- The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)
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Alexandra Foscolou, Stefanos Tyrovolas, George Soulis, Anargiros Mariolis, Suzanne Piscopo, Giuseppe Valacchi, Foteini Anastasiou, Christos Lionis, Akis Zeimbekis, Josep-Antoni Tur, Vassiliki Bountziouka, Dimitra Tyrovola, Efthimios Gotsis, George Metallinos, Antonia-Leda Matalas, Evangelos Polychronopoulos, Labros Sidossis, Demosthenes B. Panagiotakos
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J Prev Med Public Health. 2017;50(1):1-9. Published online December 19, 2016
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DOI: https://doi.org/10.3961/jpmph.16.101
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 Abstract
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- Objectives
By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands.
Methods
From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity.
Results
Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001).
Conclusions
A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
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Summary
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Citations
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- The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study
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Venetia Notara, Demosthenes B. Panagiotakos, Yannis Kogias, Petros Stravopodis, Antonis Antonoulas, Spyros Zombolos, Yannis Mantas, Christos Pitsavos
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J Prev Med Public Health. 2016;49(4):220-229. Published online June 24, 2016
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DOI: https://doi.org/10.3961/jpmph.16.005
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10,256
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133
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17
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Abstract
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- Objectives
The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated.
Methods
From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years).
Results
Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed.
Conclusions
A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.
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Summary
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Citations
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