Background Although a number of previous research studies have focused on the long-term analysis of the health and health behaviour of the elderly, there is still a shortage of information in relation to the long-term trends regarding health or risk and preventive behaviour in the elderly population taking into account gender differences and differences in educational level. Methods The database comprised subsamples of the Austrian Micro-Census, including individuals aged 65 years and older, for the years 1983, 1991, 1999, and subsamples of the ATHIS (Austrian Health Interview Survey) 2007. A trend analysis was conducted for four health-related variables with the year of the survey and education as predictors. The analysis was stratified by sex. Results We found a general trend towards better self-rated health, better preventive and less risk behaviour among the elderly, while the body mass index has been increasing over the years. There are indeed gender differences regarding the trend in smoking behaviour. While the prevalence of male smoking has been steadily decreasing, female smoking prevalence has not changed. At all points in time, individuals with higher education had significantly better self-rated health than those with lower education but the association between education and preventive behaviour significantly decreased over the years. Conclusion We agree with previous research in concluding that preventive action and health promotion should aim in particular to support older women and men with lower education.
References
[1]
Marques-Vidal P, Cerveira J, Paccaud F, Cornuz J (2011) Smoking trends in Switzerland, 1992-2007: a time for optimism? J Epidemiol Community Health 65: 281–286. doi: 10.1136/jech.2009.099424
[2]
Fries JF (1989) The compression of morbidity: Near or far? Milbank Memorial Foundation Quaterly/Health and Society 67: 208–232. doi: 10.2307/3350138
[3]
Crimmins EM, Beltran-Sanchez H (2011) Mortality and Morbidity Trends: Is There Compression of Morbidity? J Gerontol Ser B-Psychol Sci Soc Sci 66: 75–86 doi:10.1093/geronb/gbq088.
[4]
Doblhammer G, Kytir J (2001) Compression or expansion of morbidity? Trends in healthy-life expectancy in the elderly Austrian population between 1978 and 1998. Social Science and Medicine 52: 385–391. doi: 10.1016/s0277-9536(00)00141-6
[5]
Lu P, Singleton J, Rangel M, Wortley P, Bridges C (2005) Influenza vaccination trends among 65 years or older in the United States, 1989-202. Archives of internal Medicine 165: 1849–1856. doi: 10.1001/archinte.165.16.1849
[6]
Grossschaedl F, Stronegger WJ (2013) Long-term trends in obesity among Austrian adults and its relation with the social gradient: 1973-2007. Eur J Public Health 23: 306–312 doi:10.1093/eurpub/cks033.
[7]
Staub K, Ruhli F, Woitek U, Pfister C (2010) BMI distribution/social stratification in Swiss conscripts from 1875 to present. European Journal of Clinical Nutrition 64: 335–340. doi: 10.1038/ejcn.2010.7
[8]
Cambois E, Clavel A, Romieu I, Robine J-M (2008) Trends in disability-free life expectancy at age 65 in France: consistent and diverging patterns according to the underlying disability measure. Eur J Ageing 5: 287–298 doi:10.1007/s10433-008-0097-1.
[9]
Freidl W, Stronegger W, Rasky E, Neuhold C (2001) Associations of income with self-reported ill-health and health resources in a rural community sample of Austria. Sozial- und Pr?ventivmedizin 46: 106–114. doi: 10.1007/bf01299727
[10]
Chandola T, Ferrie J, Sacker A, Marmot M (2007) Social inequalities in self-reported health in early old age: follow-up of prospective cohort study. British Medical Journal 334: 990–993B. doi: 10.1136/bmj.39167.439792.55
[11]
Aiken L, West S (1991) Multiple Regression: Testing and interpreting interactions. Newbury Park, London, Delhi: Sage Publications.
[12]
Krokstad S, Kunst A, Westin S (2002) Trends in health inequalities by educational level in a Norwegian total population study. J Epidemiol Community Health 56: 375–380. doi: 10.1136/jech.56.5.375
[13]
Dalstra J, Kunst A, Geurts J, Frenken F, Mackenbach J (2002) Trends in socioeconomic health inequalities in the Netherlands, 1981–1999. J Epidemiol Community Health 56: 927–934. doi: 10.1136/jech.56.12.927
[14]
WHO Comission on Social Determinants of Health (CSDH) (2008) Closing the gap in a generation. Health equity through action on the social determinants of health. Final Report.
[15]
Stronegger W, Freidl W, Rasky E, Berghold A (1998) Educational status and resources for child care as predictors of TBE vaccination coverage in schoolchildren of an endemic area in Austria. Zentralblatt für Hygiene und Umweltmedizin 201: 437–445.
[16]
Kwong JC, Rosella LC, Johansen H (2007) Trends in influenza vaccination in Canada, 1996/1997 to 2005. Health reports/Statistics Canada, Canadian Centre for Health Information = Rapports sur la sante/Statistique Canada, Centre canadien d'information sur la sante 18.
[17]
Rodriguez de Azero M (2008) Trends in seasonal influenza vaccine distribution in the European Union: 2003-4 to 2007-8. Euro surveillance: bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin 13.
[18]
Blank PR, Freiburghaus AU, Ruf BR, Schwenkglenks MM, Szucs TD (2008) Trends in Influenza Vaccination Coverage Rates in Germany over Six Seasons from 2001/02 to 2006/07. Med Klin 103: 761–768 doi:10.1007/s00063-008-1121-0.
[19]
Castilla J, Martinez-Baz I, Godoy P, Toledo D, Astray J, et al. (2013) Trends in influenza vaccine coverage among primary healthcare workers in Spain, 2008-2011. Prev Med 57: 206–211 doi:10.1016/j.ypmed.2013.05.021.
[20]
Jimenez-Trujillo I, Lopez-de Andres A, Hernandez-Barrera V, Carrasco-Garrido P, Santos-Sancho JM, et al. (2013) Influenza vaccination coverage rates among diabetes sufferers, predictors of adherence and time trends from 2003 to 2010 in Spain. Human vaccines & immunotherapeutics 9. doi:10.4161/hv.23926.
[21]
Kunze U, Bohm G, Groman E (2013) Influenza vaccination in Austria from 1982 to 2011: A country resistant to influenza prevention and control. Vaccine 31. doi:10.1016/j.vaccine.2013.08.050.
[22]
Loranta V, Tongletb R (2010) Obesity: trend in inequality. J Epidemiol Community Health 54: 637–638. doi: 10.1136/jech.54.8.637
[23]
Zaninotto P, Head J, Stamatakis E, Wardle H, Midell J (2009) Trends in obesity among adults in England from 1993 to 2004 by age and social class and projections of prevalence to 2012. J Epidemiol Community Health 63: 140–146. doi: 10.1136/jech.2008.077305
[24]
Kahn H, Cheng Y (2008) Longitudinal changes in BMI and in an index estimating excess lipids among white and black adults in the United States. International Journal of Obesity 32: 136–143. doi: 10.1038/sj.ijo.0803697
[25]
Regidor E, De Mateo S, Ronda E, Sánchez-Payá J, Gutiérrez-Fisac J, et al. (2010) Heterogeneous trend in smoking prevalence by sex and age group following the implementation of a national smoke-free law. J Epidemiol Community Health online 2010.
[26]
Sardu C, Mereu A, Pitzalis G, Minerba L, Contu P (2006) Smoking trends in Italy from 1950 to 2000. J Epidemiol Community Health 60: 799–803. doi: 10.1136/jech.2005.043703
[27]
Johnson W, Kyvik KO, Mortensen EL, Skytthe A, Batty GD, et al. (2011) Does Education Confer a Culture of Healthy Behavior? Smoking and Drinking Patterns in Danish Twins. Am J Epidemiol 173: 55–63 doi:10.1093/aje/kwq333.
[28]
Panasiuk L, Mierzecki A, Wdowiak L, Paprzycki P, Lukas W, et al. (2010) Prevalence of Cigarette Smoking among Adult Population in Eastern Poland. Annals of agricultural and environmental medicince 17: 133–138.
[29]
Smith P, Frank J, Mustard C (2009) Trends in educational inequalities in smoking and physical activity in Canada: 1974–2005. J Epidemiol Community Health 63: 317–323. doi: 10.1136/jech.2008.078204
[30]
Giskes K, Kunst A, Benach J, Borrell C, Costa G, et al. (2005) Trends in smoking behaviour between 1985 and 2000 in nine European countries by education. J Epidemiol Community Health 59: 395–401. doi: 10.1136/jech.2004.025684
[31]
Baumert J, Ladwig K-H, Ruf E, Meisinger C, Doering A, et al. (2010) Determinants of Heavy Cigarette Smoking: Are There Differences in Men and Women? Results From the Population-Based MONICA/KORA Augsburg Surveys. Nicotine Tob Res 12: 1220–1227 doi:10.1093/ntr/ntq172.
[32]
Stafford M, Nazroo J, Popay J, Whithehead M (2008) Tackling inequalities in health: evaluating the New Deal for Communities initiative. Journal of Epidemiology and Community Health 62: 298–304. doi: 10.1136/jech.2006.058628