Baseline participation in a health examination survey of the population 65 years and older: who is missed and why?. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Gaertner, Beate; Seitz, Ina; Fuchs, Judith; Busch, Markus; Holzhausen, Martin; Martus, Peter; Scheidt-Nave, Christa
• Is Part Of: BMC geriatrics. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 12
• Publication Date: 2016-12
• Subjects: Aging population -- Non-participation -- Public health monitoring -- Reasons for non-participation -- Register-based population -- Selection bias; Geriatrics -- Periodicals; 618.97005
• DOI: 10.1186/s12877-016-0185-6
• Languages: English
• ISSNs: 1471-2318

Abstract

Abstract Background Public health monitoring depends on valid health and disability estimates in the population 65+ years. This is hampered by high non-participation rates in this age group. There is limited insight into size and direction of potential baseline selection bias. Methods We analyzed baseline non-participation in a register-based random sample of 1481 inner-city residents 65+ years, invited to a health examination survey according to demographics available for the entire sample, self-report information as available and reasons for non-participation. One year after recruitment, non-responders were revisited to assess their reasons. Results Five groups defined by participation status were differentiated: participants (N = 299), persons who had died or moved (N = 173), those who declined participation, but answered a short questionnaire (N = 384), those who declined participation and the short questionnaire (N = 324), and non-responders (N = 301). The results confirm substantial baseline selection bias with significant underrepresentation of persons 85+ years, persons in residential care or from disadvantaged neighborhoods, with lower education, foreign citizenship, or lower health-related quality of life. Finally, reasons for non-participation could be identified for 78 % of all non-participants, including 183 non-responders. Conclusion A diversity in health problems and barriers to participation exists among non-participants. Innovative study designs are needed for public health monitoring in aging populations.