Revenue Associated With Gambling-Related Harm as a Putative Indicator for Social Responsibility: Results From the Swiss Health Survey

Gambling behaviours represent a significant social and economic cost and an important public health problem. A putative index for monitoring gambling-related harm is a concentration of spending indicator that reports the proportion of gambling revenue derived from problem gambling. Using this indicator, we aimed to provide a first estimate of the proportion of gambling revenue associated with gambling-related harm in Switzerland according to the Swiss Health Survey. Data were obtained from the Swiss Health Survey 2017. The National Opinion Research Centre Diagnostic and Statistical Manual of Mental Disorders – Loss of Control, Lying and Preoccupation (NODS-CLiP) screening tool was used as part of the questionnaire, and the study findings were evaluated to determine the prevalence of gambling-related harm. Self-reported spending on terrestrial and online gambling (including gaming tables, electronic gaming machines, lotteries, sports betting) during the past 12 months was then used to calculate the portion of gambling revenue derived from players experiencing harm. A total of 12,191 respondents were included. Gambling-related harm was reported by 3.10% of our sample, according to NODS-CLiP criteria. The findings showed that although 52% of people experiencing harm spend less than 100 francs per month on gambling, 31.3% of total spending is attributable to gambling-related harm. In addition to pre-existing national prevalence studies, data on spending should be made readily available by gambling operators and regulators, in keeping with their regulatory obligations. The revenue structure, according to gambling type, should also be provided, including data from third-party gambling operators. In an interdisciplinary effort to improve public health and consumer protection, organized national structural prevention measures should be developed and evaluated.

On the Association between Insurance Deductibles and Prevention Behaviour: Evidence from the Swiss Health System

Many studies have attempted to investigate the drivers of preventive behaviour. This study contributes to this strand of literature by examining the association between higher insurance deductibles in the Swiss health system and preventive behaviour that allows for maintaining a good diet, exercising and limiting/abstaining from smoking and alcohol consumption. To conduct our study, we made use of the 2017 Swiss Health Survey and employed an ordered probit model with each prevention aspect as a dependant variable. Our results show that, except for alcohol consumption, higher insurance deductibles were significantly associated with higher behavioural prevention. Our study also highlighted how numerous other factors influenced prevention and offered some guidance for public policies to further incentivise prevention decisions.

Physical and mental health of older people with disabilities in residential homes in Switzerland

Objectives: People with disabilities are underserved in terms of health care and prevention, and special health conditions exist among older people with intellectual disabilities. The Swiss Health Survey only covers people over the age of 15 years living in private households. Therefore, this study aims to assess the health status of older persons living in residential facilities for adults with disabilities. Methods: A cross-sectional survey with written questionnaires was conducted in six cantons in Switzerland to capture context factors and the physical health status of persons aged between 50 and 65 years in residential homes in Switzerland. The survey collected data on physical and mental health from 241 persons aged 50–65 years living in residential homes for people with disabilities. This was compared with data from the 2012 Swiss Health Survey comprising a sample of 2261 persons of the same age with chronic morbidities living in their own apartments. Results: Regarding their health, 94.1% of the survey respondents rated it as being very good, good or moderate. Although higher limitations on activities of daily living, higher levels of psychological distress and lower energy and vitality were reported by all respondents, a lower level of health issues was assessed than in the sample of persons with chronic morbidities living in their own apartment. Conclusion: Low energy and vitality, high limitations on activities of daily living, high psychological distress, high obesity rates and the assessment of health issues and pain should be specifically addressed in residential homes for people with disabilities.

Losing ground at the wrong time: Trends in self-reported influenza vaccination uptake in Switzerland, Health Survey 2007–2017

ObjectivesWe studied time trends in seasonal influenza vaccination and associations with socioeconomic and health-related determinants in Switzerland, overall and in people aged ≥ 65 years.DesignThree cross-sectional surveys.ParticipantsIndividuals who participated in the Swiss Health Surveys 2007, 2012, and 2017. We calculated the proportion reporting influenza vaccination in the last 12 months, and performed multivariable logistic regression analyses.ResultsThe proportion of reporting a history of influenza vaccination overall was 31.9% (95% confidence intervals [95% CI] 31.4–32.4); and dropped from 34.5% in 2007 to 28.8% in 2017. The uptake of vaccination within the past 12 months was 16% in 2007 and similar in 2012 and 2017 (around 14%). In people with chronic disease, uptake dropped from 43.8% in 2007 to 37.1% in 2012 and to 31.6% in 2017 (p<0.001). In people aged ≥ 65 years, uptake dropped from 47.8% in 2007 to 38.5% in 2012 to 36.2% in 2017 (p<0.001). Similarly, a decrease in vaccine uptake was seen in people with poor self-reported health status (39.4%, 33.1%, and 27.0%). In logistic regression, self-reported vaccination coverage decreased in the 65 to 75 years old (adjusted odds ratio (aOR) aOR 0.56, 95% Cl 0.48–0.66 between 2007 and 2012; aOR 0.89, 95% CI 0.77–1.03). Uptake was positively associated with the ≥ 65 age group, living in French-speaking and urban areas, history of smoking, bad self-reported health status, private/semiprivate health insurance, having a medical profession, and having any underlying chronic disease. Use of any alternative medicine therapy was negatively associated with influenza vaccination (aOR 0.72, 95% CI 0.67–0.80).ConclusionInfluenza vaccination coverage was low in older and chronically ill persons. Significant efforts are required in preparing for the flu season 2020/21 to reduce the double burden of COVID-19 and seasonal influenza. These efforts should include campaigns but also novel approaches using social media.Strengths and limitations of this studyData analysis of the Swiss Health Survey 2007, 2012, and 2017 focussing on influenza vaccine uptake overall and in the age group ≥65 years in Switzerland.The Swiss Health Survey is a nationwide, representative survey that is repeated every five years using the same methodology.Analyses were weighted and adjusted for a wide range of important cofactors.We calculated percent of people reporting having been vaccinated and associations between vaccination status and socio-demographic and health-related factors.Influenza vaccination status is self-reported in the Swiss Health Survey and the reliability of the data not ascertained.

Differences in Insomnia Symptoms between Immigrants and Non-Immigrants in Switzerland attributed to Emotional Distress: Analysis of the Swiss Health Survey

Migration can be a stressful experience and may lead to poor health and behavioral changes. The immigrant population in Switzerland is disproportionately burdened by several negative health outcomes, chief among these is mental health issues. The aim of the study was to investigate whether sleep disturbances are more prevalent among immigrants compared to non-immigrants and whether emotional distress might explain sleep differences. Based on the Swiss Health Survey 2012 dataset, we analyzed the data of 17,968 people, of which 3406 respondents were immigrants. We examined variables including insomnia symptoms, emotional distress and clinical and socio-demographic data using unadjusted and adjusted generalized linear models. Compared to non-immigrants, immigrants suffer significantly more often from insomnia symptoms. Immigrants also endured higher levels of emotional distress. Higher values of emotional distress are related to other symptoms of sleep disorders. Immigrants with emotional distress were at significant risk of sleep disturbances. Sleep disparities between immigrants and non-immigrants may be influenced by emotional distress. Migration health care should address emotional distress, a more proximal and modifiable factor, as a possible cause of insomnia symptoms in immigrants.

Social exclusion of people with severe mental illness in Switzerland: results from the Swiss Health Survey

Aims.People with severe mental illness (SMI) have a high risk of living socially excluded from the mainstream society. Policy initiatives and health systems aim to improve the social situation of people who suffer from mental health disabilities. The aim of this study was to explore the extent of social exclusion (employment and income, social network and social activities, health problems) of people with SMI in Switzerland.Methods.Data from the Swiss Health Survey 2012 were used to compare the social exclusion magnitude of people with SMI with those suffering from severe physical illness, common mental illness and the general population.Results.With the exception of Instrumental Activities of Daily Living, we found a gradient of social exclusion that showed people with SMI to be more excluded than the comparison groups. Loneliness and poverty were widespread among people with SMI. Logistic regression analyses on each individual exclusion indicator revealed that people with SMI and people with severe physical illness were similarly excluded on many indicators, whereas people with common mental illness and the general population were much more socially included.Conclusions.In contrast to political and health system goals, many people with SMI suffer from social exclusion. Social policy and clinical support should increase the efforts to counter exclusionary trends, especially in terms of loneliness and poverty.

Is body weight dissatisfaction associated with depression?

IntroductionBody image dissatisfaction is a risk factor for depression. Research has focused on female adolescents; yet little is known about sex and age differences.Objectives/aimsThe aim of our study was to evaluate the association of body weight dissatisfaction, a component of body image, with depression overall, and for different sex and age-groups independent of body weight.MethodsWe analyzed data of 15,975 individuals from the cross-sectional 2012 Swiss Health Survey. Participants were asked about their weight satisfaction. Patient Health Questionnaire (PHQ-9) was used to ascertain depression. Age was stratified in three groups (≥ 18-29; ≥ 30-59; ≥ 60 years). Body mass index (BMI) was self-reported and categorized into normal weight (BMI: 18.5-24.9 kg/m2), overweight (BMI: 25.0-29.9 kg/m2), and obesity (BMI: ≥ 30 kg/m2). The association between weight dissatisfaction and depression was assessed with logistic regression analyses and adjusted for known confounders (including BMI).ResultsWeight dissatisfaction was associated with depression in the overall group (OR: 2.04, 95% CI: 1.66-2.50) and in men (1.85, 1.34-2.56) and women (2.25, 1.71-2.96) separately, independent of body weight (multivariable adjusted). Stratification by age groups revealed associations of weight dissatisfaction with depression in young (1.78, 1.16-2.74), middle-aged (2.1, 1.61-2.74) and old individuals (2.34, 1.30-4.23) independent of BMI. A sub-analysis in the overall group revealed statistically significant positive associations of weight dissatisfaction with depression in underweight, normal weight, overweight and obese individuals.ConclusionBody weight dissatisfaction is associated with depression in men, women, young, middle-aged and old individuals independent of BMI.Disclosure of interestThe authors have not supplied their declaration of competing interest.