the outbreak and thus are potentially the oldest individuals. The cross-country comparison highlighted heterogeneous effects of economic vulnerability on forgoing care and having care postponed among countries, which are not comparable to the initial cross-country differences in social inequalities in access to healthcare.
Arpino, B., C. Mair, N. T. Quashie and R. Antczak(2021): Loneliness Before and During the COVID-19 Pandemic: Are Unpartnered and Childless Older Adults at Higher Risk?. SocArXiv. Ithaca
Abstract: Objectives. COVID-19 mitigation efforts had the potential to exacerbate loneliness among older adults, particularly for the unpartnered or childless, yet COVID-19 loneliness among these groups remains unstudied. Methods. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected before (October 2019-March 2020) and during the pandemic (June-August 2020), we examine two loneliness outcomes: 1) “have you felt lonely recently?” (both waves), and 2) “have you felt lonelier than before the pandemic?” (2020), and explore differences by partnership and parenthood status. Results. Before COVID-19, those who lacked one tie but had the other (unpartnered parents or partnered childless) were at highest loneliness risk. During COVID-19, unpartnered and childless—especially unpartnered—remain at higher risk for loneliness, entering loneliness, and not “exiting” loneliness. Discussion. We discuss these findings in light of family norms and needs in pandemic and non-pandemic times, and provide recommendations for future research.
Atzendorf, J. and S. Gruber (2021): The Mental Well-being of Older Adults after the First Wave of COVID-19. SHARE Working Paper Series 63-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3292887.
Abstract: Epidemic control measures that aim to introduce social distancing help to decelerate the spread of the COVID-19 pandemic. However, their consequences in terms of mental well-being might be negative, especially for older adults. While existing studies mainly focus on the time during the first lockdown, we look at the weeks afterwards in order to measure the medium-term consequences of the first wave of the pandemic. Using data from the SHARE Corona Survey, we include retired respondents aged 60 and above from 26 European countries plus Israel. Combining SHARE data with macro data from the Oxford COVID-19 Government Response Tracker allows us to include macro indicators at the country level, namely deaths per 100,000 population and the number of days with stringent epidemic control measures, in addition to individual characteristics. The findings show that both macro indicators are influential for increased feelings of sadness/depression, but that individual factors are crucial for explaining increased feelings of loneliness in the time after the first lockdown. Models with interaction terms reveal that the included macro indicators have negative well-being consequences, particularly for the oldest survey participants. Additionally, the results reveal that those living alone had a higher risk for worsened mental well-being in the time after the first COVID-19 wave.
Bassoli, E., A. Brugiavini and I. Ferrari (2021): Care Provision at the Time of the Covid-19: Who Suffers Most?. University Ca' Foscari of Venice, Dept. of Economics Research Paper Series 10/WP/2021. SSRN. New York. DOI: 10.2139/ssrn.3807762..
Abstract: This paper focuses on the changes in care provision at the time of the COVID-19 outbreak by exploiting variation in lockdown policies across Europe. We use the SHARE-COVID-19 survey, which involves about 50000 respondents of age 50 and over in 26 countries, to investigate how the stringency of the policy measures have affected care provision. Our study is based on the linkage of the SHARE-COVID-19 data with an individual specific “stringency index” which measures the intensity of the restriction policies and the degree of individual’s exposure. We find that older individuals, low-income individuals and people affected by limitations in everyday life faced a higher probability of receiving help because of the lockdown policies. Women and people in the age group 50-65 were more likely to provide help/care, but we also uncover a complex interaction with the labour market condition of caregivers. Lockdown policies hit hard individuals who were already receiving care as they experienced a form of rationing, both due to higher financial costs and travelling restrictions. Since these individuals are already among the most fragile.
Bergeot, J. and F. Jusot (2022): Beliefs, risk and time preferences and COVID-19 preventive behavior: Evidence from France.SHARE Working Paper Series 79. Max Planck Institute for Social Law and Social Policy. Munich.
Abstract. We analyze how preferences with respect to time and risk as well as trust in others, political opinion and religiosity correlate with COVID-19 related protective behavior in France. We leverage individual-level data from the corona survey of the Survey of Health Aging and Retirement in Europe linked with a paper questionnaire survey about preferences conducted in France just before the coronavirus outbreak. Our results suggest that patience and risk aversion are strong predictors of individuals’ protective behavior. More patient individuals are more likely to not visit their family members anymore, wear a mask and keep their distance from others when outside, wash their hands more regularly and cover their cough. Risk aversion increases the likelihood of not meeting more than 5 other people and not meeting with family members anymore. Concerning trust, we find that a higher level of trust in others reduces compliance with the recommendations about meeting with 5 or more people and family gatherings. We interpret this result as a sign that individuals with trust in others perceive a lower risk of being infected by friends and family members. Finally, we find that although the association is not always statistically significant, individuals who identify themselves as positioned on the extreme right or left of the political spectrum are less likely to comply. This latter result is particularly interesting in the French context, where the government identifies itself as centrist and more extreme political groups are its main opponents. The government should therefore consider individuals’ heterogeneity in preferences and beliefs when implementing a strategy to encourage people to comply with its COVID-19 protective recommendations.
Bergmann, M., T.-V. Hannemann, A. Bethmann and A. Schumacher (2021): Determinants of SARS-CoV-2 Vaccinations in the 50+ Population. SHARE Working Paper Series 72-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3345550..
Abstract: With the arrival of effective COVID-19 vaccines, the main issue in the fight against the pandemic became how to quickly vaccinate as many people as possible to contain the pandemic and especially to protect those most at risk, e.g. the older population. After initial problems with vaccine supply have been overcome, the focus now is on a slowdown in vaccination uptake. The Survey on Health, Ageing and Retirement in Europe (SHARE) is in a unique position to provide insights into the reasons for vaccination hesitancy, as it very recently collected data on vaccination uptake and a number of influential factors from about 47,000 individuals in the high-risk 50+ age group across Europe and Israel. In this paper we will look at the interrelation of a willingness to get vaccinated with socio-demographic and health factors as well as living conditions and economic situations. The subjective and objective economic situtation as well as diagnosed physical illnesses and education show the strongest relation to vaccination hesitancy. The results in this paper provide a comprehensive picture of influential factors that might be helpful to further the success of the immunization campaigns in Europe.
Bergmann, M. and M. Wagner (2021): Caregiving and Care Receiving Across Europe in Times of COVID-19. SHARE Working Paper Series 59-2021. Munich Center for the Economics of Aging (MEA). Munich.
Abstract: The first wave of the COVID-19 pandemic hit the European countries at the beginning of 2020. This has become particularly problematic for those in need for personal care as related epidemiological control measures (physical distancing, stay-at-home requirements etc.) installed in almost all European countries strongly affected the possibility to provide care to others as well as to receive care from people outside the own household. Against this background, this paper focus on how caregivers and care recipients living at home (the non-institutionalized) dealt with the situation using preliminary data from the 8th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) until its suspension in March 2020 and the SHARE Corona Survey fielded from June to August 2020. Concretely, we analyzed the effects of the pandemic as well as accompanying public health measures on those giving as well as receiving personal care by exploring country differences on COVID-19-related changes. Our results show that giving personal care to parents has increased, while care to children, in turn, has decreased. Further, about one out of five care recipients had difficulties in obtaining personal care during the pandemic, which was mainly because carers could not come to the home of the care recipients. In addition, country differences played an important role in explaining perceived difficulties in receiving home care and hence are an important starting point for policy makers and social organizations.
Berniell, I., Y. Fawaz, A. Laferrère, P. Mira and E. Pronkina(2021): The COVID-19 Curtain: Can Past Communist Regimes Explain the Vaccination Divide in Europe?.SHARE Working Paper Series 75-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3351839.
Abstract: As of November 2021, all former Communist countries from Central and Eastern Europe exhibit lower COVID-19 vaccination rates than Western European countries. Can institutional inheritance explain, at least in part, this heterogeneity in vaccination decisions across Europe? To study this question we exploit novel data from SHARE (Survey of Health, Ageing, and Retirement in Europe) Wave 9 Corona Survey 2 fielded in Summer 2021 that covers 27 European countries and Israel. First, we document lower Covid-19 vaccine take-up amongst individuals above 55 years old who were born under Communism in Europe. Next, we turn to reunified Germany to get closer to a causal effect of exposure to Iron curtain regimes. We find that exposure to the Communist regime in East Germany decreases one’s probability to get vaccinated against Covid-19 by 8 percentage points, increases that of not wanting the vaccine by 4 percentage points. Both effects are quite large and statistically significant, and they hold when controlling for individual socio-economic and demographic characteristics. We identify low social capital -measured as voluntary work, political engagement, trust in people- as a plausible channel through which past Communist regimes would still affect individuals’ preferences for Covid-19 vaccination.
Berniell I., A. Laferrère, P. Mira and E. Pronkina (2021): Robinson Crusoe: Less or More Depressed? With Whom and Where to Live in a Pandemic if you are above 50. SHARE Working Paper Series 70-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3333206
Abstract: This paper studies the differential impact of the first wave of the COVID pandemic on mental well-being across individuals with different living arrangements and housing conditions. We use data on Europeans aged 50+ interviewed in the SHARE Corona Survey, right after the first wave of the pandemic in June-July 2020, which we link longitudinally with two previous waves of SHARE (2013 and 2015). New to the pandemic period was the relatively lower mental well-being among those who lived only with a spouse and the protective impact for mental well-being of parents of having (adult) children in the same building as opposed to children, however close, who were not co-residing. Finally, living in cities and in multi-unit housing also led to a decrease in mental well-being relative to the general population aged 50+.
Bertoni, M., D. Cavapozzi, G. Pasini and C. Pavese(2021): Remote Working and Mental Health during the First Wave of COVID-19 Pandemic. IZA Discussion Paper 14773. IZA – Institute of Labor Economics. Bremen.
Abstract: We use longitudinal data from the SHARE survey to estimate the causal effect of remote working during the COVID-19 pandemic on mental health of senior Europeans. We face endogeneity concerns both for the probability of being employed during the pandemic and for the choice of different work arrangements conditional on employment. Our research design overcomes these issues by exploiting variation in the technical feasibility of remote working across occupations and in the legal restrictions to in-presence work across sectors. We estimate heterogeneous effects of remote working on mental health: we find negative effects for respondents with children at home and for those living in countries with low restrictions or low excess death rates due to the pandemic. On the other hand, the effect is positive for men and for respondents with no co-residing children.
Bertoni, M., M. Celidoni, C. Dal Bianco and G. Weber (2021): How did European Retirees Respond to the COVID-19 Pandemic? SHARE Working Paper Series 61-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3291835.
Abstract: We investigate the role of retirement on the adoption of preventive behaviours and on mental health during the first wave of the pandemic. We address the endogeneity of the timing of retirement using variation in early retirement and old-age pension eligibility. We find that those who retired earlier responded to the pandemic by limiting their mobility more, and by adopting stricter preventive behaviours in public. These limitations did not hamper their mental health.
Bíró, A., R. Branyiczki and P. Elek (2021): Time Patterns of Precautionary Health Behaviours During an Easing Phase of the COVID-19 Pandemic in Europe. SHARE Working Paper Series 57-2021. Munich Center for the Economics of Aging (MEA). Munich.
Abstract: Using data from the COVID19 questionnaire of the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate the time patterns of precautionary health behaviours of individuals aged 50 and above during the summer of 2020, an easing phase of the COVID-19 pandemic in Europe. We also examine how these health behaviours diﬀer by the presence of chronic conditions such as hypertension, high cholesterol level, heart disease, diabetes or chronic bronchitis, which can be considered as risk factors for COVID-19. Our results suggest that while on average, people became less precautious during our analysed time period, this is less so for those who are at higher risk. We also document large regional diﬀerences in precautionary health behaviours and show that higher risk individuals are on average more cautious in all regions. We conclude that people adjusted their health behaviours in line with the generally understood risk of the COVID-19 disease. At the same time, our results also point out divergences in the level of willingness to take diﬀerent precautionary steps.
Bonfatti, A., G. Pesaresi, G. Weber and N. Zambon (2021): The Economic Impact of the First Wave of the Pandemic on 50+ Europeans.SHARE Working Paper Series 74-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3346667.
Abstract: We analyse the effects of the Covid-19 crisis on the economic situation of 50+ Europeans. We construct a financial distress indicator that captures experiencing an income loss, difficulties to make ends meet and the need to postpone payments. We find that education and income before the pandemic have a protective role, and so does being past retirement age. For households under retirement age, instead, the pandemic has exacerbated inequalities. We also investigate whether households report worse difficulties in making ends meet compared to the pre-COVID period. We show that their ability to make ends meet worsens more with income losses during the pandemic compared to losses experienced in the two-year period before the pandemic.
Bonsang, E. and E. Pronkina (2021): Family Size and Vaccination among Older Individuals: The Case of COVID-19 Vaccine.SHARE Working Paper Series 76-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3361025.
Abstract: While vaccination is generally considered an efficient way to protect against transmissible diseases, vaccine hesitancy is still widespread in many countries. In this paper, we investigate how individual-specific factors -the number of children- affect the probability of getting the vaccine against COVID-19. To answer this research question, we focus on the population aged 50 year-old or older as the risk of developing severe symptoms is the highest among them and use the Survey of Health, Ageing and Retirement in Europe (SHARE) Corona wave conducted in Summer 2021. To identify the effect of family size on vaccination, we exploit an exogenous variation in the probability to have more than two children due to the sex composition of the two firstborns. We document that having more than two children increases the probability of getting the COVID-19 vaccine among older individuals. This impact is economically and statistically significant. We propose a potential mechanism behind this result - the higher probability of being exposed to the disease proxied by knowing someone who tested positive with the Coronavirus or had symptoms similar to it, and by network size and number of contacts with children before the outbreak of Corona.
Brugiavini, A., R. E. Buia and I. Simonetti (2021): Occupation and Working Outcomes during the Coronavirus Pandemic. SHARE Working Paper Series 60-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3291840.
Abstract: Using data from the recent SHARE Corona Survey and additional information collected in the previous waves of SHARE, we explore the effects of occupation’s characteristics on two outcomes: (i) the probability of work interruptions during the pandemic, coupled with the length of such interruptions and (ii) the probability of switching to homeworking during the lockdown. In order to assess how job features affected the likelihood of having experienced work interruptions or shifted to teleworking, we define six occupation categories by classifying the ISCO job titles according to two criteria: the safety level of the occupation and the essential (unessential) nature of the good or service provided. We find that characteristics of the occupation are major determinants of the probability of experiencing work interruptions and determine the length of such interruptions. Working from home also largely depends on the features of the job, even controlling for many other covariates at the individual level. In addition, we show that labour market outcomes of women, selfemployed and less educated workers are negatively affected by the pandemic to a much larger extent than men.
Brugiavini, A., C. Di Novi and C. E. Orso (2021): Visiting Parents in Times of COVID-19: The Impact of Parent-adult Child Contacts on the Psychological Health of the Elderly. SHARE Working Paper Series 73-2021. Munich Center for the Economics of Aging (MEA). Munich.
Abstract: The novel coronavirus pandemic (COVID-19) and the consequent restrictions imposed by governments worldwide have affected individuals’ health and well-being globally. The most significant public health costs of lockdown restrictions include potential adverse effects on mental health. In the recent literature on symptoms of depression in the elderly due to the COVID-19 pandemic, one of the neglected topics is the impact of disrupting parent–adult child contacts on their psychological and emotional well-being. Using data from the 8th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) and the SHARE Corona Survey, this study aims to fill this gap, providing additional insights into the psychological status of, and strain on, older people during the COVID-19 outbreak and contributing to the body of research on the negative association between social isolation and the psychological well-being of the elderly. Our findings show that the interventions deemed essential to reduce the spread of the pandemic, such as the “stay-at-home” order, have necessarily disrupted personal parent–child contacts and the social processes that facilitate psychological well being, with negative consequences on the mental health of elderly parents.
Dasgupta, S. and J. Emmerling (2021): COVID-19 Lockdown Led to an Unprecedented Increase in Inequality. Research Square (online first). DOI: 10.21203/rs.3.rs-191155/v1.
Abstract: The COVID-19 pandemic has affected households across the globe due to the health impacts but also through indirect socioeconomic effects as a result of the additional stress on the health systems, implications of the lockdowns and other policy measures undertaken by governments. Moreover, there is evidence that these impacts are associated with socioeconomic characteristics of households and could lead to an increase in inequality and poverty. In this paper, we conduct a first assessment based on household surveys in a large set of countries and analyze the determinants of income shocks at the household-level and macroeconomic inequality implications. While the average income losses of on average 4% but up to 27% are already high (similar to GDP losses in 2020 of on average 6% in our sample), we find an even more striking increase in inequality, of up to several points (1.2 points on average) of the typically very flat Gini index. Across countries, we find that on average an additional one percentage point loss in GDP was associated with an increase in the Gini by one percentage point. Analyzing the determinants of the income shock, we find strong evidence of heterogeneity with higher likelihood of income shocks for poorer, female-led, and less-educated households. The results indicate that we are experiencing an unprecedented crisis also in terms of economic inequality. The policy response to limit the macroeconomic repercussions therefore should explicitly include reducing inequality. Otherwise, a rebuilt macro-economy, will exhibit a much higher degree of social and economic inequality that are likely to persist.
Delerue Matos, A., A. F. Paiva, C. Cunha and G. Voss (2021): Precautionary Behaviours of Individuals with Multimorbidity during the COVID-19 Pandemic. SHARE Working Paper Series 69-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3332949.
Abstract: Studies show that older individuals with multimorbidity are more susceptible to develop a more severe case of COVID-19 when infected by the virus. These individuals are more likely to be admitted to Intensive Care Units and to die from COVID-19 related conditions than younger individuals or those without multimorbidity. This research aimed to assess whether there are differences in terms of precautionary behaviours between individuals aged 50+ with multimorbidity and their counterparts without multimorbidity residing in 25 European countries plus Israel. We used data from the SHARE Corona Survey on the socio-demographic and economic characteristics, multimorbidity, and precautionary behaviours of individuals. SHARE wave 8 and 7 databases were also used to fully identify individuals with multimorbidity. Our results showed that individuals with multimorbidity were more likely to exhibit precautionary behaviours than their counterparts without multimorbidity when gender, age, education, financial distress and countries were included as controls. Additionally, we found that women, more educated individuals and those experiencing more financial distress adopt more protective behaviours than their counterparts. Our results also indicate that the prevalence of precautionary behaviours is higher in Southern Europe and lower in Northern countries. To guarantee the adoption of preventive actions against COVID-19, public health messaging and actions must continue to be disseminated among middle and older aged persons with multimorbidity, and more awareness campaigns should be targeted at men and less educated individuals but also at persons experiencing less financial distress, particularly in countries where people engaged in fewer precautionary behaviours.
Fors Connolly, F., J. Olofsson, G. Malmberg and M. Stattin (2021): Adjustment of Daily Activities to Restrictions and Reported Spread of the COVID-19 Pandemic across Europe. SHARE Working Paper Series 62-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3292885.
Abstract: This paper addresses adjustments of daily activities in the wake of the COVID-19 pandemic among people aged 50 years and older in Europe, and investigates the extent to which such adjustments are associated with the stringency of governmental restrictions and the overall spread of COVID-19. We use data from the SHARE Corona Survey collected during summer 2020, published data on government response stringency, and reported country-specific prevalence and mortality of COVID-19. Our analyses show that older Europeans across the continent have reduced their daily activities quite substantially during the pandemic. However, we observe variation across countries and demographic groups, which may be important to highlight for policymakers. Our explanatory analysis replicates previous studies using mobility data, showing that both restrictions and infections predict a reduction in mobility. Thus, policymakers could potentially rely on both restrictions and voluntary adjustments in order to decrease the spread of the virus. However, it is noteworthy that we find relatively weaker associations with restrictions compared to previous studies using mobility data. One explanation for this discrepancy could be that our study focuses on older people, who face a higher risk of becoming severely ill and therefore have stronger incentives to adjust their behaviours independent of governmental regulations.
Giordana, G. and M. N. Pi Alperin (2022): Old age takes its toll: Long-run projections of health-related public expenditure in Luxembourg. Working Paper 158. Central bank of Luxembourg. Luxembourg.
Abstract: This paper simulates long-term trends in Luxembourg’s public expenditure on healthcare and on long-term care. We combine population projections with micro-simulations of individuals’ health status that account for their demographic, socio-economic characteristics and their childhood circumstances. Model equations estimated on data from the SHARE survey and from several branches of Social Security provide a rich framework to study policy-relevant applications. We simulate public expenditure on healthcare and long-term care under different scenarios to evaluate the separate contributions of population ageing, costs of producing health-related services, and the distribution of health status across age cohorts. Results suggest that rising per capita expenditure on healthcare will mostly result from production costs, while rising expenditure on long-term care will mostly reflect population ageing.
Mikucka, M. and R. Antczak(2022): Covid-19 Protective Behaviour Depends on an Interplay of National Policies and Individual Vulnerability: A Cross-Sectional Study of Older Adults in 27 European Countries. SocArXiv Paper. SocArXiv. Ithaca. DOI: 10.31235/osf.io/tfb7r.
Abstract: Objectives. To date, little is known on how policies and individual vulnerability affected the prevalence of protective behaviour. The objective of this study is to examine the effect of policies and individual vulnerability on the prevalence of protective behaviours. Design. Data on the individual behaviour in 27 countries come from the “Corona Survey” module of the Survey of Health, Ageing and Retirement in Europe, collected in summer 2020. We considered: (a) never leaving home, (b) never going for a walk, (c) always wearing a face mask in a public space, and (d) never participating in social meetings. Data on policies from the “Our World in Data” database included: (1) stay-at-home restrictions, (2) face coverings policies, and (3) gatherings’ restrictions. We used the statistical method of multilevel regression. Participants. Nationally representative sample of older adults (50 years and over); N=52,061 respondents (58% of women). Results. The prevalence of protective behaviours and strictness of policies differed across countries, showing heterogeneity of responses to Covid-19. Stricter policies correlated with a higher prevalence of protective behaviour, but only for two out of four behaviours: stay-at-home policies correlated with avoiding walks, and stricter face-covering policy correlated with always wearing a mask. Vulnerable groups (older people and those in worse health) were more likely to use the protective measures. For social meetings and walks, stricter policies distributed the burden of protective behaviours more equally between more and less vulnerable groups. Conclusions. Stricter policies not only increased the propensity of protective behaviour but also reduced social differences in protective behaviours. Our results suggest that visible and not-limiting behaviours responded to policies, whereas less visible and more limiting behaviours reflected individual vulnerability.
Pronkina, E.(2021): Long-lasting Impact of Education on Individual Extreme Confinement Choice among 50+ during the First Wave of the COVID-19 Pandemic. SHARE Working Paper Series 71-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3339651.
Abstract: This paper studies the long-run impact of education on individual strict confinement choice in Europe during the first wave of the COVID-19 pandemic among 50+. We do so by using the SHARE Corona Survey conducted in Summer 2020. First, we show that almost 20 percent of individuals chose always staying home during the first wave of Corona. On average, they were in worse health before the outbreak and more likely to experience mental health deterioration after the outbreak. Next, using changes in compulsory schooling reforms as an instrumental variable, we document that one year less of schooling increases the probability of always staying home since the outbreak. Mediators such as individual health before the outbreak can only partially explain the impact of schooling on this extreme degree of self-isolation. Changes in country specific confinement measures do not attenuate this effect.
Rocard, E., P. Sillitti and A. Llena-Nozal(2021): COVID-19 in Long-term Care: Impact, Policy Responses and Challenges. OECD Health Working Papers No. 131. OECD. Paris.
Abstract: The COVID-19 crisis has hit the long-term care (LTC) sector particularly hard, with large numbers of people dependent on care and particularly vulnerable to COVID-19 have fallen ill, and a disproportionate rate of LTC workers both exposed to, and infected by, COVID-19. The analysis presented in this report describes the effects of COVID-19 on LTC in OECD countries, mainly showing infection rates and mortality of LTC recipients. It takes stock of the wide range of policy responses that countries have implemented, detailing the changes over time on testing strategies, reduction of interactions and isolation measures, digitalisation of services, and workforce. The report also assesses emergency preparedness in the sector, as well as workforce, organisational and coordination challenges. Finally, the report analyses how policy responses affected care continuity and the well-being of residents while also outlining the effectiveness of vaccination.
Sand, G. and J. Bristle(2021): The Relationship of Threat Perceptions and Optimistic Attitude with Protective Behavior in the COVID-19 Crisis. SHARE Working Paper Series 64-2021. Munich Center for the Economics of Aging (MEA). Munich. DOI: 10.17617/2.3309027.
Abstract: Mortality in the COVID-19 crisis is highest among older adults and other vulnerable groups. Based on Protection Motivation Theory and using data from the first SHARE Corona Survey, we investigate how threat perceptions and optimistic attitudes are associated with motivation to engage in protective behavior in the population 50+. Multivariate regression analyses are based on a sample of more than 30,000 individuals from 26 countries. Our results show that around 15 percent of all respondents stayed home completely during the initial phase of the COVID-19 crisis—mainly the elderly aged and those with prior health risk conditions. On average, older Europeans responded strongly to the recommended protective behavior measures (6 out of 7 measures adopted). While feeling more anxious than before Corona and fear of infection are the main motivators for protective behavior, an optimistic outlook into the future shows an equally strong association with protective behavior. Optimistic attitudes are the strongest predictor in the Czech Republic, France, Luxembourg, and Sweden—all countries with high levels of trust in their health care systems. In contrast, fear is the strongest predictor in Estonia, Latvia, Finland and Poland—all countries with below average mortality rates. We further hypothesize that the influence of threat appraisal and optimistic attitudes vary based on contextual severity of and perceived institutional protection against COVID-19 (measured as COVID-19 mortality, stringency of control measures, and trust in the health care system). We find that the influence of personal exposure varies and can be observed mainly in country groups with high COVID-19 mortality, medium stringency, and high trust in the health care system. Against the background of negative, long-term health effects of fear and the situation of a long-term crisis, the results of this study may help evaluate and revise governmental policy responses and communication strategies.
Theodoropoulos, N. and G. Voucharas(2021): The Impact of the COVID-19 Pandemic in Cyprus: Results of the 1st and 2nd SHARE Corona Survey. SHARE Bulletin No. 01/2021. University of Cyprus. Nicosia.SHARE Bulletin No. 01/2021. University of Cyprus. Nicosia.
Wang, H., A. Verdery, R. Margolis and E. Smith-Greenaway(2021): Bereavement from COVID-19 and Depressive Symptoms among Older Adults in Europe. SocArXiv Papers. DOI: 10.31235/osf.io/tzm9n.
Abstract: Objectives. The COVID-19 pandemic has left older adults around the world grieving the sudden death of relatives and friends. We examineifCOVID-19 bereavement corresponds with older adults’ depressive symptoms in 27 countries, and test for variation by gender and country context. Methods. We analyze SHARE COVID-19 data collected between June-August 2020 from N=51,383older adults (age 50–104) living in 27 countries, of whom1,363reportedthe death of a relative or friend from COVID-19. We estimate pooled-multilevel logistic regression models to examine if COVID-19 bereavement was associated with depressive symptoms and worsening depressive symptoms, and we test whether the COVID-19 mortality rate in their country has an additive or multiplicative influence. Results. COVID-19 bereavement is associated with significantly higher odds of reporting depressive symptoms, and reporting that these symptoms have recently worsened. Net of personal loss, living in a country with the highest COVID-19 mortality rate is associated with women’s depressive symptoms but not men’s. However, the COVID-19 mortality rate does not moderate the implications of personal loss for depressive symptoms. Discussion. COVID-19 deaths have lingering mental health implications for surviving older adults. Even as the collective toll of the crisis is apparent, bereaved older adults are in particular need of mental health support.
Cusa, M. (2022): Social capital and resilience to the Covid-19 crisis. Evidence for senior Europeans. Master's thesis. Università degli Studi di Padova. Padova.
Abstract. Has social capital positively contributed to human resilience during the Covid-19 crisis? The pandemic provoked by this virus has hugely impacted on people’s mental health, increasing depression and sadness. The aim of this thesis is to study whether social capital, measured with trust in others, has buffered these negative effects, decreasing the probability of worsening the own psychological condition. Focusing on European seniors and relying on the SHARE dataset, I find a positive and significant relation between trust in others and individual resilience. These results are valid both with the individual level measure of social capital and with the aggregate level one, computed by NUTS 1. Furthermore, considering the second indicator, the relation is proved also with IV methodology, taking into account this way endogeneity and strengthening the claim for causal effects. Therefore, my thesis provides empirical evidence for European seniors of a causal effect of social capital on human resilience to the Covid-19 crisis.
Koroleva, I., I. Reine and A. Aleksandrovs(2021):Изменения межличностной коммуникации в период пандемии COVID-19 и роль цифровых технологий в снижении социальной изоляции среди пожилых людей: пример Латвии. (Changes in Interpersonal Communication during the COVID-19 Pandemic and the Role of ICT in Reducing the Social Isolation in Elderly Population: An Example of Latvia.). Belarusian State University Digital Library. Minsk.
Abstract: The epidemiological restrictions introduced throughout the COVID-19 pandemic are aimed at stimulating social distancing and limiting personal social contact. This exposes older people, who, even in non-crisis situations, have a narrower circle and frequency of social contacts with age, to an even greater risk of loneliness and social isolation. Modern digital technologies help to maintain social activity in these conditions. The pandemic has accelerated the digitalization of people of virtually all generations, spreading across all areas of daily life. But if young people, already surrounded by digital technologies from birth, received a variety of support, including government support, the elderly, and especially the oldest and those who are not employed in the labor market, went unnoticed. Thus, the COVID-19 pandemic has revealed new risks of inequality in the emotional and social well-being of older people, namely: inequality in access to modern technologies and their use, which depends not only on age, but also on education, employment and place of residence. The analysis of changes in interpersonal communication during a pandemic and the availability of digital technologies to overcome social exclusion in old age is based on empirical data from the 8th wave of the international longitudinal "Research on health, aging and retirement in Europe" (The Survey of Health, Aging and Retirement in Europe [SHARE], Wave 8).
Koroļeva, I., S. Snikere, A. Aleksandrovs, I. Reine, M. Trapencieris and A. Ivanovs (2021): Effects of Social Isolation on Mental Health during COVID-19 in the Context of Ageing. Proceedings of the International Scientific Conference VI.SIE. Rēzekne.
Abstract: The COVID-19 pandemic brought significant changes to the usual rhythm of life. Reduced opportunities to meet with family members and friends in a situation of heightened stress leads to increased feelings of loneliness and social isolation, as well as increases the risk of mental health problems. The aim of this paper is to evaluate the effect of social contacts on the changes in psychoemotional states in the elderly population in Latvia during the crisis caused by the COVID-19 pandemic. The analysis draws upon quantitative data collected by the Survey of Health, Ageing and Retirement in Europe within Wave 8 in Latvia (n=1207). Measurements of the frequency of social contacts were used to construct social isolation indexes. Changes of psychoemotional state, characterized by sleeping problems, nervousness, frustration during the pandemic were included as dependent variables in multinomial logistic regression models that were run to identify the effect of social isolation on psychoemotional health in the context of other factors: age, gender, perceived health status, affluence and feelings of loneliness. The results show that in the group of those aged 50+, close to one-fifth of respondents experienced the effect of the COVID-19 crisis on their mental health. The link between reduced social contacts and changes in psychoemotional states proved to be statistically significant. In the group with the highest level of social isolation, irregularities in psychoemotional health are three times higher compared to other groups.
Peronio, T. (2022): The Covid-19 isolation effect on the mental health of older people. Master's thesis. Università degli Studi di Padova. Padova.
(last Update 7. June; 2022)