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Johnson BN, Freiburger E, Deska JC, Kunstman JW. Social Class and Social Pain: Target SES Biases Judgments of Pain and Support for White Target Individuals. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2024; 50:957-970. [PMID: 36905133 DOI: 10.1177/01461672231156025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Social pain, defined as distress caused by negative interpersonal experiences (e.g., ostracism, mistreatment), is detrimental to health. Yet, it is unclear how social class might shape judgments of the social pains of low-socioeconomic status (SES) and high-SES individuals. Five studies tested competing toughness and empathy predictions for SES's effect on social pain judgments. Consistent with an empathy account, in all studies (Ncumulative = 1,046), low-SES White targets were judged more sensitive to social pain than high-SES White targets. Further, empathy mediated these effects, such that participants felt greater empathy and expected more social pain for low-SES targets relative to high-SES targets. Social pain judgments also informed judgments of social support needs, as low-SES targets were presumed to need more coping resources to manage hurtful events than high-SES targets. The current findings provide initial evidence that empathic concern for low-SES White individuals sensitizes social pain judgments and increases expected support needs for lower class White individuals.
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Bammert P, Schüttig W, Novelli A, Iashchenko I, Spallek J, Blume M, Diehl K, Moor I, Dragano N, Sundmacher L. The role of mesolevel characteristics of the health care system and socioeconomic factors on health care use - results of a scoping review. Int J Equity Health 2024; 23:37. [PMID: 38395914 PMCID: PMC10885500 DOI: 10.1186/s12939-024-02122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Besides macrolevel characteristics of a health care system, mesolevel access characteristics can exert influence on socioeconomic inequalities in healthcare use. These reflect access to healthcare, which is shaped on a smaller scale than the national level, by the institutions and establishments of a health system that individuals interact with on a regular basis. This scoping review maps the existing evidence about the influence of mesolevel access characteristics and socioeconomic position on healthcare use. Furthermore, it summarizes the evidence on the interaction between mesolevel access characteristics and socioeconomic inequalities in healthcare use. METHODS We used the databases MEDLINE (PubMed), Web of Science, Scopus, and PsycINFO and followed the 'Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols extension for scoping reviews (PRISMA-ScR)' recommendations. The included quantitative studies used a measure of socioeconomic position, a mesolevel access characteristic, and a measure of individual healthcare utilisation. Studies published between 2000 and 2020 in high income countries were considered. RESULTS Of the 9501 potentially eligible manuscripts, 158 studies were included after a two-stage screening process. The included studies contained a wide spectrum of outcomes and were thus summarised to the overarching categories: use of preventive services, use of curative services, and potentially avoidable service use. Exemplary outcomes were screening uptake, physician visits and avoidable hospitalisations. Access variables included healthcare system characteristics such as physician density or distance to physician. The effects of socioeconomic position on healthcare use as well as of mesolevel access characteristics were investigated by most studies. The results show that socioeconomic and access factors play a crucial role in healthcare use. However, the interaction between socioeconomic position and mesolevel access characteristics is addressed in only few studies. CONCLUSIONS Socioeconomic position and mesolevel access characteristics are important when examining variation in healthcare use. Additionally, studies provide initial evidence that moderation effects exist between the two factors, although research on this topic is sparse. Further research is needed to investigate whether adapting access characteristics at the mesolevel can reduce socioeconomic inequity in health care use.
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Affiliation(s)
- Philip Bammert
- Chair of Health Economics, Technical University of Munich, Munich, Germany.
| | - Wiebke Schüttig
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Anna Novelli
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Iryna Iashchenko
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
- Lausitz Center for Digital Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert-Koch-Institute, Berlin, Germany
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Irene Moor
- Institute of Medical Sociology, Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, University Hospital and Medical Faculty, University of Duesseldorf, Duesseldorf, Germany
| | - Leonie Sundmacher
- Chair of Health Economics, Technical University of Munich, Munich, Germany
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Louvel S, Soulier A. Biological embedding vs. embodiment of social experiences: How these two concepts form distinct thought styles around the social production of health inequalities. Soc Sci Med 2022; 314:115470. [PMID: 36327636 DOI: 10.1016/j.socscimed.2022.115470] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/10/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES This article compares research on biological embedding and the embodiment of social experiences, two concepts proposed in the 1990s to introduce a new perspective on the social production of health inequalities. We draw on Ludwig Fleck's concept of 'thought style' (1935/2008) to question the possible emergence of a common research program around the processes by which the social becomes biological. METHODS We compiled a corpus of 322 articles referring to either biological embedding or to the embodiment of social experiences, identified in the Web of Science core collection and published from 1990 to 2021. We analyzed the articles' use of these concepts using scientometric indicators and qualitative content analysis. RESULTS Initial differences between the research agendas associated with biological embedding and embodiment are strengthened as both concepts circulate around scientific communities studying the social production of health inequalities. Thought styles formed around embedding and embodiment differ significantly in terms of shared references, sets of methods and research questions, and policy recommendations. Research on biological embedding forms a thought style shared by researchers in the biomedical and public health sciences. Conversely, the concept of embodiment of social experiences connects perspectives from biomedical, public health, human and social sciences, and gathers three thought styles, one identical to that of biological embedding and two formed in social epidemiology and in medical anthropology. CONCLUSIONS Acknowledging the differences between the concepts and divergences in their evolution provides an opportunity for identification of topics where thought styles are either complementary or in tension.
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Affiliation(s)
- Séverine Louvel
- PACTE - Sciences Po Grenoble, 1030 Avenue Centrale, Domaine Universitaire, 38040 Grenoble Cedex 09, France.
| | - Alexandra Soulier
- IHPST - Institut D'histoire et de Philosophie des Sciences et des Techniques (UMR 8590), Maison de La Philosophie - Marin Mersenne, 13, Rue Du Four, 75006 Paris, France.
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Mollborn S, Limburg A, Pace J, Fomby P. Family Socioeconomic Status and Children's Screen Time. JOURNAL OF MARRIAGE AND THE FAMILY 2022; 84:1129-1151. [PMID: 36211640 PMCID: PMC9541918 DOI: 10.1111/jomf.12834] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 03/21/2022] [Accepted: 04/05/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This mixed-methods study examined whether higher-SES children's digital technology use adhered to contemporaneous pediatric guidelines, how it compared to lower-SES children, and why, as analyses showed, higher-SES children's technology use far exceeded pediatric recommendations. BACKGROUND 2013 American Academy of Pediatrics (AAP) guidelines recommended limited "screen time" for children. Higher socioeconomic status (SES) families tend to follow guidelines, but digital technology use-simultaneously a health behavior and a pathway for building human capital-has complex implications. METHOD Quantitative analyses provide new nationally representative estimates of the relationship between social class and 9- to 13-year-old children's technology time (including television), device access, and parenting rules (2014 PSID Child Development Supplement, N=427). Qualitative analyses of 77 longitudinal higher-SES parent interviews articulated explanatory processes. RESULTS Higher-SES children used technology as frequently as others and in excess of recommendations. Their device access, activities, and agency in adhering to rules, however, differed from others. Qualitative analysis uncovered processes that helped explain these findings: parents' ambivalence about technology and perception that expert guidance is absent or unrealistic, and children's exercise of agency to use technology facilitated by "concerted cultivation" parenting styles, led to higher-SES individualistic parenting practices that supported children's increased non-television technology use. CONCLUSION Cultures and structures related to children's technology use are in flux, and classed norms and understandings are emerging to construct relevant class-based distinctions around parenting.
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Affiliation(s)
- Stefanie Mollborn
- Department of SociologyStockholm UniversityStockholmSweden
- Institute of Behavioral Science and Department of SociologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Aubrey Limburg
- Institute of Behavioral Science and Department of SociologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Jennifer Pace
- Department of SociologyMidwestern State UniversityWichita FallsTexasUSA
| | - Paula Fomby
- Institute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
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Herr RM, De Bock F, Diehl K, Wiedemann E, Sterdt E, Blume M, Hoffmann S, Herke M, Reuter M, Iashchenko I, Schneider S. Associations of individual factors and early childhood education and care (ECEC) centres characteristics with preschoolers' BMI in Germany. BMC Public Health 2022; 22:1415. [PMID: 35883054 PMCID: PMC9317063 DOI: 10.1186/s12889-022-13814-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background The number of obese children is rising worldwide. Many studies have investigated single determinants of children’s body mass index (BMI), yet studies measuring determinants at different potential levels of influence are sparse. The aim of this study is to investigate the independent role of parental socioeconomic position (SEP), additional family factors at the micro level, as well as early childhood education and care (ECEC) centre characteristics at the meso level regarding BMI. Methods Analyses used the baseline data of the PReschool INtervention Study (PRINS) including up to 1,151 children from 53 ECEC centres. Multi-level models first estimated the associations of parental SEP indicators (parental school education, vocational training, and household income) with the children’s standard deviation scores for BMI (SDS BMI, standardised for age and gender). Second, structural (number of siblings), psychosocial (strained family relationships), and nutrition behavioural (soft-drink consumption, frequency of fast-food restaurant visits) family factors at the micro level were included. Third, characteristics of the ECEC centre at the meso level in terms of average group size, the ratio of overweight children in the group, ECEC centre type (all-day care), and the location of the ECEC centre (rural vs urban) were included. All analyses were stratified by gender and adjusted for age, migration background, and parental employment status. Results Estimates for boys and girls appeared to differ. In the full model, for boys the parental SEP indicators were not related to SDS BMI. Factors related to SDS BMI in boys were: two or more siblings; B = -.55; p = 0.045 [ref.: no sibling]), the characteristics of the ECEC centre in terms of average group size (20 – 25 children; B = -.54; p = 0.022 [ref.: < 20 children]), and the ratio of overweight children (more overweight children B = -1.39; p < 0.001 [ref.: few overweight children]). For girls the number of siblings (two and more siblings; B = .67; p = 0.027 [ref.: no sibling]) and average group size (> 25 children; B = -.52; p = 0.037 [ref.: < 20 children]) were related to SDS BMI. Conclusions The BMI of preschool children appears to be associated with determinants at the micro and meso level, however with some gender differences. The identified factors at the micro and meso level appear largely modifiable and can inform about possible interventions to reduce obesity in preschool children.
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Affiliation(s)
- Raphael M Herr
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany. .,Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Freia De Bock
- Child Health Services Unit, Clinic for General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Katharina Diehl
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany.,Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Wiedemann
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
| | - Elena Sterdt
- Competence Centre for Early Education, Magdeburg-Stendal University of Applied Sciences, Stendal, Germany
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Max Herke
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Marvin Reuter
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Iryna Iashchenko
- Professorship of Health Economics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Sven Schneider
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167, Mannheim, Germany
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Graetz N, Boen CE, Esposito MH. Structural Racism and Quantitative Causal Inference: A Life Course Mediation Framework for Decomposing Racial Health Disparities. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:232-249. [PMID: 35001689 DOI: 10.1177/00221465211066108] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Quantitative studies of racial health disparities often use static measures of self-reported race and conventional regression estimators, which critics argue is inconsistent with social-constructivist theories of race, racialization, and racism. We demonstrate an alternative counterfactual approach to explain how multiple racialized systems dynamically shape health over time, examining racial inequities in cardiometabolic risk in the National Longitudinal Study of Adolescent to Adult Health. This framework accounts for the dynamics of time-varying confounding and mediation that is required in operationalizing a "race" variable as part of a social process (racism) rather than a separable, individual characteristic. We decompose the observed disparity into three types of effects: a controlled direct effect ("unobserved racism"), proportions attributable to interaction ("racial discrimination"), and pure indirect effects ("emergent discrimination"). We discuss the limitations of counterfactual approaches while highlighting how they can be combined with critical theories to quantify how interlocking systems produce racial health inequities.
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Affiliation(s)
- Nick Graetz
- Princeton University, Princeton, NJ, USA
- University of Pennsylvania, Philadelphia, PA, USA
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Rattay P, Blume M, Wachtler B, Wollgast L, Spallek J, Hoffmann S, Sander L, Herr R, Herke M, Reuter M, Novelli A, Hövener C. Socioeconomic position and self-rated health among female and male adolescents: The role of familial determinants in explaining health inequalities. Results of the German KiGGS study. PLoS One 2022; 17:e0266463. [PMID: 35390046 PMCID: PMC8989218 DOI: 10.1371/journal.pone.0266463] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/21/2022] [Indexed: 11/19/2022] Open
Abstract
Objective
Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining the association between the family’s socioeconomic position and adolescents’ self-rated health. The current study aimed to explore whether the association between socioeconomic position and self-rated health was mediated by familial determinants.
Methods
Using data from wave 2 of the”German Health Interview and Examination Survey for Children and Adolescents” (KiGGS) (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of income, education, occupational status, socioeconomic position index and adolescents’ subjective social status on self-rated health into direct effects and indirect effects through familial determinants (family cohesion, parental well-being, parental stress, parenting styles, parental obesity, smoking and sporting activity).
Results
A significant total effect of all socioeconomic position indicators on self-rated health was found, except for income in male adolescents. In female adolescents, more than 70% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations between income, parental education, the socioeconomic position index and subjective social status were also mediated by familial determinants (family cohesion, parental smoking, obesity and living in a single-mother family). However, a significant direct effect of subjective social status remained.
Conclusion
The analysis revealed how a family’s position of socioeconomic disadvantage can lead to poorer health in adolescents through different family practices. The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions (macro-level), community-based strategies (meso-level) and programs to improve parenting and family functioning (micro-level).
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Affiliation(s)
- Petra Rattay
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
- * E-mail:
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Lina Wollgast
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Lydia Sander
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Raphael Herr
- Medical Faculty Mannheim, Mannheim Institute of Public Health, Social and Preventive Medicine, Heidelberg University, Mannheim, Germany
| | - Max Herke
- Medical Faculty, Institute of Medical Sociology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Marvin Reuter
- Medical Faculty, Institute of Medical Sociology, Centre for Health and Society, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna Novelli
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
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Hoffmann S, Sander L, Wachtler B, Blume M, Schneider S, Herke M, Pischke CR, Fialho PMM, Schuettig W, Tallarek M, Lampert T, Spallek J. Moderating or mediating effects of family characteristics on socioeconomic inequalities in child health in high-income countries - a scoping review. BMC Public Health 2022; 22:338. [PMID: 35177014 PMCID: PMC8851861 DOI: 10.1186/s12889-022-12603-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND By explaining the development of health inequalities, eco-social theories highlight the importance of social environments that children are embedded in. The most important environment during early childhood is the family, as it profoundly influences children's health through various characteristics. These include family processes, family structure/size, and living conditions, and are closely linked to the socioeconomic position (SEP) of the family. Although it is known that the SEP contributes to health inequalities in early childhood, the effects of family characteristics on health inequalities remain unclear. The objective of this scoping review is to synthesise existing research on the mediating and moderating effects of family characteristics on socioeconomic health inequalities (HI) during early childhood in high-income countries. METHODS This review followed the methodology of "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". To identify German and English scientific peer-reviewed literature published from January 1st, 2000, to December 19th, 2019, the following search term blocks were linked with the logical operator "AND": (1) family structure/size, processes, living conditions, (2) inequalities, disparities, diversities, (3) income, education, occupation, (4) health and (5) young children. The search covered the electronic databases PubMed, PsycINFO, and Scopus. RESULTS The search yielded 7,089 records. After title/abstract and full-text screening, only ten peer-reviewed articles were included in the synthesis, which analysed the effects of family characteristics on HI in early childhood. Family processes (i.e., rules /descriptive norms, stress, parental screen time, parent-child conflicts) are identified to have mediating or moderating effects. While families' living conditions (i.e., TVs in children's bedrooms) are suggested as mediating factors, family structure/size (i.e., single parenthood, number of children in the household) appear to moderate health inequalities. CONCLUSION Family characteristics contribute to health inequalities in early childhood. The results provide overall support of models of family stress and family investment. However, knowledge gaps remain regarding the role of family health literacy, regarding a wide range of children's health outcomes (e.g., oral health, inflammation parameters, weight, and height), and the development of health inequalities over the life course starting at birth.
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Affiliation(s)
- Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitaetsplatz 1, 01968, Senftenberg, Germany.
| | - Lydia Sander
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitaetsplatz 1, 01968, Senftenberg, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Sven Schneider
- Center for Preventive Medicine and Digital Health Baden-Württemberg (CPD-BW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Max Herke
- Institute of Medical Sociology, Medical Faculty Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Claudia R Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Paula Mayara Matos Fialho
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Duesseldorf, Duesseldorf, Germany
| | - Wiebke Schuettig
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Marie Tallarek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitaetsplatz 1, 01968, Senftenberg, Germany
| | - Thomas Lampert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Universitaetsplatz 1, 01968, Senftenberg, Germany
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Mollborn S, Modile A. "Dedicated to being healthy": Young adults' deployments of health-focused cultural capital. Soc Sci Med 2022; 293:114648. [PMID: 34906829 PMCID: PMC8810689 DOI: 10.1016/j.socscimed.2021.114648] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 01/03/2023]
Abstract
Performances of "health" through diet, exercise, and body size are an increasingly important form of cultural capital transmitted to children. Yet less is known about how socioeconomically privileged young people internalize and deploy that capital or how those less privileged manage their relative lack of capital. How does health-focused cultural capital acquired in childhood shape socioeconomic inequalities, health behaviors, and understandings of health in young adulthood? Our analysis of 113 interviews found that health-focused cultural capital acquired in early life reinforced young adults' socioeconomic and health advantages by helping them claim discipline and morality on the basis of their health behaviors and body size. Two key phenomena tended to be present among our many socioeconomically privileged but not our fewer less privileged participants: family socialization into classed diet- and exercise-related health behaviors resulting in a classed appearance of health (despite less-than-ideal behaviors), and cohesive life course narratives linking these behaviors to hard work and moral worth. Less socioeconomically privileged participants' understandings of health and healthy behaviors were different, rarely linking health to worthiness and discipline. To understand the intergenerational transmission of socioeconomic attainment and health in US society, we must consider how behaviors and group-based norms, identities, and understandings of health coalesce in classed health lifestyles that convey cultural capital.
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Affiliation(s)
- Stefanie Mollborn
- Department of Sociology, Stockholm University, 106 91, Stockholm, Sweden; Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO, 80309, USA.
| | - Adenife Modile
- Institute of Behavioral Science and Department of Sociology, University of Colorado Boulder, UCB 483, Boulder, CO, 80309, USA
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Blume M, Rattay P, Hoffmann S, Spallek J, Sander L, Herr R, Richter M, Moor I, Dragano N, Pischke C, Iashchenko I, Hövener C, Wachtler B. Health Inequalities in Children and Adolescents: A Scoping Review of the Mediating and Moderating Effects of Family Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7739. [PMID: 34360031 PMCID: PMC8345625 DOI: 10.3390/ijerph18157739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 01/02/2023]
Abstract
This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6-18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.
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Affiliation(s)
- Miriam Blume
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany; (M.B.); (P.R.); (C.H.)
| | - Petra Rattay
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany; (M.B.); (P.R.); (C.H.)
| | - Stephanie Hoffmann
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, 01968 Senftenberg, Germany; (S.H.); (J.S.); (L.S.)
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, 01968 Senftenberg, Germany; (S.H.); (J.S.); (L.S.)
| | - Lydia Sander
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, 01968 Senftenberg, Germany; (S.H.); (J.S.); (L.S.)
| | - Raphael Herr
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany;
| | - Matthias Richter
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (M.R.); (I.M.)
| | - Irene Moor
- Institute of Medical Sociology, Medical Faculty, Martin-Luther-University Halle-Wittenberg, 06112 Halle, Germany; (M.R.); (I.M.)
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (N.D.); (C.P.)
| | - Claudia Pischke
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (N.D.); (C.P.)
| | - Iryna Iashchenko
- Health Economics, Technical University of Munich, 80992 München, Germany;
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany; (M.B.); (P.R.); (C.H.)
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, 13353 Berlin, Germany; (M.B.); (P.R.); (C.H.)
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Novelli A, Schüttig W, Spallek J, Wachtler B, Diehl K, Moor I, Richter M, Dragano N, Sundmacher L. Correlation of mesolevel characteristics of the healthcare system and socioeconomic inequality in healthcare use: a scoping review protocol. BMJ Open 2021; 11:e044301. [PMID: 33550263 PMCID: PMC7925933 DOI: 10.1136/bmjopen-2020-044301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Although the impact of macrolevel characteristics of health systems on socioeconomic inequity in health has been studied extensively, the impact of access characteristics on a smaller scale of health systems has received less attention. These mesolevel characteristics can influence access to healthcare and might have the potential to moderate or aggravate socioeconomic inequity in healthcare use. This scoping review aims to map the existing evidence of the association of socioeconomic inequity in healthcare use and mesolevel access characteristics of the health system. METHODS AND ANALYSIS In conducting the scoping review, we follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Extension for Scoping Reviews. The search will be carried out in four scientific databases: MEDLINE (via PubMed), Web of Science, Scopus and PsycINFO. Main eligibility criteria are inclusion in the analysis of a measure of socioeconomic position, a measure of individual healthcare use and a mesolevel determinant of access to healthcare services. The selection process consists of two consecutive screening stages (first: title/abstract; second: full text). At both stages, two reviewers independently assess the eligibility of studies. In case of disagreement, a third reviewer will be involved. Cohen's kappa will be calculated to report inter-rater agreement between reviewers. Results are synthesised narratively, as a high heterogeneity of studies is expected. ETHICS AND DISSEMINATION No primary data are collected for the presented scoping review. Therefore, ethical approval is not necessary. The scoping review will be published in an international peer-reviewed journal, and findings will be presented on national and international conferences.
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Affiliation(s)
- Anna Novelli
- Department of Health Services Management, Ludwig-Maximilians-University Munich, Munich, Germany
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Wiebke Schüttig
- Department of Health Services Management, Ludwig-Maximilians-University Munich, Munich, Germany
- Chair of Health Economics, Technical University of Munich, Munich, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Benjamin Wachtler
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Katharina Diehl
- Mannheim Institute for Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Irene Moor
- Institute of Medical Sociology, Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Matthias Richter
- Institute of Medical Sociology, Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Nico Dragano
- Institute for Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Leonie Sundmacher
- Chair of Health Economics, Technical University of Munich, Munich, Germany
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12
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Hammond MA, Khurana A, Stormshak EA. Adolescent measures of family socioeconomic status: Reliability, validity, and effects on substance use behaviors in adolescence and young adulthood. Prev Med Rep 2021; 21:101317. [PMID: 33511027 PMCID: PMC7815999 DOI: 10.1016/j.pmedr.2021.101317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 10/26/2022] Open
Abstract
Socioeconomic status (SES) is a robust predictor of health disparities in adolescence and early adulthood, yet obtaining accurate and reliable measurements of family SES from younger participants remains a challenge. We evaluated the reliability and validity of a subjective SES measure, i.e., perceived family financial security (PFS), which assesses adolescents' perceptions of whether their family has enough money to meet their needs. We also examined the predictive associations of PFS and parental education (adolescent reports) with alcohol, marijuana, and tobacco use during adolescence and young adulthood. Longitudinal data were obtained from 593 parent-child dyads in the Pacific Northwest region of the United States, who were assessed eight times between 2005 and 2014. Present analyses included data from four annual assessments conducted when the participating children were adolescents (age range = 10.25-16.33 years) and a final follow-up in young adulthood (age range = 20-23.42 years). PFS had good test-retest reliability and convergent validity with other parent and adolescent reported SES measures. Adolescent-reported PFS significantly predicted tobacco use frequency in young adulthood, whereas adolescent-reported parental education predicted alcohol use frequency. PFS was not a significant predictor of alcohol or marijuana use. Findings suggest that PFS can be a psychometrically sound measure to assess a unique dimension of SES in adolescent samples, with differential predictive associations among substance use outcomes in young adulthood compared to more traditional measures like parental education. Future research should evaluate the psychometric properties and utility of PFS as a complementary SES measure.
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Affiliation(s)
- Mark A Hammond
- Department of Counseling Psychology and Human Services, University of Oregon, United States
| | - Atika Khurana
- Department of Counseling Psychology and Human Services, University of Oregon, United States
| | - Elizabeth A Stormshak
- Department of Counseling Psychology and Human Services, University of Oregon, United States
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13
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Trentacosta CJ, Mulligan DJ. New directions in understanding the role of environmental contaminants in child development: Four themes. New Dir Child Adolesc Dev 2020; 2020:39-51. [PMID: 32920950 PMCID: PMC8189654 DOI: 10.1002/cad.20363] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Environmental contaminants, which include several heavy metals, persistent organic pollutants, and other harmful chemicals, impair several domains of child development. This article describes four themes from recent research on the impact of environmental contaminants on child development. The first theme, disparities in exposure, focuses on how marginalized communities are disproportionately exposed to harmful environmental contaminants. The second theme, complexity of exposures, encapsulates recent emphases on timing of exposures and mixtures of multiple exposures. The third theme, mechanisms that link exposures to outcomes, focuses on processes that elucidate how contaminants impact outcomes. The fourth theme, mitigating risks associated with exposures, sheds light on potential protective factors that could ameliorate many of the harmful effects of contaminant exposures. Developmental scientists are well positioned to contribute to interdisciplinary research that addresses these themes, which could foster additional conceptual and empirical innovations and inform policies and practices to mitigate risks and improve children's well-being.
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14
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Kramer MR, Strahan AE, Preslar J, Zaharatos J, St Pierre A, Grant JE, Davis NL, Goodman DA, Callaghan WM. Changing the conversation: applying a health equity framework to maternal mortality reviews. Am J Obstet Gynecol 2019; 221:609.e1-609.e9. [PMID: 31499056 PMCID: PMC11003448 DOI: 10.1016/j.ajog.2019.08.057] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/07/2019] [Accepted: 08/29/2019] [Indexed: 01/16/2023]
Abstract
The risk of maternal death in the United States is higher than peer nations and is rising and varies dramatically by the race and place of residence of the woman. Critical efforts to reduce maternal mortality include patient risk stratification and system-level quality improvement efforts targeting specific aspects of clinical care. These efforts are important for addressing the causes of an individual's risk, but research to date suggests that individual risk factors alone do not adequately explain between-group disparities in pregnancy-related death by race, ethnicity, or geography. The holistic review and multidisciplinary makeup of maternal mortality review committees make them well positioned to fill knowledge gaps about the drivers of racial and geographic inequity in maternal death. However, committees may lack the conceptual framework, contextual data, and evidence base needed to identify community-based contributing factors to death and, when appropriate, to make recommendations for future action. By incorporating a multileveled, theory-grounded framework for causes of health inequity, along with indicators of the community vital signs, the social and community context in which women live, work, and seek health care, maternal mortality review committees may identify novel underlying factors at the community level that enhance understanding of racial and geographic inequity in maternal mortality. By considering evidence-informed community and regional resources and policies for addressing these factors, novel prevention recommendations, including recommendations that extend outside the realm of the formal health care system, may emerge.
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Affiliation(s)
- Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
| | - Andrea E Strahan
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jessica Preslar
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | | | - Jacqueline E Grant
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Durham, NC
| | - Nicole L Davis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - David A Goodman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - William M Callaghan
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Preschool Interventions for Children with Autism Spectrum Disorder: a Review of Effectiveness Studies. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00170-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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