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Merchant RM, Becker LB, Brooks SC, Chan PS, Del Rios M, McBride ME, Neumar RW, Previdi JK, Uzendu A, Sasson C. The American Heart Association Emergency Cardiovascular Care 2030 Impact Goals and Call to Action to Improve Cardiac Arrest Outcomes: A Scientific Statement From the American Heart Association. Circulation 2024; 149:e914-e933. [PMID: 38250800 DOI: 10.1161/cir.0000000000001196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Every 10 years, the American Heart Association (AHA) Emergency Cardiovascular Care Committee establishes goals to improve survival from cardiac arrest. These goals align with broader AHA Impact Goals and support the AHA's advocacy efforts and strategic investments in research, education, clinical care, and quality improvement programs. This scientific statement focuses on 2030 AHA emergency cardiovascular care priorities, with a specific focus on bystander cardiopulmonary resuscitation, early defibrillation, and neurologically intact survival. This scientific statement also includes aspirational goals, such as establishing cardiac arrest as a reportable disease and mandating reporting of standardized outcomes from different sources; advancing recognition of and knowledge about cardiac arrest; improving dispatch system response, availability, and access to resuscitation training in multiple settings and at multiple time points; improving availability, access, and affordability of defibrillators; providing a focus on early defibrillation, in-hospital programs, and establishing champions for debriefing and review of cardiac arrest events; and expanding measures to track outcomes beyond survival. The ability to track and report data from these broader aspirational targets will potentially require expansion of existing data sets, development of new data sets, and enhanced integration of technology to collect process and outcome data, as well as partnerships of the AHA with national, state, and local organizations. The COVID-19 (coronavirus disease 2019) pandemic, disparities in COVID-19 outcomes for historically excluded racial and ethnic groups, and the longstanding disparities in cardiac arrest treatment and outcomes for Black and Hispanic or Latino populations also contributed to an explicit focus and target on equity for the AHA Emergency Cardiovascular Care 2030 Impact Goals.
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Gugushvili A. The heterogeneous well-being effects of intergenerational mobility perceptions. J Health Psychol 2024; 29:99-112. [PMID: 37466150 DOI: 10.1177/13591053231187345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Individuals make comparisons with their parents which determine their intergenerational mobility perceptions, yet very little is known about the areas used for intergenerational comparison and whether these matter for individuals' well-being. In 2021 we commissioned a nationally representative survey in Georgia in which we explicitly asked 1159 individuals an open-ended question on the most important areas in their intergenerational comparisons. More than 170 types of answers were provided by respondents and many of these responses went beyond the standard indicators of intergenerational mobility. We show that the areas of intergenerational comparison significantly differ between those who perceive themselves as being downwardly and upwardly mobile or immobile using the measure of mobility previously validated in cross-national research. Using, among other statistical approaches, treatment effects estimators, we demonstrate that some areas of intergenerational comparison, particularly in terms of income attainment, are significantly and consistently associated with internationally validated measures of well-being.
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Pongdee T, Brunner WM, Kanuga MJ, Sussman JH, Wi CI, Juhn YJ. Rural Health Disparities in Allergy, Asthma, and Immunologic Diseases: The Current State and Future Direction for Clinical Care and Research. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:334-344. [PMID: 38013156 PMCID: PMC11089647 DOI: 10.1016/j.jaip.2023.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/06/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
Rural health disparities are well documented and continue to jeopardize the long-term health and wellness for the millions of individuals who live in rural America. The disparities observed between urban and rural residents encompass numerous morbidity and mortality measures for several chronic diseases and have been referred to as the "rural mortality penalty." Although the unmet health needs of rural communities are widely acknowledged, little is known about rural health disparities in allergies, asthma, and immunologic diseases. Furthermore, the intersection between rural health disparities and social determinants of health has not been fully explored. To achieve a more complete understanding of the factors that perpetuate rural health disparities, greater research efforts followed by improved practice and policy are needed that account for the complex social context within rural communities rather than a general comparison between urban and rural environments or focusing on biomedical factors. Moreover, research efforts must prioritize community inclusion throughout rural areas through meaningful engagement of stakeholders in both clinical care and research. In this review, we examine the scope of health disparities in the rural United States and the impact of social determinants of health. We then detail the current state of rural health disparities in the field of allergy, asthma, and immunology. To close, we offer future considerations to address knowledge gaps and unmet needs for both clinical care and research in addressing rural health disparities.
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Affiliation(s)
- Thanai Pongdee
- Division of Allergic Diseases, Mayo Clinic, Rochester, Minn.
| | - Wendy M Brunner
- Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, Cooperstown, NY
| | - Mansi J Kanuga
- Division of Allergic Diseases, Mayo Clinic Health System, Red Wing, Minn
| | | | - Chung-Il Wi
- Precision Population Science Lab, Mayo Clinic, Rochester, Minn; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn
| | - Young J Juhn
- Precision Population Science Lab, Mayo Clinic, Rochester, Minn; Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minn; Office of Mayo Clinic Health System Research, Mayo Clinic Health System, Rochester, Minn.
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Zang E, Tian M. Upward Mobility Context and Health Outcomes and Behaviors during Transition to Adulthood: The Intersectionality of Race and Sex. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2024:221465231223944. [PMID: 38279819 DOI: 10.1177/00221465231223944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2024]
Abstract
This study investigates how upward mobility context affects health during transition to adulthood and its variations by race and sex. Using county-level upward mobility measures and data from the Panel Study of Income Dynamics, we apply propensity score weighting techniques to examine these relationships. Results show that low upward mobility context increases the likelihood of poor self-rated health, obesity, and cigarette use but decreases alcohol consumption probability. Conversely, high upward mobility context raises the likelihood of distress, chronic conditions, and alcohol use but reduces cigarette use likelihood. In low-opportunity settings, Black individuals have lower risks of chronic conditions and cigarette use than White men. In high-opportunity settings, Black women are more likely to experience depression and chronic conditions, and Black men are likelier to smoke than White men. Our findings emphasize the complex link between upward mobility context and health for different racial and sex groups.
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Aldea N, Ordanovich D, Palloni A, Ramiro D, Viciana F. Influence of Place of Birth on Adult Mortality: The Case of Spain. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2023; 39:30. [PMID: 37679516 PMCID: PMC10484828 DOI: 10.1007/s10680-023-09679-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 07/31/2023] [Indexed: 09/09/2023]
Abstract
We use a unique data set from Spain and we estimate life expectancy at age 50 for males and females by place of residence and place of birth. We show that, consistent with expectations regarding the influence of early conditions on adult health and mortality, the effects of place of birth on adult mortality are very strong, irrespective of place of residence. Furthermore, we find that mortality levels observed in a place are strongly influenced by the composition of migrants by place of birth. This is reflected in a new measure of heritability of early childhood conditions that attains a value in the range 0.42-0.43, implying that as much as 43 percent of the variance in Spain's life expectancy at age 50 is explained by place of birth. Finally, we find evidence of the healthy migrant effect, that is, positive health selection of migrants, at a regional level.
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Affiliation(s)
- Néstor Aldea
- Institute of Economy, Geography and Demography (IEGD), CSIC-CCHS, Calle Albasanz 26-28, 28037, Madrid, Spain.
- French Institute for Demographic Studies (INED), Aubervilliers, France.
| | - Dariya Ordanovich
- Institute of Economy, Geography and Demography (IEGD), CSIC-CCHS, Calle Albasanz 26-28, 28037, Madrid, Spain
| | - Alberto Palloni
- Institute of Economy, Geography and Demography (IEGD), CSIC-CCHS, Calle Albasanz 26-28, 28037, Madrid, Spain
- Center for Demography & Ecology, University of Wisconsin-Madison, Madison, WI, USA
| | - Diego Ramiro
- Institute of Economy, Geography and Demography (IEGD), CSIC-CCHS, Calle Albasanz 26-28, 28037, Madrid, Spain
| | - Francisco Viciana
- Institute of Statistics and Cartography of Andalusia (IECA), Seville, Spain
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Himmelstein KEW, Lawrence JA, Jahn JL, Ceasar JN, Morse M, Bassett MT, Wispelwey BP, Darity WA, Venkataramani AS. Association Between Racial Wealth Inequities and Racial Disparities in Longevity Among US Adults and Role of Reparations Payments, 1992 to 2018. JAMA Netw Open 2022; 5:e2240519. [PMID: 36342718 PMCID: PMC9641537 DOI: 10.1001/jamanetworkopen.2022.40519] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
IMPORTANCE In the US, Black individuals die younger than White individuals and have less household wealth, a legacy of slavery, ongoing discrimination, and discriminatory public policies. The role of wealth inequality in mediating racial health inequities is unclear. OBJECTIVE To assess the contribution of wealth inequities to the longevity gap that exists between Black and White individuals in the US and to model the potential effects of reparations payments on this gap. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed the association between wealth and survival among participants in the Health and Retirement Study, a nationally representative panel study of community-dwelling noninstitutionalized US adults 50 years or older that assessed data collected from April 1992 to July 2019. Participants included 7339 non-Hispanic Black (hereinafter Black) and 26 162 non-Hispanic White (hereinafter White) respondents. Data were analyzed from January 1 to September 17, 2022. EXPOSURES Household wealth, the sum of all assets (including real estate, vehicles, and investments), minus the value of debts. MAIN OUTCOMES AND MEASURES The primary outcome was all-cause mortality by the end of survey follow-up in 2018. Using parametric survival models, the associations among household wealth, race, and survival were evaluated, adjusting for age, sex, number of household members, and marital status. Additional models controlled for educational level and income. The survival effects of eliminating the current mean wealth gap with reparations payments ($828 055 per household) were simulated. RESULTS Of the 33 501 individuals in the sample, a weighted 50.1% were women, and weighted mean (SD) age at study entry was 59.3 (11.1) years. Black participants' median life expectancy was 77.5 (95% CI, 77.0-78.2) years, 4 years shorter than the median life expectancy for White participants (81.5 [95% CI, 81.2-81.8] years). Adjusting for demographic variables, Black participants had a hazard ratio for death of 1.26 (95% CI, 1.18-1.34) compared with White participants. After adjusting for differences in wealth, survival did not differ significantly by race (hazard ratio, 1.00 [95% CI, 0.92-1.08]). In simulations, reparations to close the mean racial wealth gap were associated with reductions in the longevity gap by 65.0% to 102.5%. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that differences in wealth are associated with the longevity gap that exists between Black and White individuals in the US. Reparations payments to eliminate the racial wealth gap might substantially narrow racial inequities in mortality.
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Affiliation(s)
- Kathryn E. W. Himmelstein
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jourdyn A. Lawrence
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Jaquelyn L. Jahn
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Joniqua N. Ceasar
- Department of Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pediatrics, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michelle Morse
- Center for Health Equity and Community Wellness, New York City Department of Health and Mental Hygiene, New York, New York
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Bram P. Wispelwey
- Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - William A. Darity
- Sanford School of Public Policy, Duke University, Durham, North Carolina
| | - Atheendar S. Venkataramani
- Leonard Davis Institute of Health Economics, Division of Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
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Schmengler H, Peeters M, Stevens GWJM, Kunst AE, Delaruelle K, Dierckens M, Charrier L, Weinberg D, Oldehinkel AJ, Vollebergh WAM. Socioeconomic inequalities in adolescent health behaviours across 32 different countries - The role of country-level social mobility. Soc Sci Med 2022; 310:115289. [PMID: 35994878 DOI: 10.1016/j.socscimed.2022.115289] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 12/01/2022]
Abstract
Higher family affluence is associated with healthier behaviours in adolescents, but the strength of this association varies across countries. Differences in social mobility at the country-level, i.e. the extent to which adolescents develop a different socioeconomic status (SES) than their parents, may partially explain why the association between family affluence and adolescent health behaviours is stronger in some countries than in others. Using data from adolescents aged 11-15 years from 32 countries, participating in the 2017/2018 wave of the Health Behaviour in School-aged Children (HBSC) study (N = 185,086), we employed multilevel regression models with cross-level interactions to examine whether country-level social mobility moderates the association between family affluence and adolescent health behaviours (i.e. moderate-to-vigorous physical activity, vigorous physical activity, healthy and unhealthy foods consumption, having breakfast regularly, and weekly smoking). Higher family affluence was more strongly associated with higher levels of adolescent physical activity in countries characterized by high levels of social mobility. No cross-level interactions were found for any of the other health behaviours. Differences in social mobility at the country-level may contribute to cross-national variations in socioeconomic inequalities in adolescent physical activity. Further research can shed light on the mechanisms linking country-level social mobility to inequalities in adolescent physical activity to identify targets for policy and interventions.
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Affiliation(s)
- Heiko Schmengler
- Utrecht Centre for Child and Adolescent Studies, Department of Interdisciplinary Social Science, Utrecht University, the Netherlands.
| | - Margot Peeters
- Utrecht Centre for Child and Adolescent Studies, Department of Interdisciplinary Social Science, Utrecht University, the Netherlands
| | - Gonneke W J M Stevens
- Utrecht Centre for Child and Adolescent Studies, Department of Interdisciplinary Social Science, Utrecht University, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Katrijn Delaruelle
- Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Hedera, Department of Sociology, Ghent University, Ghent, Belgium
| | - Maxim Dierckens
- Health Promotion Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Lorena Charrier
- Department of Public Health and Paediatrics, University of Torino, Torino, Italy
| | - Dom Weinberg
- Utrecht Centre for Child and Adolescent Studies, Department of Interdisciplinary Social Science, Utrecht University, the Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center of Groningen, University of Groningen, the Netherlands
| | - Wilma A M Vollebergh
- Utrecht Centre for Child and Adolescent Studies, Department of Interdisciplinary Social Science, Utrecht University, the Netherlands
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Poulson MR, Geary A, Annesi C, Dechert T, Kenzik K, Hall J. The Impact of Income and Social Mobility on Colorectal Cancer Outcomes and Treatment: A Cross-sectional Study. Ann Surg 2022; 275:546-550. [PMID: 34954755 DOI: 10.1097/sla.0000000000005347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the impact of income mobility on racial disparities in colorectal cancer. BACKGROUND There are well-documented disparities in colorectal cancer treatment and outcomes between Black and White patients. Socioeconomic status, insurance, and other patient-level factors have been shown important, but little has been done to show the discriminatory factors that lead to these outcomes. METHODS Data were obtained from the Surveillance Epidemiology and End-Results database for Black and White patients with colorectal cancer between 2005 and 2015. County level measures of Black (BIM) and White income mobility (WIM) were obtained from the Opportunity Atlas as a measure of intergenerational poverty and social mobility. Regression models were created to assess the relative risk of advanced stage at diagnosis (Stage IV), surgery for localized disease (Stage I/II), and cancer-specific mortality. RESULTS There was no significant association of BIM or WIM on advanced stage at diagnosis in Black or White patients. An increase of $10,000 of BIM was associated with a 9% decrease in hazards of death for both Black (hazard ratio 0.91, 95% confidence interval 0.86,0.95) and White (0.91, 95%CI 0.90,0.93) patients, while the same increase in WIM was associated with no significant difference in hazards among Black patients (hazard ratio 0.99, 95% confidence interval 0.97,1.02). There were no predicted racial differences in hazards of death at high levels of BIM. CONCLUSIONS Increased Black income mobility significantly improves survival for both Black and White patients. Interventions aimed at increasing economic and social mobility could significantly decrease mortality in both Black and White patients while alleviating disparities in outcomes.
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Affiliation(s)
- Michael R Poulson
- Department of Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | - Alaina Geary
- Department of Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | | | - Tracey Dechert
- Department of Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | - Kelly Kenzik
- Department of Surgery, Boston Medical Center, Boston, MA
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL
| | - Jason Hall
- Department of Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
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Bulczak G, Gugushvili A. Downward income mobility among individuals with poor initial health is linked with higher cardiometabolic risk. PNAS NEXUS 2022; 1:pgac012. [PMID: 36712801 PMCID: PMC9802411 DOI: 10.1093/pnasnexus/pgac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 02/01/2023]
Abstract
The effects of socioeconomic position (SEP) across life course accumulate and produce visible health inequalities between different socioeconomic groups. Yet, it is not well-understood how the experience of intergenerational income mobility between origin and destination SEP, per se, affects health outcomes. We use data from the National Longitudinal Study of Adolescent to Adult Health collected in the United States with the outcome measure of cardiometabolic risk (CMR) constructed from data on LDL Cholesterol, Glucose MG/DL, C-reactive protein, systolic and diastolic blood pressure, and resting heart rate. Intergenerational income mobility is estimated as the difference between Waves 1 and 5 income quintiles. Diagonal reference models are used to test if intergenerational income mobility, net of origin and destination income quintile effects, is associated with CMR. We find that individuals in the lowest and the highest income quintiles have, respectively, the highest and the lowest CMR; both origin and destination income quintiles are equally important; there are no significant overall income mobility effects for different gender and race/ethnicity groups, but downward income mobility has negative health implications for individuals with poor initial health. We conclude that downward income mobility can increase inequalities in CMR in the United States by worsening the health of those who had poor health before their mobility experiences.
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Affiliation(s)
- Grzegorz Bulczak
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Nowy Świat 72, 00-330, Warsaw, Poland
- Faculty of Management,Gdynia Maritime University, 81-87 Morska, 81-225 Gdynia, Poland
| | - Alexi Gugushvili
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Nowy Świat 72, 00-330, Warsaw, Poland
- Department of Sociology and Human Geography, Harriet Holters hus, Moltke Moesvei 31, 0851, University of Oslo, Oslo, Norway
- Nuffield College,University of Oxford, Oxford, UK
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O'Brien R, Bair EF, Venkataramani AS. Death by Robots? Automation and Working-Age Mortality in the United States. Demography 2022; 59:607-628. [PMID: 35195250 DOI: 10.1215/00703370-9774819] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The decline of manufacturing employment is frequently invoked as a key cause of worsening U.S. population health trends, including rising mortality due to "deaths of despair." Increasing automation-the use of industrial robots to perform tasks previously done by human workers-is one structural force driving the decline of manufacturing jobs and wages. In this study, we examine the impact of automation on age- and sex-specific mortality. Using exogenous variation in automation to support causal inference, we find that increases in automation over the period 1993-2007 led to substantive increases in all-cause mortality for both men and women aged 45-54. Disaggregating by cause, we find evidence that automation is associated with increases in drug overdose deaths, suicide, homicide, and cardiovascular mortality, although patterns differ by age and sex. We further examine heterogeneity in effects by safety net program generosity, labor market policies, and the supply of prescription opioids.
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Affiliation(s)
- Rourke O'Brien
- Department of Sociology and Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
| | - Elizabeth F Bair
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Daza S, Palloni A. Early Exposure to County Income Mobility and Adult Individual Health in the United States. J Gerontol B Psychol Sci Soc Sci 2022; 77:S199-S208. [PMID: 35106575 PMCID: PMC9154259 DOI: 10.1093/geronb/gbab240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES Previous research in the United States suggests contextual income mobility may play a role in explaining the disparities between life expectancy in the United States and peer countries. This article aims to extend previous research by estimating the consequences of average individual exposure to mobility regimes during childhood and adolescence on adult health. METHODS This study draws its data from two longitudinal datasets that track the county of residence of respondents during childhood and adolescence, the Panel Study of Income Dynamics and the National Longitudinal Survey of Youth 1997. We implement marginal structural models to assess the association of the average exposure to county income mobility on five health outcomes and behaviors. RESULTS The results are only partially consistent with a systematic association between exposure to income mobility and health outcomes. Evidence obtained from the National Longitudinal Survey of Youth suggests less income mobility might increase the probability of smoking by age 30. DISCUSSION The paper provides a precise assessment of the hypothesis that childhood exposure to income mobility regimes may influence health status through behavior later in life and contribute to longevity gaps. Only partial evidence on smoking suggests an association between income mobility and health, so we discuss potential reasons for the disparities in results with previous research.
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Affiliation(s)
- Sebastian Daza
- Address correspondence to: Sebastian Daza, PhD, Center for Demography and Ecology, University of Wisconsin–Madison, Madison, WI 53706, USA. E-mail:
| | - Alberto Palloni
- Center for Demography and Ecology, University of Wisconsin–Madison, Madison, Wisconsin, USA,Institute of Economy Geography and Demography, CSIC-CCHS, Madrid, Spain
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12
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Gugushvili A, Zelinska O, Präg P, Bulczak G. Does perceived social mobility affect health? Evidence from a fixed effects approach. Soc Sci Med 2022; 294:114705. [PMID: 35030398 DOI: 10.1016/j.socscimed.2022.114705] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/31/2021] [Accepted: 01/05/2022] [Indexed: 01/17/2023]
Abstract
RATIONALE The question as to whether changing one's socioeconomic position over the life course affects health has not been answered in a conclusive manner. At the same time, it has been established that individuals who think of themselves that they are higher in the social hierarchy are healthier than those who think otherwise. OBJECTIVE In this study, we focus on perceived social mobility to shed new light on the issue of how social mobility affects health. We examine whether perceived social mobility, i.e., an individual's appraisal of doing better or worse than their parents, affects health by analyzing longitudinal data from Poland. METHODS Using a fixed effects approach to account for all time-invariant and important time-varying confounders, we analyze the Polish Panel Survey which has been collecting data on participants' social mobility perceptions along with information on their self-reported physical health and psychological wellbeing. RESULTS We find that perceived social mobility is a significant predictor of self-reported physical health and psychological wellbeing, even in models that adjust for a host of theoretically relevant control variables. The results demonstrate that upward subjective mobility has a consistent and strong positive effect on health outcomes. The effect of perceived social mobility is stronger for males and for those with less advantageous social origins. CONCLUSIONS Our findings are in line with the "from rags to riches" theoretical perspective, emphasizing the positive implications of upward social mobility on health through various psychological mechanisms. Based on our findings, we call for greater scholarly attention to subjective aspects of social mobility in research on health outcomes.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo Postboks 1096 Blindern, 0317, Oslo, Norway; Institute of Philosophy and Sociology, Polish Academy of Sciences, Nowy Swiat 72, 00 330, Warszawa, Poland.
| | - Olga Zelinska
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Nowy Swiat 72, 00 330, Warszawa, Poland.
| | - Patrick Präg
- Center for Research in Economics and Statistics (CREST), ENSAE, Institut Polytechnique de Paris, 5 Avenue Henry Le Chatelier, 91764, Palaiseau, France.
| | - Grzegorz Bulczak
- Institute of Philosophy and Sociology, Polish Academy of Sciences, Nowy Swiat 72, 00 330, Warszawa, Poland; Faculty of Management, Gdynia Maritime University, 81-87 Morska, 81-225, Gdynia, Poland.
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Javed Z, Haisum Maqsood M, Yahya T, Amin Z, Acquah I, Valero-Elizondo J, Andrieni J, Dubey P, Jackson RK, Daffin MA, Cainzos-Achirica M, Hyder AA, Nasir K. Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease. Circ Cardiovasc Qual Outcomes 2022; 15:e007917. [PMID: 35041484 DOI: 10.1161/circoutcomes.121.007917] [Citation(s) in RCA: 99] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health care in the United States has seen many great innovations and successes in the past decades. However, to this day, the color of a person's skin determines-to a considerable degree-his/her prospects of wellness; risk of disease, and death; and the quality of care received. Disparities in cardiovascular disease (CVD)-the leading cause of morbidity and mortality globally-are one of the starkest reminders of social injustices, and racial inequities, which continue to plague our society. People of color-including Black, Hispanic, American Indian, Asian, and others-experience varying degrees of social disadvantage that puts these groups at increased risk of CVD and poor disease outcomes, including mortality. Racial/ethnic disparities in CVD, while documented extensively, have not been examined from a broad, upstream, social determinants of health lens. In this review, we apply a comprehensive social determinants of health framework to better understand how structural racism increases individual and cumulative social determinants of health burden for historically underserved racial and ethnic groups, and increases their risk of CVD. We analyze the link between race, racism, and CVD, including major pathways and structural barriers to cardiovascular health, using 5 distinct social determinants of health domains: economic stability; neighborhood and physical environment; education; community and social context; and healthcare system. We conclude with a set of research and policy recommendations to inform future work in the field, and move a step closer to health equity.
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Affiliation(s)
- Zulqarnain Javed
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, TX (Z.J., M.C.-A., K.N.)
| | | | - Tamer Yahya
- Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.)
| | | | - Isaac Acquah
- Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.)
| | - Javier Valero-Elizondo
- Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.).,Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, TX (J.V.-E., M.C.-A., K.N.).,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, TX (J.V.-E., M.C.-A., K.N.)
| | - Julia Andrieni
- Population Health and Primary Care (J.A.), Houston Methodist Hospital, TX
| | - Prachi Dubey
- Houston Methodist Hospital, Houston Methodist Research Institute, TX (P.D.)
| | - Ryane K Jackson
- Office of Community Benefits (R.K.J.), Houston Methodist Hospital, TX
| | - Mary A Daffin
- Barrett Daffin Frappier Turner & Engel, L.L.P., Houston, TX (M.A.D.)
| | - Miguel Cainzos-Achirica
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, TX (Z.J., M.C.-A., K.N.).,Center for Outcomes Research, Houston Methodist, TX (T.Y., I.A., J.V.-E., M.C.-A., K.N.).,Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, TX (J.V.-E., M.C.-A., K.N.).,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, TX (J.V.-E., M.C.-A., K.N.)
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, DC (A.A.H.)
| | - Khurram Nasir
- Division of Health Equity & Disparities Research, Center for Outcomes Research, Houston Methodist, TX (Z.J., M.C.-A., K.N.).,Division of Cardiovascular Prevention and Wellness, Houston Methodist DeBakey Heart and Vascular Center, TX (J.V.-E., M.C.-A., K.N.).,Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist, TX (J.V.-E., M.C.-A., K.N.)
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14
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Zang E, Kim N. Intergenerational upward mobility and racial differences in mortality among young adults: Evidence from county-level analyses. Health Place 2021; 70:102628. [PMID: 34280713 PMCID: PMC8328956 DOI: 10.1016/j.healthplace.2021.102628] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/21/2022]
Abstract
Inspired by the influential "deaths of despair" narrative, which emphasizes the role of worsening economic opportunity in driving the increasing mortality for non-Hispanic Whites in the recent decades, a rising number of studies have provided suggestive evidence that upward mobility levels across counties may partly explain variations in mortality rates. A gap in the literature is the lack of life-course studies examining the relationship between early-life upward mobility and later-life mortality across counties. Another gap is the lack of studies on how the relationship between upward mobility and mortality across counties varies across diverse sociodemographic populations. This study examines differences across race and sex in the relationship between early-life intergenerational upward mobility and early adulthood mortality at the county level. We use administrative data on upward mobility and vital statistics data on mortality across 3030 counties for those born between 1978 and 1983. We control for a variety of county-level socioeconomic variables in a model with fixed effects for state and year. Subgroup analyses by educational attainment and urban status were also performed for each race-sex combination. Results show strong negative relationships between early-life upward mobility and early adulthood mortality across racial-sex combinations, with a particularly greater magnitude for non-Hispanic Black males. In addition, individuals without a college degree and living in urban counties are particularly affected by early life upward mobility. The findings of this study highlight the vulnerability of less-educated, young urban Black males, due to the intersecting effects of the urban context, education, race, and sex.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University, New Haven, CT, USA.
| | - Nathan Kim
- Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
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15
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Li QX, Yuan S, Yu Z, Larsson SC, He QQ. Association of food expenditure with life expectancy in the United States, 2001-2014. Nutrition 2021; 91-92:111310. [PMID: 34353683 DOI: 10.1016/j.nut.2021.111310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES A healthy diet is associated with reduced risk for premature death; however, data on the association between food expenditure and life expectancy are scarce. The aim of this study was to determine the association of expenditure on food groups with life expectancy in men and women. METHODS This study used data from 1548 counties, representing >90% of the population of the United States from 2001 through the end of 2014. Multivariable adjusted Bayesian generalized linear models were used to assess the association of county-level expenditure on nine groups of individual food and combined healthy and unhealthy foods, and a constructed healthy diet score with life expectancy at 40 y of age by sex. RESULTS A 1-unit increase in the healthy diet score based on food expenditure was associated with a 0.07 y (95% confidence interval [CI], 0.05-0.10), 0.04 y (95% CI, 0.02-0.07), and 0.06 y (95% CI, 0.04-0.08) increase in county-level life expectancy among men alone, women alone, and men and women combined, respectively. Increasing expenditure on whole grains (estimate of per 1% increase 0.07; 95% CI, 0.03-0.11), fresh fruit and vegetables (0.06; 95% CI, 0.02-0.09), and dairy products (0.05; 95% CI, 0.03-0.07), as well as reducing expenditure on sugar-sweetened beverages (-0.02; 95% CI, -0.04 to -0.01) and processed red meat (-0.05; 95% CI, -0.08 to -0.02) showed a positive association with increased county-level life expectancy. CONCLUSIONS These findings may inform a nutritional measure against premature death and stagnation of increase in life expectancy.
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Affiliation(s)
- Qing-Xiao Li
- Department of Applied Economics, University of Minnesota, St Paul, MN, USA
| | - Shuai Yuan
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zhixiu Yu
- Department of Economics, University of Minnesota, Minneapolis, MN, USA
| | - Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Wuhan, China.
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16
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Gugushvili A, Präg P. Intergenerational social mobility and health in Russia: Mind over matter? ADVANCES IN LIFE COURSE RESEARCH 2021; 47:100390. [PMID: 36695147 DOI: 10.1016/j.alcr.2020.100390] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/11/2020] [Accepted: 11/23/2020] [Indexed: 06/17/2023]
Abstract
The consequences of changing one's socio-economic status over the life course-i.e. social mobility-for individual health are not well understood. Theories of the health implications of social mobility draw on the human perception of one's changing conditions, but empirical studies mostly examine the health implications of moving from objectively defined indicators of parental socio-economic position such as education, occupation, or income, to own socio-economic position in adult life. Little is known about the consequences of individuals' own assessment of changes in socio-economic position for health outcomes. In this study, we examine the association of social mobility and health in a unique sample of the Russian population after the transition to a market society. We take a broad perspective on social mobility, putting emphasis on subjectively perceived social mobility. Results show that individuals' objective characteristics only partially explain the variation in their subjective perceptions of intergenerational mobility. Net of social origin and destination variables, subjective social mobility is associated with individuals' health outcomes, as measured by the 12-Item Short Form Health Survey. Those who perceive being upwardly mobile report better health, and downward mobility is associated with poorer health. The association holds for mental and physical health, for perceived downward and upward social mobility, and for a general subjective measure of mobility and a subjective measure prompting respondents to only think of mobility in terms of occupation. These findings are robust to controlling for a rich set of socio-demographic predictors on childhood adversity, contemporaneous material wellbeing, and family-related circumstances. We conclude that a conventional focus on single socio-economic status dimensions such as occupation might be too narrow to capture the health consequences of social mobility.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo, Postboks 1096, Blindern, 0317, Oslo, Norway.
| | - Patrick Präg
- CREST/ENSAE Paris, 5 Avenue Le Chatelier, 91120, Palaiseau, France.
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17
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Venkataramani AS, O’Brien R, Whitehorn GL, Tsai AC. Economic influences on population health in the United States: Toward policymaking driven by data and evidence. PLoS Med 2020; 17:e1003319. [PMID: 32877406 PMCID: PMC7467305 DOI: 10.1371/journal.pmed.1003319] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Atheendar S. Venkataramani and colleagues discuss economic factors and population health in the United States.
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Affiliation(s)
- Atheendar S. Venkataramani
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Rourke O’Brien
- Department of Sociology, Yale University, New Haven, Connecticut, United States of America
| | - Gregory L. Whitehorn
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Alexander C. Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Harvard Medical School, Boston, Massachusetts, United States of America
- Mbarara University of Science and Technology, Mbarara, Uganda
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