Factors associated with worsening in the self-rated health status of Brazilian women who lived with dependent elderly people during the first wave of COVID-19

Romero, Dalia Elena; Maia, Leo; Muzy, Jessica; Andrade, Nathália; Souza Junior, Paulo Roberto Borges de

doi:10.1590/1413-81232023287.13702022EN

Dalia Elena Romero

design

analysis

interpretation

writing

review of the manuscript

Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil. dalia.fiocruz@gmail.com

https://orcid.org/0000-0002-2643-9797

Leo Maia

design

database curation

analysis

interpretation

writing

review of the manuscript

Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil. dalia.fiocruz@gmail.com

https://orcid.org/0000-0003-1531-0880

Jessica Muzy

curation of the database

analysis

interpretation

writing

revision of the manuscript

Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil. dalia.fiocruz@gmail.com

https://orcid.org/0000-0003-2526-2317

Nathália Andrade

design

analysis

interpretation

writing

revision of the manuscript

Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil. dalia.fiocruz@gmail.com

https://orcid.org/0000-0003-1364-8642

Paulo Roberto Borges de Souza Junior

curation of the database

analysis

interpretation

revision of the manuscript

Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil. dalia.fiocruz@gmail.com

https://orcid.org/0000-0002-8142-4790

Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Variables		Living with FDOA		Living with FIOA		Total			P- value
Variables		%	95%CI	%	95%CI	n	%	95%CI
Total		9.3	8.7-9.9	90.7	90.1-91.3	7.842	100	-	-
Sociodemographic
Age
	Less than 60	66.2	62.8-69.6	49.2	48.0-50.4	3.979	50.7	49.6-51.8	<0.001
	60 and over	33.8	30.4-37.2	50.8	49.6-52.0	3.863	49.3	48.2-50.4	<0.001
Ethnicity/skin color
	Black	50.7	47.1-54.3	48.7	47.5-49.9	3.799	48.9	47.8-50.0	0.001
	White	49.3	45.7-52.9	51.3	50.1-52.5	3.973	51.1	50.0-52.2	0.001
Per capita income in Minimum Wages (MW)
	Less than 1 MW	59.2	55.4-63.0	50.2	49.0-51.4	3.679	51.0	49.8-52.2	0.002
	1 MW and over	40.8	37.0-44.6	49.8	48.6-51.0	3.538	49.0	47.8-50.2	0.002
Household density
	Living with two people and over	81.4	78.6-84.2	60.8	59.7-61.9	4.918	62.7	61.6-63.8	0.195
	Living with one person	18.6	15.8-21.4	39.2	38.1-40.3	2.924	37.3	36.2-38.4	0.195
Socioeconomic changes and routine activities in the pandemic
Level of difficulty in performing routine activities during the pandemic
	Very difficult	21.9	18.9-24.9	18.3	17.4-19.2	1.454	18.6	17.7-19.5	<0.001
	Not very difficult	78.1	75.1-81.1	81.7	80.8-82.6	6.364	81.4	80.5-82.3	<0.001
Impact on income during the pandemic
	Very much affected	34.0	30.6-37.4	27.0	26.0-28.0	2.171	27.7	26.7-28.7	0.018
	Not very much affected	66.0	62.6-69.4	73.0	72.0-74.0	5.671	72.3	71.3-73.3	0.018
Impact of the pandemic on domestic chores
	Increased a lot	79.0	76.0-82.0	65.8	64.7-66.9	5.221	67.0	66.0-68.0	<0.001
	Did not increase much	21.0	18.0-24.0	34.2	33.1-35.3	2.572	33.0	32.0-34.0	<0.001
Effects of the pandemic on health
Poor mood
	Often/always	67.8	64.4-71.2	59.1	58.0-60.2	4.697	59.9	58.8-61.0	<0.001
	Never or rarely	32.2	28.8-35.6	40.9	39.8-42.0	3.145	40.1	39.0-41.2	<0.001
Felt isolated during the pandemic
	Often/always	44.5	40.9-48.1	41.3	40.2-42.4	3.260	41.6	40.5-42.7	<0.001
	A little or never	55.5	51.9-59.1	58.7	57.6-59.8	4.583	58.4	57.3-59.5	<0.001
Impact of the pandemic on sleep
	Deteriorated during the pandemic	58.7	55.1-62.3	46.2	45.0-47.4	3.701	47.4	46.3-48.5	<0.001
	Did not affect	41.3	37.7-44.9	53.8	52.6-55.0	4.114	52.6	51.5-53.7	<0.001
How do you assess your health?
	Fair to extremely poor	45.9	42.3-49.5	29.7	28.6-30.8	4.559	31.2	30.3-32.1	<0.001
	Excellent or good	54.1	50.5-57.7	70.3	69.2-71.4	5.393	68.8	67.9-69.7	<0.001
Started to have a back problem or the pre-existing problem deteriorated
	Yes	67.1	63.7-70.5	49.7	48.5-50.9	4.023	51.3	50.2-52.4	<0.001
	No	32.9	29.5-36.3	50.3	49.1-51.5	3.816	48.7	47.6-49.8	<0.001

Variables		Living with FDOA				Living with FIOA
Variables		n	Prevalence	95%CI	P- value	n	Prevalence	95%CI	P- value
Total		293	40.3	36.7-43.9	-	2.105	29.6	28.5-30.7	-
Sociodemographic
Age
	Less than 60	209	43.5	39.1-48.0	0.015	1.304	37.3	35.7-39.0	<0.001
	60 and over	84	34.1	28.2-40.0		801	22.2	20.8-23.5
Ethnicity/skin color
	Black	160	43.7	38.7-48.8	0.065	1.181	34.5	32.9-36.1	<0.001
	White	132	37.0	31.9-42.0	0.065	901	24.9	23.5-26.3	<0.001
Per capita income in Minimum Wages (MW)
	Less than 1 MW	153	40.7	35.7-45.7	0.109	1.107	33.5	31.9-35.1	<0.001
	1 MW and over	89	34.5	28.7-40.3	0.109	809	24.7	23.2-26.2	<0.001
Household density
	Living with two people and over	237	40.0	36.1-44.0	0.768	1.346	31.1	29.8-32.5	0.001
	Living with one person	56	41.7	33.4-50.0	0.768	760	27.3	25.6-29.0	0.001
Socioeconomic changes and routine activities in the pandemic
Level of difficulty in performing routine activities during the pandemic
	Very difficult	110	69.7	62.5-76.8	<0.001	638	49.2	46.5-52.0	<0.001
	Not very difficult	182	32.2	28.4-36.1	<0.001	1.451	25.1	24.0-26.2	<0.001
Impact on income during the pandemic
	Very much affected	161	65.2	59.3-71.2	<0.001	676	35.3	33.1-37.4	<0.001
	Not very much affected	132	27.5	23.5-31.5	<0.001	1.430	27.5	26.3-28.8	<0.001
Impact of the pandemic on domestic chores
	Increased a lot	255	44.4	40.4-48.5	<0.001	1.559	33.6	32.2-34.9	<0.001
	Did not increase much	38	24.9	18.0-31.7	<0.001	521	21.5	19.9-23.2	<0.001
Effects of the pandemic on health
Poor mood
	Often/always	238	48.3	43.9-52.8	<0.001	1.767	42.1	40.6-43.5	<0.001
	A little or never	55	23.5	18.0-28.9	<0.001	338	11.7	10.5-12.8	<0.001
Felt isolated during the pandemic
	Often/always	141	43.6	38.2-49.0	0.105	1.044	35.7	33.9-37.4	<0.001
	Never or rarely	152	37.7	33.0-42.5	0.105	1.061	25.4	24.1-26.7	<0.001
Impact of the pandemic on sleep
	Deteriorated during the pandemic	246	57.9	53.2-62.6	<0.001	1.441	44.1	42.4-45.8	<0.001
	Did not affect	47	15.7	11.6-19.8	<0.001	648	17.0	15.8-18.2	<0.001
How do you assess your health?
	Fair to extremely poor	201	60.4	55.1-65.7	<0.001	1.164	55.1	53.0-57.2	<0.001
	Excellent or good	92	23.3	19.1-27.5	<0.001	941	18.9	17.8-19.9	<0.001
Back problem
	Started to have or deteriorated	263	54.0	49.5-58.4	<0.001	1.439	40.7	39.1-42.3	<0.001
	Did not start to have, nor did it deteriorate	30	12.5	8.3-16.7	<0.001	666	18.7	17.4-19.9	<0.001

Variables		Living with FDOA			Living with FIOA
Variables		PR	95%CI	P- value	PR	95%CI	P- value
Sociodemographic
Age
	Less than 60	1.28	0.92-1.73	0.021	1.67	1.06-1.40	<0.001
	60 and over	1	-	0.021	1	-	<0.001
Ethnicity/skin color
	Black	1.07	0.89-1.28	0.492	1.31	1.21-1.41	<0.001
	White	1	-	0.492	1	-	<0.001
Per capita income in Minimum Wages (MW)
	Less than 1 MW	1.01	0.80-1.28	0.911	1.2	1.10-1.30	<0.001
	1 MW and over	1	-	0.911	1	-	<0.001
Household density
	Living with two people and over	0.77	0.59-1.0	0.054	0.82	0.76-0.89	<0.001
	Living with one person	1	-		1	-
Socioeconomic changes and routine activities in the pandemic
Level of difficulty in performing routine activities during the pandemic
	Very difficult	2.12	1.80-2.51	0.054	1.78	1.65-1.92	<0.001
	Not very difficult	1	-		1	-
Impact on income during the pandemic
	Very much affected	2.43	2.02-2.92	<0.001	1.28	1.18-1.38	<0.001
	Not very much affected	1	-		1	-
Impact of the pandemic on domestic chores
	Increased a lot	1.65	1.22-2.22	0.001	1.5	1.37-1.64	<0.001
	Did not increase much	1	-	0.001	1	-	<0.001
Effects of the pandemic on health
Poor mood
	Often/always	1.90	1.46-2.46	<0.001	3.22	2.85-3.64	<0.001
	Never or rarely	1	-	<0.001	1	-	<0.001
Felt isolated during the pandemic
	Often/always	1.13	0.94-1.36	0.184	1.36	1.26-1.47	<0.001
	A little or never	1	-	0.184	1	-	<0.001
Impact of the pandemic on sleep
	Deteriorated during the pandemic	2.34	2.14-2.56	<0.001	3.59	2.67-4.82	<0.001
	Did not affect	1	-		1	-
How do you assess your health?
	Fair to extremely poor	2.82	2.28-3.50	<0.001	3.24	3.01-3.49	<0.001
	Excellent or good	1	-		1	-
Back problem
	Started to have or deteriorated	4.92	3.32-7.29	<0.001	2.01	1.85-2.19	<0.001
	Did not start to have, nor did it deteriorate	1	-	<0.001	1	-	<0.001

Variables		Sociodemographic			Socioeconomic changes and routine activities in the pandemic			Effects of the pandemic on health
Variables		PR	95%CI	P- value	PR	95%CI	P- value	PR	95%CI	P- value
Age
	Less than 60	1.22	0.94-1.60	0.141	0.95	0.73-1.25	0.735	0.97	0.74-1.28	0.837
	60 and over	1	-	0.141	1	-	0.735	1	-	0.837
Ethnicity/skin color
	Black	0.81	0.65-1.00	0.055	0.8	0.65-0.98	0.028	0.76	0.60-0.96	0.019
	White	1	-	0.055	1	-	0.028	1	-	0.019
Per capita income in Minimum Wages (MW)
	Less than 1 MW	1.17	0.91-1.52	0.222	0.96	0.75-1.23	0.730	0.78	0.64-0.96	0.018
	1 MW and over	1	-	0.222	1	-	0.730	1	-	0.018
Household density
	Living with two people and over	1.02	0.75-1.38	0.904	1.00	0.72-1.39	0.986	0.77	0.56-1.07	0.123
	Living with one person	1	-	0.904	1	-	0.986	1	-	0.123
Level of difficulty in performing routine activities during the pandemic
	Very difficult	-	-	-	2.37	1.90-2.95	<0.001	1.49	1.23-1.82	<0.001
	Not very difficult	-	-	-	1	-	<0.001	1	-	<0.001
Impact on income during the pandemic
	Very much affected	-	-	-	1.49	1.18-1.88	0.001	1.20	0.99-1.46	0.057
	Not very much affected	-	-	-	1	-	0.001	1	-	0.057
Impact of the pandemic on domestic chores
	Increased a lot	-	-	-	1.20	0.92-1.56	0.173	0.77	0.60-0.98	0.032
	Did not increase much	-	-	-	1	-	0.173	1	-	0.032
Poor mood
	Often/always	-	-	-	-	-	-	2.91	1.64-5.14	0.001
	Never or rarely	-	-	-	-	-	-	1	-	0.001
Felt isolated during the pandemic
	Often/always	-	-	-	-	-	-	1.33	1.10-1.61	0.003
	Never or rarely	-	-	-	-	-	-	1	-	0.003
Impact of the pandemic on sleep
	Deteriorated during the pandemic	-	-	-	-	-	-	1.73	1.32-2.27	<0.001
	Did not affect	-	-	-	-	-	-	1	-	<0.001
How do you assess your health?
	Fair to extremely poor	-	-	-	-	-	-	1.71	1.39-2.11	<0.001
	Excellent or good	-	-	-	-	-	-	1	-	<0.001
Back problem
	Started to have or deteriorated	-	-	-	-	-	-	1.95	1.24-3.06	0.004
	Did not start to have. nor did it deteriorate	-	-	-	-	-	-	1	-	0.004

Variables		Sociodemographic			Socioeconomic changes and routine activities in the pandemic			Effects of the pandemic on health
Variables		PR	95%CI	P- value	PR	95%CI	P- value	PR	95%CI	P- value
Age
	Less than 60	1.83	1.67-2.00	<0.001	1.6	1.46-1.76	<0.001	1.38	1.28-1.50	<0.001
	60 and over	1	-	<0.001	1	-	<0.001	1	-	<0.001
Ethnicity/skin color
	Black	1.37	1.26-1.49	<0.001	1.31	1.21-1.43	<0.001	1.16	1.07-1.25	<0.001
	White	1	-	<0.001	1	-	<0.001	1	-	<0.001
Per capita income in Minimum Wages (MW)
	Less than 1 MW	1.23	1.13-1.35	<0.001	1.19	1.09-1.30	<0.001	1.00	0.92-1.08	0.963
	1 MW and over	1	-	<0.001	1	-	<0.001	1	-	0.963
Household density
	Living with two people and over	1.31	1.20-1.43	<0.001	1.30	1.19-1.42	<0.001	1.13	1.05-1.23	0.002
	Living with one person	1	-	<0.001	1	-	<0.001	1	-	0.002
Level of difficulty in performing routine activities during the pandemic
	Very difficult	-	-	-	1.75	1.61-1.89	<0.001	1.03	0.95-1.11	0.513
	Not very difficult	-	-	-	1	-	<0.001	1	-	0.513
Impact on income during the pandemic
	Very much affected	-	-	-	1.11	1.02-1.21	0.017	0.90	0.83-0.97	0.004
	Not very much affected	-	-	-	1	-	0.017	1	-	0.004
Impact of the pandemic on domestic chores
	Increased a lot	-	-	-	1.42	1.29-1.57	<0.001	1.1	1.01-1.20	0.035
	Did not increase much	-	-	-	1	-	<0.001	1	-	0.035
Poor mood
	Often/always	-	-	-	-	-	-	1.98	1.73-2.27	<0.001
	Never or rarely	-	-	-	-	-	-	1	-	<0.001
Felt isolated during the pandemic
	Often/always	-	-	-	-	-	-	1.17	1.09-1.26	<0.001
	Never or rarely	-	-	-	-	-	-	1	-	<0.001
Impact of the pandemic on sleep
	Deteriorated during the pandemic	-	-	-	-	-	-	1.67	1.51-1.85	<0.001
	Did not affect	-	-	-	-	-	-	1	-	<0.001
How do you assess your health?
	Fair to extremely poor	-	-	-	-	-	-	2.42	2.22-2.63	<0.001
	Excellent or good	-	-	-	-	-	-	1	-	<0.001
Back problem
	Started to have or deteriorated	-	-	-	-	-	-	1.48	1.34-1.63	<0.001
	Did not start to have, nor did it deteriorate	-	-	-	-	-	-	1	-	<0.001

[1] Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Brasil

Brasil

Factors associated with worsening in the self-rated health status of Brazilian women who lived with dependent elderly people during the first wave of COVID-19

Abstract