[The Impact of Migration Background on Health: Results of the Austrian Health Interview Survey (ATHIS 2014)]. / Die Bedeutung des Migrationshintergrunds für die Gesundheit. Ergebnisse der österreichischen Gesundheitsbefragung (ATHIS 2014).

OBJECTIVES: Previous research has shown migrants to have a poorer health status than those without a migration background in many respects. So far, it is not completely clear whether the poorer health results of migrants are mainly the cause of their socioeconomic status (SES), which on average is lower than the SES of people without a migration background. The present study explores the question whether the fact of having a migration background has an impact on health, even though SES and health-related behavior are taken into account. METHODS: Based on data from the current Austrian Health Interview Survey (ATHIS 2014) multiple linear regression models, adjusted for age and stratified by gender, were conducted. The dependent variables were physical quality of life, psychological quality ofZ life, self-perceived health, body-mass-index (BMI), headaches/musculoskeletal pain, and diabetes/cardiovascular diseases (n=15,748). RESULTS: We found differences in health between men and women with migration background and men and women without migration background. After adjusting for age, SES and health-related behavior, almost all of the revealed differences got smaller. The strongest link between migrant status and health status was detected for migrants from countries with a lower Inequality-adjusted Human Development Index (IHDI) in comparison to Austria. CONCLUSION: The results lead to the conclusion that although SES and health-related behavior do not fully explain health differences between people with migration background and those without, they can explain the differences to a large extent. However, for the health status of migrants who stem from countries with a lower standard of living and a weaker distributive justice in comparison to Austria, further factors might play a role. With respect to this group of migrants, differences in health compared to non-migrants are not solely attributable to SES and health-related behavior.

Impact of migration background on health of children and adolescents in Austria. Results of the Austrian Health Survey 2014.

OBJECTIVE: The present study examines the question as to whether the wellbeing of children and adolescents in Austria and the use of vaccination are influenced by migration background. METHODS: The data was extracted from the Austrian Health Survey 2014 (ATHIS 2014). It contains health-related information of 5,277 children and adolescents aged 0 to 17 years. The analysis was based on logistic regression models. RESULTS: To stem from a migration background had no influence on the assessment of health or the assessment of complaints. Regarding vaccination, the results showed that the children of study participants born in non-EU foreign countries had twice the chance of being vaccinated as the children of Austria-born parents. No difference existed between the children of Austria-born parents and the children of parents born in non-EU countries. CONCLUSIONS: The analysis suggests that children and adolescents with a migration background in Austria are not worse off in terms of their physical wellbeing and vaccination status than children without a migration background. Some thought should, however, be given to the fact that the notion of migration background refers to a heterogenic population. To analyse the risks and chances of children and adolescents from different migrant backgrounds, a more differentiated survey of their migrant background and social situation and a more differentiated survey of health parameters will be required.

Explaining the impact of poverty on old-age frailty in Europe: material, psychosocial and behavioural factors.

Background: Previous research found poverty to be associated with adverse health outcomes among older adults but the factors that translate low economic resources into poor physical health are not well understood. The goal of this analysis was to assess the impact of material, psychosocial, and behavioural factors as well as education in explaining the poverty-health link. Methods: In total, 28 360 observations from 11 390 community-dwelling respondents (65+) in the Survey of Health, Ageing and Retirement in Europe (2004-13, 10 countries) were analysed. Multilevel growth curve models were used to assess the impact of combined income and asset poverty risk on old-age frailty (frailty index) and associated pathway variables. Results: In total, 61.8% of the variation of poverty risk on frailty level was explained by direct and indirect effects. Results stress the role of material and particularly psychosocial factors such as perceived control and social isolation, whereas the role of health behaviour was negligible. Conclusion: We suggest to strengthen social policy and public health efforts in order to fight poverty and its deleterious health effects from early age on as well as to broaden the scope of interventions with regard to psychosocial factors.

Sex and gender matters : A sex-specific analysis of original articles published in the Wiener klinische Wochenschrift between 2013 and 2015.

BACKGROUND: The variables sex and gender are significantly related to health and disease of women and men. Aiming at quality research, biomedical publications need to account for the key variables sex and gender. METHODS: All original articles published in the Wiener klinische Wochenschrift between 2013 and 2015 were extracted into a database. As a result, the 195 published articles were selected for review led by the Sex and Gender Equity in Research Guidelines (SAGER) by the European Association of Science Editors (EASE). The slightest indications of mentioning sex and/or gender were assessed by two reviewers independently from one another. RESULTS: Of the 195 publications 4 specified sex and/or gender in the title, and 62 in the abstract. None of the authors reported whether the variables sex and/or gender may have relevance and were taken into account in the design of the study. Of the 195 publications 48 mentioned the potential implications of sex and/or gender on the study results. CONCLUSION: In the time span studied most of the selected articles of this journal did not account for the variables sex and/or gender systematically or adequately. For future research the existing guidelines can help authors and editors to overcome gender bias due to inadequate methods. Applying sex and gender-sensitive methods to biomedical and health research is necessary for high quality and as a precondition for results which are generalizable and applicable to both women and men.

Exploring differential health effects of work stress: a latent class cluster approach.

BACKGROUND: While evidence highlights the detrimental health consequences of adverse working conditions, effect sizes vary by the stressor examined. In this study, we aimed to explore the differential effects various constellations of job demands have on prevalent symptom clusters. METHODS: We analysed self-reported data from a nationwide Austrian survey (N = 16,466), based on a cross-sectional design. By means of latent class analysis, a set of items was used to assess the burden from several job demands as well as the frequency of occurrence of mental and physical symptoms in order to identify stress profiles and symptom clusters, respectively. RESULTS: Analysis revealed four subgroups that each demonstrated a typological response pattern regarding job demands and health symptoms, respectively. The revealed stress profiles were found to be strongly related to the symptom clusters, while the effects differed considerably depending on the types of demands experienced. CONCLUSION: The current study presents an alternative method of examining the stress-health link by using a combined person- and variable-centred approach. The findings suggest a hierarchy in stress exposure with the most pronounced health consequences found for a synchronous burden from physical, psychosocial and organizational demands.

Attitudes towards end-of-life decisions in case of long-term care dependency: a survey among the older population in Austria.

BACKGROUND: Research on attitudes towards end-of-life decisions (ELDs) contextually most often refers to the very end of life, that is, to situations of terminally ill patients or severe pain, but it is rarely applied to the broader context of long-term care dependency in old age. METHODS: In a representative survey among older Austrians (50+, n=968), respondents were asked about their approval of assisted suicide and euthanasia (EUT) when requested by an older, severely care-dependent person. The influence of sociodemographics, care-related experiences and expectations, religiosity, trust, locus of control and concerns regarding constrictions of old age on the approval of both these ELDs was assessed through logistic regression analyses. RESULTS: 42% and 34% of the respondents approved assisted suicide and EUT, respectively, in case of care dependency. Non-religious individuals, less trusting respondents and those concerned about constrictions associated with old age were more likely to approve both these ELDs. CONCLUSIONS: Widespread concerns regarding long-term care dependency in old age should be addressed in information campaigns, and public discourse about ELDs should pay more attention to situations of long-term care dependency.

Impact of socioeconomic position on frailty trajectories in 10 European countries: evidence from the Survey of Health, Ageing and Retirement in Europe (2004-2013).

BACKGROUND: Whether or not, and how, health inequalities change throughout older age is currently under debate. The goal of this study was to assess the net impact of education, occupational class, income and wealth on frailty trajectories among older adults in Continental Europe. METHODS: We modelled frailty index trajectories within a repeated cohort design among the community-dwelling population (50+) in 10 countries, using growth curve models based on 54 036 observations from 20 965 respondents in 4 waves (2004-2013) of the Survey of Health, Ageing and Retirement in Europe. RESULTS: Gaps in frailty due to education, occupational class and wealth continued throughout old age, while the gap due to income, smaller in comparison, converged. Frailty levels were higher and trajectories steeper in later birth cohorts, and the impact of education increased over time. Frailty levels and growth curves were higher in Southern European countries, and results were consistent across countries regarding the continuous effect of education and occupation and more mixed regarding wealth and income. CONCLUSIONS: Health inequalities due to education, occupational class and wealth tend to persist throughout old age, whereas the negligible effect of income declines with age, which, substantially, highlights the importance of social conditions on the pace of physiological decline in older Europeans and, methodologically, highlights the need to assess multiple measures of socioeconomic position.

The Role of Personal and Job Resources in the Relationship between Psychosocial Job Demands, Mental Strain, and Health Problems.

Recent research highlights the importance of both job resources and personal resources in the job demands-resources model. However, the results of previous studies on how these resources are related to each other and how they operate in relation to the health-impairment process of the job demands-resources model are ambiguous. Thus, the authors tested an alternative model, considering job and personal resources to be domains of the same underlying factor and linking this factor to the health-impairment process. Survey data of two Austrian occupational samples (N 1 = 8657 and N 2 = 9536) were analyzed using confirmatory factor analysis (CFA) and structural equation modeling (SEM). The results revealed that job and personal resources can be considered as indicators of a single resources factor which was negatively related to psychosocial job demands, mental strain, and health problems. Confirming previous studies, we further found that mental strain mediated the relationship between psychosocial job demands and health problems. Our findings suggest that interventions aimed at maintaining health in the context of work may take action on three levels: (1) the prevention of extensive job demands, (2) the reduction of work-related mental strain, and (3) the strengthening of resources.